Michael's Case Study, Lira July 2008
With unlimited resources, TPO would have a social worker placed in every village spread out over the four sub-counties of Lira where the organisation is currently working, such is the need in this war torn part of Uganda.
But the resources are far from unlimited, nor would this be a sustainable solution. Therefore the majority of TPO’s work is carried out using a family and community oriented approach. It is no surprise therefore that the majority of TPO interventions are group and household oriented on the understanding that entire households have been affected and also in recognition of the cost effectiveness of targeting individuals. Examples of group and household interventions include; group counselling & support, patient support groups, sports & recreation groups, school based interventions, training of existing support structures, youth and women’s groups, and child protection committees. Yet every now and then a case is so complex that a TPO social worker becomes directly involved. In this case individual support is given to those persons expressing severe emotional distress and who are unable to cope on their own. They are then moved to groups once they begin showing positive signs of recovery.
Michael is ten years old and, a mixture of sadness, isolation and aggression in his demeanour, looks a broken child. An observation that becomes manifest as his story unfolds.
Nobody seems to be able to give us an exact timeframe, but for as long back as he would be able to remember, Michael has lived in an IDP (Internally Displaced Persons) camp, a result of ongoing rebel activity in the area. Some years back, things took a turn for the worse, when his mother died and his father turned to drugs and alcohol, leaving the four children to fend for themselves. The oldest daughter, Angela, now 16 years old, was left with the task of looking after her three siblings, all of whom had to endure an increasingly violent father. During this time Michael stopped talking and engaging with his family and started showing signs of severe mental health problems.
In early 2008, the family returned to their village, and Michael enrolled in the local school where teachers quickly picked up on his mental health problems. His Headmaster, Ogwal Charles explains, “He is not mentally ill, but simply traumatised by the hardships of his childhood. He doesn’t talk to anyone and won’t listen to or engage with adults. But he does play with other children, so we’re trying to include him in activities with kids of his age to encourage some positive development.”
TPO social workers and staff have been involved in the case for months, and when visiting Michael’s home and speaking to his extended family and neighbours, all fingers of blame pointing at Dad, Simon, an addict beyond the reach of help. However, when Simon arrives, you are quickly reminded that this is not a black and white world. In clothes so raggedy, you think for a second they have been customised for a staging of Oliver Twist, Simon humbly greets the visitors, showing no signs of the villain we have had painted to us. Two TPO staff take Simon to one side to discuss the situation in private, and a different picture emerges; a picture that, by no means condoning his behaviour or forgetting the enduring effect it will have on his children, makes it difficult not to empathise.
Simon tells us his own story, how he was abducted by the rebels, beaten and tortured, and as a result now has a lot of medical issues – and psychological ones as well one would image. He talks of Michael as being stubborn and difficult and acting like he has a mental disorder, being out of control, stealing from the neighbours, upsetting kids younger than him. He admits to having beaten, harassed and intimidated his son in the past, but swears this has stopped since the TPO social worker became involved, now trying to support instead of punish.
TPO Child Protection Officer, Sarah Akera explains; “It’s difficult to know what really goes on, especially as Michael doesn’t talk to give his own version, but there are obvious signs of improvement. Simon is becoming more involved in Michael’s life, has been visiting his school and now knows the headmaster. But Simon put forward his own personal challenges, saying he can’t provide food and clothing for his family because he doesn’t have anything to give, that Michael sometimes steals food because there is no food at home. How life is hard because he doesn’t have a wife, that maybe if he had a wife who could work hand in hand with the children, things would be better.”
It is agreed that the TPO social worker will continue to counsel the family, that TPO will provide the family with some clothes for the children, and refer them to other NGOs like World Food Program for food rations.
“It is a very painful situation,” continues Sarah. “You can see that Simon is so far from his children because of what he has had to endure himself. For now, this is simply the best he can do. He is very weak and his health is too poor for him to do any farming or hard labour, so where does he make his living? It is very distressing, because most likely he is going to continue to live like that, and pass on the hardships to his children. His personal problems need to be addressed and healed in order for him to help his own children. He has great depression. You could see from the tears in his eyes that he really needed someone to talk to.”
So who do you help? Michael because he is the youngest and shows the most immediate signs of mental health problems? Angela, so she can keep looking after her siblings best possible? Or Simon, so he can reclaim his role as family provider?
This is not a simple problem with one simple solution. The only clear cut fact is that this is a broken family – one of thousands of broken families in the region, bearing the scars of years of war and conflict. The challenges for TPO and the many humanitarian organisations working in the area, are to try and heal what can be healed, to make sure this sad legacy stops here and is not passed on to the children and future generations responsible for rebuilding this war torn country.
Over time as Michael begins to improve and show signs of being able to cope on his own, he will be encouraged to join an existing group of children who have gone through a similar experience or simply a group of children his own age with whom he can interact freely, gradually restoring his self esteem and relational abilities. Moving an individual to a group will reduce the burden of caring for an individual on the TPO Social Worker and allow them to pick up other new cases. This cycle goes on and on.
Some names in this story have been changed to protect identities.
