Section 1: What We Know

Section 2: African Experiences and Responses

Section 3: Practice Implications for Social Workers

The purpose of this book is to inform social workers and other helping professionals in the United States about the context and realities of children and families affected by armed conflict in Africa and the strategies used to support them and to increase the awareness and knowledge that social workers bring to their work with individuals from these areas who are currently in the United States. This book focuses on armed conflict experiences in Africa, and most of the practice examples are based on the armed conflicts in Uganda and Rwanda. The focus on children and families affected by armed conflict in Africa is important for four reasons. First, although armed conflict affects children and families throughout the world, Africa is one region that is disproportionately affected by armed conflict and thus deserves singular attention. Second, although the percentage of immigrants, refugees, and asylum seekers from Africa is small in comparison to the total foreign-born population in the United States, it is a growing population. Third, the traditional African worldview that influences health and well-being is different from the Western worldview predominant in U.S. social services. Fourth, there are few social work books or articles that focus solely on the psychosocial issues of African children and families affected by war in Africa. It is important that practitioners understand the experiences that children and families from areas of armed conflict in Africa bring to social services, health services, and educational settings and reflect on what this may imply for helping professionals in the United States working with this population.

The objectives of the book are to

• increase awareness and knowledge of the nature of children and families’ involvement in armed conflicts in Africa;


• increase awareness of the psychosocial interventions being used in several contexts in Africa among U.S. practitioners and to enhance their capacity to incorporate these strategies into their work;


• increase knowledge of the ways exposure to violence and trauma affects individual, family, social, and community functioning and the impact on recovery;


• understand the theories used in interventions with children and families affected by trauma experiences and identify the effective practices that have been researched;


• increase the cultural competence of U.S. practitioners working with refugee and immigrant populations from conflict-affected areas in Africa by examining the social and cultural understandings of mental health through selected exemplars;


• increase practitioners’ ability to implement social services and programs among resettled and relocated populations that meet basic human needs and support the development of human capacities.

Background

Each day, the news informs us of wars and armed conflicts throughout the world. Many individuals’ lives are defined by armed conflicts that last for years. Although the total number of armed conflicts has decreased in the world since the 1990s and the number of international and interstate wars has decreased, the number of intrastate wars has increased. These intrastate wars are more likely in Africa and Asia: Africa experiencing 40 percent of the armed conflicts worldwide and Asia 37 percent. Since the 1990s, the United States has seen an increase in the number of individuals coming from African countries affected by war as immigrants, refugees, and asylum seekers. The African population in the United States is a small percentage of the foreign-born population; however, it is an increasing one with an experience that is culturally different from that of Western society. Some individuals are involved as combatants, others as victims, and others as witnesses to the violence. Often, individuals fall into all three categories. Social service professionals at state and local agencies, medical facilities, mental health centers, and schools are likely to encounter individuals having such backgrounds. Therefore, it is important for social service professionals to become better informed about the situations of armed conflict that people may be coming from and the experiences that they may have been exposed to.

The need for a book that addressed these issues was identified as a result of a conference that was held at Smith College School for Social Work in 2005 on Children in Armed Conflict: Implications for U.S. Clinical Practice. The conference brought social workers, researchers, and policy developers with a range of backgrounds on this issue together to discuss critical issues for working with children and families affected by armed conflict. These issues involved the effects of armed conflict on the lives of individuals in these areas, the strategies that were used to cope, importance of cultural compatibility of the interventions, and the demographic information on Africans who are arriving in the United States from countries affected by armed conflict. This conference evolved from research on the effects of armed conflict on children who had been abducted by the Lord’s Resistance Army (LRA) in northern Uganda. A critical aspect of this work for the editor was the importance of working with individuals affected by armed conflict, not working on them. The research, conference, and this book grew out of dialogue with practitioners in this field and with American and African practitioners who have worked in armed conflict in Africa. This book presents the perspectives of Africans who discuss the political, economic, cultural, social, and spiritual elements of life that have been affected by war.

The chapters in the book discuss topics of relevance for children and families affected by armed conflict in Africa and use the context of the LRA conflict in Uganda and Rwandan genocide as exemplars. However, the themes that are emphasized are global in nature, such as the nature of armed conflict and its impact on families; the impact of trauma on children, families, and communities; the importance of developing interventions that support an individual’s worldview of well-being; the cultural and social adjustment of individuals immigrating to the United States; and the clinical implications of populations from areas of armed conflict moving to the United States. Therefore, the overarching themes and practice implications may apply to children and families affected by armed conflict from other regions.

Organization of the Book

The book is organized into three sections. The first section, What We Know, includes chapters 1, 2, and 3 and focuses on the increase in individuals coming to the United States from regions of armed conflict in Africa and experiences of children and families in war-affected communities in Africa. Authors provide contextual information about the experiences of armed conflict in Africa and the experiences of individuals and families resettling in the United States. The second section, African Experiences and Responses, chapters 4, 5, and 6, describes psychosocial and healing approaches used in African contexts of armed conflict. Contributors use firsthand experience to describe the basic needs of the population, the complexity of the children and families’ lives, the challenges in gender relationships, and expectations for psychosocial healing and well-being. The third section, Practice Implications for Social Workers, chapters 7, 8, and 9, discusses practice issues related to war-affected populations. Theories that shape these practices are identified. These chapters also explore African cultural and traditional practices that might lend themselves to being integrated in U.S. social work practice. A Conclusion summarizes the key themes, highlights the practice implications for helping professionals, and identifies future areas of practice and research with children and families living in the United States who have been affected by armed conflict in Africa.

