The Brain Function : Use it or Lose It

Learning new things like a skill challenges the brain and opens up new connections between the right and left parts of the brain.

It is now nineteen months since World Health Organisation(WHO) declared the COVID-19 respiratory disease a global pandemic. Unfortunately, this COVID-19 crisis shows no signs of going away. A few countries like Demark, Norway and Sweden have started easing the pandemic restrictions following a three-phased plan. This has become possible after achieving nearly 75 percent of their population fully immunised.

For the developing countries like mine, where full immunisation is less than five percent, we are still depending on the Standard Operative Procedures(SOPs) for preventing transmission of the virus as set out by the WHO:
• Frequent washing of the hands using alcohol-based hand rub or soap and water.
• Proper use of face masks.
• Physical distancing- allowing at least two metres between you and other people.
• Limiting social gatherings and time spent in crowded places.
• Avoiding close contact with other people – no hugging or shaking hands.

The pandemic has gone on for so long that the majority of us have started suffering from the effects of isolation: some form of anxiety and depression. Isolation is affecting our brain health. None of us had gone through such an experience in the past so we are all learning as we go along. It is vital that we promote brain health and wellness during this COVID -19 crisis otherwise we shall find it extremely difficult to cope when something like normal life returns.

The brain which controls everything below it is like a muscle: it has to be exercised every day or else it gradually loses its function.
I covered how each one of us can keep her/his brain functional as an integral part of general wellbeing, in the post of 15th October 2020: USE IT OR LOSE IT. I am therefore reposting it here because of its relevancy and usefulness.

Brain function is one of those things that deteriorate as one grows old.  Watching my octogenarian mother struggle  to play with the Rubik cube box, requiring skill and determination, made me think more about the age-related deterioration of brain function. One renown expert , Dr. Michael Merzenich  Ph.D. of Scientific Learning Corporation in Oakland , California has made numerous studies  on brain function. He tells us that this age-related functional decline can be reversed or be slowed down by engaging into mentally demanding activities. The mentally demanding activities include reading, solving hard crossword puzzles and playing brain games. They stimulate and challenge the brain unlike the simple mundane ones like walking to the neighbour’s or performing any task routinely. 

He also informs us that by the age of 40, most of us are largely using the abilities we acquired early in life. We could be said to be operating in ‘automated pilot’ mode. We are doing things without being consciously engaged in what we are doing. As a result, gradually the brain function begins to slowly deteriorate. We become slow in action and slow in making decisions.

He reassures that we can reverse this functional decline by appropriate stimulation of the brain with new challenges. He therefore recommends  that each one of us should engage in new learning all our lives by picking new hobbies or learning new skills altogether. The best is any activity that engages all your five senses and imagination.

 After the age of fifty, it is essential that we maintain and improve brain function simply by keeping it mentally active. An active brain is a healthy brain. We do not have to wait to grow old to start playing the recommended mentally demanding activities; the earlier we start the better.

Proverbs 19 verse 27 warns us that :  If you stop learning, you will forget what you already know.

I for one have started seeing the changes in bits and pieces: how fast I remember names, how fast I make decisions but have found the following activities extremely useful:

  • Reading- I have been a voracious reader since the age of six. I read for fun then read for knowledge.

As a medical doctor I read a lot to acquire new knowledge, to remember what I already know but in my leisure time I read for fun. The Internet has increased access to reading materials to many of us.

I also make time to read my Bible every morning.

I can say that this is the best time to be an avid reader. Reading helps me to concentrate, and engages my brain fully as I follow the characters through the story. It also improves my fluency in the language.

  • Writing- I would have cheated the literary world if I just read others’ books or blogs all this long.

I had to contribute to something which has given me so much joy and knowledge. I have published two fiction novels, several short stories and I am working on several of them at the moment. I have been running a personal blog since October 2016. I wanted to share my wealth of experiences and impact other people’s lives for the better.

I always research what I write about so this opens me up for more reading and acquisition of knowledge. I have made lifelong learning a priority. Posting articles regularly on my personal blog teaches me the discipline of remaining consistent.

As I write, I am fully engaged and my mind is taken off everyday worries. I am alone with myself so it helps me to decompress and unwind too.

  • Crossword Puzzles- I usually solve the crossword puzzles in the daily newspapers that I read and those in the magazines I buy regularly. I have been doing this for a long time but while researching about crosswords I noted with great interest that the first crossword puzzle was published in the New York World newspaper in December 1913!

As I try to solve the puzzle, I am fully engaged and focused on what I am doing. The hardest puzzles are the most engaging and challenging. Completing such a crossword puzzle gives me a sense of satisfaction. The feeling causes the brain to release the ‘feel good factor’ known as Dopamine , in several areas in the brain. It is the Dopamine which makes us happy and motivated as we go through life. Small jobs and achievements throughout the week naturally keep up my Dopamine levels. Low levels of Dopamine are associated with feelings of apathy, depression and low energy.

Of late I am trying to solve the number puzzle called SUDOKU, it is based on 9by 9 grid and MUDOKU, based on a 16 by 16 grid. It  exercises my brain immensely and has improved my memory and my number skills. Such puzzles open up new connections in the brain; making it more active.

Dr. Merzenich‘s team of top scientists has developed some brain games to improve the brain function.  You can look them up at BrainHQ. Playing them regularly sharpens the brain and as a result you think faster, focus better and remember more. Who would not want to remember more? I am at the beginner’s level but just like any learned skill, the more you practice, the better you become.

Next time I have a full house, I will dust off Chess,the board game. It is an engaging game that demands total concentration and intense focus. It tests your memory too.

The pandemic has brought online activities like teaching, webinars to the forefront. These are intellectually challenging.

Regular, quality sleep is most essential for brain health. Good sleep improves concentration and productivity and enhances memory.

Mark Twain said: “When I was younger, I could remember anything, whether it had happened or not.’’

And Thomas Fuller said:   “We all  forget, more than we remember.”

QUESTION:

How fast are you at making decisions or remembering things?

Has this post helped you to see the need for keeping your brain active during the COVID-19 restrictions and thereafter?

AND IN THE END IT’S NOT THE YEARS……..

Makula with her dad in Papua New Guinea

Thanks to the Internet; our graduate class has reached out to one another and formed a strong fraternity. The seeds were sown decades ago during our five years in the medical school during Idi Amin ‘s reign of terror, 1971-1979. To survive and thrive, we became each other’s keeper. These strong bonds are still intact and are being fully exploited. Recently, we came up with a project to give back to the Makerere medical school that shaped us. We are ordinary doctors but we chose to buy 108 Research desks for the new extension of the Post Graduate section of the Sir Albert Cook Medical Library, established in 1924. Slowly but surely, things are falling in place.

Come March 2020, the COVID-19 pandemic descended on us and is showing no signs of going away any time soon.

We are now all 65+ and fall under the senior citizens bracket of our population. Sadly, we have lost two of our best: Dr. David Sennoga, a veteran paediatrician of Durban, South Africa and Dr. Sam Mutumba, a paediatric Surgeon, to COVID. The deaths left us rather helpless.

 Due to the civil strife of the 70s and the fact that our Class was the last one to admit international students, we are scattered in several countries: Tanzania, Kenya, South Africa, Botswana, USA, Canada and Australia.

We were still struggling to come to terms with the deaths of our colleagues, relatives and friends, when our colleague: Dr.Sekkade Kiyingi of Brisbane, Australia lost his daughter, Makula(gorgeous)) to cancer of the bowel on the 7 th August 2021.

Makula was only thirty-four years old! She was in a specialised paediatric training programme.

Her elder brother, Kulumba, described her as a kind, ever smiling doctor, radiating positivity and optimism. She enriched the lives of all those around her.

 She had a brave heart and a strong spirit and these carried her through the six years of fighting the cancer. She had fierce loyalty and protectiveness of those she loved.

Makula as a teenager. She loved life and had a good sense of humour.

I cannot begin to understand what the Kiyingis have been going through but I have seen my elderly mother almost go to pieces after losing her youngest child to cancer of the breast, four years ago. If she had her way, she would have willingly chosen to die and let her daughter live.

