First in Weekly Observer, July 5th - 11th, 2007

Lost in a world of pambers

The situation for old people in tUganda and Denmark cannot even be compared, because while a Ugandan lucky to see his/her 70s is still struggling as a caretaker, a Dane in the same age bracket is being cared for like a baby.

By Carolyne Nakazibwe

Copenhagen – The New Vision newspaper of June 29 carried the story of Stanley Tomusange, 99, who once led a life of plenty in the king’s palace but now lives in absolute poverty and ill health, awaiting the final call from his Maker.

His teeth are falling out unaided, he is not sure where his next meal will come from and the house he lives in could crumble under a storm’s force.

As I read that, I realised if Tomusange were born and bred in Denmark, his fortunes would have been much different.

For one, he would probably be put up in a specialised old people’s apartment block or in a nursing home for old people.

He would most likely have a steady supply of diapers, complete with beautiful nurses to change them whenever need arose.

He would also most likely suffer from a disease called Alzheimer’s, since many Danes above 60 also have the disease that progressively erodes their memory to zero.

But above all, since he has three teeth left out of 32, he would have a nurse mashing his food for him and if he were lucky, feeding it to him complete with bib and the company of his age mates.

And if Tomusange has pulled off 99 years under a leaking roof, with a broken untreated leg and no food in a country with a life expectancy of 51 years, he would easily have blown 120 candles in the Nordic country where the average Dane lives to be at least 76 years old.

The situation for old people in the two countries cannot even be compared, because while a Ugandan lucky to see his/her 70s is still struggling as a caretaker, a Dane in the same age bracket is being cared for like a baby.

Because of Uganda’s life expectancy, many children die early, casting their aging parents – who by Danish standards deserve to be in elderly homes ‘comfort’ – into roles of nannies and caretakers for the grandchildren left orphans.

When I took a day off on July 4 to follow the elderly health care system in Denmark, I realised that on the contrary, most Danes can account for their parents and grandparents and in many cases great-grandparents. All alive, although not necessarily kicking.

In Oerbygaard Nursing Home outside Copenhagen, a young nurse is at work in the same room where her grandfather is visiting his own mother – a client in the home.

In room 30, Serina Eggersborg, 68, who grew up in the circus is now confined to a wheelchair after she was paralysed on the left side.

Many of the stories in the home are similar to Serina’s. Depressing. People who had a life and are now waiting to die. Although Serina has a son, she admits she does not know where he is or what he looks like anymore, because he does not visit.

But Dan Soerensen a head nurse at the home said, “Many say good bye to their parents when they can still remember them. They hate to see them this way. They only return to pick the body.”

This was a reality that hit hard for an African coming from a country where families take care of their elderly, even if it means bringing in an extra pair of hands.

There are constant visits to the village to make sure the elderly relatives are okay and sometimes, a grandchild is dedicated to this honourable duty.

When Mary Babirye, 74, suffered a stroke more than ten years ago, her son picked her from her home in Katwe and started living with her in his own home. Her stroke caused her paralysis from the waist down, rendering her also incontinent. But she stayed with her son until March 2007, when she died in Mulago Hospital, with a granddaughter at her bedside as the caretaker.

Not if she were Dane.

“Some of these people are incontinent. I wouldn’t have my wife that way! That is stretching the border too far,” Soerensen said.

In Denmark it is a world of pampers. They are there to trace under the pants of the old man who lumbers by on a walker. They are there, on Rita Matz, 87, who spent her younger days as a camper, travelling all over Europe with her camping van. Now she sits by a window in the home, filling crosswords and eying the world outside.

“It was very difficult to move here. I didn’t like it at first because of cultural shock, but I am now used to it,” she said.

Matz has problems hearing, but just as well because she cannot hold a conversation with the other clients in the home.

“Several of them don’t know how to speak. I miss driving around, sight-seeing…” she says.

Denmark’s health care system also has outreach services, where nurses are dispatched to homes of old people who prefer to stay in their environment albeit with a little help. It is a system that works like clockwork, and it is also the one that absorbs a big number of migrant workers, because there is a constant need of the poorly paid personnel.

Ruth Jacobi is a Kenyan nursing assistant at Oerbygaard, married to a Dane and they lived in Uganda for 6 years. Two more Ugandans work here but are off duty when I visit.

In the afternoon I play Agnete Lou’s shadow nurse, on the outreach programme as she drives in the Roedovre community to give medication, warm food, changes diapers and clean a respiratory tube one of the elderly has in the neck. There are eight such visits a day by different nurses.

As we leave 93-year-old Anna Hansen’s home, she whispers in Danish, “I am glad you came to see me although I am not so beautiful to look at.” I force back the tears and gush about her beauty. Yes, because in a frame on a table, a stunning portrait of a 30-year-old version of Hansen is smiling at me.

“I wish you all the best for your country,” is her parting shot. Agnete explains that Hansen has dementia and thinks Uganda is still ruled by Idi Amin.

The nurses’ role is staggering. Where I come from, nurses are trained to make sure people get better. In elderly care, nurses actually treat people to die.

“It is part of being a nurse too. You live to die. It is important to have a quality life until you die,” Hanne Hodel the head of Roedovre’s home care department said.

And Denmark has many old people. In a community like Roedovre with 36,000 residents, there are 800 elderly people dependent on home visits. This number excludes the elderly who are still self reliant and those in the nursing homes.

“Due to industrialisation the women [the natural caretakers in families] are now out working and we needed to develop a system where the elderly are taken care of,” Hodel said. “We need taxes to run this and Danes pay a lot of money in taxes.” The old people also pay for the care through their pension.

According to nurse Soerensen, in a country where Alzheimer’s is almost as rampant as cancer, it is expecting too much from a family to stick it out with you.

But again compared to Uganda, the statistics don’t differ only in number of people above 70 years.

Where Uganda has 2,209 physicians to take care of a population of 30 million, Denmark has 15,653 physicians to take care of a 5 million-strong population. Uganda has 14,805 nurses, against Denmark’s 55,425 nurses.

With such a divide, there will be many more Babiryes and Tomusanges for Uganda, as more elderly couples in smooth running health systems in the West celebrate marriage’s platinum jubilee in old people’s nursing homes.

carol@ugandaobserver.com