Poverty could lead to ill health

Ms. Wakooli at her home with some of the children in Kiwata village, Bugobero sub-county in Manafwa district. (Photo by David Mafabi)

MANAFWA –Pictures of a haggard Hana Wakooli rising up her baby to my attention at Kiwata village, Bugobero sub-county in Manafwa district brought tears to my eyes.

Wakooli, 27, a mother of five who looks frail seems to be getting weaker every day but says she is well with a twinge of poverty and sadness written on her face.

As the storm gathers, she is gripped with more fear when she remembers that the only semi-permanent shelter that serves as her house can’t shelter them from the heavy storm and rains.

Her mud and wattle house does not only leak but it is dilapidated with the sticks used for building it, seen from outside, it is also bent because it has stood a long time without being repaired and risks collapsing.

Behind the house is a banana plantation; an almost dead silence only interrupted by birds chirping and distant noise from wild trees in the area.

This is Wakooli’s home where more than five people, with children infested with Jiggers converge to live. It serves as a kitchen, store, chicken house, living room and a bedroom for Ms Wakooli and her husband who has taken on drinking alcohol from morning to evening.

She says her husband has abandoned them to take to drinking and only comes back at night to sleep.

“This home is without a husband during the day and only gets a husband at night to just come and sleep. Some of my elder children are not at school because they have to wake up to go and work for people to earns a living, it is a sad situation,” said Wakooli before breaking down into tears.

She added that she regrets her marriage but has no choice but to stay with the man because she has children with him.

Wakooli is just one among the many women in rural areas who have been abandoned by men and are looking after the families without the help of the men.

In rural areas of Uganda, women are the worst hit by chronic poverty, they are the most illiterate, the most involved in ungainful employment or work where they don’t get paid and bear the brunt of bringing up children and ensuring they go to school.

Reports indicate that despite all work, rural women don’t get anything and that they have no control over land which they use and they also know that it doesn’t belong to them.

Mr John Musira, the LCV chairman for Manafwa says most men go on a drinking spree and just come back at night to sleep without finding out how the children are and whether they have eaten or not.

Wakooli is among the 67% of Ugandans who are either poor or highly vulnerable to poverty according to the expenditure review for Uganda 2012 by the Directorate of Social Protection in the gender ministry.

Dr. Fred Matovu, a senior lecturer of economics at Makerere University, who participated in the review, says the study that was aimed at establishing the number of Ugandans who require social protection due to their susceptibility to poverty found out that the 67% represented both Ugandans who spend below the poverty line of $ 1.20 (about sh3,170)per day and those who are below twice the poverty line, $2.40 (about sh6,340) per day.

“According to the World Bank, even those who are below twice the poverty line are likely to fall back into poverty,” Dr Matovu explained.

Wakooli holds off one of the children in her home. (Photo by David Mafabi)

And going by the United Nation’s Fund for Population Activities (UNFPA), Uganda currently has about 40 million people, meaning about 23.1 million are prone to poverty, and about 8.4 million of them (about 24.5%) are trapped in absolute poverty.

Ms Josephine Ahikire in her Electronic publications at Uganda martyrs university also says that women are the poorest of the poor, what is termed the “feminization of poverty”, thereby highlighting the significance of the gender dimension of poverty.

Mr Musira says that this new revelation implies that the country is sliding into poverty, which clearly shows that the government’s multiple development efforts of eradicating poverty have not yielded anything.

Dr Peter Wakooba, a reproductive health specialist said poverty and poor health worldwide are inextricably linked and that besides poverty, Wakooli could also be suffering from ill health.

“The causes of poor health for millions globally are rooted in political, social and economic injustices, poverty is both a cause and a consequence of poor health and poverty increases the chances of poor health,” said Dr Wakooba.

“And poor health, in turn, traps communities in poverty and infectious and neglected tropical diseases kill and weaken millions of the poorest and most vulnerable people each year,” added Dr Wakooba.

He explained that the very poor and vulnerable people may have to make harsh choices – knowingly putting their health at risk because they cannot see their children go hungry when they are buying medicine.

He revealed that the less money people earn, the less access they have to the ingredients of a healthy life and that research shows that those with lower incomes are more likely to smoke, have poor diets and not get enough exercise.

“TB is closely related to lifestyles of poverty, overcrowded conditions, alcoholism, stress, drug addiction and malnutrition and when you look at Wakooli’s house, the number of people who stay there, there are higher chances of contracting TB,” said Dr Wakooba.

