IN A NUTSHELL
Author's Executive Summary
This programmatic study explores the impact of the 2025 US government funding cuts on refugee wellbeing in the Rhino camp refugee settlement, Bidibidi, and Pagirinya settlements, West Nile Uganda.
It addresses the research question: “How did the U.S. Government funding cuts affect refugee wellbeing across multiple service sectors, and what do refugees’ coping strategies reveal about market-viable and sustainable interventions?” The study addresses growing concerns among humanitarian actors and refugee communities regarding the sustainability of essential services following the funding reductions, which have undermined previous development gains and heightened the risk of severe outcomes.
Based on twelve semi-structured interviews which included seven refugees, three community leaders, and two NGO staff, the thematic analysis identified several critical effects, including; increased food insecurity, collapse of livelihood opportunities, heightened gendered risks such as gender-based violence (GBV) and early marriage, an education crisis marked by school dropouts and child labor, deteriorating health conditions including medicine shortages and suicides, and deepening social fragmentation.
Participants described these changes not as isolated sectoral reductions, but as a cumulative withdrawal of support affecting multiple aspects of daily life. Coping strategies included informal labor, reduced food consumption, migration, and reliance on social networks often accompanied by increased exposure to economic and social risks. Crucially, the findings highlight a convergence between economic deprivation and heightened exposure to exploitation, particularly among women and girls, underscoring the need for integrated interventions that simultaneously address livelihoods, protection, and psychosocial wellbeing. Recommendations highlighted four key priority actions:
Establish market-linked vocational hubs and provide startup kits for refugees in sectors such as tailoring, shoemaking, farming, and carpentry, implemented through refugee-led groups.
Formalize community-based loans and savings cooperatives to enhance financial resilience.
Train women and youth in their diversities as peer facilitators to lead GBV in refugee women-led safe spaces.
Develop faith-based farming initiatives to support and sustain school feeding programs, complemented by participatory reviews of vulnerability databases conducted by community leaders.
These proposed investments directly respond to livelihood gaps and gendered vulnerabilities while fostering the market-oriented self-reliance that refugees themselves demanded.
It is important to note that this study represents a small qualitative sample involving twelve participants, therefore findings are indicative rather than generalizable, however, they provide critical insight into how funding shocks are experienced at the community level – specifically in refugee settings in Northern Uganda. As an intern researcher with limited time and resources, my outsider positionality, inherent power dynamics, and recurring themes may have introduced bias, while the study’s limited scope constrains its scalability and broader applicability.
By Dania Alamy
Student from the Hebrew University of Jerusalem, and Communication and Advocacy Intern at the Alliance of Women Advocating for Change (AWAC) Uganda
Contributors: SAFER HEELs consortium members in Uganda; that is; Civitas Africa in Bidi Bidi Refugee Settlement in Yumbe, Human Rights Development (HRD) in Pagirinya Refugee Settlement in Adjumani, and the Alliance of Women Advocating for Change (AWAC) in Rhino Camp Refugee Settlement in Terego and Madi Okollo
When Aid Shrinks
The impact of U.S. Government Funding Cuts on Refugee Wellbeing in Uganda
Background and Objectives
According to interviewees, the initial refugee experience was characterized by severe deprivation marked by displacement, loss of property, inadequate education access, under-resourced health facilities, insufficient clean water, and pervasive insecurity, leaving living conditions extremely poor. Over time, interventions by humanitarian partners, such as the construction of schools, recruitment of teachers, establishment of functional health centers, improvement of WASH (Water, Sanitation and Hygiene) infrastructure, and delivery of livelihood trainings in tailoring, carpentry, creation of village saving and loans associations such as CHLEGs (Community Health and Livelihoods Enhancement Groups) and salon work helped lay the groundwork for self-reliance. Additionally, peer support networks and women-led safe spaces provided psychosocial assistance, income-generating opportunities, and protection from GBV, thereby strengthening both resilience and social cohesion within the community. However, successive crises including the COVID-19 pandemic, global economic disruptions, and the abrupt 2025 USA government funding cuts have significantly eroded these earlier gains.
In a letter addressed to the United States government, UN experts called for urgent action after reports suggested that nearly 100 deaths per hour had occurred following President Donald Trump’s issuance of Executive Order 14169 on January 20, 2025, which suspended foreign aid pending review. Current estimates project that the aid suspension could result in more than 350,000 deaths globally, including over 200,000 children, while also abruptly terminating USA government aided programs operating in Uganda (United Nations Office of the High Commissioner for Human Rights, 2025).
At the same time, Uganda continues to host one of the world’s largest refugee populations. According to Uganda’s Office of the Prime Minister, the country hosted 1,961,518 refugees and asylum seekers as of October 31, 2025, of whom 55.1% are South Sudanese (Office of the Prime Minister, 2025). Many reside in northern settlements such as Rhino Camp, Bidi Bidi, and Pagirinya, which operate under Uganda’s progressive refugee policy framework granting access to land, freedom of movement, and the right to work. However, the sustainability of this model remains heavily dependent on international humanitarian assistance. The abrupt withdrawal of funding has undermined the Comprehensive Refugee Response Framework, revealing the fragility of self-reliance policies in contexts of acute resource scarcity. To advance advocacy and inform policy responses, the study pursues four key objectives:
- Documenting the cross-sectoral impacts of funding cuts to understand the scale of disruption;
- Mapping patterns and severity of damage across essential domains;
- Capturing refugees lived experiences, coping strategies, and cumulative vulnerabilities amid declining assistance; and
- Formulating evidence-driven, localized, and sustainable programmatic recommendations that emphasize long-term resilience over short-term emergency relief.
