A nation goes to the polls – but the majority are too young to vote

Uganda's birth rate and population are soaring, putting its society, and democracy, under strain

It is a "quiet morning", according to the nurse at Mulago Hospital's maternity ward, but it does not look like it. A dozen expectant mothers fill the wooden bench in the waiting area. A heavily pregnant girl in a blue dress – little more than a child herself – writhes on the floor, already in labour.

The 30 beds of the labour suite are too few for the numbers so some women are giving birth on the floor. "We are the baby factory," Sister Bernadette Numugema says with a shrug. "We run 24 hours."

Kampala's biggest hospital is home to the busiest maternity wing in the world. The record for a single day stands at 105 deliveries. It delivered 33,000 babies last year. Mulago is the engine room of a population surge that means Ugandans are younger on average than any other nation in the world.

It also means that when the country goes to the polls tomorrow most Ugandans will be too young to vote.

The pearl of Africa, as it was dubbed by Winston Churchill, has doubled in size in the last two decades, moving from 17 million to 33 million people. Its fertility rate puts it in the top five worldwide.

The impact of the demographic phenomenon is felt in every sector: it has eroded the gains from modest economic growth and placed a massive burden on already creaking health and education systems.

Despite this legacy, after 25 years in power Yoweri Museveni is almost certain to win re-election against a fractious and divided opposition. The 66-year-old oversees a gerontocracy in which the 2 per cent of the country as old as he is has total control over political power.

The former general likes the baby boom and welcomed projections showing Uganda doubling its population again in the next 10 years. He even suggested he would like to overtake Russia.

These statistics mean that 14-year-old Jimmy Ssenkya is the median age for a Ugandan. He lives in a village about a two-hour drive out of Kampala's smog in the countryside of banana palms and jackfruit trees, near the town of Mukono.

Like thousands of other Ugandan children, Jimmy is now the head of a household. He and his two brothers, aged nine and six, were abandoned first by their mother and then by their father, who was a drunk with a violent streak. They survive on charity and farm labour. "I'm the mother and the father now," Jimmy says.

Still patriotic, he has drawn an excellent likeness of the national coat of arms with a crested crane. He has written underneath: "For God and Country."

"The number of kids being produced is extraordinary," says Dr Jotham Musinguzi, who was head of Uganda's population programme for 15 years. "We don't want to call it a curse but it has serious implications."

The economy would need to grow by 12 per cent a year, he explains, to absorb the population pressure. But growth has peaked at 7 per cent. International donors make up one-third of Uganda's budget.

The new demographics are transforming a prim and conservative country into one in which entertainment is the main currency. In the process it is offering an accelerated preview of what is happening in many parts of sub-Saharan Africa, where a hyper-youth culture is emerging.

As a child the doctor remembers walking across the border into DR Congo, or Zaire as it was then known, to hear music. "We used to think of Congo as a country that was nothing but music. Uganda had no music... now it's music, music, music everywhere."

Ssebaggala Francis is one of a new breed of local celebrities. In a rundown suburb on the outskirts of the capital he and his breakdance crew are rehearsing in the shade of a canvas church. One of the stars of Uganda's frenzied "B-Boy" scene, Francis is still basking in the afterglow of a television appearance last year in the finals of Hotsteps, a popular local talent show. He lost in the final to two girls, both younger than him. Only 17-years old, he speaks like a veteran. He schooled himself on the pirated DVDs of Western acts, like Rock Steady Crew, which pour out of roadside shacks all over the city.

"I saw these tricks and moves and thought only the whites can do that," he says. " It looked like magic that guys could spin on their heads. But I discovered Africans can do this." The crew hires itself out as entertainment at middle class parties and events where the mantra for the hosts is the "younger the better".

The weight of competition has started to weigh on the young dancer, he admits. He is the oldest in his crew, which includes performers as young as six. "Sometimes I get worried," he says. "I speak to God and I say, 'Oh God, I don't want to get old'."

The B-Boys live in a world ignored by Uganda's election campaign. Posters for the youth wing of the ruling party show smiling men in their mid-30s. If the political elite has been slow to appreciate the youth phenomenon, the previously fringe Christian churches immediately saw a market.

The Kampala Pentecostal Church looks like a venue for an awards ceremony. On Sunday the church works in shifts with 2,000 or more worshippers waiting along rope lines with a red carpet. Inside is a vision of young, middle-class Africa.

The style is aspirational and the gospel is prosperity. The stage has all the trimmings of stadium rock with a drummer in a glass cage, four guitarists, a lead singer and a backing choir of 100. The pews erupt in dancing, jumping and clapping. "It's entertainment," says Alan Atulinda a 24-year-old cameraman with local television station. "We like to go crazy in church."

The affluent clothing is just a veneer, he says. Most of the congregation will go home to the slums to wait for next week's show.

The closest today's election has come to touching this congregation came with the surprise success of a rap mix of the president performing a traditional tribal chant at a political rally. It was cut and turned into an underground hit. At first, Mr Museveni was furious and had it banned before he was advised to go with it. The pensionable president was taking accidental advantage of the popularity of indigenous rap – known as "Luga Flow".

In a small compound in one of the capital's ghetto areas you can find the Luga-Flow Embassy. It belongs to Babaluku, a renowned Ugandan hip-hop artist who came back to pioneer an indigenous rap scene after growing up in Canada. The 30-year-old was struck by the number of kids everywhere he went: "You see all these young people and you're like, 'what do you do with your time?'"

The Luga-Flow movement is an effort to answer that question while breaking from "imported hip hop" to "rap in a language that people can understand".

Five years on, the ghetto youth movement is getting mainstream attention and Babaluku's last recording – a rap in Lugandan – got wide play on local stations. The Embassy, with its scattering of well-used computers, cameras and a vintage ghetto blaster, is open to any child who does not skip school.

Brash and confident 10-year-old MC Ship, a regular who leads a crew of eight, wants to be a lawyer. The quieter MC Hope, 9, wants to be a journalist.

The crew's girls MC Roy, 7, and Flower, 8, can rap in three languages. To a subdued beat, the duo start to freestyle: "We have ears, eyes and a brain; our legs can carry us any distance; In our hands we hold what you need to eat; If you're hungry we can feed you some Luga Flow."