Dr. Godfrey Mulekwa, District Health Officer Pallisa district says overcrowded and poor living conditions like Wakooli’s can contribute to the spread of airborne diseases such as tuberculosis and respiratory infections such as pneumonia.

“Reliance on the traditional three stones for cooking inside the house can lead to deadly indoor air pollution and a lack of food, clean water and sanitation can also be fatal,” added Dr Mulekwa.

Dr Godfrey Kigenyi [PHD], a lecturer at Uganda Christian University says that poor people like Wakooli tend to have lower levels of education, which affects everything from how much people know about health and nutrition to how well they understand risk factors or doctors’ instructions.

“Poor people have trouble in accessing treatment or lack reliable transportation to a doctor and this means illnesses are often caught late and worsened conditions bring greater dangers of disability and death,” said Dr Kigenyi

According to a 2016 poverty assessment report, poverty in Uganda reduced significantly between 2006 and 2013 and that the number of Ugandans living below the poverty line declined from 31.1 percent in 2006 to 19.7 percent in 2013 but the report adds that despite this progress Uganda remains among the poorest in the world.

Dr Fred Muhumuza, a lecturer in the school of economics at Makerere University says that although poverty levels have tremendously reduced since independence, many Ugandans remain poor.

Dr Muhumuza [PHD] added that according to the Uganda National Household Survey (UNHS) 2016/17 report released by the Uganda Bureau of Statistics (UBOS), more Ugandans are slipping into poverty with the number of poor people increasing from 6.6 million in 2012/13 to 10 million in 2016/17.

“And the above development translates into income poverty levels rising from 19.7 percent to 27 percent,” said Dr Muhumuza.

Dr Muhumuza explained that the safety net programs are of limited availability in Uganda, which has increased the vulnerability of households to fall back into poverty and that poor health also reduces a family’s work productivity, causing poverty to be passed down through generations

He said Wakooli represents the persistence of poverty in Uganda, despite significant poverty reduction, conveys the need for further governmental assistance and global contribution and that to sustain poverty reduction for Uganda, more attention to foreign aid policy is needed.

The Uganda National Household Survey (UNHS) 2016/17 report released by the Uganda Bureau of Statistics (UBOS) cites poverty worst hit regions as Karamoja, with 61 percent of the people categorised as income poor, followed by Bukedi with 48 percent and Busoga with 42 percent.

While presenting the findings of the UNHS survey in Kampala, Mr James Muwonge, the UBOs director of Social Economic Surveys, said the incidence of poverty is highest in the eastern region with 42 percent.

Wakooli raises up her child for PML Daily to see. (Photo by David Mafabi)

A survey of Health, Aging and Retirement in Europe (SHARE) that analyzed data from a repeat survey (panel), conducted between 2006 and 2012 found out people who assess themselves as poor get sick more often (38 percent) and suffer more from health setbacks (48 percent) than those who do not and the probability of dying earlier is also much higher  around 40 per cent for men in this age group.

Government interventions

Dr Kigenyi says that reducing poverty, improving nutrition and making sure people have access to safe water and sanitation, as well as strengthening national health systems, is of the utmost importance.

“Otherwise tackling one particular threat simply leaves people open to another deadly disease soon afterward. We need to tackle the structural causes of poverty and poor health,” said Dr Kigenyi.

Dr Kigenyi adds that Wakooli should join a women group in the village to benefit from the government program of UWEP that is aimed at increasing Household income and empowering women in the rural communities.

In 1995, President Museveni launched the Entandikwa scheme to reduce poverty and facilitate the small scale entrepreneurs, this was followed in 1997 by the Uganda Poverty Eradication Action Plan, which has been replaced with National Development Plan with the intention of transforming the economy into a modern one in which people in all sectors can participate in economic growth.

The Bona Bagagawale effort was later launched too, intended to make everyone in Uganda at least wealthy and the latest being operation wealth creation which has replaced National Agricultural Advisory Services (Naads).

All these programmes were introduced to improve people’s incomes but the questions in people’s minds are, what happened to these well-intentioned poverty alleviation efforts?, where were the likes of Wakooli?

Dr Muhumuza says the trickle-down effect has not been felt, and not only stagnating but also beginning to retard growth and that in the end, the country is now slipping into more poverty.




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