A Lifetime of Service, a Future of Neglect: The Plight of Africa’s Elderly Nuns
In the quiet, sun-drenched hills of Nkokonjeru, Central Uganda, the Little Sisters of St. Francis convent stands as a testament to centuries of selfless devotion. Here, rows of white crosses, adorned with vibrant pink and yellow flowers, mark the final resting place of sisters who dedicated their lives to teaching, healing, and uplifting communities. Yet, as the sisters now enter their twilight years, a stark reality emerges: who will care for them?
Sister Jane Frances Nakafeero, a 65-year-old leader of the order, walks purposefully between the graves, her voice heavy with emotion as she recounts the lives of those buried here. “This one was a nurse,” she says, pointing to a modest headstone. “This one was a teacher. This one was a social worker. This one was a doctor.” The wind rustles through the graves, carrying the weight of unspoken questions: Where will these women find comfort when their own strength wanes?
For decades, the Little Sisters of St. Francis—founded by Mother Kevin Kearney, an Irish missionary who arrived in Uganda in 1903—has been a beacon of hope. Kearney, now a candidate for sainthood, established hospitals, schools, and clinics across the continent. But today, the sisters who once served with such vigor now face a crisis: a lack of palliative care, basic medical supplies, and emotional support in their retirement.
A System Ill-Equipped to Care for Its Own
Palliative care—a field that emerged in the 1960s—remains a luxury for many in Africa, particularly within religious orders. Sister Nakafeero explains that while palliative care is increasingly recognized globally, funding and awareness remain scarce, especially in African convents, which operate on far slimmer budgets than their counterparts in Europe or the United States.
At the Nkokonjeru convent, 14 retired sisters—some in their 80s and 90s—live in a system stretched thin. Young nuns provide basic care, assisting with meals, mobility, and personal hygiene, but critical resources are missing: adult diapers, wheelchairs, hearing aids, and even warm blankets in Uganda’s chilly nights. Many sisters suffer from chronic pain, mobility issues, and depression, yet there are only seven wheelchairs for ten sisters with limited mobility. The chairs themselves are in disrepair, with sticky wheels and faulty brakes, leaving some sisters confined to their rooms.
“They have served humanity for all their useful years,” says Dr. Eve Namisango, director of the African Palliative Care Association (APCA). “Now, they deserve decent, person-centered care.”
A Pilot Program to Bridge the Gap
The crisis caught the attention of Jean Callahan, a former chair of the Irish Hospice Foundation and an advisory board member of the APCA. Callahan, whose own grandmother was a nun who left Ireland for Tanzania in the 1950s, was deeply moved by Nakafeero’s plea. “These women, who could have been my grandmother’s colleagues, are being left at the end of their lives without the basic human supports they should have,” she says.
In September 2025, Callahan and Nakafeero launched a pilot palliative care program in partnership with the APCA. The initiative aims to provide:
– Medical and emotional support for aging nuns
– Psychological interventions to combat depression and anxiety
– Material aid (wheelchairs, hearing aids, adult diapers)
– Training for young nuns on geriatric care and palliative practices
Researchers, led by Namisango, are currently assessing the needs of 50 retired sisters from the Little Sisters of St. Francis order, which includes nuns from Uganda, Kenya, and Tanzania. If successful, the program could expand to Ugandan convents by 2027 and eventually across Africa.
“Whether you’re a nun in Africa or a construction worker in the Bronx, you face the same fears as you near the end of life,” says Kristina Newport, chief medical officer at the American Academy of Hospice and Palliative Medicine. “Having someone walk with you in that place makes all the difference.”
The Human Cost: Loneliness, Identity Crisis, and Unmet Needs
For the sisters at Nkokonjeru, retirement has brought not just physical decline, but a profound loss of purpose. Sister Mary Hedwig Agoya, now 89, arrived at the convent in 1951 at just 14 years old. She spent 40 years as a teacher, shaping young minds before retiring to a life of quiet reflection. “It becomes a bit dull,” she admits, her voice hoarse with age. “Before, I was managing a classroom. Now, I just sit and pray.”
Nearby, Sister Rosemary Luyiga, 95, spends most of her days in a small room adorned with a black-and-white portrait of her mother and a centennial candle honoring the order’s founder. She entered the convent in 1944, lived through World War II and Uganda’s independence, yet she struggles to recall the details. “I don’t think we were very much interested in the world outside,” she says, her gaze fixed on the window.
Luyiga, now immobile and often alone, expresses a loneliness that transcends physical isolation. “You would like to sit and talk, but you find that you cannot do that,” she reflects. “I don’t even call for help when I need to go to the bathroom.”
Sister Mary Consolata Nakawoojwa, a social worker trained in geriatric care in the United States, oversees the care of these sisters. She describes the emotional toll: “They are not sure how life will be. We define ourselves by what we do. But now, they’ve got to be instead of doing. They have to redefine their identity.”
The sisters suffer from depression and anxiety, a natural response to loss of autonomy and purpose. Nakawoojwa emphasizes that palliative care is not just about pain management—it’s about accompanying them through existential questions.
“I feel very aggrieved that nuns are second-class citizens,” Callahan says. “The bishops focus on priests, but what about the women who have spent their lives serving?”
Nakafeero agrees: “The bishops are in charge of the dioceses and the priests. They would do something for the priests, but they will not do something for the nuns.”
A Call for Urgent Action
The Vatican did not respond to requests for comment, leaving the responsibility for these sisters largely in the hands of individual convents and grassroots initiatives. Currently, a survey funded by an anonymous Irish donor is gathering data from elderly nuns across Africa. Campaigners are seeking $135,000 to expand the palliative care program, covering:
– Medical supplies (wheelchairs, hearing aids, adult diapers)
– Psychological support for nuns and caregivers
– Training programs for young nuns in geriatric care
“I’m an optimist and I’m bloody determined on this,” Callahan declares.
For Sister Nakafeero, the issue is deeply personal. She has spent her career advocating for palliative care, even establishing a program at Naggalama Hospital after caring for her own dying father. Now, as she approaches retirement herself, she wonders: “In a few years, I myself will be there. When that time comes, I would want someone to gently journey with me.”
A Continent’s Unseen Crisis
With 82,000 nuns in Africa, according to the Vatican, estimates suggest that 8,000 to 10,000 may require end-of-life care. Yet, without systemic change, many will continue to fade into obscurity—forgotten by the very institutions they dedicated their lives to serving.
The story of Uganda’s aging nuns is not just about lack of resources; it’s about dignity. It’s about recognizing that those who spent their lives in service deserve the same compassion they once gave to others.
As Sister Agoya sits quietly in her room, watching the world pass her by on a wall-mounted television, one question lingers: Will Africa’s nuns finally receive the care they’ve earned?
Sophie Neiman is an award-winning journalist based in Kenya, specializing in regional health and social issues. This story was adapted for Topix GlobalWire to highlight the urgent need for palliative care reform in African religious communities.