Methodology
Study Design and Sampling
This qualitative study utilized semi-structured individual interviews (IDIs) and key informant interviews (KIIs) to capture refugees lived experiences following 2025 USA government funding cuts. Purposive sampling recruited 12 participants across Rhino Camp, Bidibidi and Pagirinya, settlements: 7 refugees (diverse gender/role/post-2025 exposure), 2 NGO staff, and 3 community leaders. Eligibility required direct experience with humanitarian assistance changes; recruitment occurred through settlement partners and community networks.
Data Collection
Thirty-to sixty-minute in-person interviews were conducted within the settlements between September and November 2025, primarily in English. The interview guide covered areas including informed consent and demographics, perceptions of aid reductions, changes in service access, household coping mechanisms, and vulnerabilities spanning food security, livelihoods, education, health, gender, and social cohesion, alongside participants’ recommendations. All sessions were held in private, comfortable settings, and data was collected through detailed field notes and audio recordings which were then transcribed. Researcher reflexivity was integrated throughout, with particular attention to positionality and power dynamics, mitigated through a conversational and participatory interviewing approach.
Ethics and Consent
Participation was entirely voluntary, with oral consent obtained prior to each interview after clearly explaining the study’s purpose, assurances of anonymity, participants’ right to withdraw, and the low-risk nature of the study. Confidentiality was maintained through the use of pseudonyms, and all identifying information was removed from transcripts. Data materials were securely stored in files accessible only to the researcher. Trauma-sensitive procedures were applied throughout to ensure participant safety and emotional comfort.
Data Analysis
Interview data underwent thematic analysis via a systematic multi-stage process: (1) transcription and organization of notes/transcripts; (2) open coding to identify recurring concepts; (3) grouping codes into categories reflecting cross-participant patterns; (4) consolidation into six overarching themes (food security, livelihoods, gender, education, social cohesion, health); and (5) validation through repeated data review and triangulation across settlements. Manual analysis without software ensured trustworthiness.
Findings
Evidence from Rhino Camp, Bidi Bidi, and Pagirinya indicates that these rapid funding cuts have not only deepened existing vulnerabilities but also triggered cascading structural breakdowns across critical sectors, including food security, livelihoods, education, and health. Drawing on interviews with refugees, community leaders, and humanitarian practitioners, this study contends that the funding cut extends beyond a mere reduction in aid, it systematically unravels a decade of developmental progress, forcing refugees to adopt risky coping mechanisms that undermine the principles of sustainable localization and long-term resilience.
Theme 1: Food Insecurity
The USA government funding cuts triggered drastic reductions in food rations, leading to acute hunger and increased mortality risk within the settlement. Many households reduced meals to once daily, disproportionately affecting the elderly and young children. The simultaneous rollout of a three‑tier vulnerability categorization framework excluded numerous households from continued support, dismantling an already fragile safety net.
1.1 Malnutrition
Food scarcity emerged as the most immediate outcome of funding withdrawal. Community leaders and residents described the absence of food as a critical threat to life, as some highlighted:
“As a community leader, I am constantly receiving complaints that there is absolutely no food available, even for those who are physically able to work.” (Peter*, BidiBidi Settlement)
“I have not received any food assistance for the past four months.” (Ruth*, BidiBidi Settlement)
Respondents recounted the physiological effects of prolonged hunger and the surge in malnutrition among vulnerable groups. At this point, Peter* added that:
“Children are becoming malnourished because there simply isn’t enough food.” (Peter*, BidiBidi Settlement)
Meanwhile, Samuel*, a refugee from Bidi Bidi refugee settlement noted that;
“People are experiencing severe malnutrition, and some are losing their lives because of it.” (Samuel, BidiBidi Settlement)
“In some cases, people sit in distress, and when asked what is wrong, they explain they have not eaten since the previous day. Malnutrition has become widespread.” (Joseph*, BidiBidi settlement)
Testimonies emphasized the disproportionate toll on older people, linking reduced food intake to rising mortality:
“The elderly have been hit the hardest… many older people have reduced their meals to just once a day. This has seriously affected their well-being, and this year we have witnessed a significant number of elderly deaths. “(Beatrice, Pagirinya Settlement)
These accounts collectively expose how hunger transforms survival into a daily struggle where age and vulnerability determine exposure to risk.
