NABALANGA, Uganda (AP) — His father died when he was a little boy, his mother when he was a young man. His grandparents, save but one, never made it to old age either. His wife is gone now, too, in the ground with four of their children, so forgive Yafesi Nakyanga’s surprise that he is still breathing.
Long past an age when the farmer could make out a visitor’s face, much less still bend in the fields, Nakyanga is still living at 86, part of a swell of the old in the land of the young.
“I never expected,” he says softly, “to live this long.”
Across Africa, a stunning success story has quietly taken hold: Decades of progress have begun delivering a wave of longevity that promises to reshape the demographics of the continent. But as lifespans lengthen and villages begin to fill with the old, pensions and social safety nets are minimal, medical care is lacking and routine problems of age are so commonly unaddressed that cataracts turn to blindness and minor infections end in death.
Longer lives, time and again, come with more suffering.
“They’re living in poverty. They’re living in pain,” says Kenneth Mugayehwenkyi, who founded Reach One Touch One Ministries to help older people. “That’s the old people that I see.”
In just 15 years, the number of people 60 and older has ballooned by an estimated 50 percent in sub-Saharan Africa, to about 67 million people. Even more dramatic growth awaits, with the World Health Organization projecting 163 million older people in the region by 2050.
Respect for older people is deeply ingrained in African cultures and the presence of an elder is a source of joy for many families and a point of pride for many villages. But on this continent known for its staggering number of the young, the challenges of growing old never before arrived in a large-scale way. Scores of interviews across a dozen African countries and a review of research and data make clear how few resources await those who reach old age and how much festering poverty disrupts their final years.
“Everything is lacking,” says Dr. Mie Rizig, a Sudanese-born neurologist at University College London who researches aging and dementia across Africa.
Falling birthrates and rising life expectancies have combined to bring the aging revolution nearly everywhere in the world. As the number of older people has multiplied, even the richest countries have stumbled to meet their needs, triggering warnings of catastrophe when the same challenges are heaped on some of the globe’s poorest places.
Rzig concedes Africa’s challenges are steep but remains hopeful it can learn from other regions’ mistakes and capitalize on what she sees as its innate advantages: Cultural values that make tending to the vulnerable second nature; a network of public health programs for communicable diseases that provide a framework for addressing problems related to aging; and an unrivaled population of young people offering economic promise and a strong ratio of potential caregivers.
“The continent has a kind of inherent power,” says Rzig, part of an Africa task force for the Davos Alzheimer’s Collaborative. “Africa could be a model for the rest of the world.”
Here in Uganda, Mugayehwenkyi has built one of the country’s only organizations dedicated solely to supporting the elderly, and this day, a Reach One Touch One team has arrived at Nakyanga’s small home on a dirt road in a village about a 90-minute drive from the capital. A 26-year-old nurse, Derrick Ssemanda, in royal blue scrubs, hustles inside and sits beside Nakyanga. The man’s catheter has been causing pain and Ssemanda pulls white surgical gloves from a camouflage backpack and gets to work changing it.
“Are you strong enough?” he asks Nakyanga.
“I’m a strong man,” he replies. “I can handle it.”
Nakyanga sweated in the fields just to grow enough to feed children who would later die of AIDS and laid the bricks and poured the cement to build a house he nearly lost to medical bills.
He has no electricity or running water. His bathroom is an outdoor pit.
To make it to this age in a place like this seemed impossible to Nakyanga. It’s made all the more an oddity by the fact that it is a country with one of the youngest populations in the world.
“You’re surrounded by young people,” Nakyanga says, “and you’re standing next to death.”
Nakyanga is thin and in tattered clothes and his hair is short and gray. His medical file is thick but he makes little chatter and offers no complaints.
Ssemanda keeps making small talk, trying to distract his patient from the procedure. He pushes a syringe’s plunger, sending an arc of saline in the air, then peels open the packaging to a new catheter, and before Nakyanga knows, it’s over, and Ssemanda rises from his seat.
The list of people clamoring for Reach One’s help is long. It is just one small aid group in one African nation, but to shadow its workers is to see themes that repeat across the continent.
The nurse bounds for the door. There are so many seniors to see.
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Matt Sedensky can be reached at [email protected] and https://x.com/sedensky
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