On Saturday 21 st August 2021, I was woken up by the alarm clock just before 5am local time to attend Makula’s funeral at 12 noon Brisbane time. I just felt that I had to be a part of the ceremony for my own ‘closure’.

Over seventy mourners gathered at the Belgian Gardens cemetery to send off our Makula Agnes Nabbosa of the Ndiga/sheep clan. There were several young women of Makula’s age , reflecting on Makula’s character; a leader and a friend to many. There were many of our age group- parents mourning the passing of one of their children. The gem in this somber mood was seeing my young sister Juliet and her husband John among the mourners. They have lived in Perth for over thirty years and had become like a brother and a sister to the Kiyigis. They had flown in two days earlier to console their friends. It was comforting to see a few women dressed in our traditional wear.

Half way through the Mass, Dr. Sekkade Kiyingi was given an opportunity to talk to the mourners. He stood up tall in a dark green African print shirt over black trousers and in a clear voice gave a brief tribute to their daughter then thanked all the mourners wherever they were for joining them at their daughter’s final farewell.

In my heart of hearts, I was crying as a bereaved parent- In Africa, a child is raised by the whole village. I was crying for all the potential buried with her.

It was sunny but so windy that the flowers on the coffin were bending in it. The coffin was then placed in a vault and the mourners were invited to place a few flower petals at the rear. The burial was over in twenty-five minutes! Life goes on for the living.

Instantly I remembered Abraham Lincoln’s quote: ” And in the end it’s not the years in your life that count; it’s the life in your years.’’

Makula in her short life had lived a life of meaning and purpose. She had lived a full life. Having lived a life of purpose had created passion and made her effective as an individual. She had lived with hope till the end.

I left the virtual funeral happy that she had rested from the pain and suffering but at the same time, her inner beauty- looking out for the beauty in each individual had enhanced her external beauty to her family, friends and colleagues.  It was her inner beauty that had given her the confidence to be herself. This was a life well lived.

I spent the day thinking about death and life.

Kahlil Gibran ,the renowned Lebanese- American philosopher once said:

”LIFE IS A TEAR AND A SMILE.”  He knew that it was the tears that made us more human.

He also believed that life and death were essentially two sides of the same coin. There is no life without death- accepting your mortality helps you to live a meaningful life and to enjoy your life more.

I for one accepted my mortality twenty-three years ago when I was involved a nearly fatal accident. Since then, I have learned to live as a person deserving that second chance at life.

At my age, I know with absolute clarity that I have lived more than three quarters of my life. This has made life so valuable to me. It has given my life a deadline so I have stopped procrastinating instead I just get on with things. I have had to reorder my life by getting my priorities in life right: relationships and my character. I devote 80 percent of my time on these two and they have given great meaning to my life. I have learned to use my life for something good for myself and others. I have also learned to take joy in all the small things that each day offers.

Comparing now and fifteen years ago, I am doing less and yet it translates into more done because I am focused and therefore more effective and productive. After all I am human; I cannot do everything.

The greatest tragedy in life is not death but living a life without purpose and not living a life you want for yourself. The latter leaves you with a lot of regrets in life.

This quote by Myles Monroe says it all: ”The wealthiest places in the world are not gold mines, oil fields, diamond mines or banks. The wealthiest place is the cemetery. There live companies that were never started, masterpieces that were never painted. In the cemetery are buried the greatest treasures of untapped potential. There is a treasure within you that must come out. Don’t go to the grave with your treasure still within YOU.

Bronnie Ware, an Australian nurse who worked for several years with terminal care patients observed the top five regrets of the dying. They include the following:

  1. I wish I’d had the courage to live a life true to myself, not the life others expected of me. Many dreams were unfulfilled because the person feared to make certain choices or left it too late.
  2. I wish I had not worked so hard– many missed their children’s youth and their partner’s companionship because they failed to balance work and family.
  3. I wish I ‘d had the courage to express my feelings– many had suppressed their own feelings to keep peace with others.  They lived mediocre lives. At the end they carried a lot of bitterness and resentment.
  4. I wish I had stayed in contact with my friends– many got so wrapped up in their own lives and let the golden friendships slip by over the years. Everyone misses their friends when they are dying.
  5. I wish that I had let myself be happier– happiness is a choice but many of these people had stayed stuck in old patterns and habits and forgot how to look for laughter, fun and adventure in their lives.

We all have our regrets at this point in our lives, but it is never too late to change and have a happy ending. Arise, play and dance to the music of life.

 If I picked anything from Makula’s short life it is : Absolute clarity about life gives you focus and purpose and that we all need hope to cope.

Rest in eternal peace, our beloved Makula. May God give the family the strength, courage and inner peace they need to go on with their lives.

WHAT I HAVE BEEN READING LATELY

World Health Organisation (WHO) declared the COVID- 19 Respiratory Disease a global pandemic on the 11 th March 2020.  It is now exactly seventeen months into the pandemic.  The virus is continuing to rage havoc in all countries; each one of us has either been affected or infected by it or both.

 As of the 18 th August 2021, data from the Johns Hopkins Corona Virus Resource centre shows:

Global confirmed cases –   208,653,614

Global Deaths –                        4,383,333

Uganda:

Confirmed case –                    97,186 (No access to mass testing)

Deaths                                          2, 905

Vaccine Tracking:

1, 167,733 doses administered in Uganda

4, 129  fully vaccinated ( 2 doses of Astra Zeneca vaccine) making up 0.01% of the population.

To reach Herd Immunity in any community, 60-70% of its population have to be fully vaccinated.

As the pandemic rages on, many of us have been driven into some degree of anxiety or depression because of the uncertainty and not knowing when it will end.

One thing is for sure: Life goes on. Time and tide wait for no man so says an old adage. Definitely, we have to become more innovative and creative in finding ways to continue with our lives amidst the pandemic. No more excuses for remaining inactive.

The best place to start is where we are: in our homes.

I have been reading widely about strategies for coping in a situation that you have no control over.

One American psychologist, Jessica Gold, Assistant Professor of psychology at Washington University of Medicine, gives us three main coping strategies. We should practice them daily so as to get better.

They include:

  • Being in the present moment, or the here and now. Intentionally being fully engaged in what is happening at that very moment; not distracted by ruminations of the past or worries of the future.
  • Open up to feelings and uncertainty. What you do not talk about can kill you. Accept what you cannot change and change what you are able to change. This is where the SERENITY prayer attributed to a German-American theologian named Reinhola Neibuhr(1892-1971) comes in handy.

God give us the grace to accept with serenity the things that cannot be changed,

 courage to change the things that should be changed,

 and the wisdom to distinguish the one from the other.

  • Focus on who is most important and what is most important in your life. Devote your time , efforts and energy on these.

Having these strategies in mind, I have been taking one day at a time. Having a lot of time to myself, I have focused on honing my writing skills by reading many books and writing several short stories.

I want to share with you, a few of the books that I have been reading lately.

THE CANE PRIZE FOR AFRICAN WRITING 2010 and 2012

These are collections of short-listed short stories from Africa and some other ones written by emerging African writers at workshops sponsored mainly by the Oppenheimer Memorial Trust.

Each book has seventeen such stories of different genres from different African countries . The stories transport you to the authors’ countries of origin; whetting your appetite for more reads. Countries like Uganda, Rwanda, Tanzania are yet to make themselves visible at the Caine Prize For African Writing.

I would recommend these great reads to you since they offer short forms of fiction that give you a lot of expectations and excitement. You visit several African countries in the writers’ eyes. Finishing one story excites you to read the next one. Quick reads which offer a fast way of completing a story. You will feel that you have accomplished something.

For the writers like me, reading such books offers you many genres which give you ideas for your writing. They introduce you to emerging writers to look out for on the continent. I have read enough of them to try writing one for 2022.

Life Beyond Measure/ LETTERS TO MY GREAT- GRAND DAUGHTER

Most of us who are 50+ know Sidney Poitier the icon film star who later became a film director but is now retired. He was the first black man to win an Academy Award in 1964. You must have seen him in any of these unforgettable films: Lilies of the Field (1963), Guess Who’s Coming to Dinner, To Sir, With Love, and in the 1997 movie Mandela and De Klerk where he played the icon Mandela.

