Deworming Delusions? Mass Drug Administration in East African Schools

Recent debates about deworming school-aged children in East Africa have been described as the ‘Worm Wars’. The stakes are high. Deworming has become one of the top priorities in the fight against infectious diseases. Staff at the World Health Organization, the Gates Foundation and the World Bank (among other institutions) have endorsed the approach, and school-based treatments are a key component of large-scale mass drug administration programmes.
There is no doubt that curative therapy for children infected with debilitating parasitic infections is appropriate, but overly positive evaluations of indiscriminate deworming are counter-productive.

Crisis Responses, Opportunity and Public Authority during Covid‐19’s First Wave in Uganda, the Democratic Republic of Congo and South Sudan

Discussions on African responses to Covid-19 have focused on the state and its international backers. Far less is known about a wider range of public authorities, including chiefs, humanitarians, criminal gangs, and armed groups.
This paper investigates how the pandemic provided opportunities for claims to and contests over power in Uganda, the Democratic Republic of the Congo, and South Sudan.

Reluctant Representatives of the State: Teachers’ Perceptions of Experienced Violence (DR Congo)

My qualitative research in South-Eastern Democratic Republic of Congo suggests that teachers link experienced violence to their role as state representatives. Three elements evoke the militia’s distrust: literacy, cell phones, and mobility. Reportedly, militias assume that teachers use these elements to cooperate with the military. This article therefore understands these elements as symbols of stateness, and it demonstrates how a state with overall weak capacities can have significant meaning for teachers’ everyday lives in the form of the state-image.
Thereby, the article sheds a critical light on approaches that frame teacher (re)deployment in conflict-affected contexts around normalcy and resilience. As teachers cannot escape their affiliation to the state, they live in an unsettling proximity to people who turned against them and who might again do so. Since reasons of the conflict remain unaddressed, teachers become reluctant representatives of a state system in which they themselves are structurally neglected.

Competing Networks and Political Order in the Democratic Republic of Congo: A Literature Review on the Logics of Public Authority and International Intervention

This CRP synthesis paper presents an overview of shifting dominant narratives on the Congo wars and the major findings of a systematic qualitative literature search on conflict and violence in the Democratic Republic of Congo (DRC) in relation to the political economy of public authority. It identifies gaps and limits in the existing literature and engages in current debates on peacebuilding and peacemaking strategies and policies.

Urbanizing Kitchanga: Spatial Trajectories of the Politics of Refuge in North Kivu, Eastern Congo

This article presents the historical and political trajectory of Kitchanga town in North Kivu, to demonstrate how current processes of urbanization in a context of civil war in Eastern Congo are strongly intertwined with regional politics of refuge. Kitchanga, an urban agglomeration that emerged from the gradual urbanization of IDP and refugee concentrations, has occupied very different positions through different episodes of the wars, ranging from a safe haven of refuge, to a rebel headquarter, to a violent battleground.
On the basis of a historical account of Kitchanga’s development, the paper argues for a spatial reading of broader geographies of war, displacement and ethnic mobilization in North Kivu. It shows that these urban agglomerations as ‘places’ and their urbanization as ‘processes’ are crucial to better understand the spatial politics of refuge in North Kivu. The article builds on original empirical data.

The Politics of the Second Vaccine: Debates Surrounding Ebola Vaccine Trials in Eastern Democratic Republic of the Congo

Two experimental Ebola vaccines were deployed during the tenth Ebola epidemic (2018–20) in the DRC. International debate ensued about the value and ethics of testing a second vaccine in an epidemic context. This article examines how this debate unfolded among actual and potential trial participants for the second vaccine in Goma. Drawing on ethnographic observation, interviews and focus groups, it explores how the trial was perceived and contested on the ground and situated in broader debates about the ethics of clinical trials, especially during the COVID-19 pandemic.
We illustrate how debates around the ethics of clinical research are not simply centred on bioethical principles but are inseparable from local political dynamics and broader contests about governance, inequality and exclusion.

Humanitarian Fables: Morals, Meanings and Consequences for Humanitarian Practice

This article describes how events are turned into fables in humanitarian organisations. It explores how these fables circulate, the lessons they come to embody and their influence in maintaining an organisational status quo. The article argues that such stories teach new humanitarian employees certain ‘facts’ about ‘the field’ and help form and consolidate consensus about why things are the way they are in an organisation.
By describing three such fables circulating amongst Médecins Sans Frontières ‘international’ employees in the Democratic Republic of the Congo, each of which suggested a need for foreign humanitarians to maintain a certain distance from local citizens (including their nationally hired colleagues) as a means of personal and organisational security, the article illustrates how such fables can ‘justify’ certain organisational decisions that ultimately reinforce structures of unequal power relations between different humanitarian employees.

