Contribution to MMI Annual Report 2014

The “Granny Project” has been funded in 2013/14 by action medeor and implemented by PEFO Uganda in Jinja district Uganda, East Africa as a response to challenges faced by older persons in accessing health care services. The project targeted 600 grandmothers as primary beneficiaries for the pilot year 2013-2014. The project’s design based on the contextual analysis that access to services has remained a challenge in most parts of sub Saharan Africa particularly in Uganda.

In Uganda, access to health services is by far the greatest challenge affecting both middle and lower class clusters of the populace. Over the years, this situation has attracted global attention resulting into increased technical and funding support for health projects from international partners and governments. This support has been mainly provided HIV/AIDS, Malaria and reproductive healthcare leading to substantial number of malaria deaths reflecting more than half of mortality cases in Uganda. However, very limited concern is given to older persons; their health remains in jeopardy irrespective of the nature of disease or illness.

According to UNHS, 2009/10, 92.6% of older persons in Uganda reside in rural areas and depend on rain fed agriculture as their main source of livelihood; this source is very prone to shocks and stress resulting from climate/weather changes, reduced soil fertility among others. At the same time this older people are responsible for giving care to 63% of all orphans in Uganda and are caring for the sick children and grandchildren especially the HIV positive patients despite their diminishing vitality. It is important to note that in a country of approx. 34 million people, the total government health unit coverage stands at 14.3% and that of government hospitals at 0.9% (UNHS 2009/10). It is clear that Uganda’s healthcare is largely lacking to make consideration for the populace constituting 60 years of age or more a special priority.

The project for grandmothers was therefore designed to find working and sustainable measures to minimize such challenges as these mentioned before. The project’s overall strategy was garnering efforts aimed at strengthening the healthcare referral system within Jinja district. The project focused on interventions geared at strengthening the capacity of existing structures and actors to deliver qualitative good and age friendly healthcare services for older persons. In the process, the project encouraged the formation of grandmother associations, information dissemination and moral support; facilitated training in social gerontology and geriatrics to community health workers from health facilities commonly visited by grannies. The project worked together with the district health department to recruit and train registered Village Health teams (VHTs) who work on voluntary basis, procured and distributed bicycles, gumboots and first Aid kits to VHTs. They use the bicycles between the granny homes as they conduct home visits and help carry ill grannies to the distant health facilities, conducted community medical camps for NCDs (Non communicable diseases) – the health facilities at parish level where grannies visit do not provide medical services for NCDs.

In Nakayiza’s story below, we see how the project tries to support suffering and hopeless grannies in rural Uganda access healthcare services:

“In December 2013, I got involved in fatal road traffic accident in which I was seriously injured and sustained multiple complicated fractures especially on my legs. I woke up from unknown hours of unconsciousness on a hospital bed in Jinja National referral hospital where I had been taken by good Samaritans. The doctor who was by my bed narrated to me a scanty account of my ordeal and announced that I needed an urgent surgery to save my legs; a surgery he said would cost an average of Ugx 4.000.000 (€ 1,250).

I was alarmed by what I heard, I thought about my grandchildren. They were home alone and didn’t even know what was going on with me. I hopelessly cried on the hospital bed with only painkillers, I couldn’t move myself yet had no attendant to help move me. I asked the nurses to let me go home and figure out what I would do about the doctor’s proposal but they didn’t buy in. they instead helped me connect with my son whom I instructed to sell part of our farm land, and hire out the other to raise the money. He did exactly that. We lost our garden land and the people hiring are hiring for 8 years before we can use it again. I raised the money and had the surgery and a week after the sur

gery I Iran away from hospital.

A few months later, I started feeling pain on the scar from the surgery; the pain gradually intensified and I had challenges moving around again. Around the same time (Aug, 2014) Pefo organized a medical retreat for grannies at a health facility within my community which I attended hoping to get some tabs for the pain. The doctor booked me for another appointment and didn’t tell me exactly why. When I returned, he sent me for some investigations which revealed I had a bone implant infection and the infection was to spread to all my bones if the infected implant is not removed. He referred me to Jinja Regional Referral Hospital (JRRH) for the operation. The memories of my struggles to find the money for the first operation were still so fresh and now again they needed me to pay Ugx 2.000.000 (€625).

At this point I stopped caring about the pain and about me dying I only worried about my helpless grandchildren whom I was about to leave on earth alone.

I returned home and had no adult to share with my condition until the next granny meeting day where I shared with a few friends who encouraged me to try herbs but the swelling and pain persisted. My life became so unbearable, I limped to the granny meetings which we hold once every week to relieve off some stress, my friends joked about with me and helped me lighten up for at least the hours I was with them there.

Then one day the project officer from PEFO traced me with the support from the VHT; he had shared with her the medical notes from the doctor who worked on me. She found me at the granny group weekly meeting point and asked to go with me home. She asked why I had defaulted prescriptions and referral advice from the doctors and I shared with her my financial situation and she left. She returned a few days later with two other colleagues who interviewed me and comforted me with hopes of finding me help; they encouraged my friends to visit me and help with some of the chores.

In October 2014, the project officer visited again and told me there was hope closing in as they were bargaining with the hospital to reduce the charges to an amount they could pay. She also asked if I could get an attendant for the hospital and a little money to help with meals during my admission to the ward. This good news though not confirmed made me feel healed already. I was overwhelmingly happy and wasn’t even scared about the surgery at all. I was picked up at my home and admitted to the surgery ward on the evening of 17th, October and operated upon the next day.

By 1st November, 2014 the pain had greatly reduced and I was able to move my two lower limbs with minimal support and in January 2015 I was able to walk normally without any support. I owe my life to this project, because of the support I received, am back to my normal businesses and caring for my grandchildren.” (narrated by Granny Jane Nakayiza)



  • Report by Justine Ojamboj (PEFO Uganda) and Jutta Herzenstiel (action medeor e.V.)
  • action medeor website and project page:
  • The Phoebe Educational Fund for AIDS Orphans and Vulnerable Children (PEFO Uganda) facilitates care and support for older persons and AIDS Orphans and Vulnerable Children households to promote sustainable development •

Contribution by action medeor to the Annual Report 2014 of the MMI Network