Overview of the Chapters

In chapter 1, Joanne Corbin explores the increase in the number of individuals coming to the United States from countries experiencing armed conflict in Africa. This information establishes the need for helping professionals to increase their knowledge and skills with this population. From 1990 to the present there has been a decrease in the overall number of armed conflicts but an increase in the number of intrastate conflicts. There has been a corresponding increase in the number of African individuals coming to the United States from countries that have experienced armed conflict. The resettlement patterns for immigrants have expanded, with implications that most counties in the United States have African populations. This chapter highlights the importance of U.S. helping professionals understanding the impact of these data on their work and the sociocultural characteristics of these populations.

One of the most concerning issues on the global scene is the involvement of children under 18 years of age in armed conflict. In chapter 2, Jo Becker presents the context of children involved in armed conflict. Most armed conflicts worldwide involve children under 18 years of age, and children’s involvement in armed conflict is a growing phenomenon. Understanding the ways that children become connected to the armed forces or armed groups can help U.S. social service providers understand the day-to-day economic and political challenges facing many families. The author uses examples of individual children she has met to describe their experiences within these armed groups.

In chapter 3, Eugenie Mukeshimana describes the firsthand experience of coming to the United States after living through the Rwandan genocide. Mukeshimana explains the fears and challenges of surviving through the genocide and the loss of family, friends, and community; the challenge of finding a way out of a country in the political instability of the aftermath; and resettling in a foreign country. The biopsychosocial perspective is used to frame the experiences of an individual in resettlement and the strategies to support that individual. The chapter will help practitioners reflect on how social service delivery and individual interventions can support the needs of newly arrived populations.

In northern Uganda, the strategies for working with children, families, and communities affected by armed conflict involves addressing violence and increasing the capacity of individuals to work for peace. In chapter 4, Reverend Father Remigio C. Obol examines the concept of peace in the Acholi population, the ways that peace has been damaged in the armed conflict, and strategies for retuning to peace. The chapter identifies key concepts in the Acholi culture and African culture that support peace and are important for individual and collective well-being.

In chapter 5, Stella Ojera describes the psychosocial approach to working with children affected by armed conflict in northern Uganda. The cultural and contextual issues that shape the development of psychosocial approaches are described. The components of the center-based approach and communitybased approach are discussed. The important role of community involvement and agency collaboration is highlighted. The psychosocial approach is a common approach used in many countries in Africa; several examples are included.

In chapter 6, Theresa S. Betancourt and colleagues Sarah E. Meyers-Ohki, Sara N. Stulac, Christine Mushashi, Felix R. Cyamatare, and William R. Beardslee examine locally defined constructs of mental health for conflict-affected communities in Rwanda. This chapter describes a research study designed to develop knowledge and understanding of Rwandan conceptualizations of mental health issues that affect family functioning. The findings from the study were used to create a family-based intervention to strengthen family functioning. The chapter highlights the importance of culturally congruent interventions and significant participation of the community.

In chapter 7, Joan Granucci Lesser provides the groundwork for working with individuals affected by trauma. She begins by providing an understanding of the major concepts in trauma work including trauma, acute stress disorder, posttraumatic stress disorder, cultural trauma, collective memory, and vicarious traumatization. Throughout her discussion of the impact of trauma on individuals, Lesser pays attention to the importance of the political, social, and cultural worlds of individuals who have experienced trauma. She uses a developmental perspective for conducting psychosocial assessments, looking at the types of trauma symptoms that are seen during childhood, early adolescence, and late adolescence. Lesser offers a description of the techniques that have been used to help individuals recover and heal from trauma.

In chapter 8, Joanne Corbin explores the conceptual integration of African cultural orientation into the Western psychological approaches to intervene with trauma. Cultural worldviews influence how individuals and communities understand experiences, respond to these experiences, and develop interventions. Two traditional African ceremonies are examined to understand the implications for healing from the psychological and social effects of armed conflict. Ways of working with trauma from a Western perspective may be culturally incongruent to individuals from a traditional African perspective. Key beliefs and values of the African worldview are presented.

In chapter 9, Joanne Corbin explores the importance of using an ecological framework for assessing the areas of strengths and vulnerabilities that African individuals and families from contexts of armed conflict have experienced. The challenges for practitioners working with populations affected by armed conflict are identified.

The conclusion of the book provides a summary of the key themes that are presented in the chapters and identifies implications for practice. It also provides recommendations for further development in practice and research areas.

Conclusion

The goal of this book is to help practitioners expand their understanding of the contextual issues affecting children and families affected by armed conflict in Africa through the book’s focus on Uganda and Rwanda. It is hoped that the content prompts helping professionals to increase their knowledge of the effect of armed conflicts on client populations; expand the questions that become part of assessments; deepen their understanding of the significance of cultural worldviews; and increase their awareness and knowledge of integrating aspects of culture, where appropriate, into the interventions used with armed conflict-affected populations.

Joanne Corbin, PhD, MSS, BA, is associate professor and chair of the research sequence at Smith College School for Social Work (SSW), in Northampton, Massachusetts. Dr. Corbin’s current research focuses on children and families involved in armed conflict in northern Uganda. She has conducted research on the reintegration experiences of former child soldiers in northern Uganda and on the resettlement of internally displaced populations in northern Uganda. An outgrowth of this research was the development of a training-of-trainers program with service providers in northern Uganda addressing the psychosocial needs of individuals and families affected by armed conflict. Dr. Corbin developed a social work internship program in northern Uganda for students from Smith College School for Social Work, and she has written about the values conflicts that U.S.-based social workers experience in international settings. She has also explored global social work issues in South Africa, Tanzania, and Canada. In 2010, Dr. Corbin was appointed to the Council on Social Work Education’s Council for Global Learning, Research and Practice, which seeks to develop social workers who are competent in international practice. Dr. Corbin is a clinical social worker and is trained in family therapy.