Humanitarian Shapeshifting: Navigation, Brokerage and Access in Eastern DR Congo

This article examines the experience of Congolese humanitarians negotiating access with armed groups in eastern DRC. It describes how humanitarians become shapeshifters: they play different roles for different audiences as a tactic of social navigation in a context of uncertainty. Because humanitarians encounter risks related to their perceived identity, they play upon identity categories and personal histories, situating themselves tactically during encounters with different armed actors through creative modes of self-fashioning.
Whilst there remains a focus on performing a distinct humanitarian identity, NGOs in practice draw upon the embedded local knowledge and skills of employees to work in conflict areas.

From Rebel to Humanitarian: Military Savoir Faire and Humanitarian Practice in Eastern DR Congo

This article explores the experience of ex-rebels who have become humanitarians in the eastern Democratic Republic of the Congo. It describes how rebel-cum-humanitarians navigate a turbulent political environment, integrating the knowledge they acquired through military experience into a career in the humanitarian sector. ‘Distinction’ between combatants and humanitarians remains central to the humanitarian imaginary. However, rebel and humanitarian spheres are interlinked by individuals who do not just broker relationships between the two, but also move between them. They walk a tightrope: their rebel past is seen as a threat to performing a ‘neutral’ humanitarian identity, but at the same time, it constitutes a resource in brokering access with armed groups.
Despite a focus on performing principles, humanitarian agencies in practice draw on their employees’ savoir faire which is sometimes gained through rebel experience — the very identity deemed antithetical to a humanitarian status.

Guidance for Applied Cross-National Research in Under-Resourced Countries: Lessons from a Gender-Based Violence Intervention in the Democratic Republic of Congo

Via a personal account of our experiences in conducting a study on a gender-based violence intervention in Congo, we share our lessons and offer recommendations (e.g., using multiple methodologies) for conducting applied cross-national research. We hope that as a result more scholars will be encouraged to undertake this impactful and rewarding work.

The story of Kitchanga: Spatial politics of presence, refuge and return in North Kivu, Eastern DRCongo

In the Kivu provinces of the Eastern Congo, permanent semi-urban towns emerge from the protracted presence of refugees and internally displaced persons. Using the example of Kitchanga in North Kivu, Gillian Mathys and Karen Büscher (Ghent University) show the importance of such towns as important spaces in the politics of mobility, presence and return in a context of violent conflict and ethnic mobilisation.

Therapy in Uganda: a failed MHPSS approach in the face of structural issues

The past 30 years have seen an unprecedented rise in attention towards the mental health of conflict-affected populations. The World Health Organization (WHO) estimates that the burden of mental disorder among conflict-affected individuals may be as high as 22% and to be particularly prevalent among refugees and forced migrants. This is certainly the case in Uganda, where the mental health needs of the large number of displaced people have been described as dire and largely unmet, despite MHPSS interventions being a common part of the humanitarian response.
This short article reports a study that considered the effects of the psychological intervention of Cognitive Behaviour Therapy among women in the Palabek refugee camp in Northern Uganda. While the combination of therapy and livelihood creation may appear to be beneficial for refugees’ mental health more broadly, the reality in Uganda has been rather different.

Vigilantes, Witches and Vampires: How Moral Populism Shapes Social Accountability in Northern Uganda

Strange murders have occurred in northern Uganda. Blood is said to have been removed from the victims, and there are tales about child sacrifice and terrifying witchcraft. An ‘election’ was organised to select the culprit, known as ‘Mr Red’, and vigilante mobs have destroyed his property. This article places these events in context, and shows how understandings of the spirit world, religion, and wealth accumulation relate to local notions about egregious acts.
No conventional evidence has been found to show that the man accused is responsible for any crimes, but he has been imprisoned, and has had threats on his life. The case illustrates widespread phenomena, which are too often ignored, and draws attention to the ways in which local elites draw on strategies of moral populism to establish and maintain their public authority.

Conceptual Resilience in the Language and Lives of Resilient People: Cases from Northern Uganda

This special issue explores post-conflict recovery in northern Uganda from the perspective of survivors themselves. Normative notions of resilience are widely critiqued as reductive, depoliticising and simplistic. Although the papers here, based on ethnographic methodologies, are largely sympathetic to this understanding, they also suggest that consideration of resilience should not be abandoned.
The papers offer insights into how communities’ experiences and strategies of resilience often diverge from the ambitions of international actors. They demonstrate that micro-level studies of real people’s experiences of post-conflict recovery allow space for wider comparative and theoretical insights to emerge.

