Half the population of Uganda is made up of children up to the age of fifteen. A significant proportion of these children lives a cruel life of hazardous work, armed conflict, mental and physical abuse, family disintegration, poverty and environmental degradation. In most cases, all the people can do is support each other and hope for the best.
 

Poverty is the "underlying cause" of problems children are facing in Uganda. The children who survive do so despite a serious lack of resources at the household level, and an inadequate provision of basic social services that makes physical access to services difficult or impossible. Housing is poor. Suffice it to say that the most popular materials used for building houses are tin, grass and mud. In the eastern district of Mbale, for instance, in 1988, 88% of all houses had mud walls and 72% tin roofs. In the western district of Arua, 92% of all houses had mud walls and 93% grass roofs. 8% had brick or cement walls and 7% tin roofs.

Moreover, most Ugandan children are brought up in families who are unaware of the services that are available to them, or who show no interest in these services because of their attitudes and practices.

A serious lack of basic education definitely plays a leading role in the unbroken vicious circle inspired by poverty. According to UNPAC, Uganda National Programme of Action for Children (UNPAC), Priorities for social services sector development in the 1990's and Implementation Plan 1992/93 - 1994/95), a report published by the Ugandan Ministry of Finance and Economic Planning in September, 1992, only 20% of children living in Uganda attend primary school. The time children in more prosperous countries spend at school Ugandan children devote to collecting water from distant sources and working alongside their parents in the home and fields.

Short cuts to premature death

Three out of every four Ugandans have to walk more than one and a half kilometres to obtain water, and 70% of the population doesn't have access to adequate sanitation facilities. Consequently such water borne and water related diseases as diarrhoea, guinea worm and malaria flourish in Uganda. Moreover, tap water is of very poor quality: drinking water has to be boiled and filtered but only few Ugandans have the awareness and means to see the whole decontamination process through.

Ugandans work their solitary way to survival against all odds. In 1991, their government spent 1% of its total annual expenditure on water and environmental sanitation, the latter referring to all aspects of keeping domestic and public environments clean! Besides that, UNPAC emphasises that tariffs for water supply and sewerage and garbage collection systems in urban and peri-urban areas "are beyond the means of the population that is supposed to pay them".

But health officials in Uganda will tell you that contracting water borne and water related diseases is not the only short cut to a premature death. Out of every 1000 live births, 101 infants (less than one year old) and 180 children under the age of five die. UNPAC found that the interplay between malnutrition and common diseases including malaria, respiratory tract infections, diarrhoea, some of the immunisable diseases, particularly tetanus, and AIDS, was among the immediate causes of these deaths.

One out of every five children is born underweight. 55% of all households consume less than 80% of the recommended daily energy intake and because of this 23% of Ugandan children suffer from either moderate or severe malnutrition. The high levels of malnutrition lead to 44.5% of children being stunted, one of the highest levels in Africa.

In Uganda, a relatively large number of women die while giving birth. UNPAC estimates that the rate is about 500 per 100,000 live births. This high maternal mortality rate is largely due to two factors:

(i) Only 26% of women deliver in health institutions with specialised assistance. 23% use traditional birth attendants and a staggering 51% give birth at home without any specialised assistance.

(ii) Many women have pregnancies near both the extremes of women's reproductive age limits.

Living despite AIDS

In recent years, life expectancy in Uganda has dropped from 46 to 42. In Malta, life expectancy in 1990 was estimated at 72 for men and 77 for women. Many Ugandans attribute this to AIDS. AIDS has wrecked physical and emotional havoc in many Ugandan families. According to UNPAC, in 1991, 6 to 10% of the country's population of 16.8 million was infected with HIV. The situation in 1994 cannot be any better. If anything, it's worse: of the estimated 1.0 to 1.6 million infected people about a quarter were women of child bearing age (15 to 49 years old). Mother to baby (vertical) transmission is estimated to be between 25 and 50%, with 25 to 40% of the infected children dying in their first year of life.

According to the Feb./Mar.,1994 issue of the Letter of Taizè, the region of Masaka on Lake Victoria is one of the areas that has been most affected by AIDS. "We are told that there are no families in that area without AIDS orphans."

The Letter goes on to describe how these orphans are cared for: "They do not place the children in orphanages where they would be in danger of losing their roots and their culture, but provide material aid that stimulates sharing by reinforcing already existing bonds of kinship and relations between neighbours. In some cases this aid is administered by small Christian communities linked to the local parish," but these are not the only players in this strong chain of solidarity. Families that can hardly support themselves willingly take in children who have lost their parents to AIDS and bring them up as their own.

Survival solidarity

This chain of solidarity has pulled Uganda out of the treacherous waters of its turbulent, often cruel recent past. It has rescued people from battle grounds and unscrupulous poverty. And it has served as a unique lifeline for the most vulnerable.

__________________________

I would like to thank Mr. Emmanuel Unenboth for patiently answering my many questions. However, this article expresses only my views.


© Adrian Grima (1994)
Published as "Living and Surviving in Uganda" in The Malta Independent, 16 October, 1994
 

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