But the resources are far from unlimited, nor would this be a sustainable solution. Therefore the majority of TPO’s work is carried out using a family and community oriented approach. It is no surprise therefore that the majority of TPO interventions are group and household oriented on the understanding that entire households have been affected and also in recognition of the cost effectiveness of targeting individuals. Examples of group and household interventions include; group counselling & support, patient support groups, sports & recreation groups, school based interventions, training of existing support structures, youth and women’s groups, and child protection committees. Yet every now and then a case is so complex that a TPO social worker becomes directly involved. In this case individual support is given to those persons expressing severe emotional distress and who are unable to cope on their own. They are then moved to groups once they begin showing positive signs of recovery.
Michael is ten years old and, a mixture of sadness, isolation and aggression in his demeanour, looks a broken child. An observation that becomes manifest as his story unfolds.
Nobody seems to be able to give us an exact timeframe, but for as long back as he would be able to remember, Michael has lived in an IDP (Internally Displaced Persons) camp, a result of ongoing rebel activity in the area. Some years back, things took a turn for the worse, when his mother died and his father turned to drugs and alcohol, leaving the four children to fend for themselves. The oldest daughter, Angela, now 16 years old, was left with the task of looking after her three siblings, all of whom had to endure an increasingly violent father. During this time Michael stopped talking and engaging with his family and started showing signs of severe mental health problems.
In early 2008, the family returned to their village, and Michael enrolled in the local school where teachers quickly picked up on his mental health problems. His Headmaster, Ogwal Charles explains, “He is not mentally ill, but simply traumatised by the hardships of his childhood. He doesn’t talk to anyone and won’t listen to or engage with adults. But he does play with other children, so we’re trying to include him in activities with kids of his age to encourage some positive development.”
TPO social workers and staff have been involved in the case for months, and when visiting Michael’s home and speaking to his extended family and neighbours, all fingers of blame pointing at Dad, Simon, an addict beyond the reach of help. However, when Simon arrives, you are quickly reminded that this is not a black and white world. In clothes so raggedy, you think for a second they have been customised for a staging of Oliver Twist, Simon humbly greets the visitors, showing no signs of the villain we have had painted to us. Two TPO staff take Simon to one side to discuss the situation in private, and a different picture emerges; a picture that, by no means condoning his behaviour or forgetting the enduring effect it will have on his children, makes it difficult not to empathise.
Simon tells us his own story, how he was abducted by the rebels, beaten and tortured, and as a result now has a lot of medical issues – and psychological ones as well one would image. He talks of Michael as being stubborn and difficult and acting like he has a mental disorder, being out of control, stealing from the neighbours, upsetting kids younger than him. He admits to having beaten, harassed and intimidated his son in the past, but swears this has stopped since the TPO social worker became involved, now trying to support instead of punish.
TPO Child Protection Officer, Sarah Akera explains; “It’s difficult to know what really goes on, especially as Michael doesn’t talk to give his own version, but there are obvious signs of improvement. Simon is becoming more involved in Michael’s life, has been visiting his school and now knows the headmaster. But Simon put forward his own personal challenges, saying he can’t provide food and clothing for his family because he doesn’t have anything to give, that Michael sometimes steals food because there is no food at home. How life is hard because he doesn’t have a wife, that maybe if he had a wife who could work hand in hand with the children, things would be better.”
It is agreed that the TPO social worker will continue to counsel the family, that TPO will provide the family with some clothes for the children, and refer them to other NGOs like World Food Program for food rations.
“It is a very painful situation,” continues Sarah. “You can see that Simon is so far from his children because of what he has had to endure himself. For now, this is simply the best he can do. He is very weak and his health is too poor for him to do any farming or hard labour, so where does he make his living? It is very distressing, because most likely he is going to continue to live like that, and pass on the hardships to his children. His personal problems need to be addressed and healed in order for him to help his own children. He has great depression. You could see from the tears in his eyes that he really needed someone to talk to.”
So who do you help? Michael because he is the youngest and shows the most immediate signs of mental health problems? Angela, so she can keep looking after her siblings best possible? Or Simon, so he can reclaim his role as family provider?
This is not a simple problem with one simple solution. The only clear cut fact is that this is a broken family – one of thousands of broken families in the region, bearing the scars of years of war and conflict. The challenges for TPO and the many humanitarian organisations working in the area, are to try and heal what can be healed, to make sure this sad legacy stops here and is not passed on to the children and future generations responsible for rebuilding this war torn country.
Over time as Michael begins to improve and show signs of being able to cope on his own, he will be encouraged to join an existing group of children who have gone through a similar experience or simply a group of children his own age with whom he can interact freely, gradually restoring his self esteem and relational abilities. Moving an individual to a group will reduce the burden of caring for an individual on the TPO Social Worker and allow them to pick up other new cases. This cycle goes on and on.
Some names in this story have been changed to protect identities.
Child Protection Committee meeting chaired by TPO social worker Rose
Michael's Headmaster Charles Ogwal
Michael's family and neighbours join TPO staff for group counseling
Father Simon discusses Michael's case with TPO staff
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