Advocacy
strategy on
enhancing the
wellbeing of
veterans with
Post Traumatic
Stress Disorders
in Uganda
Mweru Samuel Byachi
Uganda Veterans Assistance Board
PTSD Advocacy strategy
What is PTSD?
Shell shock or battle fatique
syndrome
A
condition that can develop after one
has experienced/witnessed traumatic
event
 First brought to world attention by war
veterans
 May begin within 3 mths but could also
take years
 Families of PTSD victims can develop the
disease
PTSD cont.
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A global problem underestimated by LDCs
In the US, 200,000 veterans received disability
compensation for PTSD worth $4.3bn in 2005
11-20% of US Iraq and Afghanistan war
veterans were PTSD positive
About 10% of US Gulf veterans were positive
Uganda estimates are about !0% of the
veterans
Military related causes of PTSD
 Exposure
to combat
 Exposure to life threatening missions
 Shot at, seen a buddy shot, or seen death
 Military sexual trauma (sexual harassment)
 Other factors such as what you do in war,
politics around the war, where it is fought,
and type of enemy you face add more
stress to an already stressful condition
Effects of PTSD
 Victim’s
loss of faith for safety,
predictability or meaning in the world
 Haunts victim and prevents normal life
 Difficulty in relationships
 Feelings of shame, guilt, despair,
helplessness, grief/loss
 Poor health behavior among pregnant
women
 Memory loss among pregnant women
PTSD effects cont.
 Babies
born to PTSD mothers are likely to
experience a change in at least one
body chemical and later taking on the
condition
 Failure to engage in productive life
 Victims risk of higher use of cigarettes,
alcohol and marijuana
 Likelihood of committing crime
PTSD treatment
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Treatment through psychotherapy (restoring
safety feelings, calming the nervous system)
Educating the victims what they are feeling
Stress reducing foods also recommended
Recovery involves (feeling empowered,
finding meaning in life again, re-establishing a
connection to oneself and feelings for other
people)
Why the PTSD advocacy
strategy?
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WHO’s health definition(veterans not healthy)
Uganda’s 1995 constitution provides for a
right to health(yet PTSD is still a terror)
Problem is big but generally faced with
silence
Yet it is treatable!
It is worthwhile that the advocacy aimed at
favorable policy change begins with me
The challenges are surmountable
Campaign narrative for
advocacy strategy
Retired Captain Moses Tabora was 10 years and illiterate when he joined the armed
struggle and fought till 1995 when he left the army with one leg! Retired Sergeant
Mwaka Hassan joined the rebel force when he had lost all his parents and did revenge
killings whenever he could till he was discharged from the army in 1997. Retired Private
Baluka Harriet was a child soldier and now has ten children each with a different father.
She recently returned from Somalia as part of the Amisom troops and was diagnosed with
PTSD. All these were liberators who now have become a “nuisance” through no fault of
theirs.
A local song composed in Uganda describes the veterans as used condoms yet they
contributed a lot in ousting the dictatorship and stopped state inspired killings then. All
the three have PTSD problems but government is silent. What a pity! The families of
these veterans cannot afford a smile. These veterans have unexplained behavior, make
noise, issue threats, utter vulgar words and cannot fend for their families. Government
had put up a law to take care of the veterans but never took this problem serious.
Veterans are committing crime quite often and are jailed. Nobody ever bothers to find
out what the exact problem is.
Families are resorting to witchdoctors for a remedy and others are going to Pentecostal
churches for miracle cure. Yet this is a medical condition that can be addressed when
government has the will to take it up, and mainstream it in its programs. The time is now
for our legislators to own up this matter and make all interventions necessary to make the
world of PTSD sufferers’ worthwhile if they are to measure up to the global standards
pushed by the World Veterans Federation. It is your duty to make this change happen.
Brief about UVAB
 UVAB
is a statutory body mandated to
discharge the soldiers from military service
and ensure that they are sustainably
reintegrated in civilian life.
 UVAB faces challenges of increased
veterans now about one million
 PTSD condition not well handled
 Existing law has gaps that need
amendment
Context analysis of advocacy
strategy
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Problem affecting about 10% of the veterans
Manifestations of PTSD already explained
Origin of PTSD grounded in 1981-1986 war
Causes of PTSD explained
Limited medical interventions made
Family members, community and
government most affected by problem
Frequency of problem periodic or continuous
PTSD impacts negatively on socio-economic
and political aspects
CAMPAIGN STRATEGIC
FRAMERORK
Objectives and key targets
(SMART)
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To push for the amendment of the UVAB Act
to include the support and treatment of the
Post-Traumatic Stress Disorders (PTSD)
condition among ex- soldiers by 2015
To work towards a community that has
favorable perceptions of PTSD sufferers and
support them by 2015
Enabling easy access of PTSD services by exsoldiers through the creation of special wings
at both the regional and national psychiatric
referral hospitals by 2018
Campaign strategic
framework cont.
