Aging nuns in Uganda face end-of-life care gaps as a pilot hospice program seeks to fill the void

At the Little Sisters of St. Francis convent in Nkokonjeru, Uganda, Sister Jane Frances Nakafeero walks through a cemetery where nurses, teachers, social workers, and doctors—all of them nuns who served communities across East Africa—are buried beneath simple white crosses. The motherhouse, she said, is "where we begin and where we end." It is also, she has come to recognize, where a care crisis unfolds quietly among the elderly women who remain.

The convent currently houses 14 retired sisters, most with significant mobility limitations. Of the roughly ten nuns who need wheelchairs, the convent has only seven, all in poor repair with sticky wheels and faulty brakes. Resources such as adult diapers, hearing aids, and warm blankets are scarce. Sister Rosemary Luyiga, 95, who entered the convent in 1944 and spent decades teaching girls, said she does not call for help even when she needs it urgently, because there are not enough caregivers to respond. "I don't know what can take away loneliness," she said.

The pilot program, which began in September 2025, grew out of a 2023 meeting of the African Palliative Care Association, where Nakafeero described her order's unmet needs to Jean Callahan, former chair of the Irish Hospice Foundation. Callahan said she thought of her own grandmother, who had left Ireland for Tanzania as a nun. "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," Callahan said. The two women agreed to develop a structured response. Researchers led by African Palliative Care Association director Eve Namisango are currently completing needs assessments of the 50 retired sisters. Caregiver training is expected to follow, with a goal of rolling out palliative care across Ugandan convents by 2027 and then across the continent.