Moral Spaces and Sexual Transgression: Understanding Rape in War and Post Conflict

Evocative language describing rape as a ‘weapon of war’ has become commonplace. Although politically important, overemphasis on strategic aspects of wartime sexual violence can be misleading. Alternative explanations tend to understand rape either as exceptional — a departure from ‘normal’ sexual relationships — or as part of a continuum of gendered violence. This article shows how, even in war, norms are not suspended, nor simply continue. War changes the moral landscape.
Drawing on ethnographic research over 10 years in northern Uganda, this article argues for a re-sexualization of understandings of rape. It posits that sexual mores are central to explaining sexual violence, and that sexual norms — and transgressions — vary depending on the moral spaces in which they occur. In Acholi, moral spaces have temporal and spatial dimensions which help explain the occurrence of some forms of sexual violence and the rarity of others.

After rape: justice and social harmony in Northern Uganda

This thesis explores responses to rape in the Acholi sub-region of northern Uganda, based on ethnographic research in two villages. Northern Uganda has been at the heart of international justice debates in the context of ongoing conflict between the Lord’s Resistance Army and Ugandan government. Two opposing representations of Acholi society have emerged: as innately forgiving and able to deal with mass crime through traditional justice; or as needing and often supporting formal legal justice. These characterisations miss crucial aspects of Acholi reality, including the profound value of social harmony, and deep distrust of distanced authorities. Experience of rape are predicated on understandings of wrongdoing related to challenges posed to social harmony.
This thesis adds empirical, locally-¬grounded, and culturally-¬specific evidence in support of a more nuanced explanation of rape and its aftermath than is familiar in the analytical/normative frameworks in post-¬atrocity justice debates or anti–rape feminist activist discourse.

Humanitarian Remains: Erasure and the Everyday of Camp Life in Northern Uganda

The impacts of protracted displacement can be understood through the spatial and material afterlives of war. This article examines leftover aid rations, archives, former displacement camp sites and even unmarked graves as evidence to better understand what happens when people try to return “to normal” after decades of war between the government and Lord’s Resistance Army in Northern Uganda. It asks what narrative and material erasure implies for survivors who seek to create memorials to reflect on the war and have come to find the past destroyed. Understanding how forgetting occurs, whether intentional or not, illuminates the difficulty of using archival material or artefacts as tools for remembrance projects.
The article undertakes an examination of the everyday experiences of displacement and traces of aid assistance to show how memorial efforts can better make sense the past in the present

Lessons learned from implementation of a national hotline for Ebola virus disease emergency preparedness in South Sudan

The authors conducted a descriptive analysis on quantitative data from call logs reflecting 22 weeks of South Sudan’s Ebola alert hotline, along with thematic coding of qualitative data collected routinely. The hotline was set up during the preparedness phase of an outbreak in neighbouring DRC. Only one EVD alert was generated during the entire period.
However, the authors argue that despite a large number of missed calls, the high number of callers reporting symptoms and asking questions suggest the role of the hotline was understood.

Assessment of infection prevention and control readiness for Ebola virus and other diseases outbreaks in a humanitarian crisis setting: a cross-sectional study of health facilities in six high-risk States of South Sudan

This study uses data from a structured questionnaire to assess the readiness and capacity of 151 health facilities across six states in Couth Sudan. It found that facilities most lacked a coordination committee structure (13.19%), guidelines and SOPs (21.85%), vector control (22.02%), staff management (30.63%), and appropriate training (33.64%). Components most commonly found included integrated disease surveillance and response capacity (69.83%), medical waste management system (57.12%) and infrastructure compliance (54.69%) – but large gaps still remained even in these.
The authors recommend developing and implementing a comprehensive and long-term infection prevention and control strategic plan as part of the country’s broader health sector recovery planning.

Analyses of the performance of the Ebola virus disease alert management system in South Sudan: August 2018 to November 2019

This research paper analysed the performance of the Ebola alert management system, established in response to the Ebola outbreak in DRC in August 2018. EVD alerts reported in South Sudan in 2018-19 were anlaysed using quantitative and qualitative data.
Strengths identified included the existence of a dedicated national alert hotline, case definition for alerts and rapid response teams. Weaknesses included the occasional inability to access the alert toll-free hotline and lack of transport for deployment of the rapid response teams which often constrain quick response.

Community Approaches to Epidemic Management in South Sudan: Lessons from local healthcare systems in tackling COVID-19

Recognising the long experience and knowledge South Sudanese people have of infectious diseases and their responses, this research documents the various community infectious disease management strategies employed in the Yei, Juba, Wau, Malakal, Aweil West and Rubkona areas. Such responses tend to rely on symptomatic identification, the containment of potential infections through locally specific methods and creative treatment.

