Kitaburaza, Uganda — In the quiet of night, when only the moonlight bathes the hilltop and the breeze rustles the branches, turmoil often revisits this place. An elderly woman is gripped by the belief that her house is on fire, and in a panic, she hauls her sparse belongings outside. Her son, knowing no other remedy, resorts to locking her in.
Herbert Rutabyama, 62, explains, "She yells. She pounds on the door." Dementia, long understated across this continent where life expectancy has lagged behind the rest of the world, is becoming increasingly prevalent. As Africa's population of older adults rises, experts note a surge in dementia diagnoses, each introducing profound challenges to patients and their families.
The continent faces an impending wave of new dementia cases as demographic changes continue. Already, the strain on caregivers for those with diseases like Alzheimer's is becoming apparent.
Assistance is scarce in a region where many languages lack even a word for dementia.
On this day, the Reach One Touch One crew visits this Ugandan village near the Rwandan border. As he approaches an elderly woman with troubling nighttime visions, aid worker Moses Kahigwa exudes warmth: "You look good!"
Alice Ndimuhara, 87, meets him with a cold stare. "This looks good to you?" she responds.
It's early afternoon, yet Ndimuhara hasn't eaten today. She has no money, her limbs are weak, and her persistent headache is unrelieved.
Without visitors, she'd remain in bed. "My life is just meaningless," she declares.
Her son, Rutabyama, returns from fieldwork, his boots caked in mud and his brow damp with sweat. Despite his mother's feisty demeanor, he clarifies that this is one of her better days.
Her wandering and other troubling signs emerged a few years ago, leading to a dementia diagnosis at ROTOM's clinic. His father has since been diagnosed as well.
"It's really, really hard," Rutabyama admits, describing the challenge of their care.
When his mother wanders during the day, he searches for her, sometimes finding her in the next village. But her nocturnal confusion leaves him at a loss. He locks her door with a padlock, fastens the window shutters, and hesitates to release them, even amidst her screams.
"You know better," she rebukes when this is mentioned.
Such measures are not isolated. In 2022, Claudia Mahler, the UN's advocate for older persons' rights, highlighted reports of elders being confined or tied, though specific countries weren't identified.
Even in wealthy nations, dementia solutions often fall short, offering only palliative care to an incurable condition. Here, options are virtually nonexistent.
Rutabyama shoulders the duty of caring for his parents. Even if he could afford nursing home care, few exist in Uganda, and the nearest is a day's journey away.
Africa's increasing longevity introduces myriad problems in already strained communities. Many elders, immobilized and lacking wheelchairs, are trapped in homes that are difficult to navigate. Eye surgeries are nearly impossible to contemplate when access to medical care is complex, and essentials like glasses are unavailable.
Dementia, often accompanied by social isolation and suspicion, finds little expertise or understanding. Witchcraft beliefs persist, diagnostic language is lacking, and Rutabyama, while not justifying his method of confining his mother, struggles with options.
In dealing with dementia, flawed responses are inevitable when good answers remain elusive. (AP) GSP
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