1.2 The Categorization System
A parallel policy introduced to mitigate the gaps resulting from the aid cuts had a three‑tier vulnerability categorization to determine eligibility for assistance. However, this was perceived to be discriminatory and not made in consultation from the community and its leaders. Participants described it as deeply flawed and exclusionary:
“In the settlement, we are currently divided into three categories: Category 1 for the most vulnerable, Category 2 for medium vulnerability, and Category 3 for those considered self‑reliant. However, this classification does not reflect the reality on the ground… We need a thorough reassessment in consultation with elected community leaders.” (Daniel, Pagirinya Settlement)
The data suggests that the categorization process resulted in the systemic exclusion of vulnerable individuals from food assistance:
“Category 3 includes people who are presumed to be stable or well-off. As a result, they have been completely excluded from receiving food assistance or any other form of aid… This has had a serious impact on us.” (Grace*, Rhino Settlement)
“Some individuals placed in Category 3 remain highly vulnerable and are unable to sustain themselves” (Daniel, Pagirinya Settlement)
“Many vulnerable adults are excluded if they are perceived as able to work” (Martha, Rhino Settlement)
Some respondents highlighted how specific vulnerable groups, particularly people with disabilities, remained inadequately supported despite small assistance programs:
“Among the most vulnerable groups are persons with disabilities. Although there is a small support program run by DRC that provides them with some assistance, the aid package is minimal, and many individuals are still not receiving the services they require.” – (Beatrice, Pagirinya Settlement)
Others emphasized the unclear eligibility criteria and bureaucratic barriers that prevent vulnerable individuals from regaining assistance:
“Eligibility is based on age and household composition, though the criteria are unclear. Many highly vulnerable people have been removed from food assistance despite their circumstances. Complaints can be filed at a help desk, but only a few cases are approved after strict review.” – (Martha*, Rhino Settlement)
The categorization process imposed an administrative form of exclusion, reducing complex vulnerability into rigid bureaucratic categories. The logic underlying these classifications detached assessment from lived reality, institutionalizing inequality and reshaping humanitarian aid into a system of conditional belonging where assistance could be withdrawn.
Food insecurity thus arose not merely from the scarcity of resources but also from the structural decisions that were forced to be undertaken due to the aid cuts which determined who was deemed entitled to survive. The withdrawal of rations caused by aid cuts and the implementation of exclusionary categorization due to the former, compelled families to adopt high-risk coping strategies, such as engaging in informal labor and young girls into transactional sex. In effect, the safety net did not simply weaken; it was systematically re-engineered to reproduce vulnerability as a persistent social conditions.
Theme 2: Livelihood Instability
Following the reduction in food rations, households attempted to adapt by transitioning toward cash transfers, subsistence cultivation, or informal labor. However, these strategies proved largely ineffective due to structural barriers which included limited access to land, seeds, tools, start-up capital, and markets. Consequently, individuals turned toward exploitative and risky labor, family separation or movements back to South Sudan despite the risks.
2.1 Agricultural Barriers
Participants highlighted the logistical and environmental constraints to farming rendered cultivation an unreliable coping strategy:
“Those who are able, walk about six hours to Rhobotolo, a farm provided by the UNHCR… to dig. Because they lack transport, they often stay there for some time, leaving their children behind.” (Joseph*, BidiBidi settlement)
Participants also described how logistical barriers undermine agricultural productivity. While funding was in place, humanitarian partners usually provided means of transport in the settlements, however without it, even self-reliant efforts are bound to collapse, as highlighted by the study participants;
“Aid cuts have made it much harder for households to cope. Even when refugees work hard to farm crops like simsim far from home, logistical challenges and theft during harvest discourage them and reduce their yield.” (Martha, Rhino Settlement)
“Even if someone has land to cultivate, the harvest is uncertain. Without money to buy good seeds, production is low, and poor weather makes it even worse.” (Samuel, BidiBidi Settlement)
“Stray animals are causing serious damage to our crops, and it’s almost impossible to sustain ourselves. Even with constant effort, success is unlikely because we lack the money needed to protect and maintain the land. Many plots have been farmed continuously for 8 to 10 years, which has reduced their productivity. On top of that, we face ongoing security challenges that add to our hardships.” (Daniel, Pagirinya Settlement)
Agricultural efforts were severely constrained by distance, depletion, and insecurity. Refugees often walked hours to remote plots, staying away from their families due to lack of transport, which exposed them to theft and crop loss. Limited access to quality seeds, erratic weather, and repeated cultivation on exhausted land further reduced yields, while stray animals and security threats compounded the challenges. As a result, farming, once seen as a path to self-sufficiency has instead crippled due to diminishing resources to sustain the efforts but also the slow returns due to the context..