Life Beyond Measure/ LETTERS TO MY GREAT- GRAND DAUGHTER is not an ordinary Memoir but it is 23 letters written to his first great- granddaughter, AYELE, born on 21 December 2005. These twenty-three letters are life’s lessons as experienced by Sydney Poitier. His goal was to help Ayele and others that were to follow her to experience Poitier’s life and connect to their lineage. He starts with his childhood on Cat Island, Nassau, Bahamas and goes on to capture memories and moments as he savours his life.

Sidney was born prematurely in Miami, Florida, where his peasant parents had gone to sell their harvest of tomatoes. When he was 15 years of age, his father noticed that Sidney had an impulsive risk trait that was likely to lead him into committing crimes so he sent him to Miami, Florida, to live with his eldest brother. He was trying to save him from himself in a place with limited opportunities and choices.

At that age, he was most fascinated by seeing his face in a wall mirror in a shop in Miami!

Circumstances forced him to move to New York and fend for himself. He became a dishwasher. Thankfully, he met a Jew dishwasher to whom he confessed that he could not read well! The friend offered to teach him how to read in between their chores. This friend unknowingly turned Sidney into an actor. Later he tried to audition with a member of the American Negro Theatre and was sent away as he had neither talent nor skills. This motivated him to become an actor. Applying logic and reason, he succeeded in becoming an actor in this hostile environment. As they say the rest is history. In 2001 he was awarded an Honorary Award as the most respected actor of his time. He is now 93 years old and remains strongly attached to his environment at home in Bahamas.

This is a unique memoir which will inspire many people to aspire for greatness while documenting their struggles and successes along the way. Each one of us is unique and each story told, has so much power to impact others. It is one of the most exciting and revealing memoirs that I have read and would recommend it to you too.

ARIEL SHARON: An autobiography of the Warrior.

Ariel Sharon (1928- 2014) was Israel’s most famous soldier who rose to become Israel’s 11 th Prime Minister (2001-2006)

Born to Russian Immigrant farmers in Israel in 1928, from the age of 15 participated in all major wars in Israel. Close to 60 years, he was at the forefront of events in Israel. He was admired and hated but not in equal measure. His military achievements and political policies were often considered controversial.

As a soldier, he served in the Israel army from its inception in 1948 until he retired in the late 90s. After retirement he went back to farming but remained as a reserve commander. He was the most daring and successful Commander in Israel; uncompromising, ruthless but commanded respect and love of his troops. He considered the security of Israel’s borders paramount to living a normal life in Israel.

As a politician he was considered a hardliner and always walked in a minefield of intrigue and backstabbing.

This most decorated warrior had a soft side too:  a husband and a father.

He shares their struggle to have children but later they had two sons with his second wife, Lily.

His first wife, Margalit died in in a car accident then he married her sister in 1963.

 In 1967, they lost their first son, Gur, aged 11 years in a freak accident at home. He was playing with a friend with an old short gun given to him by one of the family friends. Sharon never overcame this loss and always mourned for the potential that was buried with Gur. The loss affected the family more than anything else in their lives.

He always struggled to make time for his family.

As Prime Minister, he was considered as one of the most pragmatic. He remained in this position until he was incapacitated by a massive stroke in January 2006. He died aged eighty- five years in January 2014.

Reading this big book where Sharon candidly tells it all, was like reading the history of the Jewish nation of Israel from 1936 and the selfless men and women who shaped it.

I would greatly recommend it as a remarkable story more so to those who may aspire to become politicians in future.

Whenever I finish reading such remarkable stories, I pause to thank God for my late father and my school teachers for opening up a world of magic and wonder for me. It is inexhaustible and offers rewarding challenges.

Let us keep reading to sharpen our minds and to increase our ability to empathise with other people.

As Lailah Gifty Akita ably put it: ‘’IF YOU WISH TO RENEW YOUR MIND, READ.’’

QUESTION: What books have you been reading lately and why?

THE UNPREDICTABILITY OF LIFE

One moment life may be colourful only to become dark in the next.

I must apologise for taking long without posting articles on this page. I have not been well since April 2021. It has reminded me of the unpredictability of life- one moment I was as fit as a fiddle and then a few days later I was lying in a hospital bed. Generally, medical doctors do not make the best patients due to the reversal of the roles and knowing what they know. We are human too!

What made the situation more complex is that we are in the second wave of the COVID-19 pandemic and are restricted by the Lockdown. Here in Uganda, the new cases are on the rise and so are the deaths.

From the Johns Hopkins Corona Virus Resource Centre, as of the 30 th July 2021:

Global confirmed cases were 197,462,343 and the Global deaths were 4,211,491

UGANDA as of 30th July 2021:

Confirmed cases were 93, 675- We cannot afford Mass testing.

The deaths were 2,661

Doses of Corona virus vaccine administered were 1,143,763

People fully vaccinated ( received the 2 doses of the Astra Zeneca Corona virus Vaccine)were 4,129

Percentage of the population fully vaccinated were 0.01%

For anyone who is 60+, this is not the best time to be lying in a hospital bed if you can help it.

Thankfully, I am fully vaccinated against the COVID-19 Respiratory Disease, having taken my second dose of Astra Zeneca vaccine in early May. There is still some uncertainty as the virus keeps changing rapidly; forming new variants that spread fast in a community.

Like any other individual, I have continued to lose relatives, friends and colleagues. This has drained me emotionally.

It has been extremely tough on me to fall sick during the Lockdown, my children and friends cannot visit me though we talk regularly on the phone . I miss the direct human connection.

The psychologists tell us that lack of human connection can be more harmful to our health than smoking and high blood pressure. Lack of human connection  causes anxiety and depression. Meaningful human connection helps us regulate our emotions. Once we can regulate our emotions, our self-esteem and empathy increase, making our Immune system function better. A functional Immune system protects us from recurrent infections and reduces our risk to develop cancer.

Within this limited human connection , I have had to make the most of what is available for me:

  • The few loved ones around me
  • Nature
  • Books
  • Communication- video calls and webinars

Exercising out in the  open has its health benefits but it also serves as a distraction from the uncertainty of the COVID-19 pandemic which seems to be unending.

I have had to ‘’slow down and smell the roses’’ as the old adage demands of me.  Spending a lot of time with nature has sharpened my five senses of touch,  sight, hearing, smell and taste. It has also stretched my imagination and made me more creative.

Allow me to share some of the photos that I have taken of the environment around me. I now understand my position in the universe better and my responsibility to conserve and preserve the environment for future generations.

This plant growing in shallow soils has developed buttress roots to keep it stable in the winds blowing from the nearby lake.

Waking up to a lush green view like this wakes up all your senses thus preparing you for the day.

The buttress roots are solid and spiked.

Colour in a garden like this strongly resonates with colour in our souls.

I found these two Japanese proverbs useful and relevant to my situation.

  1. It is the same life whether we spend it laughing or crying.
  2. Be not afraid of going slowly. Be afraid of standing still.   

Last but not least, those who read the Bible know the famous verses in Matthew chapter 6 verse 34 :

‘’So do not worry about tomorrow; it will have enough worries of its own. There is no need to add to the troubles which each day brings.’’

I have learned to live one day at a time; savoring each moment and making the most of it. It has helped to reduce the stress in my life thus increasing my physical, mental and emotional well-being during these uncertain times.

QUESTION :

Has the prolonged COVID-19 pandemic uncertainty taught you to invest in the Present- cherishing what you have in that moment in time?      

REMAINING HOPEFUL IN A DIRE SITUATION

A Sunrise symbolises birth and rebirth. New beginnings, new challenges and new possibilities. It gives us hope for a better day.

The invention of the Internet shrank the world into a global village. On the 7th April 2021 when I read from the Johns Hopkins Corona Virus Resource centre that Brazil had suffered 4000 deaths in 24 hours, a cold shudder went down my spine. Brazil has a new more virulent strain that runs a short clinical course than the original one. It has affected the youth in big numbers. Many video clips  of elderly parents wailing after the deaths of their children are making rounds on the Social Media. Their echoes keep ringing in my ears. The crisis is compounded by the country President’s continued rejection of public health restrictions such as mask-wearing, physical distancing and lockdowns. As a health worker , I have always believed that the greatest asset for each country is its people and these people must be healthy first to engage in economic activities and the growth of their country. 

