A psychologist specialized in treating former child soldiers told the International Criminal Court (ICC) that the issues most important to former child soldiers are stigma, their interrupted education, and lack of a livelihood.

Michael Gibbs Wessells told the court on May 15 that former child soldiers did not rank their mental health as a top priority. He said the focus of many mental health specialists on providing clinical diagnosis and treatment to former child soldiers was “a cookie-cutter approach”.

Wessells said rehabilitating former child soldiers should include listening to them and combining Western psychiatry and psychology with traditional healing.

“Young people often tell me that stigma is a bigger problem than presumed or actual mental illness. Others say it is really the loss of education,” said Wessells.

Wessells said some former child soldiers he has worked with told him getting a livelihood mattered most to them.

He said some of them told him, “‘I have no livelihood and without livelihood I can’t get married’ or, if it is a woman, ‘I can’t support my children’”.

Wessells is a professor of clinical population and family health at Columbia University. He was testifying in the trial of Dominic Ongwen, a former commander of the Lord’s Resistance Army (LRA). Ongwen has been charged with two counts of war crimes for his alleged role in conscripting child soldiers between July 2002 and December 2005.

Ongwen has also been charged for his alleged role in attacks on four camps for internally displaced people (IDPs), as well as sex and gender-based crimes. In total he has been charged with 70 counts of war crimes and crimes against humanity. He has pleaded not guilty to all counts.

Wessells was called as an expert witness for one group of victims in the trial. This group of 1,501 victims is represented by a legal team led by Paolina Massidda. Wessells told the court on May 15 that he travelled to northern Uganda on three separate occasions, including when the conflict between the LRA and the Ugandan government was ongoing.

He said he went to northern Uganda in 1998, between 2006 and 2007, and between 2008 and 2011, and worked on child protection issues during those trips. He said he worked with the Christian Children’s Fund during these trips, and his last position with the organization was as a senior advisor on child protection.

During the May 15 hearing, Massidda led Wessells through the process of admitting a report he wrote into evidence as prescribed by Rule 68(3) of the ICC Rules of Procedure and Evidence. Massidda did this because Trial Chamber IX decided on March 6 to allow Wessells’ report to be entered into evidence using this provision.

Under Rule 68(3), a report can be admitted into evidence if the author has no objection. On May 15, Wessells told the court he did not object to his report being entered into evidence. The rule also requires a witness is present in court for questioning by lawyers and judges.

On May 15, Massidda asked Wessells how Acholi culture could be used to help reintegrate former child soldiers into their community. He said one aspect of Acholi culture that could be useful is the rituals used when someone shows cen, or having a spirit or spirits in them.

“Local people will not accept a former child soldier back if that former child soldier exhibits cen. They will be fearful. They will be concerned about that discord. So, these rituals will be useful” to their reintegration into society, said Wessells.

He said one former child soldier described to him what happened to him when he had cen.

“I can’t sleep at night. I can’t sleep because the spirit of the man I killed comes to me at the night,” Wessells reported the boy telling him.

He said he and others working with the boy took him to a traditional healer who washed him with substances that were believed to wash away bad spirits. He said the boy was seated on a stool and then the healer asked him to step out of that space and he was believed to cleansed of the spirit. Wessells said similar rituals were conducted for former child soldiers in Sierra Leone, Congo, and Liberia.

Later Wessells was asked whether he knew if LRA members also experienced cen. He said there was evidence they did. He was also asked if he would recommend that a mental health specialist consult with a traditional healer to help in diagnosing cen.

“I think it’s a responsibility for all of us to listen first and to try and understand and empathize with local people. In the case of cen, I think a lot of harm got done by not listening,” replied Wessells. He said many former LRA members who said they were experiencing cen were told to pray and they would be okay.

“I think for people who are clinicians it would be of huge help to expand their basket of remedies. To actually collaborate with selected traditional healers. Just to be clear cen is not reducible to PTSD (post-traumatic stress disorder) and vice versa,” continued Wessells.

Massidda asked Wessells about the psychological state of children who lived in IDP camps during the conflict in northern Uganda but were never abducted. He said it was like that of children who had been abducted.

“They see death and destruction. They see siblings being taken. They get trauma. They get depression at somewhat lower rates than children who were abducted. But the bigger problem I think is growing up with this constant stress,” said Wessells.

“I think reintegration programmes go wrong when they focus only or primarily on the abducted children. We need to focus on the children who were not abducted,” said Wessells.

Another line of questioning Massidda pursued with Wessells was to ask him about the resilience of former child soldiers and whether there were things that could be done to overcome what they experienced as child soldiers.

“I would say that it is very possible for most children who have been in the LRA, given appropriate support … to be able to move forward in their lives and achieve resilience. However, I would be reluctant to talk about overcoming completely … It takes a lot of work and it takes time. Five years to 10 years,” replied Wessells.

Thomas Obhof, a lawyer representing Ongwen, asked Wessells a series of questions on the brutal initiation into the LRA, on women exploited by Uganda government soldiers and the selective information given to LRA members to keep them in the group.

Obhof also asked Wessells what effect the orders to kill over a long period of time had on the moral development of child soldiers.

“I think there are multiple ways of looking at this. I would say that, first of all, one has to do what one has to do to survive. This was a very common theme. They talked about how profoundly disturbing it was (to kill) but they did it because they had to survive,” replied Wessells.

“I think the evidence seems to be that most people retain their sense of right and wrong. When they describe the reason they had to escape, it was not just because life was difficult. It is that there were a lot of bad things being done. They didn’t like having to kill, to perform orders,” continued Wessells.

Wessells concluded his testimony on May 15. The next witness will testify on May 23.