 Scope
covers veterans countrywide and
policy makers/legislators, community
leaders by 2018
 Critical pathways vital for each of the
three objectives as road maps
 Various circles of influence at play for
each objective remain almost the same
because of the security nature of the
vulnerable target
M&E Framework of the
strategy
Objectives
Desired impact
Success indicators
Means of verification
Objective 1
A law that will take
care of ex combatants
with PTSD condition
and improve their
condition
Amendment tabled and
discussed
Parliamentary sessions
monitored
Amendment passed
Hansard Reports
Bill assented to by H.E
the President
80% of community
leaders having a
favorable attitude
Press reports
To push for the
amendment of the
UVAB Act by 2015
Objective 2
To work towards a
community that has
favorable perceptions
of PTSD sufferers and
support them by 2015
Objective 3
To enable easy PTSD
access services through
special PTSD wings in
regional and national
psychiatric hospitals by
2018
A civil community that
fully understands the
PTSD problem and be
in position to
sustainably address
those challenges
Hospitals with PTSD
wings that make it easy
for the ex-combatants
to get quick attention
regarding their
conditions
Community meetings
80% of PTSD veterans
receiving support from
the community
Radio feedback
80% PTSD wings
established
Hospital Reports
80% Special wings
operational
80% of PTSD cases
reporting for treatment
registered
Reduced violence in
PTSD homes
No of veterans assisted
Minutes of ministerial
meetings
Campaign elements
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Creative brief with emphasis to background
to the problem hyping need for intervention
Campaign objectives seek favorable attitude
change and actualizing the change
Messaging to policy makers and other targets
focuses on need to rise to the challenge
Emotions elicited seek policy change by
comparison between past and present with
liberators turned into rejects
Campaign elements cont.
Lobbying
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Importance of lobbying is critical in the policy
process from agenda setting, option formulation
and implementation
My case falls at agenda setting given my targets
and desired policy change
Alternatives later considered
Implementation would be the dream as soon as
OPM communicates accordingly
Policy brief document prepared aimed at giving
the bigger sieved picture giving solutions and
recommendations and call to action
Campaign elements cont.
Popular mobilization
 Grounds
for passion for MPs done (scratch
where it itches)
 Go for what works not strategy per se
 Threats of demonstration, petition to
parliament and request to meet H.E the
President
 Continuous engagement of friendly forces
(via dialogue, sports, media, reminders,
workshops) to keep fire burning
Campaign elements cont.
Media analysis
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Media analysis key in any campaign
Done with view to getting to my objectives with
cost effectiveness, efficiency, mass audiences in a
timely manner
Media channels identified and prioritized
Relevant press releases issued with call to action
Media relations should take mutually beneficial,
loudspeaker, agenda setter, cordial and
supportive relationships
Media is supportive because of its alleged non
biased nature as a fourth estate (informative,
educative and entertaining roles)
Alliance building
(UVAB SWOT analysis)
Strengths
Opportunities
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Skilled manpower
Long serving staff at headquarters
Financing availed by the donor
community for demobilization
Created a favorable history of good
performance
Weekly veterans radio programs (that
help in sensitization)
Weaknesses
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Space limitations at Head Office
Location on 7th Floor that is bad for
Veterans with Disabilities
Current limited funding
Regular staff turnover in districts
affecting
district
veterans
office
performance
Decentralization local government policy
adopted in 1997
 Favorable community
 H.E the President is a veteran
 Many cabinet ministers are ex-soldiers
 Rt. Hon. Prime Minister is the Minister
for veterans affairs
 Liberalization policy
 Vibrant civil society
Threats
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Fight for control over veterans
Limited legal mandate
Instability in the region
A
non-supportive
opposition
parliament
Confusion of who a veteran is
Political definition of a veteran
in
Alliance Building cont.
SWOT analysis
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SWOT analysis vital in the strategy to locate
our standing as an organization
Opportunities and risks identified help in way
forward leading to a number of allies to fill
gaps and enhance capacity
Alliances to build in this strategy include
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NRM Veterans League (Ruling party organ)
Uganda Local Government Association (ULGA)
Uganda NGOs Forum (vibrant civil society)
Uganda Medical Association
Action Plan For One year
Objective
Target
Year 1
Desired
Outcome
Board of
Directors
approve a
board paper
highlighting
the need for
amendment
Activity
Timeline
Resources
1.1 Drafting of
researched
board paper
1.2 Distribution
of agenda
1.5 Two (2)
Board meetings
called and sat
April –
Novembe
r 2013
Funds
(facilitation)
Technical staff
The Prime
Minister
Board
minute on
amendment
considered
by the Rt.
Hon. Prime
Minister
February
2014
Technical staff
Members
of
Parliament
Members of
Parliament
get to
appreciate
the dangers
associated
with PTSD
among
veterans
1.1 Premier
tables the need
for action in the
top management
meeting for
adoption
1.2 Need for
amendment
tabled in cabinet
1.3 Cabinet
memo done
1.1 Conduct
district veterans
advisory
committee
meetings
countrywide
1.2 Conduct
workshops
targeting the
parliamentary
defence
committee and
other members
of parliament
2.1 Regional
officers asked to
present budgets
for mobilization
2.2 Budget
preparation for
national
mobilization
after receipt of
January
2014
Technical
staff/Facilitator
s
Funds
AprilJune
2014
Funds
Technical staff
1.
Board of
Amendmen directors
t of the
UVAB
UVAB Act
2
Board of
Have a
directors
community UVAB
that has
favorable
perceptions
of PTSD
sufferers.
Board
approves
expenditure
on
mobilization
of various
stakeholders
THE LAST REMARKS
I
AM AN IMPROVED HUMAN RESOURCE
NOW
WITH ADVOCACY SKILLS TO RALLY MY
TARGETS FOR CHANGE
 VETERANS IN UGANDA HAVE CAUSE TO BE
HOPEFUL
 I SAY THANK YOU TO THE COURSE
SPONSORS, COURSE ORGANIZERS, FELLOW
PARTICIPANTS, VALERIE AND CO.