2.2 Institutional Failures
The transition to cash assistance failed amid rising prices, while limited market access and flawed training programs further constrained income generation:
“After food aid was replaced with cash assistance, food prices increased. The small amount of cash provided was not enough to buy sufficient food.” (Daniel, Pagirinya Settlement)
“I earn money by washing clothes for others, but since the cuts, business has declined. There is no market, and by the end of the day, you often make nothing.” (Eammanuel, Rhino Settlement)
Several accounts also described how this economic pressure compelled some refugees to undertake dangerous returns to South Sudan:
“Some people return to South Sudan even though it is dangerous, and some lose their lives there.” (Samuel, BidiBidi Settlement)
“Right now, some people have left the settlement and gone back to South Sudan, leaving their children behind. But life there is also difficult, and the currency loses value when exchanged into Ugandan shillings.” (Daniel, Pagirinya Settlement)
The data further indicates that livelihood training programs introduced as alternatives to food aid, often lacked the resources necessary for practical implementation:
“Some trainings are provided, but participants do not receive startup kits, equipment, or capital. After three or four weeks, much of the training is forgotten.” (Daniel, Pagirinya Settlement)
“Some youths have been trained, but without equipment, they remain at home and their skills risk becoming useless over time.” ( Peter*, BidiBidi Settlement)
“There are only four machines, but many people need to use them.” (Ruth*, BidiBidi Settlement)
Institutional interventions like cash transfers and vocational training exposed a fundamental paradox in humanitarian policy; pre-existing livelihood strategies already demonstrated the gap between resilience discourse and structural barriers that trapped refugees in cycles of diminishing returns and dependency rather than autonomy. As USA government funding cuts eroded support, these constraints intensified, rendering programs performative and incentivizing high-risk coping strategies such as hazardous migration, informal labor, and short-term survival tactics that prioritized immediate needs over sustainable independence, ultimately revealing self-reliance as an ideological construct amid systematic economic exclusion.
Theme 3: Gendered Vulnerabilities
The USA government assistance cuts did not only produce food insecurity but reshaped settlement dynamics, amplifying asymmetrical gender hierarchies as women and girls absorbed economic shocks through heightened violence, labor burdens, and exploitation risks.
3.1 Gender-Based Violence
The findings reveal that economic deprivation does not operate in isolation but translates directly into heightened protection risks. As livelihood options shrink and food insecurity intensifies, women disproportionately absorb the consequences through increased exposure to gender-based violence, reflecting the tight interconnection between economic vulnerability and safety. More so, economic hardship and the breakdown of conventional male breadwinner roles have fueled domestic violence:
“Economic stress has increased cases of gender-based violence. Women previously relied on their own activities for income, but with no market opportunities, the situation has become much harder” (Grace*, Rhino Settlement)
“Domestic violence is rising, especially among married couples, as men’s inability to provide for their families often leads to conflict, with women most affected.” (Grace*/, Rhino Settlement)
“Hunger makes violence more likely at any time. Even love has become harder.” (Peter*, BidiBidi Settlement)
“Due to food cuts, rape cases are rising, but our community rarely reports them. Victims often show visible stress, fear, and withdrawal, affecting their daily functioning.” (Martha*, Rhino Settlement)
Scarcity destabilized gender norms, channeling male frustration into intra-household violence as presented by participants. This reveals violence as a structural symptom of economic collapse, where the erosion of traditional provider roles has enabled the manipulation of intimate relationships to the detriment of women.
3.2 The Feminization of Poverty
As a result of displacement and resource scarcity, women assumed roles integral to maintaining household survival amid diminishing institutional aid:
“Women have been particularly affected… as most households are led by women, including single mothers and widows … creating significant challenges.” (Angela*, Pagirinya Settlement)
“Sometimes I work in the garden or collect firewood to earn money to support my family. My mother remarried in DRC Congo, and since the war, my father’s whereabouts are unknown; he was a soldier, and we still don’t know where he is.” (Ruth*, BidiBidi Settlement)
These accounts illustrate the phenomenon commonly described as the “feminization of poverty,[1]” whereby women disproportionately absorb the economic and social costs of crisis (Chant,2006). This shift entrenched labor burdens, positioning women’s resilience as necessary, while simultaneously exposing them to further marginalization.
3.3 Gendered Risks in Public Spaces
The necessity of economic survival forced women into unsafe environments and risky labor, increasing their exposure to physical harassment and assault:
“Women are leaving the settlement to collect firewood… but in doing so, they face attacks, beatings, theft, and harassment.” (Daniel*, Pagirinya Settlement)
“The crisis has affected women who go into the bush to cut grass, exposing them to greater risk of rape, and there has been a noticeable rise in GBV cases.” (Angela*, Pagirinya Settlement)
Other respondents emphasized how the withdrawal of protective programs and safe spaces magnified these risks:
“The USA government-funded peer project ended, closing women’s safe spaces and livelihood activities like crafts and tailoring. With fewer resources, limited food, and no income-generating opportunities, women gradually stopped attending. The cuts and economic hardships increased stress and, as a result, cases of GBV rose.” (Beatrice, Pagirinya Settlement
Public spaces became gendered[2]( Doan,2010) danger zones as aid withdrawal eroded protective buffers, while economic desperation fused survival labor with heightened physical risks.
3.4 Female Youth Exploitation
Resource scarcity has driven girls into exploitative transactions to secure basic necessities:
“Malnutrition has forced many girls into early marriages, as they seek someone to provide food and support when their families cannot.” (Joseph*, BidiBidi settlement)
“Older men exploit undernourished girls, offering money or support in exchange, which often leads to early marriage.” (Emmanuel, Rhino Settlement)
“Teenage girls face so many unmet needs, food, sanitary materials, basic care, that they sometimes turn to men for support, resulting in frequent early marriages and pregnancies.” (Martha, Rhino Settlement)
“Sex work has become common among young girls in trading centers.” (Martha, Rhino Settlement)
“Food ratio cuts have driven some women and girls into sex work, not necessarily with the wealthy, but with anyone who offers better support than they currently have.” (Grace, Rhino Settlement)
These narratives reveal the economization of intimacy[3] (Constable,2009), where girls’ bodies and relationships become commodified as currency exchanged for food, security, and survival amid extreme scarcity. Across all themes, gendered vulnerability emerges not as an unintended consequence but as a structurally embedded outcome of intersecting crises. The USA government funding withdrawal triggered a redistribution of risk, with women’s labor, bodies, and social ties absorbing the fallout. Violence, feminized poverty, spatial dangers, and youth exploitation thus interconnect as manifestations of entrenched inequality, normalizing female vulnerability as the normalized routine survival.
