DAKAR, Senegal (AP) — The sun has not yet risen in Senegal's capital, Dakar, but about 100 people in swimsuits and life jackets already crowd a section of beach, ready for aquagym class.
In the chilly Atlantic, 63-year-old Aminata Sall is soon kicking in rhythm with others, foam noodles tucked under her arms. On the beach, people with limited mobility are buried knee-deep in the sand and gently rotate their torsos in a therapy session meant to ease
pain.
Sall's doctor once warned her she could lose the ability to walk within five years because of rheumatoid arthritis, an autoimmune disease that causes pain, stiffness and swelling in the lining of joints and can cause severe damage if left untreated.
“The shock was enormous,” she said. “I stayed at home for almost a year, doing nothing.” Then one morning she wandered down to a beach in Dakar's Ngor neighborhood and saw people exercising in the water.
“I asked what they were doing, and they told me to try,” she said. “I’m still walking.”
Senegal's first aquagym program with its low-impact exercises has drawn praise from health professionals for helping people with reduced mobility caused by chronic illnesses such as heart disease, stroke and arthritis.
As life expectancy rises sharply across Africa, these diseases have become more common, often leaving older adults with pain and limited mobility. But prevention, diagnosis and rehabilitation services have not kept pace on a largely youthful continent whose public health systems prioritize infectious diseases, maternal care and children.
Many older people have little access to geriatricians or other doctors and tend to forego diagnostics or treatment to cut costs.
The aquagym emerged little over a decade ago as a rare, low-cost option to relieve pain and improve mobility.
After Sall was diagnosed with her autoimmune condition, she said her doctor told her she would need surgery at a cost of about $10,000, which she could not afford. She was prescribed an anti-inflammatory drug, but it was later taken off the market due to complications.
“That’s when I started losing hope,” she said. “Some mornings, a blocked vertebra or swollen ankles would leave me unable to move all day.”
In Senegal, most medical care is paid out of pocket. Public insurance coverage is limited, and private plans remain unaffordable for many. Costly procedures like surgery are often not covered.
“A lot of people don’t come to us until things get really bad, and by then it’s much harder and more expensive to treat them,” said Dr. Seydina Ousmane Ba, director of the National Orthopedic Prosthetics and Rehabilitation Center in Dakar.
Khadija Wade, 76, has spinal stenosis, a degenerative condition that can compress and irritate the nerves in the spinal cord. She was diagnosed three years ago and her condition worsened after her husband died earlier this year.
“I became very sedentary. I could spend an entire month at home without walking,” Wade said.
Many suggested she see a specialist in Italy or France, but visas are hard to obtain for many Senegalese and treatment abroad is costly.
Last month, Wade began aquagym classes on her doctor’s recommendation. She said she is already seeing results.
“I came to my first session with a cane, but now I can walk without it,” she said.
People with reduced mobility in West Africa face especially steep hurdles, said Clément Philit, director of Handicap International in Senegal. Public spaces and transport are often inaccessible, and specialized health care and rehab services are scarce, he said.
“Aquagym has benefits you don’t always get on land,” Ba said. “The water supports your body, reduces pain and makes movement easier, so patients can exercise more comfortably.”
The program’s founder and head coach, 69-year-old Ndiamé Samb, previously worked as a firefighter specializing in underwater operations before becoming a lifeguard in 1988, teaching swimming to older people.
Samb is a member of the Lebu, considered the Indigenous people of Dakar’s peninsula, who have maintained strong cultural and spiritual ties to the ocean.
While training in Paris, Samb discovered aquagym and its benefits. His classes in Dakar are among the few in the world that are held in the sea rather than a pool. Public pools remain rare, and the sea is free.
“At first it was just eight or 10 people coming to the class,” Samb said. “But now, we sometimes get up to 200 people per session and have a total of around 600 students.”
The low-cost aquagym classes — 300 CFA francs ($0.50) per session — are led by volunteer coaches. The fees are used to keep the center running and buy equipment, along with a $3,000 subsidy the city granted this year.
Samb's brother Alassane, 60, a lifeguard and licensed massage therapist, guides new participants and said some even come from France and the United States for treatment.
As the day's session ends, Sall walks out of the water with a smile. She attends three times a week.
“What keeps me coming back is seeing other people not giving up," she said.
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