Manila, Philippines

Information on the ageing in Manila is provided by Mr. Edward M. Gerlock, who for 10 years was the Executive Director of the Coalition of Services of the Elderly, Inc. (COSE). In place of interviews, Mr. Gerlock chose to describe conditions in the “Pasadena, San Juan neighbourhood” as he is very familiar with its living conditions. The following sections are selected quotations from COSE’s submission to Habitat’s Best Practices Programme:

Due to a confluence of factors, the Philippines is on the verge of a crisis in the care of the elderly due to:

1. An estimated 10 million mainly young and majority women workers (the traditional care-givers of the elderly) are employed outside the country

2. As in many Asian countries, a massive rural to urban migration has put a strain on the traditional extended family system.

3. Due to better health care people are living longer and a moderately successful family planning programme is resulting in people over 60 being the fastest growing sector of Philippine society.

There are presently 40 organized urban poor communities of older people in Manila with affiliates throughout the country. Older people are respected, but not a priority on anyone’s agenda. For example, there are more than 200 groups in Greater Manila alone dealing with street children; but for the “street elderly” and urban poor elderly, virtually nothing. Resources are scarce and the potential of residential care for older persons is not only economically but also culturally unattractive. The potential for community based programmes for the elderly is vast.

COSE was founded in 1989 as an attempt to keep the elderly poor in their communities. The programme empowers them to make the decisions, which determine their lives. The programme includes a social component, an income generating capability, an insurance system to assure a decent burial; and in 1998 was about to embark on a peer-counseling programme. In a “Community-Based Health Programme” an organized urban poor community (“squatter area”) chooses two of their members to become “community gerontologists. For 3 days they are trained by a doctor, dentist and a nurse with an emphasis on ailments of older people and their prevention. At their graduation they receive a kit with a thermometre, blood pressure and sugar measuring instruments, etc., and become health workers for their own organized elderly in their community. They meet regularly to deepen their knowledge, and keep health records of every older person in the community.

Mr. Gerlock described Pasadena, San Juan “as having an area of 3-1/2Ha. with a population of about 3,000, located on top of the City water reservoir. The San Juan River which flows around the area is very polluted. A road leads to the area, but only narrow dark paths provide access within it. Electricity is available, but expensive, so a number of connections are illegal.

People have tapped into the reservoir for water. There are a number of small shops in the area. A hospital and a day centre are 2-1/2km. distant. Transport is by “Jeepney” or tricycle.

Of the 9.6 million people in Metro Manila, about 2-1/2 to 3 million are squatters who say they “own their home” even though they don’t own the property it sits on. Piped water is available and baths where it is drawn from the reservoir. Bottled gas and charcoal are used for cooking. Waste disposal is into the San Juan River. Police and fire protection is theoretically, but not practically available. However, security from those within the settlement does not seem to be a problem. The residents are tight-knit groups from different homogenous areas of the country who supply most of their own services. Intergenerational activities consist of fiestas, and everyone participates in older persons sponsored activities such as fund raising, socials, etc. TV and radios are common, and mail is delivered somehow.

Of the organized group, which has 113 members, about 25% of the elderly are men and 75% are women. The most common health complaints are rheumatism, high blood pressure, TB/lung diseases, and Diabetes. Most people do income generating projects at home in the informal sector. A major source of income is remittances from children working abroad which is estimated at $5 to $7 billion per year for the nation. A small but significant number of NGOs have achieved grass roots impact. For example, St. Lukes Geriatric Centre invites Pasadena elderly to come for day care activities 3 times a week free. With a little support the elderly virtually run their own Programmes.