This has reminded me of the period of the peak of the HIV/AIDS epidemic in Botswana in the late 90s.  The president then- Festus Mogae, made this bold statement: ” Botswana was threatened with extinction.”

Thereafter, he made HIV/AIDS a national priority and launched   Botswana’s Mass Antiretroval Therapy Programme- MASA( New Dawn) in 2002.  I was working there and was very privileged to be part of this comprehensive programme. With such a committed leader and a stable democratic government, we saw a dramatic drop in AIDS-related deaths from 21,000 in 2002 to 5,800 in 2013. The decline in numbers was sustained for the following years. There were many challenges but the results fired us to work even harder to overcome them.

The COVID-19 virus is not going anywhere anytime soon. This demands that wherever we are, we have to triple our efforts to fight it. Currently, USA, Brazil, India and Mexico are the countries most hit by the virus.

From the Johns Hopkins Corona Virus Resource Centre, as of the 20th April 2021,

There were 142,965,975 global confirmed cases and 3,044,492 global deaths.

Brazil had 14,043,076 confirmed cases and 378,003 deaths.

South Africa had 1,568,366 confirmed cases and 53,887 deaths.

Some encouraging news came in from Israel last week. Israel has had half of its adult population vaccinated fully against Covid-19 disease. As a result, the number of new cases and the number of patients developing the severe form of the disease has declined. They seem to have put themselves on the path of herd immunity by this campaign of massive vaccination.

The majority of us feel that the pandemic has gone on for so long that we have started suffering from Caution fatigue or  COVID-related fatigue. The fatigue is affecting our physical and emotional wellbeing.

 However, the numerous deaths happening around us during the third wave of the pandemic, prompt us not to relax until the transmission is reduced to the lowest level possible worldwide. This echoes what Dr. Tedros Adhanom Ghebreyesus, the Director- General of the World Health Organisation, has been telling us all along:” We are not safe until everyone is safe.”

 The vaccine offers us hope for attaining herd immunity but the public health measures of:

  • Frequent washing of hands using alcohol-based hand rub or soap and water
  • Proper use of Face masks
  • Physical distancing- maintaining 2 metres between you and other people.
  • Limiting social gatherings and time spent in crowded places.
  • Avoiding close contact with other people- no hugging, no shaking of hands.

These measures are still in place to reduce the transmission of the virus in our communities. Prevention is better than cure more so with this Covid-19 infection in the 60 plus groups of any population.

Here are some inspiring quotes to keep us going in this state of confusion, caution fatigue and uncertainty.

If there is life, there is hope.’’ – Stephen Hawky

” A little hope each day can fill rivers to overflowing. ”- Unknown

” Once you choose hope, anything’s possible.’’- Christopher Reeve

And sometimes, against all odds, against all logic, we still hope.’’- Ellen Pompeo as Dr. Meredith Grey

If the rhythm of the drum beat changes, then the dancer’s steps must adapt. – Kenyan Proverb

The best way to eat an elephant in your path is to cut her up into little pieces .- African Proverb.

The sun never quits shining. Sometimes , clouds just get in the way.’’– Unknown

”The forces that are for you are greater than the forces against you.’’– Joel Osteen

For those of us who have lost loved ones to the COVID-19 disease and are grieving, find a little comfort in the following:

”We grieve because we love. The intensity of the grief often proclaims the depth of our love.’’- Gary Roe

One of my favourites over the years: FOOTPRINTS IN THE SANDS by Mary Fishback Powers

One night I dreamed a dream.

As I was walking along the beach with my Lord.

Across the dark sky flashed scenes from my life.

For each scene, I noticed  two sets of footprints in the sand,

One belonging to me and one to my Lord.

After the last scene of my life flashed before me,

I looked back at the footprints in the sand.

I noticed that at many times along the path of my life,

especially at the very lowest and saddest times,

there was only one set of footprints.

This really troubled me, so I asked the Lord about it.

” Lord you said once I decided to follow you,

You’d walk with me all the way.

But I noticed that during the saddest

 and most troublesome times of my life,

 there was only one set of footprints.

I don’t understand why, when I needed You

the most, You would leave me.’’

He whispered, ” My precious child, I love you and will never leave you

Never, ever, during your trials and testings.

When you saw only one set of footprints,

It was then that I carried you.’’

Other than allowing ourselves to feel overwhelmed and distressed, let us re-evaluate the meaning of life and pick valuable lessons from this Covid-19 health/economic crisis. It will help our spirits grow stronger.

QUESTION:

How often do you count your blessings during this dire situation?

Has it helped you realise that things could be worse off?

TRUE TO MY WORD

One of the front line health workers receiving his first dose of the COVID-19 vaccine at his local clinic.

One of the virtues that my late father passed on to me at a very tender age is to keep my promises to God and to people. He believed that a person could only be as good as his word.

Words have power and when you do what you promise no matter how much it may cost you, you become a reliable and dependable person.  On the 11 th December 2020, I posted an article on this blog entitled: I will gladly queue up to receive the new COVID-19 Vaccine.

By the time I wrote that post, the COVID -19 pandemic had raged on for nine months and vaccine research scientists, pharmaceutical companies and clinicians were working together round the clock to develop and launch COVID-19 vaccines in their attempt to return the world to a sense of normality.

By my Ganda culture, I was sounding the ‘’war drums’’ to mobilize each one of us to prepare for participation in the raging COVID-19 war. It had caught us unprepared and had grown to become the biggest threat to the world since the Spanish Flu pandemic of 1918-1919.

As the Director- General of the World Health Organisation, Tedros Adhanom Ghebreyesus rightly said: “We are not safe until everyone is safe.”

The war demands for collective efforts and collaborative partnerships at all fronts.

On 20th March 2020, the President of Uganda declared the first lockdown in our country to prevent the spread of this new disease.

21st March 2020, Uganda confirmed its first case in the country, a male Ugandan

 citizen returning from Dubai.

From the Johns Hopkins Corona Virus Resource Centre, as of the 23rd March 2021, Uganda had reported 40,687 confirmed cases and 334 deaths while 123,778, 489 cases had been confirmed globally and 2,725,516 Deaths. We have all been touched by this COVID-19 disease in one way or another.

As a medical doctor, I have been all along reading scientific and medical journal articles to understand the COVID -19 disease to stay up-to-date on best practices. We are living in the Digital technology era and the management and control of the pandemic is driven by data.

By early November 2020, four vaccines had been developed. They included:  Pfizer-BioNTech, Moderna, OxfordUnivesrity /AstraZeneca, SputnikV and later the Chinese ones. In December 2020, WHO had approved  these  vaccines on an Emergency use authorization only.

On 8th December 2020, the 90- year- old Margaret Keenan of UK became the first person in the world to be given the Pfizer/BioNTech COVID-19 vaccine. She received her second dose of the vaccine on the 29th December 2020 and is still going strong.

On the 11th March 2021 with the assistance of COVAX, WHO and UNICEF,

 Uganda’s ministry of health launched the COVID-19 vaccination campaign giving the first priority to the frontline health workers: doctors, nurses in government facilities around Kampala city

and some senior doctors from the most vulnerable part of our population. True to my word, I quickly seized the opportunity to be among the first 200 or so who received the Oxford University/Astra Zeneca vaccine at the Women’s hospital in Mulago, Kampala. It was an informed decision and thankfully I have not suffered any side effects.

I took it for the following reasons:

  • From the available evidence-based medical literature, I am among the most vulnerable members of the population for the COVID- 19 disease. I am above 65 years of age. The cdc.gov website has co-related age and the risk of hospitalization and risk of death.

40-49 years of age have 3 times the risk of hospitalization and 10 times the risk of death.

50-64 years of age have 4 times the risk of hospitalization and 30 times the risk of death.

65-74 years of age have 5 times the risk of hospitalization and 90 times the risk of death.

