At the age of 90 years, Phoebe Auma's hands are rough and her hand shake is weak. Her memory is poor and she is partially blind. She cannot stand by herself and walks with the support of a walking stick and a caretaker. She is hard of hearing and one has to shout to be heard. Auma is probably the oldest person in Acero sub-county in Lira where she lives. She is a mother of 12 children, 34 grandchildren and 200 great-grandchildren.

Auma could not recognise Nancy Akuno, one of her great grandchildren, who led me to her hut which stands on Akuno's mother's premises. "I am not seeing you. I see something like the head of a person. I do not recognise your voice. What is your name? Who are your parents? Where do you stay? What brings you here?" Auma asks Akuno, who regularly visits and takes care of her.

When The New Vision visited her home, Auma was seated on the verandah of an isolated hut. Except for one grand-daughter who was washing clothes some metres away, there was silence in the home. Her fifth daughter, Akuno's mother, is over 65 years. She was not at home at the time. Piled beside Auma were a tin of Samona oil, a blanket, an old gomesi (traditional dress), water and food containers, some of her only life's possessions.

Auma's day begins at 10:00am when she leaves her hut to sit on the verandah the whole day if no one helps her to exercise. She goes to bed at 4:00pm, although she no longer falls asleep night. She is awake all night, but during the day, she dozes off. "I go inside my hut to rest after sitting here all alone," she says.

But Akuno, a widow and member of the National Association of Women living with HIV/AIDs in Lira, says: "The biggest problem we have is her toilet manners. She passes stool anywhere in the compound, probably thinking she is in the toilet. Auma is very particular and hard to please. She does not appreciate things people do to please her, like bathing her, washing her clothes, feeding her or even giving her company."

Akuno says lately, Auma complains of pain all over her body, like it has been set on fire.

"We wish God could rest her peacefully. She is suffering a lot; the caretakers are also suffering with her and are tired of looking after her," says another grandchild, who did not want to be named.

Herbert Baryayebwa, the commissioner for disability and the elderly in the gender ministry says Auma is one of the 1.5 million elderly persons whom the ministry is focusing on helping. This was after realising that unlike other vulnerable groups like orphans, women and disabled persons, the elderly have not benefited from government programmes.

He says with financial support from the Department for International Development, the ministry conducted a research to find out the specific needs of the elderly. The findings are now being used to design interventions, taking into account the gender dimensions.

The research showed that older people are disgruntled, saying they have been excluded from government programmes, isolated by members of their families, denied access to medical care and lack income.

"The needs of older people, particularly the women, are unique," says Baryayebwa. "There are more widows than there are widowers, because the survival mechanisms for women are stronger. Older people lack opportunities for any active participation and their minds deteriorate as a result. They are denied access to essential drugs and need free medical services."

According to the 2002 Population and Census Report, older people are those aged from 60 years and above, irrespective of their other demographic and socio-economic characteristics.

Traditionally, older people were protected from abuse and neglect by structures, networks and norms. But many other factors like rural-urban migration, unemployment, wars, poverty and disease like HIV/AIDS, have disorganised the traditional family, leaving older people vulnerable.

The United Nations Principles for older persons, adopted by the UN General Assembly in 1991, says older people should be treated fairly, regardless of age, gender, race, ethnicity, disability or other status. They should be valued independently of their economic contribution.

One UN Principle notes: "Older persons should be able to enjoy human rights and fundamental freedoms when residing in any shelter, care or treatment facility, including, full respect for their dignity, beliefs, needs and privacy, and for their right to make decisions about their care and quality of their lives."

But this is not possible in Uganda, where people like Akuno are looking after more than one elderly person. Akuno says her great grandmother had seven siblings and only the last-born and her, are still alive.

Auma was married to the late Saul Ongora and produced seven daughters and five sons. Ongora died 10 years ago. Auma did not go to school.

Akuno says although her great grandmother has never had a major illness for quite a long time, she suffers from high blood pressure. The family has two other elderly women who are also widows. They all depend on Akuno for assistance.

Akuno says one of the other elderly women occasionally becomes mentally unstable and accuses whoever takes for her food, of witchcraft. If not counselled, she cannot accept to eat any food.

Auma's delicacy is meat, despite the fact that she is toothless. When she is hungry, she complains of being starved and neglected. She wants to drink tea thrice a day and to eat meat daily. She has now developed a tendency of denying receiving food in order to get more. When she is served with food, she pours cold water into it before eating it.

Auma says cold water reduces the temperature of the food. "I fear the food may burn my mouth," she interjects, without batting her eyelids.

Akuno, however notes: "Auma was not behaving like this before. She used to be very appreciative, loving and caring a few years ago. This started after she lost her last two children who left her with orphans."

She regrets that the family cannot afford to buy toilet seats for Auma, her youngest sister and her sister-in-law. She pleads to whoever can help improve the family's income to render the badly-needed assistance.