BY: JOHN OKOT
29-year-old Francis Okello uses stray dogs as a form of therapy to treat people suffering from trauma, depression and anxiety in Gulu and Omoro districts in northern Uganda. Characterized by their untamed nature and mercurial temperament, stray dogs can be a potential danger to man, especially when you try to make a companion or a pet out of them. In case of a dog attack, one could sustain severe injuries and acquire infections like rabies since most stray dogs are not vaccinated.
His form of therapy is a rare phenomenon in East Africa where dogs are commonly used for guarding homes and hunting wild animals in villages. Tellingly, Okello’s Animal Assisted Intervention (AAI) works best through dog-human companionship, a gradual but effective process that has benefited many in northern Uganda, once the epicenter of the Lord’s Resistance Army (LRA) insurgency.
On my visit to the rehabilitation centre, I find Okello running a blue grooming comb through his dog, Tiger’s fur. Shortly after, he gives instructions to his patients, who are now ready with their panting dogs on leashes, for therapy. It’s clear that Okello is immensely passionate about his work: he is diligent, zealous and committed.
Having lost his sight during his childhood, Okello has for many years, battled with trauma.
“I was 12 when I became blind. It happened when a bomb exploded while I was digging in the garden in Amuru with my father,” Okello, bespectacled with dark glasses recalls. “Sleepless nights, nightmares and self-hatred, these are the things that nearly killed me. I was stigmatized by people to the extent that I tried to commit suicide on several occasions.”
During that time, Okello says that the mental unit in Gulu, was ‘limping’ with inadequate medical services, especially in the area of psychiatry.
“Government’s focus on was providing relief items whereas areas mental health was barely looked into,” he says. “Health facilities were also insecure. Rebels would loot the few medical available medical supplies and people like us had to nurse our illnesses from home.”
This was during the two-decade LRA war that was led by warlord Joseph Kony, leading to the deaths of tens of thousands of people and displacement of 1.5 million people internally. Ministry of Health estimates that 7 in 10 people in northern Uganda were traumatized by LRA war. Post Traumatic Stress Disorder (PTSD) is an anxiety disorder characterized by intrusive re-experience, (flash backs, nightmares), avoidance of trauma-related stimuli and thoughts, negative alterations in mood and changes in arousal and reactivity, like angry outburst and hyper vigilance.
Due to this alarming situation, it was found in a 2014 study by Refugee Law Project, that northern Uganda was going through a ‘mental health insurgency’, with the highest number of suicide cases, five out of 10, linked to PTSD. Amidst all these difficulties, Okello’s resilience kept him going, until 2008 when he glimpsed a ray of hope.
While at Gulu High school, an institution for the blind, Okello acquainted himself with a neighborhood dog called tiger.
“Tiger would come to my dormitory at night. He would also walk me to the toilet whenever I wanted ease myself,” Okello narrates, his face beaming. “Life started changing when I got close him. I felt good about myself that I didn’t have to rely on people all the time.”
It is at this point that Okello got himself a companion and consequently changed his life, from being a solitary person to a people person.
“I began chatting more with people thanks to Tiger. I also met the love of my life and wife,” the father of two says with glee.
The Dog Comfort Project.
Upon graduating with a Bachelors Degree in Community Psychology from Makerere University in 2015, Okello founded the Dog Comfort Project, which would be the first therapeutic program in Uganda to rehabilitate people with trauma through dog therapy using troubled, injured, homeless and malnourished dogs to treat his patients. In the early days, Sarah Schmidt, owner of The Big Fix, the biggest veterinary clinic in northern Uganda, provided Okello with space and funding to start his project.
“The thing about dog therapy is that it works best with dogs that went through hardships, if both parties are to bond well and heal together,” he says.
Since 2015, more than 300 patients have benefited from the Dog Comfort project and at the moment, 10 patients are currently receiving this kind of therapy.
His Project’s cycle starts with identifying potential patients through conducting an outreach through local leaders on the grassroots. Selected patients and dogs then undergo tests where patients are assessed to ascertain their medical condition, while dogs are subjected to temperament tests before bonding them. Male dogs are neutered while female dogs are spayed. The bonding process is gradual, and usually takes days or even weeks before a mutual relationship is established between both parties.
