The Quest for Treatment. The Violated Body of Nodding Syndrome in Northern Uganda


Karin van Bemmel

Department of African Languages and Cultures, Ghent University, Belgium



Nodding syndrome is an unexplained affliction that affects thousands of children in northern Uganda. It is characterised by episodes of repetitive dropping forward of the head and often accompanied by convulsions. Symptoms were first reported in Uganda around 1998, during two decades of violent conflict between the Lord’s Resistance Army and Ugandan government. Violence and politics have been assimilated into local narratives on nodding syndrome and illness experiences are connected to the trauma of past conflict. This paper provides insight into how narratives on nodding syndrome are affected by the experience of conflict and how they in turn shape responses to illness. Attention is paid to the complex politics of illness and healing in the context of a pluralistic medical system.



Her arms are adorned with bangles and two colourful necklaces decorate her neck. She carefully chooses her words while sharing knowledge on the poorly understood affliction that recently emerged in this area. ‘During the past, it was not there. Nodding syndrome started happening during the era of the rebels. People were abducted and burned in their huts. They were killed for no reason. That is when this illness started coming’. The story of ajwaka Apira[1] resonates with the many narratives I heard while spending countless hours with affected family members at their homes, in health centres and during burial ceremonies. ‘I know it’s the war that has brought this illness’, the mother of a young, shy-looking girl explains. ‘A lot of guns were fired, the ground was shaking. And the people who died are now cen, evil spirits, attacking the [afflicted] children’. An elderly man softens his voice when speaking about his experiences with violence: ‘During the period of war, people saw many different kinds of killing. Some people were slaughtered with pangas, some were beaten to death. Others were burned in the house and some were shot with guns’. In the surrounding area several memorial monuments show the names of numerous people who lost their lives during the twenty years of conflict in the northern part of Uganda.

    Based on fifteen months of qualitative fieldwork and ninety in-depth interviews with affected families, health workers, politicians and spiritual healers in Kitgum District (2012, 2013 and 2014), this paper aims to create insight into the conceptualisation of nodding syndrome (NS) in relation to conflict, politics and the quest for treatment. First, I focus on the context in which meaning-making takes place in order to explore the relationship between health, conflict and politics. Attention is paid to the political connotations of NS and responses from the Ministry of Health. In the second part, this paper discusses the quest for treatment and the different non-biomedical actors involved in this process, shedding light on illness management in the context of a pluralistic medical system. The narratives on nodding syndrome illustrate how illness experiences are affected by conflict and how these narratives in turn shape responses to illness.

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[1] I am using pseudonyms throughout.