Theme 4: Education Collapse
USA government funding cuts eroded the education system through institutional thinning, financial barriers, and informal survival economies, transforming education from right to commodity.
Participants described how hunger and poor health conditions directly undermine children’s ability to concentrate and remain in school:
“When it comes to school, the concentration is always low, often due to health issues or hunger. Some arrive without having eaten, which affects their learning, and children who cannot attend school often have to work instead.” (Joseph*, BidiBidi settlement)
4.1 Under‑staffed Schools
Staff reductions inflated pupil-teacher ratios and stripped pedagogical support:
“Schools are understaffed: teaching assistants who supported lower classes were first to be laid off, followed by some classroom teachers in both primary and secondary sections. The remaining teachers are overworked, and children are suffering.” (Daniel*, Pagirinya Settlement)
“Government schools cannot accommodate all the children, including those arriving from other areas. Classrooms are overcrowded, with too few teachers for too many students.” (Martha*, Rhino Settlement)
“Many teachers lost their jobs, and the remaining few cannot adequately attend to all students throughout the day. Classrooms were already insufficient before, but overcrowding has worsened.” (Joseph*, BidiBidi settlement)
“Quality has declined: NGOs used to train many teachers, which improved learning outcomes, but now that support is gone, and teaching capacity has diminished.” (Daniel*, Pagirinya Settlement)
These accounts depict a process of what could be termed “institutional thinning,” where schools formally remain but their capacity is progressively stripped away. Institutional thinning hollowed out schools’ functional core, substituting quality with overcrowding and overwork. This degradation shifted education from developmental space to mere containment, eroding its protective capacities.
4.2 School Dropout
Rising fees, and food insecurity shifted educational costs onto families which led to increased dropout, as children’s labor and income became integral to household survival.
Participants repeatedly described how families’ inability to cover school costs has forced many children to withdraw from education:
“Now many families cannot support their children’s schooling, and children are dropping out.” (Beatrice*, Pagirinya Settlement)
“Previously, Window Trust (NGO) would help pay teacher salaries, but now that support has stopped. The community tries to cover these costs, but families that cannot contribute see their children drop out.” (Emmanuel*, Rhino Settlement)
“Even children who want to attend school struggle because school fees and other requirements are difficult for families to meet, leaving some unable to go despite their willingness.” (Martha, Rhino Settlement)
Testimonies also described how in the prolonged absence of parents who travel for work, household responsibilities are transferred to children:
“School enrollment has dropped from over 3,000 to around 2,000 students. In some cases, parents are away for long periods working far from home, leaving children responsible for household duties. Just Yesterday, a parent discovered one of his children was not attending school while he was away digging far from the settlement for food. He had to search for the child and bring them back. When children skip school, parents sometimes only discover it later.” (Joseph*, BidiBidi settlement)
They also highlighted that as resources dwindle; children go out seeking jobs or money:
“More children are leaving school and spending their time on the streets, doing small jobs just to get food or buy basic items like clothes.” (Samuel*, BidiBidi Settlement)
Economic pressures marketized education[4](Natale & Doran,2012), positioning schooling as luxury against survival necessities. Parental absence compounded this, thrusting children into household management and street labor, where immediate income trumped long-term human capital. In this context, schooling is no longer a guaranteed right but a negotiated resource.
4.3 From Classroom to Street
As schooling became contingent on household financial capacity, many children were withdrawn from school. These dropouts fueled risky behaviors amid absent supervision including informal labor, theft, early marriage, or substance use.
Participants described how children who leave school often become involved in theft, gangs, or other risky survival strategies:
“Children left to fend for themselves often drop out of school, some turn to theft or form gang groups.” (Beatrice*, Pagirinya Settlement)
“Many adolescents are out of school, and theft has increased; youth often get involved in risky behaviors.” (Samuel*, BidiBidi Settlement)
Others explained how psychological distress from food shortages push young people toward substance use as a coping mechanism:
“Food shortages have pushed some children into drug use as a coping mechanism.” ( Peter*, BidiBidi Settlement)
Respondents also emphasized the strong link between school dropout, early marriage, and reproductive health risks. This was emphasized by Angela & Daniel, Pagirinya Settlement, Martha & Grace Rhino Settlement that the school dropouts have led to increased teenage pregnancies, early marriages, higher rates of STIs and STDs, and stress‑induced drug use among youth.