75-84 years of age have 8 times the risk of hospitalization and 220 times the risk of death.

  • WHO has approved the vaccine I was given as safe and effective. All pharmaceutical products have some side effects, they may not affect everybody and could be minor or temporary. But in medicine the focus is on weighing the benefits of the product against the risks. In the new Covid-19 vaccine, the benefits in the most vulnerable group of the population outweigh the risks. The vaccine has been found to reduce the risk of acquiring the infection, reduce the risk of developing the severe form of the disease requiring admission and care in the ICU and reducing the risk of death from the disease. The final outcome- the health workers and the health care systems are not overwhelmed by numbers and deaths from the disease are greatly reduced.
  • A health worker of my standing has her own clientelle and followers who believe in her. Though she makes a purely individual choice to take the vaccine, it impacts and influences her group-

to take or not to take the vaccine. I had to take action. My conscience could not allow me to sit on the fence.

  • The effect of COVID-19 on me personally. Like the majority of us, I have lost many relatives, colleagues, friends to the virus.

I lost a niece in Arizona, USA in June 2020, she had worked there as a nurse for over 25 years. In December 2020, I lost some friends here in Uganda. January 2021, I lost one of my best friends of many years Dr. Sarah Namuli Yiga of Bloemfontein, South Africa, followed by a classmate, Dr. David Ssenoga of Durban , South Africa, family friends: Mr. and Mrs. Mikka Sematimba whom we buried within a week of each other! On the 19th March I buried a brother-in law, who died in London and the list keeps growing.

 These series of deaths have been emotionally and physically draining to me. Available scientific information tells me that the vaccine is safe and effective so I would rather take the vaccine other than allow myself to risk catching the disease and ending up in the ICU.

When at least 70-90 percent of our population is vaccinated against COVID -19 disease, we would have reached the level of Herd Immunity then we can control the pandemic.

It is crystal clear to me that the COVID-19 vaccine is not the solution to the COVID-19 pandemic and that I still have to follow the laid out health and safety rules  by the Ministry of Health:

Masking up in all public places and avoiding crowds.

Practicing regular good hand hygiene.

 Keeping physical distancing of 2 metres.

Being well informed about the disease.

Lastly I may also add eating nutritious foods, taking regular exercises and having regular sleep at night to boost the body’s immunity to fight infections.

Your health is your greatest wealth and it is your responsibility to safeguard it and to protect others in your community.

To help you understand how far we have come with vaccine-preventable diseases ( WHO has 28 on its list excluding COVID-19) I always use the example of the highly contagious and serious measles disease.

The measles vaccine was developed in USA in 1963 but was never widely available to poor countries like mine until around 1994 when WHO specifically developed and supported national Expanded Immunisation Programmes in the least developed countries of the world. By the time I undertook the Internship programme in 1978, at New Mulago, the only teaching hospital in the country, a minimum of ten children under the age of 5 were dying from measles. They were dying from its main complication –  Broncho Pneumonia, in the Acute paediatric admission department almost daily. My heart could not take it so I went into Internal Medicine instead.

Records from the Uganda Health Management Information System show that between 1999 and 2001, routine immunisation and massive Immunisation campaign for children aged 6 months to 5 years were consistent.

This paid dividends: the incidence of measles in this vulnerable group declined by 39 percent, measles admissions declined by 60 percent and the measles deaths declined by 63 percent. Currently, the Ugandan child receives her/his first dose of Measles combined with Mumps and Rubella vaccine(MMR) at 9  months of age and the second dose of MMR at 18 months of age. The vaccine uptake is yet to rise from 85 percent to reach the WHO requirement of 95 percent in any given population if we are to eradicate measles disease in the world. Botswana’s measles vaccine coverage was 93 percent in 2016.

Globally, between 2000-2018, routine measles vaccination had resulted in a 73 percent drop in measles deaths. Safe and effective vaccinations save lives.

Going by these historical developments, there was nothing to hold me from taking the COVID-19 vaccine unless if I had a serious contraindication. I would therefore urge each one of us to make the right informed decision based on scientific facts not Social Media half truths, fake new and misinformation.

Get the facts about the disease from the Uganda Ministry of Health website: http://www.health.go.ug and the WHO one: http://www.who.int/Diseases.

In this digital era, plenty of information is freely available but you have to decipher and you have to keep reading to keep up-to- date with new advances in science and medicine.

Knowledge is power only if applied to improve your quality of life otherwise it remains mere information.

For us the health workers, it is very encouraging to understand that anyone catching the COVID -19 disease today stands a high chance of recovering from it when compared to those who had it in the first 6 months of 2020 when the disease was completely new.

Scientific studies are putting the pathology of the disease together while the public health specialists are sharpening their skills in preventing the disease and the clinicians are gradually learning the best practices to help optimize patient outcomes.

‘’The best way forward is the blended comprehensive approach which puts containment as a major pillar.’’– Dr.Tedros Adhanom Gebreyesus. WHO director- general

Please do your small part perfectly that fits in this big picture.

QUESTION:

Has this post helped you make an informed decision about taking the new COVID-19 vaccine if you are in the most vulnerable group of the population?

CONNECT WITH YOURSELF, WITH OTHERS AND WITH NATURE

Man is by nature a social animal, thriving best in a small group. It goes back to the ancient times when men hunted wild animals and gathered plants, seeds, berries and roots for food. Even today, the family remains as the basic unit of a nation. A family can be defined as a group of two or more persons related by birth, marriage , adoption who live together.

The Covid-19 pandemic restrictions are designed to reduce the spread of the disease in a family, community, nation and the world in general.

Physical distancing reduces human contacts- no hugs, no handshakes, no gathering together to share grief or joy. Shared common experiences help us to address our fears, worries and every day problems. This emotional support is vital for our physical and mental health.

It is almost a year since the necessary COVID-19 restrictions became the new Normal but they have left many of us in social isolation and loneliness. We are all craving for social interaction the same way hungry people crave for food.

90 years-old Margaret Keenan, could not have expressed it better the day she became the first person in the world to receive the Pfizer/BioN Tech vaccine in UK on the 8th of December 2020. She received the second dose 21 days later.

She said: “Being the first in the world was the best early birthday present I could wish for. It means I can spend time with my family and friends in the New Year after being on my own for most of the year.”

Social communication is a core psychological need essential to our health and well being. Though we feel lonely and isolated from loved ones , we have to look for ways to adapt and become more resilient during the pandemic. By the look of things, the end of the pandemic is as elusive as the flower of the local Ugandan yam plant and yet life has to go on.

I for one have found the following activities helpful as I tried to increase social contact and engagement during the pandemic.

  • Enhancing social engagement with loved ones and the community. Thanks to Digital technology that has shrunk the world to a global village. I can instantly talk to family members on the phone, send text or audio messages, arrange virtual gatherings on Zoom or WhatsApp. There are many virtual meetings or webinars that I can join to share ideas with like-mined people locally and outside Uganda. Looking through old photo albums awakens the cherished memories I have so far created with family and friends. It helps to reduce my anxiety and stress.
  • Regular physical exercise- I take long walks in the evening and do light weight lifting to tone and keep my muscles strong. It reduces the stress and uplifts my mood while keeping me healthy and strong.
  • Prayer-for any genuine religious person nothing can be as comforting as having an intimate relationship with your Father whom you can talk to about anything and everything. Just like that simple chorus we used to sing in Sunday school donkey’s years ago: Take it to the Lord in prayer.
  • Reading or listening to audio books and music. Books engage our minds and imagination, enrich us , inspire us and increase our empathy and ability to understand others. For some years, I have been a member of Online Book Clubs like the Africa Book Club, Two Drops of Ink and Yours 2-Read. I have also been an

an active member of writing cartels like The Write Practice. It  is very beneficial for an emerging writer to bond with like-minded people.

  • Spending time in Nature- the environment you live in can either increase stress on you or lower it. Pleasing environments like water, trees, plants and animals improve our moods and stimulate our immune functions to work efficiently. Walking outdoors regularly for a minimum of 30 minutes significantly lowers stress, lowers our Blood pressure and increases our heart rates. Studies have shown that exercising outdoors is the best antidote for stress. The beauty of the surroundings, the scents and smells, the sounds like birdsongs, the different people you see, the animals, insects and birds awaken all our six senses of vision, hearing, taste smell, touch and proprioception and we become fully engaged with nature. Gardening offers the greatest benefits in that you are exercising as well as being immersed in nature.