Using feminist ‘reflexive practice’ to explore stress and well-being of local researchers in South Sudan

This article shares key findings and offer personal reflections on and suggestions for improving gender-based violence research using feminist methods. The authors reflect that while they themselves valued the sharing of personal reflections on emotional challenges that the research team faced, their South Sudanese colleagues did not find these approaches very useful. They preferred to discuss technical challenges and placed emphasis on the importance of professionalism.
They conclude by arguing that more culturally diverse feminist research tools are needed, as well as better recognition of the crucial role played by national researchers in international research projects.

Participatory Ethnographic Evaluation and Research: Reflections on the Research Approach Used to Understand the Complexity of Maternal Health Issues in South Sudan

How can contextualised data be collected in a short time in conflict-affected sites? This paper shows how a Participatory Ethnographic Evaluation and Research (PEER) approach can overcome many of the challenges of conducting research in such conditions. Here, the authors trained South Sudanese marginalised women to design research instruments, then used them to collect and analyse qualitative data.
The article reflects on the research process, highlighting benefits and critiques of PEER approaches in conflict-affected settings.

Mental health in South Sudan: a case for community-based support

Based on personal reflections of the authors who were engaged in mental health and psychosocial support programmes in South Sudan between 2013 and 2016, this article illustrates the constraints and challenges facing the sector at the time. The authors emphasise the importance of following an integrated, community-based model of psychosocial care.
To aid in achieving this, the paper explores the roles and responsibilities of different local stakeholders who can and should be involved in such community-based support.

Measuring health system resilience in a highly fragile nation during protracted conflict: South Sudan 2011–15

Complementing real-time data with survey data collected in South Sudan at independence (2011) and following 2 years of protracted conflict (2015), this study constructed and then compared a resilience index and stress index.
Overall maternal, neonatal and child health coverage levels were low, but the authors found that measures of health system resilience and stress are not always negatively associated, with for example Central Equatoria State displaying health resilience and high system stress.

“Économie de la débrouille à Kinshasa informalité, commerce et réseaux sociaux”

Comment, dans un contexte de crise économique et sociale durable, les citadins réinventent-ils les moyens de leur survie à Kinshasa ? C’est à cette question que cet ouvrage s’attache à répondre. On y trouve une description ethnographique minutieuse des dispositifs microsociaux qui permettent aux citadins-commerçants d’approvisionner la ville et aux citoyens ordinaires de continuer simplement à vivre.
Le livre plonge ainsi le lecteur dans les multiples formes de la « débrouille » qui organisent l’univers du petit commerce dans les marchés de la ville de Kinshasa. La créativité de la débrouille kinoise ne cesse d’étonner.

War, Displacement and Rural–Urban Transformation: Kivu’s Boomtowns, Eastern D.R. Congo

This article addresses rural–urban transformations in the war-torn Kivu provinces. The spectacular growth and development processes of fast-expanding boomtowns in Kivu’s rural areas serve as an entry point to investigate the relationship between conflict, displacement, urbanisation and development in Eastern D.R. Congo.
Based on qualitative research on urban expansion in different smaller towns in North and South Kivu, this article analyses the characteristics of these ‘new’ urban spaces. It demonstrates that boomtowns represent centres of opportunities as well as contestation, and that they play an important role in the economic dynamics of development as well as in the political dynamics of stability and conflict.

Authority that is customary: Kitawala, customary chiefs, and the plurality of power in Congolese history

This paper uses the history of the religious/healing movement Kitawala in the Democratic Republic of Congo as a lens to explore the relationship between forms of state-sanctioned “customary” authority and alternative nodes of “authority that is customary.”
Focusing on three different case studies from different eras of the colonial and post-colonial history of Kitawala, the article explores the history of how the movement became part of the broad field of authority in Congo – at times cutting across, at times transforming, and at times subverting or fracturing the authority of customary chiefs.

Home Is Where the Heart Is: Identity, Return and the Toleka Bicycle Taxi Union in Congo’s Equateur 

While many ex-combatants in the DRC continue to be re-recruited into militia groups, one group that has reintegrated successfully is the Toleka—a several-thousand-strong group of ex-combatants who returned (or remained) in the provincial capital of Mbandaka (Equateur province). The Toleka formed a bicycle-taxi organization and unionized its membership, providing protections and collective-bargaining authority to the group, while providing a public good. It also helped to reshape identities, produce a sense of civilian solidarity and provide a bridging function from life in the military.
This article looks at how this organization was formed, how the former fighters identified and capitalized on a local need and the conditions that allowed them to successfully unionize and protect their rights as they re-entered civilian life.

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