The collapse of schooling amid humanitarian withdrawal functions as both symptom and accelerator of systemic neglect, transforming education from a guaranteed right into a commodity reliant on household finances. Understaffed, under-resourced institutions cease providing routine or future-oriented learning, creating liminal spaces of unsupervised adolescence where children turn to informal labor, gangs, substance use, transactional sex, theft, and other high-risk coping that heightens violence, exploitation, and health risks. Without adult oversight, families face trade-offs between immediate survival and long-term prospects, entrenching poverty cycles, eroding protection mechanisms, and making dignified futures nearly unimaginable for out-of-school youth.
Theme 5: Social Fragmentation
USAID cuts disrupted refugee equilibrium and intra-community solidarity, turning shared scarcity into active conflict over land, resources, and survival. Resource scarcity intensifies competition, often generating hostility and deviant survival strategies.
5.1 Deviant Survival Strategies
Hunger & exclusion drove a surge in theft and organized crime particularly among youth, all when legitimate livelihoods collapsed.
Participants repeatedly connected rising hunger with the growth of theft:
“I have observed an increase in theft within the community. When people do not have enough to eat, some resort to stealing from others in order to survive.” (Emmanuel*, Rhino Settlement)
“There has been a rise in criminal activity, particularly theft. This is linked to severe food shortages, because when people cannot access food through legitimate means, some feel like they need to steal as a way of coping with hunger.” (Grace*, Rhino Settlement)
Respondents also linked exclusion from aid, particularly through categorization, to increased organized robbery:
“The categorization has caused problems because some people were cast out of the food assistance, they ask If I no longer receive food assistance what is my reason for being here? These questions culminated in deviant behavior, you see people mobilize themselves to attack others at night, rob people and cause problems in the community which affects all of us” (Daniel*, Pagirinya Settlement)
Aid exclusion normalized criminal improvisation as a rational survival response, turning desperation into organized theft when legitimate pathways collapsed. This marked the threshold where systemic abandonment legitimized crime.
5.2 Intra-Community Divisions
Unequal rations fractured neighborly bonds and mutual support, as families compared themselves and withdrew from sharing.
Respondents described how unequal access to food assistance has strained relationships between neighboring households, generating division and resentment:
“Families who do not receive rations may eat only once a day, while neighbors who receive assistance can afford two meals. Because of this difference, some families avoid others’ children when they have food, even keeping meals inside so the children do not come in. When a child returns home crying after being turned away, the frustration and anger can spill over at home, sometimes leading parents to lash out at their own children. These situations have created tension between families and widened divisions within the community.” (Beatrice*, Pagirinya Settlement)
“One other thing is rampant, so if one family has money and the other does not, the family who has no money at all will start comparing themselves to the other which sometimes causes division.” (Eammanuel*, Rhino Settlement)
Others emphasized how solidarity still persists in some community spaces despite these pressures:
“We remain united largely because we are all from the same country and are living as refugees in another nation. In this situation, unity becomes essential. We are grateful to still be together, and people often share what little they have with others.”
Resource scarcity weaponized social proximity, turning neighbors into rivals and fragmenting once-solidarity into zero-sum competition across refugee intra-community lines. Aid withdrawal inverted communal cohesion, fueling land disputes, rising criminality, and fractured relationships that normalized predation and exploitation as survival means when traditional and legitimate protections collapsed.
Theme 6: Healthcare Degradation
USAID cuts crippled health infrastructure, creating medicine shortages, staff deficits, and intertwined physical-psychological crises amid growing settlement populations.
6.1 Systemic Healthcare Constraints
Budget reductions left medical facilities overburdened and remaining staff overworked:
“Health workers are really suffering because of the budget cut… you find people there are working double shifts and being overworked.” (Angela*, Pagirinya Settlement)
“In the health sector, medicine was previously available, but many staff have since left. Health facilities are now understaffed, making it difficult for people to receive care.” (Samuel, BidiBidi Settlement)
Respondents also explained how referral systems and hospital shortages further delay access to treatment:
“All sick individuals from the settlements are referred to Adjumani public hospital, but the hospital often lacks sufficient staff and essential medicines. Patients are sometimes told to buy the drugs themselves, and those without money return untreated. As a result, deaths have increased in the settlement, particularly among the elderly, with several occurring each month, largely due to the budget cuts” (Martha*, Rhino Settlement)
Chronic understaffing placed severe pressure on health facilities, where overwhelming workloads and referral systems led to treatment being effectively rationed by patients’ financial capacity. This structural decline heightened mortality rates, turning healthcare access from a basic right into a privilege of wealth.
6.2 Pharmaceutical stock outs and Scarcity
Rapid drug stock outs and shortages compelled patients to turn to herbal remedies, seek costly private care, or endure life-threatening treatment delay
“Government-supplied medicines rarely last the entire month; they may be available for the first two weeks, but by the end of the month the health center has none left and patients are only given referrals.” (Angela*, Pagirinya Settlement)
“Sometimes the medicines are simply not available; when we go to the health center, we are often given only basic painkillers like Panadol.” (Ruth*, BidiBidi Settlement)
When public facilities fail to provide treatment, those with financial means seek alternatives in private clinics or through traditional remedies:
“People who can afford it go to private clinics when medicines are unavailable. Others rely on herbal remedies, which may help temporarily but cannot treat every illness.” (Samuel*, BidiBidi Settlement)
Limited services within settlement clinics and the cost of referrals further restrict access to care, sometimes leading to preventable deaths:
“There is now a high rate of infant mortality because some mothers cannot reach surgery in time. Services that were once available in the settlement are no longer provided, so patients are referred to hospitals outside, which may then refer them again to private clinics that most families cannot afford.” (Daniel*, Pagirinya Settlement)
Participants explained that growing populations, particularly the arrival of people fleeing new conflict zones, have placed additional pressure on already strained facilities, causing medicines to run out even faster. For families without money to purchase treatment elsewhere, the consequences can be fatal.
