Seeing off Nyakwenkuru!

In March 2016, I lost my grandmother at one of the private health facilities in Kampala city. My grandmother was 87 years old at the time of her death. According to the hospital report, she died due to severe anemia. Like many other traditional women, my grandmother never sought medical attention early at the feeling of an ailment.  Very often, she would inform anybody who cared that she was week but would be well soon. At some point she started giving excuses of her advanced age as the reason for her ailing nature. For a long period of time, she stayed sickly but moving on with her chores.

But once in awhile, my grandmother sought medical attention. This was mostly whenever the pain in her constantly aching legs and back was severe. She would walk slowly (okushotooka) to local health facility. During most of such visits, the health care workers would confirm my grandmother’s belief that the aching of her legs and back were due to her old age. She would receive regular painkillers and go back to her house.  This would lead her to stay in the ‘comfort’ of her pain well knowing that it was as a result of old age.

Much as it was not entirely permitting to her will, my grandmother was convinced to come to Kampala for specialized care at the end of last year. According to all specialists who attended to her, my grandmother would have been better off seeking early medical attention. It dawned on her and all of us who were close to her that the cause her continuous nature was not old age at all. She had a disease killing her slowly. She sought special medicating very late.

The experience of my grandmother at the local health care facility upcountry is strange to many. In Uganda, there are few medical specialists in geriatric care. Given the high patient to doctor ratio, the majority of patients at lower health units are attended to by Nurses. In fact some simple privately ‘clinics’ are managed by poorly trained or not formally qualified medical personnel.  Even where there are qualified personnel at lower government health facilities, they are often overwhelmed by the high number of patients and lack of constant medical supplies. Such circumstances hinder medics from having adequate time and conscience to attend to unique conditions that for example affect the elderly.   

The recently released results of the November 18, 2014 National Population and housing Census showed an improved life expectancy to above 63 years. This means that more Ugandans can now leave longer and therefore the percentage of aging population will increase greatly in coming years. The statistics also showed a high age dependency ratio at 103%. According to the World Bank working definition, age dependency ratio is the ratio of dependents of people younger than 15 or older than those of working ages of 15-64 years. The Uganda Burual Of statistics also showed that 8% of the children in the country were orphaned. Just like children bellow the age of 5 years, it is common knowledge that the elderly face a high incidence of disease and require continuous medical attention.  

Without better systems established to support the elderly, the ‘burden’ of caring for them rests on the younger, working population. However, the working population naturally have the ultimate responsibility of their own children and sustaining the state through paying taxes. Such a scenario would literary leave some elderly people neglected to languish in suffering. There is need to integrate programs like geriatric care into the public health system in Uganda.