Hostname: page-component-8448b6f56d-42gr6 Total loading time: 0 Render date: 2024-04-18T16:31:33.827Z Has data issue: false hasContentIssue false
  • English
  • Français

‘This is where we buried our sons’: people of advanced old age coping with the impact of the AIDS epidemic in a resource-poor setting in rural Uganda

Published online by Cambridge University Press:  10 December 2008

JANET SEELEY ,
BRENT WOLFF ,
ELIZABETH KABUNGA ,
GRACE TUMWEKWASE  and
HEINER GROSSKURTH
JANET SEELEY*
Affiliation:
School of Development Studies, University of East Anglia, Norwich, Norfolk, UK.
BRENT WOLFF
Affiliation:
Uganda Research Unit on AIDS, Entebbe, Uganda.
ELIZABETH KABUNGA
Affiliation:
Uganda Research Unit on AIDS, Entebbe, Uganda.
GRACE TUMWEKWASE
Affiliation:
Uganda Research Unit on AIDS, Entebbe, Uganda.
HEINER GROSSKURTH
Affiliation:
Uganda Research Unit on AIDS, Entebbe, Uganda. London School of Hygiene and Tropical Medicine, London, UK.
*
Address for correspondence: Janet Seeley, School of Development Studies, University of East Anglia, NorwichNR4 7TJ, UK. E-mail: j.seeley@uea.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Much research on the impact of HIV and AIDS on older people fails to differentiate between age groups, and treats those aged from 50 years to the highest ages as homogeneous. The ‘oldest old’ or those aged over 75 years may be particularly vulnerable through declining health and independence as a result of the AIDS epidemic, which has forced some to take on roles that younger relatives would have performed had they lived. In this paper we describe the past and current experience of eight people in advanced old age living in rural Uganda who were informants for an ethnographic study of the impact of HIV and AIDS on households during 1991–92 and again in 2006–07. The aim of the study was to understand how they had coped with the impacts of the epidemic. From the eight case studies, it is concluded that family size, socio-economic status and some measure of good fortune in sustained good health enabled these people to live to an advanced age. While we recommend that targeted social protection is important in helping the poorest among the oldest, we suggest that sustaining respect for age and experience, and ensuring that older people do not feel discarded by family and society are as important as meeting their practical needs.

