A forgotten generation: Bringing hope to the elders of Fort Portal, Uganda

Most elders in Uganda live in rural areas, experience poverty, have limited access to health care and experience loneliness and social isolation. In addition, the disintegration of traditional care system resulting from modernization has undermined the extended family networks that once used to take care of the elderly. This lost system, which has not yet been replaced by any community-based care system, has compromised many elders’ psychosocial health at all levels: physical, mental, emotional, and spiritual aspects over-exposing the elderly to preventable illness. Indeed, a recent study into ageing in Uganda highlighted ‘the need for interventions that address the physical, psychological, and social aspects of ageing’ [and] ‘to provide holistic care to the elderly to cater to all aspects of ageing’ (Gumikiriza-Onoria et al., 2023) 

As elsewhere in Uganda, ageing poses a significant challenge for people in Fort Portal where, according to the baseline survey which was conducted before the implementation of this project, challenges identified included: loneliness, elder abuse, abandonment of the elders by family members, depression, land grabbing, malnutrition, weakness, illness and poverty. This is the problem that Bishop Magambo Training Institute (BMCTI) is attending to. The main aim of this project is to deliver psychosocial and nutritional support for the elderly for improved health outcomes.
The project’s Elderly community support groups have had a profound impact on the lives of older persons in Fort Portal City. By promoting psychosocial resilience, encouraging active participation, and improving a sense of belonging, these groups have played a key role in enhancing the dignity, inclusion, and quality of life for the elderly.

Community-based elderly support groups at village levels now serve as platforms for emotional expression, peer support, and community engagement. They have become a source of emotional, psychological and social strength to the elderly, have led to self-affirmation and a renewed sense of belonging as they feel loved by each other and appreciated. Elderly men and women now meet twice monthly to share their experiences, discuss common challenges, and support each other emotionally. They have developed deep friendships and a sense of belonging, which many of them lacked for years. These support groups have significantly reduced the sense of isolation among members and enhanced their emotional resilience, self-worth, and social visibility.
The more recent establishment and maintenance of the kitchen gardens for nutritional support and self-reliance intervention has improved nutrition, reduced food expenses and promoted active aging.

Apart from the psychosocial and nutritional support described above, the project also conducts Caregiver and the local leaders Skills trainings around the needs and the rights of the elderly. Community sensitization around issues around elder care issues took place via quarterly radio programs with the aim of increasing community awareness about the rights and challenges faced by the elderly.The project is also a powerful voice advocating for the rights of the elderly and managed to bring the Social Assistance Grant to the Elderly (SAGE) into the Kabarole district in 2020. BMCTI would like to see this spread to all areas of the district.

Story of change: Nakimera Mugisa (not her real name) 66 years, Uganda.

Nakimera Mugisa, a 66-year-old single mother of five had lived a quiet life in the outskirts of Fort Portal. After separating from her husband many years ago, she suffered from deteriorating health and spent most of her days in isolation and loneliness. Her physical health further deteriorated when she suffered an accident 5 years ago and she developed signs of depression, anxiety, and hopelessness.

In 2023, Nakimera was identified by one of the BMCTI elder leaders during their outreach programme and was encouraged to join the elderly psychosocial programme. Through individual and group counselling, home visits, participation and sharing at the day care gatherings, Nakimera’s mental wellbeing slowly began to improve. She regained her confidence and sense of belonging. During the group sessions, Nakimera actively participated in storytelling, emotional healing exercises, and peer interactions. These activities greatly improved her self-esteem, sense of belonging, and mental well-being. She is now seen as a role model among her peers.

Nakimers’s nutritional levels have also significantly improved since the intervention. She now grows her own vegetables using a small kitchen garden introduced by the project. Her meals are more balanced, and her health has improved noticeably—she reports reduced joint pain, increased energy, and better sleep.

Following months of participation and trainings, and after regaining her strength and developing a renewed sense of purpose, inspired by the support she received, Nakimera initiated the formation of her own community-based elderly support group. The group which is now one-year-old has different activities, including twice monthly group meetings where individual meet and share their experiences, rotational home visits amongst the member, home visits of isolated and bedridden elders, visiting of the weak elderly, bi-weekly group savings, and praying together.

Nakimera is very passionate about the elderly, during day care gatherings she moves around serving food, she also offers informal counselling to fellow elders in her village and wherever she can’t manage, she refers them to BMCTI. Nakimera reported: “I used to think my life was finished. I had no strength and no one to talk to. Now I feel alive again. I eat well, I laugh with others, and I even help teach others what I’ve learned.”

Nakimera’s initiative to form and lead an elderly support group has not only improved her own life, but has also created a ripple effect of empowerment within her community.

Stories like Nakimera’s highlight the importance of inclusive and holistic support for the elderly as a means of promoting dignity, community participation and resilience in a country where they are becoming increasingly sidelined and vulnerable.