You are never alone with your thoughts. For those who cannot go outdoors , you can bring the outdoors inside by caring for potted plants or pets and if the worst came to the worst then just look through books on gardening and nature.

Nature has been scientifically- proven to delight and heal.

Here are some photographs of nature from my collection.

A lemon orchard near Cape Town, South Africa

Last week, I woke up to find a crop of these tiny button mushrooms in our backyard. I had to invite the neighbours to harvest some for themselves as the culture demands.
The calm ocean calms your soul and invites you for a swim
My mother has been planting this type of pole beans along her fence since she picked the seeds from her late sister in Nairobi in the 1970s. Its beauty is that the more you harvest the pods, the more new ones are produced.

The mixture of old trees and shrubs and young ones in a garden, remind me of the mixed generations in our communities and nation.

The local small sweet bananas have a unique taste. It is etched in my memory
Ancient cities were designed for people and reflect what was important for the people at that moment in time
The barren desert has its unique beauty too.

Just as the earth has the power to renew itself more so after a drought or a bush fire, we too have the ability to rediscover our inner selves after the unprecedented disaster of COVID-19 pandemic and go on with our lives.

QUESTION:

In this unprecedented and prolonged COVID-19 pandemic quarantine, how have you managed to re-invent yourself and bond with like-minded people?

IT NEVER RAINS BUT IT POURS

Stock Image

I could have been ten years old when our neighbours went to the village to celebrate the festive season. They had a big family but among them was a girl, Rhoda. She was of the same age as me and we were friends; playing hide and seek, tap game and skipping together. To our shock and horror, Rhoda died of a snake bite a week later. Our parents had found it terribly difficult to explain to us what dying meant. They chose to spare us the agony of the funeral. I missed Rhoda and her face is forever etched in my mind.

Fast-forward to 2021; we are in the second wave of the COVID-19 pandemic and people are dying in big numbers in many countries of the world.

Yesterday, 10th February 2021, South Africa, the worst hit country in Africa, recorded 3159 new cases and 276 deaths in 24 hours! South Africa has a new strain of COVID -19 which is so quickly transmitted that the million doses of AstraZeneca vaccine that had been ordered for the health workers were put on hold. This is because the in vitro tests done on the approved vaccine had shown a 22% efficacy on the South African variant of COVID-19.

From the official page of the Ministry of Health-Uganda: https://covid-19.gou.go.ug, on the 10th February 2021, Uganda had reported 39,942 cumulative confirmed cases and a total of 328 deaths.

I for one have lost relatives, friends and colleagues here at home and abroad. I even fear to imagine what is next.  A combination of my being a medical doctor for four decades,  a senior citizen and having a wide network of friends is causing a big disruption in my life.

My colleagues are among the health workers on the COVID-19 frontline- they are exposed to the virus and other bacteria as a biological occupational hazard. Alex, a high school classmate, is working in the Rouder Bush VA hospital in Indianapolis, USA. Thankfully, she has not caught the virus but many times she sounds tired and overwhelmed when I talk to her. I pray every day that she continues to protect herself as she offers this vital service to her community.

She is among the exception, many have not been so lucky in South Africa. Yesterday I attended a virtual funeral service followed by a cremation of one member of our graduate class. He had worked as a paediatrician in Durban, South Africa for over 35 years! Many nurses have succumbed to the disease in the line of duty though they are invisible because not many people talk about them.

A senior citizen is by definition anyone aged 65 and above. By this age, many things conspire against us to rob us of good health:

  • Many of us are already on treatment for underlying medical conditions like High Blood Pressure and heart disease, Diabetes and cancer.
  • Our immune function diminishes with each year lived beyond 65.The immune cells known as B and T-lymphocytes, do not work as quickly as they used to.
  • We carry the highest risk of developing cancer in any given population- the immune system is fully developed and functional by the age of eight and will continue to function at its best till the age of 65. Thereafter, the immune function diminishes with advancing age. This explains why cancers and recurrent infections are common in our age group.

These factors combine to make our age group the highest at risk of catching the new virus and going on to develop the severe form of the disease which requires us to be admitted  and carry the highest risk of death.

The cdc.gov website has co-related age with the risk of hospitalization and the

risk of death:

40-49 years of age run a 3 times risk of hospitalization and 10 times the risk of death.

50-64 years of age run a 4 times risk of hospitalization and 30 times high risk for death.

65-74 years of age run a 5 times high risk of hospitalization and 90 times high risk of death.                                                                   

75-84 years of age run an 8 times high risk of hospitalization and a 220 times high risk of death.                                                                   

Senior citizens , we have to brace ourselves for the loss of loved ones; my mother who is close to 90 has just a few peers around. It is the natural progress of life except that the multiple COVID -19 – related deaths at this moment in time are almost throwing us off- balance. It is a huge disruption that has left us living on the edge fearing that any of us can fall off any time. We are living in a state of increased vulnerability but we cannot allow ourselves to be totally defeated by it. We have to take back some form of control.

George Bernard Shaw rightly said: “We don’t stop playing because we are old, we grow old because we stop playing.”

It is mandatory that we take the responsibility of reducing the risk of getting sick- first from COVID and the other common diseases in the environment like Malaria fever which could demand for hospitalization. We have to continue with our regular medical check -ups and regular cancer screening tests.

For COVID-19, we have to continue practicing the proved safety measures laid out by the Ministry of Health.

It is essential that each one of us considers the level of risk before deciding to go out of home.

It is also vital that we keep up to date with available scientifically – proven information about COVID- 19 disease.

We have to stay healthy- a state of complete physical, mental and social well-being not merely the absence of disease of infirmity by:

  • Eating a healthy and balanced diet
  • Living a healthy lifestyle- no smoking, avoid alcohol and drug abuse.
  • Being physically active- regular exercise at least for 30 minutes every day.
  • Regular medical check- ups
  • Adequate sleep- 7-8 hours of sleep to allow the body to repair and restore itself and to allow the immune system to function at its best.
  • Mental well-being- your thoughts and feelings and how you cope with the ups and downs of everyday life. We have to learn how to reduce stress in our lives.

Writing about being in a state of good health is easier than putting it into practice. I have been moving on a rough sea, waves breaking over me and feeling as if drowning due to the many deaths of relatives, friends and colleagues in a short space of time. Many times I have been left feeling helpless since I could neither control or prevent what was going on around me.

I would receive the news of death with a stab of fear and withdrawal into myself. I just stayed where I was; isolated and cut off. The total digital black out from the 12 th January before the general elections of 14 January to the 10th February 2021 forced me to hold things in. I became less motivated to do the most important things in life

 as I became consciously aware of my own mortality. Then I remembered to read through the basic coping skills needed to manage a difficult situation:

  • Do not blame yourself for the deaths.
  • Feeling sad, fear anxiety was a completely normal response to a tragedy.

        Allow yourself to grieve, acknowledge the loss and mourn.

  • Mourn for a season and move on otherwise you lose yourself and the motivation to do important things in your life.
  • Do something positive for yourself and others- toward making a change in your community.

At my  age I have suffered many deaths of loved ones including brothers,  a sister, my father , my husband , nephews and friends but the COVID- related deaths are following one after another. It hardly gives you time to feel the hurt, pain and grief. At the same time, it drains your well of empathy and compassion without giving you enough time to refill it. This could lead to burn out. The COVID-19 guidelines about funerals have introduced new ways of mourning. For our safety, we can no longer gather, cry together or touch one another for comfort. Virtual funerals, cremations and memorial services are the new normal.

 However, one thing stands out to me with absolute clarity: I am yet to fulfill my highest potential in life. This has to continue to direct my life.

Gradually, I am willing myself not to be defeated by the virus, I have to find a lifeline through all these random deaths and events that life is throwing at me. I need to create warmth and love once again.

I can do this by making the most of what I am left with: family, friends and social support systems.

