Planning for the elderly again

Recently, the Government of Guyana, i.e. the Ministry of Public Health, announced that in collaboration with the Ministry of Social Protection and the Pan American Health Organisation (PAHO) it was in the process of devising a strategic plan to deal with the condition of the elderly. Over the years, this column has been paying attention to this issue because it appears to me that even if we take into consideration our generally poor socio/economic condition, this section of our population has been treated very shabbily. But for two reasons this announcement would, therefore, have been greeted with glee.

Firstly, in the first months in government most new political regimes busy themselves picking low hanging fruits, but two years into its term, the plethora of plans/enquiries, etc. that this government is still unveiling suggests that it might have become addicted to this process. However, more importantly, when it came to office there was a slew of unfulfilled promises rooted in the international system that had already been made to the elderly, which, if prioritised and successfully implemented, would have done much to ease their many burdens.

At the end of last year, I drew attention to the fact that in 2012 Guyana’s National Report on Aging (GNRA) made commitments to the elderly, the vast majority of which the PPP/C’s government promised to fulfill by the end of 2016. We are now in 2017, and neither the previous nor the present government, which came to office in 2015, has come close to fulfilling these promises. (The elderly: broken promises. SN: 21/12/2016)! To eliminate any doubt, please consider briefly some of the following promises that were made against your everyday experiences.

Our governments committed to promote the human rights of older persons: improve their access to justice, develop laws to protect their physical and mental integrity, safeguard their property and help them remain at home in old age. A bill of rights for the elderly was to be enacted and their participation as a specific interest group in development planning and physical access to all public buildings assured. There were to be minimum standards for institutional care and treatment: the compilation of standard operational procedures to deal with acceptance in such institutions and conflict resolution and abuse were to be developed. A new state of the art home that also provides day services were to aid in improving the living conditions of the elderly.

The aged were to be provided with opportunities for lifelong learning and activities that promote dependency prevention by undertaking campaigns to, for example, promote healthy ageing and early screening programmes for diabetes, hypertension, chronic illnesses and degenerative diseases.  Eighty percent of older persons were to have an advanced awareness about sexual and reproductive health, the incidence of neglect, the paucity of goods and services, and support including hot meals and trained caregivers to provide home-based care and do other personal chores for those persons living alone and/or who are shut-ins were to be provided. All staff were to be adequately certified and training customized to help caregivers and families cope with Alzheimer’s, dementia, arthritis, cancer, osteoporosis, etc.

Decent and adequate work was to be provided by expanding and mainstreaming retirement planning in all public institutions and addressing the monetary and social requirements of retirement.  A national intersectoral plan that streamlined all the rights of the elderly within all related ministries and an intersectional committee on ageing to provide oversight of the implementation process were to be key priorities.

A strategic plan for dealing with the conditions of the elderly might need to be somewhat more comprehensive than that offered in the GNRA. Transportation, emergency response, nutrition support, help with housing relocation, renovations, utilities and other such services could be addressed. Such a plan could place more emphasis on healthcare provision and further elaborate the path towards mainstreaming elderly concerns in all relevant areas of public provisioning. It could also speak more definitively about the level and possible sources of available resources, the importance of establishing a representative organisation of the elderly. Constructing such a plan based partly on focus group analyses (possibly in every neighbourhood and/or village) should help us to answer these kinds of questions, enhance buy-in and put the policy on a more solid footing. Proper performance monitoring, measures and means of complaint and providing redress, such as a special ombudsman for the elderly, also need to be considered.

Thus, I am not claiming that a properly constructed strategic plan cannot be useful, for outside of the few vague population numbers, we know nothing of the actual condition and aspirations of the elderly. What are their priorities, what contributions they feel they could make individually and collectively to ease their condition? However, if it is to be properly done, a strategic plan will take some considerable time to craft, and the GNRA report contains important commitments that the government should immediately implement.

Of course, it does not take much to see that the elderly would be treated with more respect if they had their own representative institution. In normal democratic political conditions, where the allocation of public resources is concerned the constituency with the greater political weight would acquire proportionate influence. Where, as in our context the government is in office by the smallest of margins, 60,000 elderly persons, all of whom have a vote (about 12 parliamentary seats), should be able to properly organise and safeguard their interests. Unfortunately, in Guyana the elderly are as ethnically/politically divided, and perhaps relatively even more conservative than the general population, so it will prove extremely difficult for them to organise to pressure national governments.

Regimes find it easier to work with ‘national commissions’, which they appoint and control at the same time as giving the unsuspecting public the impression that a representative institution is looking after the interest of the elderly. A commission could play a useful advisory role but difficult as it may prove to be,  if their long term interests are to be better secured,  efforts should be made to establish an independent organisation to integrate, articulate, monitor and persistently agitate for the interests of the elderly (The elderly need an independent organisation. (SN: 12/09/2012).

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