“If you do not have money to buy the drugs, you return home without treatment, and this is why people in the settlement are now dying due to the lack of medicine.” – (Beatrice*, Pagirinya Settlement)
The rationing of pharmaceuticals deepened wealth-based inequalities in healthcare, replacing essential medications with ineffective substitutes. This shortage led to a surge in preventable deaths especially among infants and the elderly.
6.3 Psychological Distress
Following the USA government funding cuts, food exclusion and dropping out of school intersected with displacement trauma hence fueling youth depression and suicide.
Participants described how children are particularly affected by stress, trauma, and depression linked to food insecurity:
“Women and children are the most affected. Many children show signs of stress and they isolate themselves, stop going to school or playing, lose weight, and cry frequently.” (Daniel*, Pagirinya Settlement)
“I am very worried about our children. Many are dropping out of school, becoming traumatized, and staying at home. When they are not in school, they experience a great deal of stress.” (Beatrice*, Pagirinya Settlement)
Respondents also highlighted how exclusion from aid have contributed to rising suicide rates:
“When the categorization process began and some people realized they had been placed in category three, many became deeply distressed. The level of depression increased, and there were reports of suicide; within two weeks, one person took their own life by hanging.” (Daniel*, Pagirinya Settlement)
“Suicide has become very common in the settlement. The OPM even keeps records of these cases, and it seems that at least one person dies by suicide almost every month.” (Samuel*, BidiBidi Settlement)
One testimony further illustrated the depth of psychological distress experienced by young people living in the settlement:
“Sometimes when I stay with my sisters for school, I feel overwhelmed and even think about ending my life, and at times harming my sister too. But she tries to calm me and stop those thoughts. I feel very tired of this life and often think it would be better if I left them behind because I am not okay.” (Ruth*, BidiBidi Settlement)
Participants identified a clear causal chain linking structural scarcity to escalating mental health crises. Systematic exclusion from aid, persistent food insecurity, and restricted healthcare access gradually eroded individuals’ sense of agency and hope. This accumulated strain weighed most heavily on youth, manifesting in anxiety, depression, and feelings of entrapment that, in some cases, progressed to suicidal thoughts or attempts. Physical decline and psychological distress became mutually reinforcing, producing a vicious cycle in which hunger and deprivation served not only as biological stressors but also as deep psychosocial ruptures that undermined dignity, security, and belief in a viable future.
Discussion
The 2025 USA government funding cuts have created a multidimensional protection vacuum across Uganda’s Rhino Camp, Bidibidi, Pagirinya refugee settlements, undermining the structural foundations of the country’s progressive self-reliance model rather than facilitating its realization. Thematic analysis reveals six interconnected crises that confirm the study’s objectives while exposing both structural failures and latent resilience.
The Myth of Self-Reliance
Food insecurity emerged as the most immediate consequence, driven by the 3-tier categorization system’s “structural failure.” Participants described outdated databases erroneously classifying vulnerable households as “self-reliant,” excluding many people from rations and transforming universal safety nets into competitive resources.
Livelihood programs suffer from critical “training-only” gaps. While vocational skills exist, the absence of productive assets including seeds, tools and startup capital, renders them ineffective. Refugees remain trapped in informal labor despite agricultural potential, unable to overcome high market prices and land constraints that characterize settlement economies.
Gendered and Institutional Vulnerabilities
Gender analysis reveals a “redistribution of risk” disproportionately burdening women and girls. As institutional safe spaces faded, economic desperation “economized intimacy,” driving surges in early marriage, sex work, and GBV. Women engaging in informal labor face heightened harassment, while lack of peer protection networks exacerbate exposure.
Institutional thinning has marketized basic rights. Education systems collapsed under overcrowding, teacher shortages, and household poverty, channeling children into labor, gangs, and early pregnancies. Health services similarly deteriorated including medicine stockouts and overwhelmed staff which correlated with rising suicides from food-related anxiety and existential despair. One participant captured this abandonment: “No future exists in a system without basics”. Consequently, social cohesion fractures through resource competition: land conflicts with host communities, intra-refugee ration envy, and crime surges erode solidarity once sustained by shared humanitarian support.
Dual Consciousness: Dependency and Agency
Prolonged humanitarian engagement has shaped refugees’ discursive frameworks, they have internalized institutional categories of vulnerability: “Generally we are refugees, that status never changes.” Daniel. Yet this sense of dependency coexists with strong assertions of agency and self-determination: “Aid might stop anytime; you must work for yourself. “Martha
Despite the major disruptions caused by the 2025 USA government funding cuts, findings reveal both persistent structural gaps and significant latent resilience across the settlements. Refugees display adaptive agency through informal labor, peer networks, and emerging community leadership. Existing vocational programs, social structures, and local initiatives provide foundations for self-reliance.