I have to reach out for help from my trusted friends and to pick up my pursuits like Creative writing, gardening and voluntary work in my community. This is what has always kept me alive and fully engaged with life. I am daring to take back some control in my life. I have started feeling safe enough to easily fall asleep and wake up at my usual time despite living on the edge.

Saltos Altos Vermeltos said: “We are all a little broken. But the last time I checked, broken crayons still colour the same.”

And Aldos Huxley said: “ The secret of genius is to carry the spirit of the child into old age, which means never losing your enthusiasm.”

QUESTION: Are you resilient enough to brave the rain and get up for the eighth time?

THE LADY WITH AN INFECTIOUS SMILE

Dr. Sarah Namuli Mukasa Yiga(2nd from the left) with one of her sisters, Margaret Nagawa, myself and Dr. Faith Muwazi, another friend, celebrating Sarah’s sixtieth birthday in Bloemfontein, South Africa.

THE LADY WITH AN INFECTIOUS SMILE.

The COVID-19 disease started in a place that seemed so far away in Wuhan city, China in December 2020 . One year later, it has spread to all the 192 countries of the world, it is in its second wave and is right inside our houses. According to the Johns Hopkins University Coronavirus Resource Centre as of the 26 th January 2021, Uganda had reported 39,261 cases and 318 deaths.

In the last one month, I have lost relatives, colleagues and friends here in Uganda and abroad. I am in a state of emotional turmoil.

Two weeks ago, one of my godsons lost his mother and father  to COVID -19 disease within a space of two weeks! As if that was not enough, I lost one of my best friends to the disease on the 13th January 2021.

Dr.Sarah Namuli Mukasa Yiga had served as a medical doctor in South Africa since 1983. She was two years ahead of me in Gayaza High School. By the time I joined university in July 1972, Sarah was a third year student in the faculty of Medicine of the only University in the country, Makerere . We resided in Africa hall, the second women’s hall in the university.

Among the four first year medical students in that hall, I was the only one from my school but students from our school made up the majority of  female students in the faculty of Medicine.

This provided us a unique small family where we thrived and looked out for each other.

 We had gone through the freshers’ week but when the continuing students joined us, out of Sarah’s big  heart, she effortlessly reached out to my group to help us settle in smoothly.

From the beginning she advised us to dress and behave as doctors, we had to learn to be punctual by being the first group of students to take our breakfast in the cafeteria when doors opened just before 7 :00am. She empasised to us that everything else was secondary to our course work. Sarah and her team gave us tips on how we could stay on top of our work, about dating and about which societies and sports teams we could join so as to make the most out of our stay at the university.

As days went by, they would spare time to quiz us on the topics we had covered, pass on past papers and notes for revision and advised on the extra text books we could buy using our book allowance apart from the standard ones recommended  for each year.

After the quick breakfast, all the medical students would walk through the Katanga slum, a place with temporary shelters teeming with children and their parents. Whether it rained or not, the lectures at the Mulago teaching hospital started at 8:00am on the dot.

We became each other’s keeper and later when the first years came in , we felt that it was our duty to show them the ropes just as Sarah and her team had done for us.

On a normal day, most of us would come back together in time for supper at 7:00pm. We did this for five years and ended up forming strong bonds of friendship for a lifetime.

Sarah and I were quickly drawn together like a duck to water. We were top students, we were voracious readers, we were from close-knit families, we loved beautiful things and were always looking for fun and something to be happy about.

Franz Kafka said: “ Anyone who keeps the ability to see beauty never grows old.”

I was impressed by Sarah’s confidence and her ability to share her feelings and tears freely, allowing her friends to see who she really was deep inside. I was later to learn that she had inherited it from her loving parents.

Sarah was the ninth child in a family of ten while I was the third born in a bigger family. She became the big sister that I never had; guiding, nurturing and caring.

Her family became mine and mine became hers and this is how it has remained.

I used to call her a “work in progress” because she was always doing self-improvement on herself- the product and the packaging!

 Two years later, she graduated and soon after got married to John, a postgraduate student in Surgery.

She had to convert to Catholicism.  I was deeply involved in all the wedding preparations and in a similar manner, she took a central role in my wedding preparations and ceremonies in 1981.

Then we got wrapped up in the raising of our young families and in the progress of our careers.

During the civil strife of the early 80’s , Sarah and her family were forced to flee to South Africa They ended up in the Orange Free State in one of the ten black homelands of Apartheid South Africa.

They left their most precious items like wedding photographs with me

and I had to send them later through their sister in Kenya.

They worked at Moroka hospital , Thaba Nchu until the apartheid system was dismantled in April 1994.

They seized the opportunity of free movement of black people in a multiracial democracy and moved to Bloemfontein city, 70 kilometres away. It remains a white –dominated city up to today.

 My grandmother could have told Sarah and I that dogs had licked our feet when we were babies;  we were both passionate about travel- visiting new places and meeting new people. In 1996 I visited them in Bloemfontein. Sarah drove me to Thaba Nchu to see all her friends and the hospital where they had worked for a decade. Open farm lands owned by Boers.

In her quest to improve herself, she took up a master’s degree course in Family Health Practice. Later, she worked with the Orange Free State University.

In 1994, when my husband and I sought for economic exile in Botswana, our visits to Bloemfontein became more frequent and Sarah’s family visited often. Our children came to know each other well.

The biggest challenge to the two of us was getting the best education for our children. Sarah ended up sending her young daughters to a boarding school in Nairobi , Kenya. Sadly the youngest , almost eleven, died in a freak accident at that school. It was an extremely traumatic experience for the family.

For university, they took their three children to University of CapeTown and mine joined her youngest ones at the same university some years later. By sheer coincidence, none of our six children chose to join our profession. They had the ability and capacity to go into medicine but mine just hated our rigorous and unpredictable schedules of work.

Among the highest moments together were:

  • The graduation and celebration of our children’s achievements. We always celebrated together.
  • Sarah’s surprise 60th Birthday party in Bloemfontein in September 2009. Her husband’s surprise birthday present was her sister and great friend, Margaret, from Uganda!
  • Our pilgrimage to Israel in April 2011- Sarah arranged for me to join a group about 60 people from her Catholic Church in Bloemfontein. I was the only protestant in the group and had I bent to their wishes, I could have converted and been baptised in River Jordan.
  • My daughter’s wedding in Uganda in November 2014- Sarah was in it from the traditional give-away of the bride to the After Party. She delightfully danced the night away.
  • During her ten day’s visit with John to Uganda in the pre-covid-19 days, January 2020. She spent an afternoon and stayed for the night with me and my octogenarian mother. Sarah cared to carry a soft scarf for my mother. We spent the night reminiscing and planning future travels together.
  • Her last birthday of 4th September 2020- I sent her an Audio message mainly thanking her for being a rock solid friend for all those years. I told her that I admired and respected her for her strong faith and spirituality, her love and concern for others- always giving and loving more than she received, her integrity , passion for life and sense of humour. She replied by sending me a photograph of herself seated among her birthday bouquets. She was as colourful as the flowers.
  • Her daily Spiritual nuggets to carry me through the day, which sometimes came in as early as 5:00am! Then later in the day she would send me the funniest clips just for the belly laughs.
  • The unbroken connection between us- She always knew where I was and I knew where she was. When she first felt unwell on the 20th December while the two of them were visiting Helen , their eldest daughter, in Johannesburg, she text me and informed me that she was going for the COVID-19 test. She text me soon after receiving the results and when she was admitted to hospital, two days later. I had even suggested that her phone should have been confiscated from her to allow her to rest- easier said than done. The last message I received from her was on the 7th January which was followed by that most dreaded call on the 13th January 2021!

What made Sarah’s death most painful is having to grieve alone due to the COVID-19 restrictions. I felt safe not to tell mother; she knows Sarah as one of my best friends. I could not be near John and our children in their greatest time of need. Due to the Internet blackout during the general election in Uganda, I was among the few who listened in to the funeral service of the 16th January in Bloemfontein. I had to be connected through a niece’s phone in Nairobi, Kenya!

