A landlocked country in sub-Saharan Africa, Zambia has a population of approximately 16.5 million. At 6 children per woman, the country’s fertility rate is amongst the world’s highest. The median age in Zambia is only 16.8 years of age, with a total life expectancy of 52.7 years which ranks as the 6th youngest median age in the world. 

Due to its youthful population and low life-expectancy, the problems of the older demographic have traditionally been overshadowed by issues requiring a more urgent response, such as the AIDS outbreak in the early 2000s which continues to plague the nation. 

According to Mapoma et. al 2012, currently “studies on aging, particularly risk factors that may engender social isolation amongst the elderly population in Zambia, are almost nonexistent.” It is difficult to find data on the topic with the most ‘recent’ figures coming from the census conducted in 2010. As of that year, there were about 500,000 elderly people in the country although scholars suggest that this is a conservative figure since many who live in rural areas may not have been accounted for (Chirwa and Kalinda 2016).  

NGOs highlight the plight of the elderly in the country, many of whom are either caregivers to people with HIV or are left with unmet needs with nobody to look after them. When it comes to dementia care, little work has been done to ensure that people with dementia have access to appropriate resources to live full and healthy lives. 

One organization, Aged Care and Service Centre, is actively trying to improve the state of dementia care in Zambia. A volunteer organization, operating in the Nakonde district and the 10 surrounding villages, 25 volunteers support 950 older people and their families at the Aged Care and Service Centre.  Anderson Simfukwe is the Founder and Executive Director of this first-of-its-kind organization in Zambia. He gave up his full-time job as a headteacher to pursue his passion for serving the needs of people with dementia. Anderson works together with Mary, a multilingual nurse, and a human rights advocate. Together, Anderson, Mary and their support network of volunteers are actively trying to change people’s attitudes towards dementia and those who live with the disease. 

Photo: Alzheimer’s Disease International

“When I was a headteacher, I extensively traveled across the Nakonde district and the greater Muchinga province. I saw that the elderly in these regions were subject to a great deal of abuse and injustice. My own father was accused of witchcraft when he started displaying certain symptoms such as wandering and getting lost. Once when he fell ill, we took him to the district hospital where the doctors diagnosed him with Alzheimer’s disease. That was the first time I heard about this disease and other dementias. As the doctors explained the symptoms, it became more clear to me that my father was, in fact, ill, and not practicing witchcraft as accused. It also became clear, the lack of awareness, education, and resources to understand and provide proper care for people living with dementia. 

As I researched the topic further, I learned about the atrocities against the elderly and people living with dementia in Zambia. As the majority don’t truly understand the disease, there is a lot of misconception about it. Care for people living with dementia is almost not available at all. This was the beginning of the journey to the setting the foundations of Aged Care and Service Centre. A few colleagues and I organized ourselves to break the myth of older people practicing witchcraft. It was a mammoth task but our work was eventually recognized and appreciated by the community. We were able to establish a working relationship with the Ministry of Health and Ministry of Home Affairs and report any form of elder abuse. This is how the Aged Care and Services Centre was established. In 2016, I was appointed the Executive Director of Alzheimer’s Disease and Related Dementias in Zambia (ADDIZ) under which the Aged Care and Service Centre operates as a support group for dementia. All the staff works on a voluntary, pro bono basis.” 

In picture: Anderson Simfukwe and some ADDIZ board members (left to right)

In February 2019, Aged Care and Services Centre reached out to Swedish Care International (SCI) for solutions to train its staff to enable them to provide the best quality of care.  Mr. Simfukwe informed SCI of some of the organizational challenges. He said, “one of the biggest challenges at present is that the volunteers leave the organization at any time and the staff retention rate is low. We have low operational costs and are not able to expand beyond the Nakonde District in Zambia.” Thus Aged Care and Services required a solution that was cost-effective, scalable, and flexible to the changing needs of the organization. 

As a part of SCI’s CSR to make knowledge of best practices in care available worldwide, it was agreed that we would partner with Aged Care and Services Centre and license our e-learning modules for beta-testing. This would be the staff’s first-ever formal training. 

Digital health solutions are not a new occurrence in Zambia. The World Health Organization has been partnering with various institutions to make digital dashboards that enable the monitoring of the malaria situation in real-time, available to the government. This allows healthcare workers to make data-driven decisions such as how best to optimize limited resources and which areas in the country have the greatest needs. Understanding the potential of digital solutions to bring good care practices into low and middle-income countries where the growth in the number of people living with dementia will be the highest, SCI developed its e-learning solutions. 

After going through an intensive period of beta-testing, Mr. Simfukwe shared his review of the course, “our shared goal with SCI to create an understanding of dementia strategies and establish an organization that enables every individual to have a good quality of life resulted in the provision of knowledge-solutions with a high degree of compatibility to our organizational needs. The information acquired through this training will not only benefit the course participants but also the larger community as volunteers will be able to lead a culture change based on sound, scientific knowledge sourced from world-class organizations in Sweden.

I believe that the key to winning the fight against dementia lies in a unique combination of global solutions and local knowledge and this is exactly what the course captures. I am now well versed with more information and knowledge about dementia.”

Some members of the ADDIZ also share their reviews of the beta-testing.  Elijah Miyenga says, “the knowledge obtained from the modules has had a far-reaching impact on my understanding of dementia and related illnesses. It has provided a nuanced view of the underlying causes and equipped me with possible creative approaches to dementia and dealing with challenging behaviors such as sexuality.”  Angela, another ADDIZ board member said, “We need to have the heart to love and to care for people with dementia, and the knowledge to do it in the best way possible. All of us at this organization are passionate about the cause but to really make a difference, we need to be equipped with the right tools and knowledge. I am thankful for this partnership which has allowed us to see the potential of digital solutions. ”

Designed for professional caregivers, SCI’s e-learning modules serve as an education tool for imparting knowledge on Swedish best practices in elderly and dementia care. The course equips the learner with essential skills to enable them to provide the best quality of care possible for the person living with dementia. If your organization would like to learn more, please contact SCI’s sales and development manager Sherry Yujing Cai at sherry.cai@sci.se or  +46(0) 72 246 02 76.