Waking at night (you know why) 2

More people in Africa have cellphones than toilets. This statistic comes to mind when I wake up in the middle of the night. Which often happens when you get older.

There’s no gender divide on this one. Both men and women tend to experience interrupted sleep as we age. You know the reason most of us wake up in the wee hours. (There’s a hint!) Little choice is involved. Older people can no longer do marathon sleep-ins like teens after a party. Inevitably the bladder calls. And that means waking at night, getting out of bed and doing a bit of walking.

An internet meme expressing this middle-of-the-night gripe

Stumbling half asleep towards a toilet is an inevitable nightly occurrence for most of us Of A Certain age. Regardless of race, religion or anything else. It’s about biology, and aging plumbing.

However, as per the ratio of phones to flush toilets cited above, there are still many people in Africa whose nightly trip is not just a few steps through the house but many steps, out into the dark – to an outside toilet. No matter whether it’s rainy or chilly. With no special dispensation for being a pensioner.

This kind of outside non-flushing toilet is prevalent throughout Africa and elsewhere in the developing world.

Given the phones vs toilets statistic, it will come as no surprise to hear that the story I am about to recount was recorded on a cellphone. In the middle of the night in a village in South Africa’s Eastern Cape province, an older woman, not fully dressed and a bit confused, was seen near someone else’s hut. Other villagers were called and a cellphone video was shot of the wandering woman. She and the video were then taken to the local chief.

I heard this story from a social worker, Phazisa Mbilini, who heard it from the residents of the Xhosa village. A speaker of the Xhosa language herself, Mbilini says the villagers believed that this woman was near their premises in the dead of night because she had fallen from her broomstick.

Excuse me? As in the Halloween trope of an ugly old woman riding across the sky on her magic broomstick, dressed in black and wearing a pointy hat? These wicked witches have Xhosa cousins? Mbilini explained that, “It’s commonly known that if someone doesn’t want to say out loud ‘She’s a witch’ they will say ‘That one is flying at night using a broom’.”

This 1799 etching by Spanish artist Francisco Goya shows an old witch giving a lift on her broomstick to a prostitute, featuring an owl as it was then a slang word for sex worker. The black robe and conical hat were ingrained as witch garb in Western culture by the Wicked Witch of the West in The Wizard of Oz.

“Fortunately she was not beaten up,” said Mbilini of the Xhosa woman found wandering at night, “because that’s what often happens when they find someone walking around confused, they say it is from practicing witchcraft at night. Then they hurt the person or even kill them, because they connect them with any problems at home or financially so they blame the supposed witch.”

Mbilini is part of an outreach campaign by Dementia South Africa to help people in Xhosa communities understand the degenerative brain diseases that can cause older people to act in strange ways. The goal is to help relatives and friends cope with their caregiving. A big problem, she says, is that women with dementia are treated differently from men with the same condition, as she explains in this video.

This kind of agist discrimination does not only happen in South Africa. In many parts of Africa older women who show signs of dementia have their possessions seized, are violently attacked and even killed.

“Imagine living in a community your whole life. Then suddenly, you are accused of witchcraft and told to leave. Or you are sent threatening letters saying you have bewitched a neighbour’s child. Or you are attacked and slashed with a machete during the night. The reality is, in many parts of the world, including Tanzania, older women are still persecuted and accused of witchcraft. Belief in witchcraft is still strong in many places and throughout society, but often these accusations have an underlying malicious element.”

– HelpAge International report

Dr. Sebastiana Kalula is a geriatric medicine specialist at the International Longevity Centre at the University of Cape Town who also knows of older women victimized as witches – often only to find that many had simply gone outside at night to use the toilet, got lost and were found wandering near someone’s door. She says that due to increased life expectancy, dementia is a relatively new phenomenon in African communities so the signs and symptoms are often misunderstood.

“People with dementia in African culture usually come to us when the disease is far advanced,” noted Dr. Kalula, who grew up in Zambia. “In rural areas they can be ignored and only come when behavioural disturbances are such that the family is not coping. It is very unusual in African settings to see someone in the early stages of dementia for it is interpreted as just part of aging.”

Most African languages have no word for dementia. In Xhosa you hear it described as “uyaqhawukelwa”, meaning a person has experienced a broken circuit in the brain. In Zulu people may say “uyaqashukelwa” – the brain is off. The Dementia SA awareness campaign aims to encourage everyone, in all languages, to rather use the internationally known medical terms: the generic word for the many different conditions that can affect the brain, dementia, and its most common form, Alzheimer’s Disease.

The newly released annual World Alzheimer Report estimates that a new case of the disease occurs every 3 seconds, with worldwide cases expected to nearly triple from 47 million today to 132 million in 2050.