Covid-19 and older persons, a forgotten vulnerable group

By Guest Writer

By June 2021, four million lives had been lost to Covid-19 globally, with the death rates for those aged above 80, five times the world’s average. In Uganda, as the virus spread, apprehension grew concerning the impact that it would have on older persons. The government, consequently, classified older persons as being at high risk of Covid-19, though it is ironical that the first batch of vaccination saw many older persons left out.
Older persons, by the United Nations standards, are individuals aged 60 years and above and the 2019 Uganda Bureau of Statistics report states that they constitute 4.2 per cent of the population, approximately, 1,482,600 persons. Thus, they form a significant fraction of Uganda’s demographic profile.
Prior to the pandemic, older persons already faced a plethora of health challenges which now risked being exacerbated by exposure to Covid-19 and heightening the likelihood of death. Commonly; high blood pressure, diabetes, arthritis, stroke, ulcers, poor eyesight, weakened dental, cancers, haemorrhoids, HIV/Aids and malnutrition.
Polypharmacy, the silent killer where multiple medical prescriptions are given to an older person at the same time, leading to unexpected death is rampant. Relatedly, specialists advise that the quantity of dosages given to older persons should be half of what they used to take while younger, yet health workers not specialised in the care of older persons do not seem to know this. Unfortunately, this is aggravated by the inadequate number of gerontologists and geriatrics in the country who specialise in the study and care of older persons.
Mental health challenges such as depression and loneliness are also common, majorly as a result of being widowed, sudden unemployment, abuse and ill-treatment. Reports of family and community members grabbing land and other assets from older persons are becoming rife.
Starvation for fear of constipation from eating hard food and embarrassment from caretakers having to clean up waste is also rampant with some older persons. This is aggravated by mobility challenges in accessing latrines/toilets.
Similarly, emergency food and nutrition programs of NGOs rarely adjust to needs of older persons, who may find hard grains inedible because of dental and digestion problems. Instead emphasis is on programs for children, persons with disabilities and expectant women.
The costs of travelling to the health facilities at the sub-district or urban centers, long patient queues and inadequate supply of medicines worsens the situation, especially for those with HIV/Aids and in need of ante-retroviral drugs.
The national minimum health care package hardly includes medicines for diseases common in old age. Resultantly, painkillers are resorted to, risking addiction and abuse of already fragile health.
Care homes for older persons are also very few yet lacking government support for their initiatives. For example, the average cost in a care home that provides holistic medication, accommodation and feeding for an older person is Shs100,000. This is quite high, compared to the monthly Shs25000 that some older persons get under the SAGE grant.
Equally, insurance schemes tend to charge high premiums for older persons, making medical cover inaccessible for many.
The Constitution of the Republic of Uganda, 1995 together with the 2002 and 2003 Madrid International and African Union Plans of Action on ageing underscore the need for the State to make provisions for the maintenance and welfare of older persons, which includes access to health/medicine.
Older persons are just a small fraction of the population; if they are to live in dignity, then appropriate and accessible health care, both physically and financially ought to be made available, even after the Covid pandemic is contained. This also calls for a comprehensive legal framework on older persons, which Uganda still lacks.
The newly sworn in members of Parliament for older persons surely have their work cut out and ought to hit the ground running.