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The pastoral life is the most suitable means of subsistence in Karamoja (© Tim Dirven / VSF).
After four long years of ethnic conflict in north-eastern Uganda, the population there is gradually recovering. Veterinarians Without Borders made a major contribution to recovery there through a comprehensive approach: humanitarian aid, peace dialogues, repair of water pumps, vaccination of livestock and so on.

Karamoja is a region in north-eastern Uganda, with its 27,528 km² slightly smaller than Belgium. Its 1.2 million inhabitants – the Karamojong – live mainly off cattle. Dressed in colourful robes, they have been herding their animals there for centuries through the vast savannah landscapes in search of grass and water.
Ruthless looting
But Karamoja is very poor. In 1980, an extremely severe famine hit the region. Moreover, conflicts regularly arise between the different ethnic groups.
After a decade of relative peace, fighting flared up again starting in 2019. And that came on top of an already explosive cocktail of poverty, corruption, political violence and climate disruption. Not only were cattle stolen, but entire villages were ruthlessly looted.
The most vulnerable pastoral communities were particularly affected. Not only did they lose their livestock and all their other possessions, but many human lives were also lost.
A veritable hell, then, for the Karamojong. In desperation, they turned to growing crops. But then again they had to deal with extreme drought and infestations of fall armyworms. Result: massive crop failures.

Cutting down wood in the ecologically valuable mountains is only an emergency solution because it can lead to flooding, among other things (© Tim Dirven / VSF).
Chopping wood
To make matters worse, food prices went through the roof due to the war in Ukraine. Many had no choice but to eat wild fruits (desert dates, tamarind pods, etc.) and grass seeds.
Chopping wood in the ecologically valuable mountains was also a stopgap measure. They then sold this as cooking wood and charcoal. But in doing so, they set in motion a vicious cycle: without trees, water flows faster to the plains. This encourages flooding and destruction of crops and also increases the risk of livestock epidemics.
In short, conflicts as well as climate disruption pushed people into a trap with no way out. The figures speak volumes: between June and September 2022 alone, more than 2,000 people starved to death; 41% of the population faced severe food shortages.
Still, the situation today is relatively peaceful and the population is gradually recovering. Only 5% of the Karamojong still suffer from lack of food. And the activities of Veterinarians Without Borders (VWB) – a partner of Belgian Development Cooperation – have certainly contributed to this.
Ngorok Angolekori: Without the unconditional gift, I would not be alive today
"I used to keep chickens, but they were all stolen," Ngorok Angolekori testified in late 2022. "When this year's harvest also failed and grain supplies ran out, it became very difficult to find enough to eat. My daughter died of starvation just after the birth of her third child. In June 2022, the three-month-old baby also died. If all the goats and cows in the village had not been robbed, we would have been able to keep the infant alive with milk."
Ngorok Angolekori was one of the beneficiaries who received a monthly gift (see text). "Without this unconditional gift, I would not be alive today. How you see me now is not how I was a few months ago. I was dying then. I did occasionally get a mouthful of food from the people in my community, but I was no longer able to fetch water from a kilometre away."

For many, a small sum of cash literally meant the difference between life and death (© Tim Dirven / VSF).
A comprehensive approach
In 2023, most cattle rustlers finally laid down their arms, in part following a disarmament campaign by the Ugandan army. A favourable rainy season also helped matters.
To firmly anchor that positive development, VWB came up with a comprehensive approach. Crucial to this was the combination of humanitarian aid – for immediate needs – with peace-building and development activities, for the longer term. In technical terms, we speak of the 'HDP nexus' – the synergy between humanitarian, development and peace.
The focus was on restoring livestock production. After all, cattle-breeding is the most suitable livelihood in Karamoja. VWB developed a variety of actions to this end:
- 1,665 vulnerable households received cash: 20 to 25 euros every month for five months to pay for food, health care and housing. A small sum, but the difference between life and death for many (see box with testimony). The homeless, people with disabilities, the elderly and the chronically ill were especially eligible. This unconditional cash distribution allows them to regain control of their lives.
- Over 70 local associations were offered training courses on peace-building. Along with the more than 900 trained individuals, VWB then promoted peace dialogue between communities through various media channels, such as radio broadcasts and theatrical plays performed by peace caravans. This led to the voluntary surrender of hundreds of weapons. More than 30,000 cattle-breeders – even from Kenya's neighbouring Turkana region – thus gained access to communal grasslands without risk of violent confrontation.
- Young cattle rustlers who turned in their weapons received sessions on conflict resolution and trauma treatment. In addition, they each received two goats, which allowed them to build a future independently and reintegrate into the community.
- VWB repaired 86 water pumps that provide clean water to 37,500 cattle-breeders and their livestock.
- VWB vaccinated 122,786 animals to maintain the health of the herds for 49,846 cattle-breeders. After all, floods make livestock far more susceptible to deadly infectious diseases such as anthrax and foot-and-mouth disease.
- In savings groups, people learn to save: 53 groups of 15 to 30 villagers each meet weekly to save money by contributing to the savings fund through one or more shares. They also make a mandatory contribution to a social security fund. Those who save can then also borrow money to set up new activities, thus diversifying their income. This includes setting up a retail business or starting a brewery in addition to their main business. That way, they can overcome unexpected setbacks such as looting or extreme drought. VWB has been committed to savings groups for 15 years.

Vétérinaires Sans Frontières repaired 86 water pumps for 37,500 cattle farmers (© Tim Dirven / VSF).
The successful approach shows that conflict can indeed be defused, provided that the needs of all are considered and understanding is fostered between communities.
A comprehensive HDP approach proves crucial in this regard. Sustainable results can only be achieved if you properly understand the context and combine aspects of humanitarian aid, development cooperation and peace-building (mediation). Only then can you rebuild a solid foundation so that people can develop again.
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