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close this bookThe Courier N 185 - March - April 2001 - Dossier: Cinema - Country Reports: Angola (EC Courier, 2001, 76 p.)
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Getting older in a changing world

by Sarah Graham-Brown

An older woman in Cameroon went to a clinic complaining of a painful leg. The nurse told the woman she was not ill, but just suffering from old age. The older woman replied: “My child, why is my old age only in the left leg, not the right leg or any other part of my body?”

In many developed and developing countries health care is routinely, if not always so explicitly, rationed according to age. As life expectancy increases worldwide, a critical gap is opening up between the needs and rights of those who survive beyond their fifties, and societies’ willingness to acknowledge the implications of this demographic “agequake”.

Human rights are not age-limited - the Universal Declaration of Human Rights and other conventions and declarations on rights apply as much to a person of 80 as to a person of 15 or 40. In the coming decades, rapid demographic change will make equal rights for older people all the more critical.

Today, older people form a growing proportion of the population in most countries. In the developing world, the number of older people is expected to double, to 12% of the total population by 2025. The Asia-Pacific region, where an estimated 62% of the world’s older people currently live, is expected to experience a disproportionate increase in numbers of older people, especially in the largest countries - China, India and Indonesia.

Older people are also likely to be among the poorest in most communities. The proportion of older women, many of whom are widows in precarious economic circumstances, will continue to grow. Most developing countries are growing old before they become rich, with traumatic consequences for the vulnerable old and their families. Already the majority of the world’s population of older people (61% or 355 million) lives in poorer countries. This proportion is expected to increase to nearly 70% by 2025.

Policy-makers, at the UN and in national governments, have been slow to address older people’s rights and needs. The adoption of the UN Principles for Older People in 1991, with the five key principles of independence, participation, care, dignity, self-fulfillment, was a first step in acknowledging older people’s rights. But these principles are not binding on states, and in practical terms they have not brought significant change.

Social development policy in the last two decades, for example, has taken little account of those who reach old age. International organisations have adopted poverty alleviation as a development goal, yet research on the causes and character of widespread poverty among older people has scarcely begun. Current poverty assessments are overwhelmingly weighted toward issues of child nutrition, child and young-adult education, infant and maternal mortality rates and reproductive health.

At the same time, the impact of globalisation and rapid social change is undermining family life and the role and status of older people. The speed of change creates difficulties in adjusting economic and social structures.

Governments have often assumed that families will care for their older relatives. But even in societies where family bonds are still strong, such as Korea, the government’s view that family care rather than social provision takes priority is under challenge. Life expectancy will reach 74 years early in the 21st century, but it is being accompanied by a rapid rise in the numbers of older people living alone to almost a quarter of the population over 65, while over two thirds of all families are now nuclear families.

In the Philippines, despite a long tradition of family and community care and respect for older people, recent economic changes have left many elderly people vulnerable and without family support. Smaller families and labour migration have diminished the numbers of family carers available to support older people. Many migrants are young women who were traditionally the main care-providers for older people. The dominant youth culture and the recent economic problems have pushed older people’s issues further down the agendas of government, non-governmental and international organisations.

HelpAge International’s research in Africa, Asia and Latin America highlights not only older people’s needs but also the range of their contributions to family and community. An older South African woman spells out the variety of ways in which she contributes to her family and community: “In the past I educated my children - paying school fees, buying books, transport, food and uniforms. I also contributed to cultural education, for example, circumcision ceremonies. I contributed in the church, medical fees when the children were ill, preparing nutritious food, cleanliness, providing accommodation, ploughing the fields and counselling whenever the children and their marital partners had problems. I am still doing all of these things, I contribute financially and to the health care of the family.”

The image of older people as a burden is also countered by the important role they play in countries where HIV/AIDS is decimating the young and those who are already parents. Older people care for their children and younger relatives when they are ill, and bring up their orphaned grandchildren. In Thailand, there is evidence that when young people who have contracted HIV/AIDS become ill, they go home to their villages where they are cared for by older relatives.

In Tanzania, HelpAge International’s research on older people caring for AIDS orphans emphasised the strain placed on both grandparents and children. “Because of the relative poverty of the household, very often grandparents cannot afford to send the children to school and they miss chunks of their education...Although it is primarily the grandparents who care for the children, from time to time the children can be forced into a caring role, for example when their grandparents fall sick.”

Acute humanitarian emergencies - wars, famines, or hurricanes - highlight both older people’s fragility and the contributions they can make if they are listened to. Recent HAI research called for older people to be seen, heard and understood. In Juba, southern Sudan, where many years of civil war have undermined the local economy and society, its programme has encouraged older people to participate in planning and delivering aid. The result is a noticeable improvement in older people’s overall quality of life. In addition to promoting their welfare, “the project helped the older persons’ image greatly,” according to Samson Kwaje, 65 year old chairman of a committee coordinating older people’s activities. “They can dress well on social occasions, so they feel well. Those without shelters are sheltered, sanitation has been taken care of and the project has brought craft skills.”

As part of civil society, older people can participate in efforts to claim and insist on their rights. In Bolivia, a governmental decision to grant pensions to the over-60s met with an outcry from older people because most were not registered at birth and therefore could not prove their eligibility for the payment. Older people took to the street and lobbied the government, the legal profession and the public to secure the help they needed to get essential identification. Some 5,000 people received their entitlements.

Poverty in old age is clearly a major issue of the 21st century, not just for older people themselves but for the generations that depend on them. This is the challenge facing the policy-makers framing new policy guidelines on ageing for the UN Conference on Ageing in Spain in 2002: not to deny the rights of other vulnerable groups, but to seek inclusion for a critical part of the world’s population.

HelpAge International’s recent publication, The mark of a noble society: human rights and older people argues: “All the evidence is that older people everywhere seek social inclusion as well as economic attention. The question is not what we should do about older people - but what would we do without them? Socially and economically, can their contributions be ignored any longer?”

Pictures: HelpAge International