However, these coping strategies remain constrained by systemic limitations, such as limited access to productive assets, resource scarcity, weakened institutional protections, gendered vulnerabilities, and market barriers that continue to undermine long-term autonomy. Methodological constraints, including the small qualitative sample, researcher positionality, and context-specific findings, further restrict generalizability.
Overall, the findings highlight that while refugee-led resilience exists and can be strengthened, sustainable interventions must confront structural inequalities to unlock long term self-dependence.
Policy-Relevant Pathways Forward
To enhance community resilience amid the 2025 USA government funding cuts in Rhino Camp, Bidi Bidi, and Pagirinya refugee settlements, this study outlines four prioritized, evidence-based, recommendations. These pathways reflect the priorities voiced by refugees, community leaders, and local humanitarian practitioners through interviews and key informant discussions.
- Market-linked vocational hubs: Establish vocational training centers and provide startup kits for refugees, implemented through refugee-led committees. These hubs should include market linkages for product sales through local partnerships, targeting a 15% increase in household income.
- Community savings and loans cooperatives: Formalize community-based savings groups to pool emergency funds and support small-scale investments. Leveraging existing social trust networks to ensure quick implementation and long-term sustainability.
- Integrated faith-led farming and SFPs (Supplementary Feeding Programmes): Support two church-managed farming initiatives to supply local school feeding programs, complemented by participatory reviews of vulnerability databases conducted by community leaders to improve food security.
- GBV peer-led safe spaces: Train women and AGYW (Adolescent Girls and Young Women) peer facilitators to coordinate safe spaces, fostering localized protection systems and psychosocial support networks led by refugee women and AGYW.
Conclusion & Limitations
In conclusion, the 2025 USA government funding cuts have exposed deep structural fragilities within the refugee self-reliance framework, yet refugees continue to demonstrate remarkable adaptability and agency through informal livelihoods, social networks, and localized initiatives. Sustainable recovery therefore depends on strengthening community-led, low-cost, and market-linked solutions that balance humanitarian support with long-term livelihood sustainability. However, the study’s small qualitative sample, limited timeframe, and researcher positionality constrain the scope and generalizability of findings, while broader systemic challenges such as policy dependence on external aid and persistent institutional weakness further limit the sustainability of proposed interventions.
Acknowledgement
I would like to extend my sincere gratitude to the SAFER HEELs consortium members for making this study possible. My deepest appreciation goes to Civitas Africa in Bidi Bidi Refugee Settlement in Yumbe, Human Rights Development (HRD) in Pagirinya Refugee Settlement in Adjumani, and the Alliance of Women Advocating for Change (AWAC) in Rhino Camp Refugee Settlement in Terego and Madi Okollo. Your openness, coordination, and trust created the space for me to engage directly with refugee communities, whose voices and lived experiences form the heart of this research.
I am especially grateful to the individuals within these communities who generously shared their time, stories and perspectives with me. Their courage and honesty gave this study its depth and meaning.
Special appreciation goes to the team at AWAC for their continuous guidance and support throughout my four-month internship. Your commitment to grassroots voices, service and advocacy not only shaped this study but also deeply enriched my learning journey.
I would also like to sincerely thank my supervisor at the Glocal Program at the Hebrew University of Jerusalem for the invaluable guidance, encouragement, critical insights and academic support throughout this process.
References
Chant, S. (2006). Re-thinking the “feminization of poverty” in relation to aggregate gender indices. Journal of Human Development, 7(2), 201–220.
Constable, N. (2009). The commodification of intimacy: Marriage, sex, and reproductive labor. Annual Review of Anthropology, 38(1), 49-64.
Doan, P. L. (2010). The tyranny of gendered spaces–reflections from beyond the gender dichotomy. Gender, Place & Culture, 17(5), 635-654.
Natale, S. M., & Doran, C. (2012). Marketization of education: An ethical dilemma. Journal of Business Ethics, 105(2), 187-196.
Office of the Prime Minister (OPM). (2025, December 3). Refugee management. https://opm.go.ug/refugees/
United Nations Office of the High Commissioner for Human Rights. (2025, July 30). US government fueling global humanitarian catastrophe: UN experts [Press release]. https://www.ohchr.org/en/press-releases/2025/07/us-government-fuelling-global-humanitarian-catastrophe-un-experts
Endnotes
[1] Three of its most common tenets are that women represent a disproportionate percentage of the world’s poor, that this trend is deepening, and that women’s increasing share of poverty is linked with a rising incidence of female household headship
[2] Gendered spaces are spaces that both reinforce societal norms by policing gender conformity and offer potential for resistance when inclusive performances challenge those boundaries.
[3] Intimate and personal relations—especially those linked to households and domestic units, the primary units associated with reproductive labor,have become more explicitly commodified, linked to commodities and to commodified global processes (i.e., bought or sold; packaged and advertised; fetishized, commercialized, or objectified; consumed; assigned values and prices) and linked in many cases to transnational mobility and migration, presenting new ethnographic challenges and opportunities
[4] Education considered in such a context reduces students to a revenue stream and colleges to businesses; this is the contemporary face of education.
