TEN GREEN BOTTLES STANDING ON THE WALL

Donkey’s years ago when I was in the primary school we used to sing one nursery rhyme often:

Ten green bottles standing on the wall, ten green bottles standing on the wall.

One bottle kept falling off accidentally , leaving one less bottles standing on the wall until all the bottles fall off. The song served the purpose of introducing counting and early number skills to us.
I would call it an exercise in subtraction. Of late, I have found myself singing that song often when alone in the house. I am relating it to what is happening in my life. In the last one year, I have found myself walking from one funeral service or burial into another!
I have been losing peers, childhood friends, relatives, colleagues left right and centre.
It just goes to confirm my birth order in society as a senior citizen. Amazingly, a few green bottles are still standing on the wall.
In Uganda, the life expectancy at birth for male and female was 62.9 and 67.2 respectively according to the 2019/2020 Uganda National Household Survey. Generally, worldwide, females tend to live at least five years longer than their male counterparts.
Generally, we are all living longer worldwide due to :
*Medical advancements- such as the development of vaccines and the discovery of antibiotics.
*Better access to health care
*Improvement in nutrition
*Better hygiene and living conditions.

I just have to learn to live comfortably with the fact that at my age , I am living on borrowed time.
I have never stopped appreciating that members of my generation have gone through turbulent years of civil strife ( 1966-1986), the HIV/AIDS pandemic of the 90s and beyond and the recent COVID-19 Respiratory Disease Pandemic of 2020-2022. Whoever is still standing is a real survivor and should exploit the opportunity of making the most of the time left.

If one green bottle should accidentally fall, there will be nine green bottles standing on the wall.

Ageing is a biological process and can be defined as the time-related deterioration of the physiological functions necessary for survival and reproduction.
The United Nations uses 60+ as old age but in Africa where generally life expectancy at birth is lower than in the developed countries, 50 or 55 is considered old. Pension schemes tend to use 60-65 for eligibility.

In August 2020, The United Nations General Assembly declared the decade of 2021-2030 as the decade of Healthy Ageing to improve the lives of old people, their families and their communities.
This healthy ageing concept consists of five key aspects aimed at improving functional ability. They include:
*The ability to meet basic needs
*The ability to learn and grow and make decisions.
*The ability to be mobile
*The ability to build and maintain relationships
*The ability to contribute to society
All five are largely dependant on the environment.
The three main factors for successful ageing include: *Physical well being, *Cognitive health and

*emotional and social well-being.

The healthiest group in any population is the 18-29 years while the ages most vulnerable to infection, disease and cancers is 65+ .
Some geographical areas were defined as Blue Zones by researchers Michel Poulain and Giovanni Mario Pes in March 2000 as areas with lower rates of chronic disease and longer life expectancy than anywhere else.
They include :
Sardinia, Italy
Okinawa, Japan
Nicoya , Costa Rica,

Icaria Greece
Loma Linda , California.
The longevity and good health of individuals in these zones is dependent on their environment. Other influencing factors include:

*Diet- mostly plant- based, *restrict their caloric intake,

*minimal use of alcohol or drink only in moderation mostly take the red wine rich in antioxidants.

*Regular exercise- their lifestyle encourages natural vigorous movement; walking, farming, gardening, cook daily, clean, doing house work as part of their daily chores.
*They have a sense of purpose in life.
*They incorporate stress relief in a purposeful, regular manner into daily life.
*Faith is central to these communities.
*They have an extended family structure with the young and old living together.
*They have strong supportive social networks that encourage healthy, happy lives.

In my country , Uganda, those aged 60+ make up about 3.7 % of the total population.
According to the Uganda Bureau of Statistics Population Projections Reports, 2015-2050
60-64—–1.4%
65-69 —–0.8%
70-74 makeup 0.7% of the population
75-79 —- 0.4
80+ —- 0.4 %
Little wonder then that anyone aged 65+ is hopping from one funeral vigil into another.

According to the Uganda Ministry of Health report on causes of death for the period of 2011-2021 , the leading causes of death in the 50+ age groups were:
*Heart disease
*Cancer
*Accidents ( preventable injury)
*Stroke(cerebral vascular diseases)
*Alzheimer’s disease
*Diabetes

There are multiple theories of ageing like the wear and tear.
Parts of the body wear out from repeated use.
Genetic mutations/abnormalities occur and accumulate with increasing age. Cells which are the building blocks of tissues and organs divide every day to replace old ones and during this process damage occurs in the genetic code/ DNA (deoxyribonucleic acid) but are removed by the cells of the immune system. At 65+ the damage occurs fast and the weakened immune system fails to repair them as fast as they are being produced. Damage to the DNA in the mitochondria- the cell’s powerhouse in which the energy to drive functions of each cell is produced results in abnormal uncontrolled growth of the body cells which is linked to cancer and increases the risk of developing chronic diseases like Alzheimer’s.
Between 70 and 80 years of age, the immune system suffers severe deterioration with age. It is less able to mount an effective immune response when challenged with germs, especially the new emerging ones like COVID -19 respiratory virus.
This explains why in Italy at the beginning of the Covid-19 pandemic, 81 % of the COVID-19 deaths occurred in people over the age of 65.
The Human Immunodeficiency virus( HIV) that has been with us for almost 40 years, infects and kills the cells of the immune system:CD4+ T lymphocytes thus weakening the body’s capacity to fight off infections. In the final stages of the disease –AIDS, the cells of the immune system are so depleted that the person dies of opportunistic infections. Since the discovery of highly active antiretroviral drugs in 1995, HIV/AIDS has become a chronic manageable disease.

Globally, we are living longer; we have to be prepared for the diseases that come with old age. Among these are different types of cancers. According to the Uganda cancer registry data of 2018, an estimated 33,000 Ugandans were diagnosed with cancer and there were 21, 829 deaths due to cancer. The most common cancers in Uganda are: cancer of the cervix, prostate, breast, Kaposi Sarcoma, Burkitt’s Lymphoma and lung cancer.
Worldwide new cancer cases are on the increase.
The old adage of : Prevention is better than cure, still holds today. The prevention of Noncommunicable diseases like cardiovascular diseases- heart attacks, stroke, cancers, diabetes and
chronic lung illness
should start early on in childhood by reducing the common risk factors and practicing healthy living.

Healthy Diets- eat a balanced diet every day.
Regular physical activity- keep your body moving and active. This boosts our mood and energy. The heart needs to be kept active.
*Avoid harmful use of alcohol.
*Avoid use of tobacco.
*Regular adequate sleep- an adult needs 7-8 hours of sleep every night.
*Stress Management – find a way that works for you to keep stress to the minimum. Stress affects other important elements of our health.
*Have a happy and positive attitude to life
*Regular health checks -especially after the age of 35- they can help to identify early warning signs of disease or illness. It increases the chances of treatment and cure.

He who has health has hope, and he who has hope has everything.- Arabian Proverb.

For the green bottles still standing on the wall, keep walking and keep having fun by doing what you love and enjoy doing.

“It is health that is real wealth not pieces of gold and silver.’’- Mahatma Gandhi

QUESTION :
Are you aware that the most healthy people among us are the ones who are always moving about like the barmaids and nurses?