Keywords

older peopleoldest oldimpact of HIV and AIDSUganda
Type
Research Article
Information
Ageing & Society , Volume 29 , Issue 1 , January 2009 , pp. 115 - 134
Copyright
Copyright © 2008 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ainsworth, M. and Dayton, J. 2003. The impact of the AIDS epidemic on the health of older persons in northwestern Tanzania. World Development, 31, 1, 131–48.Google Scholar
Barrientos, A. and Lloyd-Sherlock, P. 2002. Non-Contributory Pensions and Social Protection. Issues in Social Protection Paper, International Labour Organisation, Geneva. Available online at http://idpm.man.ac.uk/ncpps/Papers/ncpensionILO.pdf [Accessed 24 August 2004].Google Scholar
Bunnell, R. E., Nassozi, J., Marum, E., Mubangizi, J., Malamba, S., Dillon, B., Kalule, J., Bahizi, J., Musoke, N. and Mermin, J. H. 2005. Living with discordance: knowledge, challenges and prevention strategies of HIV-discordant couples in Uganda. AIDS Care, 17, 8, 999–1012.Google Scholar
Cattrell, M. G. 1990. Models of old age among the Samia of Kenya: family support of the elderly. Journal of Cross-Cultural Gerontology, 5, 375–94.Google Scholar
Crosnoe, R. and Elder, G. H. Jr 2002. Successful adaptation in the later years: a life course approach to aging. Social Psychology Quarterly, 65, 5, 309–28.Google Scholar
Dayton, J. and Ainsworth, M. 2004. The elderly and AIDS: coping with the impact of adult death in Tanzania. Social Science and Medicine, 59, 10, 2161–72.Google Scholar
DeWilde, C. 2003. A life-course perspective on social exclusion and poverty. British Journal of Sociology, 54, 1, 109–28.Google Scholar
Elder, G. H. Jr 1994. Time, human agency and social change: perspective on the life course. Social Psychology Quarterly, 57, 1, 4–15.Google Scholar
Foster, G. 2000. The capacity of the extended family safety net for orphans in Africa. Health and Medicine, 5, 1, 55–62.Google Scholar
Foster, G., Shakespeare, R., Chinemana, F., Jackson, H., Gregson, S., Marange, C. and Mashumba, S. 1995. Orphan prevalence and extended family care in a peri-urban community in Zimbabwe. AIDS Care, 7, 3–17.Google Scholar
Gilbert, N. 2001. Researching Social Life. Sage, London.Google Scholar
HelpAge International 2004. The Cost of Love: Older People in the Fight Against AIDS in Tanzania. HelpAge International, London.Google Scholar
Hosegood, V. and Timaeus, I. M. 2006. HIV/AIDS and older people in South Africa. In National Research Council of the National Academies, Aging in Sub-Saharan Africa: Recommendation for Furthering Research. National Academies Press, Washington DC, 250–74.Google Scholar
Kasozi, A. B. K. 1994. The Social Origins of Violence in Uganda 1964–1985. McGill-Queen's Universities Press, Montreal, Quebec.Google Scholar
Knodel, J., Zimmer, Z., Kim, K. S. and Puch, S. 2007. The effect on elderly parents in Cambodia of losing an adult child to AIDS. Population and Development Review, 33, 3, 479–500.Google Scholar
Knodel, J. and Im-em, W. 2004. The economic consequences for parents of losing an adult child to AIDS: evidence from Thailand. Social Science and Medicine, 59, 5, 987–1001.Google Scholar
Knodel, J., Saengtienchai, C., Im-em, W. and VanLandingham, M. 2001 a. The impact of AIDS on parents and families in Thailand: a key informant approach. Research on Ageing, 23, 6, 633–70.CrossRefGoogle Scholar
Knodel, J., VanLandingham, M., Saengtienchai, C. and Im-em, W. 2001 b. Older people and AIDS: quantitative evidence of the impact in Thailand. Social Science and Medicine, 52, 9, 1313–27.Google Scholar
Knodel, J. and Ofstedal, M. B. 2003. Gender and aging in the developing world: where are the men? Population and Development Review, 29, 4, 677–98.Google Scholar
Knodel, J. and VanLandingham, M. 2002. The impact of the AIDS epidemic on older persons. AIDS, 16, Supplement 3, 577–83.Google Scholar
Knodel, J., Watkins, S. and VanLandingham, M. 2003. AIDS and older persons: an international perspective. Journal of Acquired Immune Deficiency Syndromes, 33, Supplement 2, S153–65.CrossRefGoogle ScholarPubMed
Lundberg, O. and Nyström Peck, M. 1994. Sense of coherence, social structure and health: evidence from a population survey in Sweden. European Journal of Public Health, 4, 4, 252–7.CrossRefGoogle Scholar
Merli, M. G. and Palloni, A. 2006. The HIV/AIDS epidemic, kin relations, living arrangements and the African elderly in South Africa. In National Research Council of the National Academies, Aging in Sub-Saharan Africa: Recommendation for Furthering Research. National Academies Press, Washington DC, 117–65.Google Scholar
Ntozi, J. and Nakayiwa, S. 1999. AIDS in Uganda: how has the household coped with the epidemic?. In Orubuloye, I., Caldwell, J. and Ntozi, J. (eds) The Continuing HIV/AIDS Epidemic in Africa: Response and Coping Strategies. Health Transition Centre, Australian National University, Canberra, 155–81.Google Scholar
Roscoe, J. 1965. The Baganda: An Account of their Native Customs and Beliefs. Frank Cass, London.Google Scholar
Seeley, J. 1993. Searching for Indicators of Vulnerability: A Study of Household Coping Strategies in Rural South West Uganda. Report to UK Medical Research Council and Overseas Development Administration, London.Google Scholar
Seeley, J. A., Kajura, E. B. and Mulder, D. W. 1995. Methods used to study household coping strategies in rural South West Uganda. Health Policy and Planning, 10, 1, 79–88.CrossRefGoogle ScholarPubMed
Serwadda, D., Gray, R. H., Wawer, M. J., Stallings, R. Y., Sewankambo, N. K., Konde-Lule, J. K., Lainjo, B. and Kelly, R. 1995. The social dynamics of HIV transmission as reflected through discordant couples in rural Uganda. AIDS, 9, 7, 745–50.Google Scholar
Shafer, L., Biraro, S., Kamali, A., Grosskurth, H., Kirungi, W., Madraa, E. and Opio, A. 2006. HIV Epidemic Trends in Uganda: 1989–2005. Presentation at XVI International AIDS Conference; Toronto 13–18 August 2006 (abstract THLB0108).Google Scholar
Stloukal, L. 2004. Population Ageing in Developing Regions: Focusing on the Oldest Old. Sustainable Development (SD) Dimensions Report, Food and Agriculture Organisation, Rome. Available online at http://www.fao.org/sd/dim_pe3/pe3_040901_en.htm [Accessed 4 February 2007].Google Scholar
Wachter, K. W., Knodel, J. E. and VanLandingham, M. 2003. Parental bereavement: heterogeneous impacts of AIDS in Thailand. Journal of Econometrics, 112, 1, 193–206.Google Scholar
Williams, A. 2003. Ageing and Poverty in Africa: Ugandan Livelihoods in a Time of HIV/AIDS. Ashgate, Aldershot, Hampshire.Google Scholar
Williams, A. and Tumwekwase, G. 1999 a. ‘An elephant has to carry its tusks’: grandparents' efforts to educate their grandchildren in rural Uganda. In Thomas, P. and Bissell, S. (eds) Education for Sustainable Development. Development Studies Network, Australian National University, Canberra, 51–6.Google Scholar
Williams, A. and Tumwekwase, G. 1999 b. Why be Friends with a Poor Person? How Can He Help You? Social Support Networks of the Aged in Rural Uganda. Paper presented to the African Studies Conference, 26–28 November 1999. Perth, Western Australia.Google Scholar
Williams, A. and Tumwekwase, G. 2001. Multiple impacts of the HIV/AIDS epidemic on the aged in rural Uganda. Journal of Cross-Cultural Gerontology, 16, 3, 221–36.CrossRefGoogle Scholar