Of the 22 households interviewed, 16 households reported up to 26 separate illness (16) and death (10) events of adults, Fig. 1. Of the 16 sickness events recorded, three took place in Young households, six in Middle-aged households and seven in Old households. Of the 10 death events, eight were in Middle-aged households and two in Old households. The outcomes indicated that most households had managed to cope with illness and death, as there were 16 cases of ‘coping well’ compared with 10 of ‘struggling’. Furthermore, the analysis seemed to suggest that Middle-aged households coped more easily following a death, as seven out of eight Middle-aged households that experienced a death coped well, while five out of seven Old households struggled following an illness event. There were usually also other explanations for coping experiences, as listed in the discussion section.
The processes underlying coping: Illustrative stories from three households
The complex processes governing coping and their relation to the household life cycle can be better understood by examining the life histories of individual households. Therefore we have selected three households that represent contrasting life cycles and coping abilities and whose stories illustrate different processes and outcomes, and present these below.
Young household: Mutebi’s story
Mutebi was 53 years at the time of the interviews. From the age of thirteen, he did not have access to land and instead engaged in leja-leja (meaning casual labour) on other people’s farms. When he had saved some money from this work, he started a series of income-generating activities: he sold deep-fried fish and five years later he managed to use the profits for trading in coffee and brewing alcohol from bananas. He used the income derived from this to purchase land and livestock. To construct his house, he employed builders on credit and the materials he used were borrowed from friends. He paid after he had harvested and sold coffee, alcohol and pigs. He got married in 1997 and had two children, in 2001 and 2005.
In 2000, at the age of 34, Mutebi contracted an AIDS-related illness and was bedridden for two years. He sold all his land and livestock to meet medical bills and home needs. Having lost his own fields, Mutebi utilised his father’s land for cultivation. During the same period there was a drought (from 1998), in addition to pests and diseases that caused his crops to fail. Furthermore, in 2002 Mutebi’s wife and first child became sick with an AIDS-related illness. Mutebi sold coffee to meet their medical bills but eventually illness left Mutebi too weak to ride his bicycle and he had to stop his coffee trading. During this time, he purchased bananas from the village and continued brewing alcohol for income. In 2008, Mutebi inherited land when his father died.
As Mutebi’s children were still young, he had to hire labour for agricultural work and household chores, which he paid when he harvested and sold his coffee. Following a long dry period in 2008, all the crops failed and the household experienced food shortages. Mutebi found it difficult to cope, but managed to get some food from the shop on credit and paid after harvesting coffee. From 2009, Mutebi hired out space on his compound for pig slaughtering and selling pork. He earned two kilograms of pork whenever a pig was slaughtered, which happened around twice a month. In 2009 Mutebi’s household was categorised as struggling because of the difficulties with sustaining livelihoods.
Middle-aged household: Ntonio’s story
Ntonio was 75 years of age when these interviews took place. He had 10 acres of land which he had acquired from his parents as a teenager during the 1950s, on which he cultivated coffee and bananas and raised livestock. He married Nanta, his second wife, in 1971, and already had four children from a first wife. Ntonio also fostered his brother and a nephew. In addition to the labour from his household, he employed three bapakasi (local word for ‘porters’) on the farm. By the 1980s Ntonio’s farm output was high. He sold coffee, bananas and alcohol and acquired more assets, including 3.5 acres of land and a motorcycle.
By 1990, Ntonio’s first four children had moved to the city to work. His daughter trained and found a job as a nurse. In 1993, his brother bought his own land and moved and in 1996 his nephew joined his parents in the city. While the departure of these household members resulted in loss of agricultural labour, the burden on household resources was reduced and at the same time secure livelihoods were diversified.
In 2000, Ntonio became ill and was hospitalised for three months. To cope with the costs, the household sold eight cows, the motorcycle and the stored coffee from previous seasons. During the same period, there was a long dry spell, pests and diseases that caused crop failure and death of cows. This started a vicious cycle of falling farm output, which led to less income and the inability to pay workers, which in turn led to the workers quitting. This exacerbated the falling farm output, as parts of the land had to be left fallow for two seasons. Despite this, Ntonio continued to fund his children to receive vocational training. With start-up capital from Ntonio, they started their own businesses, for example carpentry and photography in the city. As a result, resources were freed and later diverted to healthcare. This also meant that the household had some savings ahead of any other income risks or weather shocks. In 2003, Ntonio gave 3.5 acres of his land to three of his sons. One son moved to his land directly, but the others moved to the city to find work and Ntonio continued to utilise their land.
