By Geraldine Kauma and Annika McGinnis
We set off at 10:30 a.m. Thursday on a bumpy ride in St. Mary’s Hospital Ambulance to conduct a medical outreach in the rural Kasaala trading center, where about 60 grandmothers aged 50 to 90 were gathered for their regular clinic day.
The small ambulance was filled with three clinicians, a social outreach supervisor, Salongo, the middle-aged yet energetic and fast driver, a pharmacist, and a crate bulging with a variety of drugs that the grandmothers typically need: medication for hypertension, painkillers, antibiotics, you name it…
The ambulance came to a halt at the trading center amidst claps from the grandmothers, who are fondly known as “jajias” in the local Luganda language. They ululated and clapped, and the more able and mobile ones quickly came toward the car, helping to carry the crate with drugs and a box of files to the work station. They welcomed the visitors with “mwebale kujja abasawo” – “thank you for coming, doctors.” Decked out in traditional dresses and headscarves gleaming in a rainbow of vibrant colors, the grandmothers didn’t hesitate to smile – even when toothless- and offer the visitors their calloused, wrinkled, frail but firm hands in greeting. “Muli’mutya?” (“How are you?”)
In rural villages near Kasaala in Uganda’s Luweero district, 40 percent of grandmothers are the head of their households, some also the primary caretaker of their grandchildren as many of their family members have died from AIDS. Since 2014, the Stephen Lewis Foundation has funded Reach Out Mbuya Parish HIV/AIDS Initiative to provide free health care screening and treatment for these grandmothers. Reach Out also constructs durable homes and pit latrines for the most vulnerable women and gives out farming tools such as hoes and pangas, food and nutritional support, and goods such as mattresses and scholastic materials for their grandchildren.
On Thursday morning, a Reach Out community department coordinator in Kasaala, Ibra, and Reach Out staff went ahead to welcome the grandmothers, ask how they were doing and encourage them to take their drugs and be enterprising and business-minded. He hailed the grandmothers who had carried pancakes, doughnuts, and other edible items for sale, urging the rest to support them. He also informed them of a party to be held for the grandmothers in December and asked some to demonstrate the dancing skills they would showcase. We could feel the excitement buzzing in the air and the fondness that the “jajias” have for him, and he for them.
To those frail grandmothers, Reach Out arranges home visits to check on their blood pressure and vitals and give them the drugs they need. Most of these grandmothers are looked after by their grandchildren, who help them read their prescriptions and remind them to take medication. It is during these home visits that the Reach Out staff members can assess the grandmothers’ homes to determine which support they may require, including the building of pit latrines and houses and the provision of mattresses, food, mosquito nets, and more, depending on the need.
Beginning in 2014 with 784 grandmothers, the grandmothers’ program in Kasaala now enrolls 1,254 women. Each Thursday afternoon following the clinic, the grandmothers congregate in village savings and loans groups, where they pool their small savings to be able to take out loans for expenses like school fees.
We attended one such meeting to see how the grandmothers were managing their savings. On arrival, we found 31 grandmothers sitting on mats, surrounding a metallic green case and the Reach Out coordinator. This metallic case acts like their safe, keeping all documentation and money received from the various grandmothers. At these meetings, each grandmother must contribute at least $1,000 Ugandan shillings – the equivalent of about USD $0.3.
We saw the grandmothers’ energy as they lean forward to listen to the savings group coordinator, their small packages of pills from the earlier medical visit held in their hands or placed next to them on the mats.
We left the grandmothers to make the bumpy return journey to the health center, with the clouds changing and drizzles starting to seep through. The team, now tired from the outreach, munches on the banana-flavored “pancakes” bought from one of the grandmothers on the way back – a full bag for UG $1,000.
But the journey was not yet over, as one of the grandmothers accompanied us in the ambulance to another home to check on a last frail grandmother. Sitting outside her straw roofed-hut, this grandmother received an individual medical checkup from a Reach Out clinician as we checked out her new pit latrine that staff members recently constructed.
Finally we set off, and the grandmother who had led us asked us to stop in her maize field and gave the team almost 25 cobs of maize in appreciation for their treatment and support. Earlier, another had given us a fresh pineapple. After a long but inspiring day, we shared a bit of sweetness: a reminder of the sense of hope that Reach Out provides to vulnerable grandmothers in Kasaala, who are still so full of life and optimism despite their challenges.