I have picked a few lessons from this huge loss: Life is the greatest gift that comes with each dawn and should therefore be celebrated and lived fully every day. I am only here for a while and I should consistently learn to love with no regrets- telling your loved ones every day how much you love and care for them and then strive to give of your best.

Last but not least, let each one of us go through the day knowing that COVID-19 disease is real, it has changed our lives forever. It is my responsibility to protect myself and others by masking up, hand- sanitizing often, physical distancing and keeping abreast with new information that becomes available from the Ministry of Health. While we await the new vaccine, let us stay at home and ensure that we stay safe and healthy.

Sarah Namuli, the amazing African multitasking woman, the unique human being, you touched and enriched our lives abundantly. You will live on in your children, in our hearts and in the treasure trove of memories that we created together.

May God Rest Her Soul in Eternal Peace.

ENJOY YOUR RIGHT TO VOTE FREELY

VOTE FOR YOUR OWN GOOD AND THE GOOD OF OTHERS.

Gifford Pinchot said: “It is a greater thing to be a good citizen than to be a good republican or a good democrat.”

  From the worldometers.info website, Uganda has a population of 46.486 532 million people and 50.8% of these are women.78% of the population are under the age of 30, making us the country with the youngest population in the world.

I first voted in 1980 when I was almost thirty years old. By then our population was 12.548 million with a median age of 16.4. 126 parliamentary seats were contested , there were 4.898, 117 registered voters and a voter turn out of 85.2% .

Forty years later, the population has grown to 46.486 532 with a median age of 16.7

 A hotly contested general election is due next Thursday, 14th January 2021.The Electoral Commission website shows that there are 17. 658 527 million registered voters of whom 77 % are under the age of 25. This is the group that will determine our country’s future in a free and fair election.

There are 353 constituencies seats and one women representative seat from each of the the 146 districts of Uganda.

The pre-independence elections were held early 1962, followed by Independence on the 9th October 1962. Then from May 1966, the country was embroiled in years of civil strife until April 1979 when soldiers of the Tanzanian Defence Forces assisted some Ugandan exiles to overthrow Idi Amin Dada’s military dictatorship.

The ruling military commission organized the December 1980 general elections that saw Milton Obote return to power for the second time. The elections were rigged and led to the protracted bush war in the Luwero triangle in central Buganda for five years. It ended on January 26th January 1986 when the then rebel leader , Yoweri Kaguta Museveni was sworn in as the 8th President of Uganda.

I have been in economic exile for almost 25 years so forty years after I cast my first vote, I shall be voting for the second time!

For those under 30, you could be taking the right to vote freely for granted and yet some men and women fought for this right. For the women in particular, you owe your vote to the progressive Women’s rights pioneers- they campaigned, lobbied the governments of the day, held demonstrations and protests to win the Women’s suffrage- the right of women to vote in elections. This opened up the women’s entry in the public arena.

After centuries of socialization that the women‘s role in society was motherhood and home- making while the men provided and protected them, it was a long and serious struggle. Almost all our traditional African societies believed that a woman had to first be protected and cared for by her father who then passed her on to a husband and if the husband died, her eldest son would take on the responsibility for her. By all intents and purposes, the woman was considered a minor.

It is therefore not surprising that even in Greece, the foundation of Western Civilisation democracy, the women had no voice in the democracy or governance of their country.

These women rights pioneers were fighting for the equality of the sexes in law and reality-to get half the country’s sidelined population into the democratic functioning of society. Their biggest obstacle was that feasible social changes were to be passed by men in an all-men parliament.

They struggled doggedly and recruited men on their side by proving to them that improving the position of women in society would also raise the quality of life for the average family and the nation as a whole. They believed that the problems of women were not theirs alone but they were problems for the societies they lived in.

The best example is Switzerland, it was the last country in Europe to give women the right to vote in 1984 after three referendums of 1968, 1971 and 1973!

The following list gives you an idea about the protracted struggle.

New Zealand –  full suffrage in 1893

Denmark – 1915

Russia – 1917

Britain- 1918

USA – 1919

Netherlands- 1919

Italy- 1925

South Africa- white women only – 1930

Philippines – 1937: the first in Asia.

Greece- 1930 but in reality in 1944.

Israel – since the establishment of the state of Israel in 1948.Little wonder then it had its first woman Prime Minister, Golda Meir in 1969.

India – full suffrage 1947

Ethiopia – 1955

Tanganyika – 1958

Nigeria – 1959

Rwanda- 1961

Kenya- 1963

Zimbambwe – 1978

South Africa- full suffrage in 1994.

Saudi Arabia – December 2015.  In 1957,women were banned from driving cars  and the right was restored after intensive campaigns and lobbying in September 2017!

Uganda as a British territory had its first woman member of the Legislative Council, Mrs. Florence Alice Lubega as early as 1957 and between 1958 and 1960 she was followed by a number of educated women like Pumla Kisosonkole, Joyce Mpanga, Sarah Ntiro, Frances Akello and Eseza Makumbi. At the time of Independence Florence Lubega, Sugra Visram Namubiru and Barbara Saben were members of Parliament.

As more women were empowered by good education – to university level, the number of female members of parliament increased.

The numbers surged after the United Nations End of the Women Decade Conference held in July 1985 in Nairobi, Kenya. The then Uganda government of Milton Obote- 2 sent a big delegation of Non Government Organisation and government officials for the three weeks conference. By the time they returned to Uganda the government had been overthrown but the members of the NGO forum went on to found ACFODE- Action for Development and the medical doctors among them founded the Women Doctors Association. They also fanned the activities of FIDA- UGANDA, the Uganda chapter of the International Women lawyers which had been founded in 1974 and other local organizations promoting women’s rights.

Later, in January 1986, when the new government headed by Yoweri  Kaguta Museveni was sworn in , these energetic members lobbied his government for a Ministry of Women in Development to be headed by a woman, mainly to develop social mechanisms to promote Equality and put it into practice. Over time it has grown and evolved into the Ministry of Gender Labour and social Development.

Creating the position of a Parliamentary representative of women from each district of Uganda was one of these social mechanisms and still stands today. Empowering women through education combined with these social mechanisms have changed the social position of women in Uganda forever. We never forget that the struggle for a better quality of life can only be fought by men and women together.

“In the face of impossible odds, people who love this country can change it.”– Barack Obama

 I was happy to see one female, forty years old Nancy Alice Kalembe , a mother of two, among the eleven Presidential candidates . She may be invisible among that crowd of men but she is a beacon of hope for the young generation of women and validates the efforts of those women who have waged the ceaseless battle to get the woman in the political arena.

“ No one is born a good citizen; no nation is born a democracy.  Rather, both are processes that continue to evolve over a lifetime. Young people must be included from birth. A society that cuts off from its youth severes its lifeline.”– Citizenship quote

Knowing and understanding clearly where the women are coming from, I will go out with enthusiasm and optimism to vote on Thursday 14th January 2021 and later be part of the selection of Local Authority officials. I am busy encouraging others to do the same. Politics determines our every day needs- healthcare, transport, quality of education and our livelihood, I cannot take democracy for granted, I have to play my role as a responsible citizen.

Gellhorn said: “Citizen is a tough occupation which obliges the citizen to make his own informed opinion and stand by it.

The wisest among us learn from others: the highly contested US election of 2000 between George Bush Jr. and Al Gore taught the Americans and all members of the Global Village that every vote counts.

It is extremely unfortunate that the general election will be taking place during the second wave of the COVID-19 pandemic- the new cases are surging and the deaths are increasing and yet we have to vote.

The best option is to strictly adhere to the Ministry of health safety guidelines and ensure that you are not in harm’s way as you fulfill one of your fundamental rights of citizenship.

Whom I vote for is my own business but I would want to vote for a leader with vision, integrity, accountability,humility to serve others, focused and inclusive and a strategic planner. He has to be someone who will inspire us to do things we never thought we could do.

“ Anyone who refuses to make a choice has already made a wrong choice by allowing his life for chance to rule.”- Myles Munroe

“ There can be no daily democracy without daily citizenship.” – Nader

QUESTION: Are you ready to be a good and responsible citizen by exercising your right to vote freely on the 14th January 2021?