The demand for healthcare increased in 2003 because Ntonio became ill again. This coincided with a worsening of the dry spells. However, Ntonio’s household received remittances from his adult children and brothers who worked in the city, and this kept the household afloat. This income was spent on healthcare, food, educating the young children and paying for leja-leja and farm inputs such as manure and fertiliser. Pest-resistant coffee and bananas were planted, new crops like cassava were introduced and a piggery was established.
From 2006, the farm output increased: the household had plenty of food and was able to sell coffee, cassava and bananas. During the drought of 2008/2009, the household did not experience food shortages. Ntonio’s wife Nanta harvested and sold three sacks of cassava tubers each at UGX 60 000 (about 22 USD each at 2010 exchange rates), which was a significant amount of money in their village.
The household was also able to provide for more members who joined for support: three orphaned grandchildren were adopted in 2007 and 2009 and two adults, a sister of Nanta’s and a friend’s son joined the household temporarily in 2009 due to divorce and to be closer to school, respectively. In 2008, Ntonio was hospitalised again for one month and has since moved to live with his daughter (the nurse) for better care. Ntonio’s household was able to meet its basic needs and was therefore categorised as coping well in 2009.
Old household: Kaloli’s story
Kaloli was 82 years old at the time of the interview in 2010. In 1942, twelve-year-old Kaloli migrated to Uganda from Rwanda to work as a mupakasi (singular of bapakasi) and five years later he married. Between 1948 and 1960 he was able to manage up to seven acres of land, mostly because of the savings from his wages. In addition to subsistence crops, he also planted cash crops, including coffee, cassava, beans and groundnuts. Kaloli also fished in a nearby swamp and wove mats and fishing-baskets. By 1970, Kaloli and his wife had seven children; four boys and three girls. By 1990, the girls had married and moved away and one boy had moved to the city to find work.
Kaloli gave shares of land to two of his adult sons, which they both sold. They used the money to move to town to find work. However, they had little education and no vocational skills, so they only managed to find piece-work jobs and did not send any remittances back. Instead, Kaloli had to take care of one son when he later re-joined the household for terminal care. Kaloli’s eldest daughter divorced in 1995 and also re-joined the household with four of her children. She remarried in 1997, but left the four children with Kaloli. Two years later, she died of an AIDS-related illness. Finally, another grandson joined his household in 1996.
In that same year Kaloli’s wife fell sick and was admitted to hospital. Kaloli sold an acre of land and his stocks of coffee from previous seasons to settle the accumulated treatment costs. His wife passed away two years later, in 1998. In the following year, his son drowned in Lake Victoria. Kaloli sold another acre of land to transport the body back to the village and cover burial expenses. In 1998, after a five-year stay in Kampala, Kaloli’s second son re-joined the household in need of care. His wife had left him after he had fallen ill and he needed support, which his family provided until he died of an AIDS-related illness a few years later.
From 1998, the land that the household possessed was not enough to produce food for its ten members. Kaloli also fell sick and was too weak to hire out his labour on other people’s farms. Furthermore, during the same period there was a long dry spell and pests and diseases that caused crops to wither. The swamp also dried up and Kaloli could no longer fish. Due to lack of food, Kaloli’s four grandchildren that his late daughter had left with him moved back to their father in another village. In 2005, Kaloli’s youngest daughter re-joined the household after a divorce and brought with her four children. That daughter needed money to start a business and so the household rented out one acre of land. This money was used for training and starting a business in hair-dressing and was able to occasionally provide a 100 kg bag of maize flour.
During 2008, there was a long dry spell that caused crop failure, resulting in food shortages. Kaloli’s daughter could no longer afford to buy maize flour because the price had increased. The father of her four children gained custody because the daughter was not able to feed them. The household experienced labour shortage, not only because Kaloli was weak but also because he was unable to hire labour due to lack of money. Kaloli struggled to cultivate the land with the help of his grandson and they stopped growing labour-intensive crops such as groundnuts and millet. His grandson also carried out household chores and sometimes skipped school to do various piece-work jobs. In addition, the household had problems with infertile soils and stopped growing bananas. Because of the above listed difficulties to sustain livelihoods, Kaloli’s household was categorised as struggling in 2009.