Training activities like washing, combing and grooming dogs are some of the positive reinforcements encouraged, for bonding is to be strengthened, according to Okello.
In due course, counseling sessions are also routinely held, where patients are expected to share their experiences and progress with their peers. After five months of therapy, patients that show signs of improvement are awarded a certificate and a dog. The patients are frequently followed up with during recovery and they are sometimes to share their success stories with the new patients, as a way of motivating them and demonstrating to them that they too, can heal from trauma.
Incorporating dogs in PTSD rehabilitation
AAI, sometimes called Canine Assisted Intervention (CAI), is rare in East Africa, unlike western countries where it is well documented and practiced. A 2017 study ‘How are service dogs for Adults with PTSDs integrated with rehabilitation?,’ by Centre for Developmental and Applied Psychological Science in Denmark, indicates that a dog’s presence has a positive effect on health, mood and quality of life of a patient by increasing levels of Oxytocin– an anti-stress agent that lessens depression and anxiety.
PSTD patients re-experiencing flashbacks can identify a dog as a compassionate reminder that danger is no longer present since its presence elicits positive emotions that counter the emotional numbing.
Animal Assisted Prolonged Exposure (APPE) combined with existing treatments could also encourage hesitant PSTD patients to participate and complete treatment since they would be less anxious in the presence of their companions. Besides, therapy dogs can also act as social facilitators that connect people, reduce social isolation by reducing anxious arousal.
Patients speak out
35-year-old Filda Akumu, formerly abducted at the age of ten, was traumatized for 15 years upon returning from captivity. Witnessing her father and two brothers being hacked to death with a machete was something that she never thought she get over with.
“I would see rebels beheading my family in my nightmares,” Akumu, who now volunteers at the project narrates, “But when I underwent Dog therapy, I have never felt better. In fact, my life dramatically changed when I met my dog—Sadiq.”
Her counterpart, Opoka, 58-year-old former LRA rebels and UPDF soldier used to see faces of dead people every night.
“When I escaped from the rebels, I thought all my problems would be over if I joined the UPDF, but I was wrong,” Legatek says. “They used to get tormented at night as well. I would hear voices of dead people crying for help. But when joined dog therapy, it all changed.”
Opoka has never felt better. In fact, these days, he shares his room with dog, Legatek.
Despite the therapy being free of charge, Okello says some people still demand to be paid before they can receive treatment.
“The mindset of the people here is still poor because they think that we are using their names to receive donor funds for the project, which is not the case here,” he notes.
Limited manpower is also a challenge for the project since his available work force is stretched thin due to workload.
“Being financially constrained, I have only two staffs but sometimes I work alone yet this is challenging, considering my visual impairment,” he says.
Once he stabilizes financially, Okello hopes to expand his project to benefit people in the far-flung places in northern Uganda where many people continue to battle with mental illness like trauma.
“Many people in northern Uganda are sick and they indulge in drinking alcohol as a way of fighting their trauma,” He says. “The regional hospitals are always out of drugs yet mental illness needs long time medication,”
Alcohol and substance abuse have also remained a big challenge in northern Uganda yet most cases of mental illnesses continue to rise as a result of this habit. Districts like Gulu and Kitgum in northern Uganda have now enacted ordinances banning the sale of sachet gin (waragi) in the region to curb the problem.
As trauma remains widespread in northern Uganda, especially Acholi sub region, Gulu regional referral hospital, which serves eight districts and sometimes people from South Sudan, continues to suffer drug stock outs. Last year, an Indian Community together with some pharmaceutical companies donated drugs to Gulu mental unit, following media reports that the facility had been facing a drug crisis for the past years.
But as we take steps and find ways of fighting mental illness in northern Uganda, people like Okello will continue to play their part in fighting trauma in their communities, albeit the little resources they have.
“I am here to help anyone with trauma because I was once like them. I always feel great when my patients can have a good night sleep,” Okello adds, as he chuckles.