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 TaizŤ, 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
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.
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