In Uganda, 70% of the workforce is employed in the ‘informal sector’ [UBOS, 2014], mostly self-employed in unregistered business. This is reflected in Godown, the Kampala fieldsite, where the majority of interviewees run their own small business, such as hawking fruits, market vending, driving bodas (motorbike taxis) and brewing waragi. Many of these jobs require physical labour.
The deterioration of physical health, accelerated by physically demanding work, can mean that old age presents a significant challenge to people who rely on their bodies for their income. This is the case for Achola’s husband, who throughout our recent interview, was busy bending to serve food to frequent lunchtime customers. It turned out he had chronic back pain. A visit to the hospital the day before had confirmed that ‘his spine is splitting’, a slipped disk. He’s not responded to other treatments and can’t afford a brace, so they’ve recommended surgery, but he’s nervous to weaken himself; he needs to work for his wife and grandchildren, and elderly relatives in the village. He was even planning to take the 10 hour bus to visit them the following day, ‘I have to go and farm, it’s the month’.
65 year old Palma also has back problems after 30 years of ‘moving with bananas’, carrying a basket to sell in town. She has to continue working to support her 3 orphaned grandchildren. ‘It was her parents to take care of them and her’, but now she has to do it alone. She struggles to pay their school fees, and in return, they cook, wash and clean for her. Sometimes she falls sick, and the family must rely on her neighbours to bring them food. Whilst she feels that her work has kept her active and healthy, she’s now tired, so hopes she can get a market stall so she can sit in one place.
Both stories here emphasise the reliance on family support in old age and the burden this places on individuals, especially when it breaks down. The head of physiotherapy at the local government hospital is all too familiar with such stories. He feels that informal workers contribute significantly to the Ugandan economy but are neglected by public services. He hopes for further investment in prevention and promotion to alleviate the impact of physical work on people’s bodies over time, seeking health protection for informal workers and advising them on how they can better protect themselves.
As part of the ASSA project, we plan to make a short film on the impact of physical work on older people’s health in Godown, that he can use to support further research, advocacy and community sensitisation to this end.