K M Seethi
“No one should be alone in their old age,” Santiago, the protagonist in Ernest Hemingway’s The Old Man and the Sea reflects in despair. Fisherman Santiago’s sorrows speak volumes about how loneliness is terrible, yet Hemingway sends the message that there are umpteen ways of coping with the sorrows of loneliness. The lesson in the novel is that no one can stave off loneliness that life may toss on, but one can always make the best of it, as the protagonist in the novel grapples with. That’s surely easier said than done. Battling loneliness and stigma has always been an excruciating agony of the elderly in actual life across countries. Needless to say, this is quite evident in the days of the COVID-19 pandemic.
While the ‘International Day of Older Persons’(IDOP) is observed on October 1 every year, the United Nations seeks to ensure that the special needs of the elderly people are taken care of by disseminating the key agenda set by the General Assembly way back in 1990 in line with the ‘Vienna International Plan of Action on Ageing’ and the resolution of the World Assembly on Ageing. In fact, these two endeavours led to the dedicated day for the older persons. The UN Secretary-General António Guterres pointed out that as we observe the 30th anniversary of the IDOP, the whole world is absorbed in reckoning with “the disproportionate and severe impact” that the pandemic “has wrought on older persons around the world – not only on their health, but on their rights and well-being” (United Nations 2020a).
As the world body stated, IDOP 2020 will focus on the role of the health care workforce in contributing to the health of older persons, besides underscoring the role of women which is rather unappreciated and, in most cases, they are poorly rewarded. It is quite significant that this year’s observance will also foster the ‘Decade of Healthy Ageing’ (2020-2030) and “help bring together UN experts, civil society, government and the health professions to discuss the five strategic objectives of the Global Strategy and Action plan on Ageing and Health while noting the progress and challenges in their realization.” The international strategy is well integrated into the Sustainable Development Goals (SDGs), which aims to “ensure healthy lives and promote well-being of all at all ages” (United Nations, Department of Economic and Social Affairs 2015a).
Admittedly, there has been a drastic change in the very composition of the world population during the last few decades. During 1950-2020, there was a significant rise in the life expectancy worldwide (from 46 to 68 years). Studies say that there are more than 700 million persons aged 65 or over. In the next three decades, the number of elderly persons worldwide will be more than double, and all regions will witness a rise in the size of the older population. This will be seen mainly in the Global South countries. The largest increase will be recorded in Asia, particularly in Eastern and South-Eastern Asia. The fastest increase in the number of elderly is also expected in West Asia and Northern Africa. Among the Global South countries, less developed countries excluding the least developed countries will be home to more than two-thirds of the world’s older population by 2050.
Thus, it is quite natural that ageing and health has become a priority issue globally. The SDGs underlined that “no one will be left behind.” It seeks to ensure “healthy lives” and promote “well-being at all ages” (United Nations, Department of Economic and Social Affairs 2015a; 2015b; United Nations Development Programme 2017). Even though such proclamations remain a distant goal in the neoliberal era—with little hope of blanket promises to ‘social security’ and welfare measures—the state and non-state actors are expected to make commitments to the protection of vulnerable people such as elderly whose number has been increasing in low-and middle-income countries (Seethi 2020b).
Evidently, COVID-19 has already taken a heavy toll of fatalities from the older persons. It is for the first time that the people over 65 are more susceptible to risks and fatalities than they were any time in the past (CDC 2020; WHO 2020c). The pandemic of 1918-19—which killed more than 50 million people and caused more than 500 million (one-third of the world population) infections across the world—was not so fatal for the elderly. The worst victims were the adult population. However, COVID-19 has already set devastating health scenario for the elderly. This is quite evident from the pattern of COVID-19 deaths in the United States, Spain, England, Italy, China, Brazil, Russia, India and other countries in Europe. There were also some alarming reports, in the early stage of the pandemic, that a section of hospitals in the West had discouraged older people approaching for medical care in the context of declining facilities such as ventilators (Seethi 2020a).
Organisations working for the well-being of older people reported that the COVID-19 has intensified the violence, abuse and neglect of older people around the world across the world (Age International 2020). These cases manifest in diverse ways, such as physical, psychological, verbal, financial and sexual abuse, besides neglect. Older women also remained at higher risks, and people with disabilities and those with support needs also suffer. There were further reports that economic stresses caused by the pandemic situation are intensifying the incidence of economic abuse of older people (Ibid).
The United Nations has admitted that the pandemic has triggered deep anxiety, fear and miseries for the ageing population in the world. As the virus has swept across countries in the Global South, the death rate for ageing population could mount even higher and there will be more and more cases of abuse, mistreatment, humiliation and discrimination (United Nations 2020b). The UN noted that even before the onset of the pandemic, a significant section of the elderly people around the world were living in poverty and leading a life of social exclusion. In the background of the pandemic, the UN warned that the emerging situation “may significantly lower older persons’ incomes and living standards.” It also noted that the “downturn will most likely have a disproportionate impact on older women, given their limited access to income” (United Nations 2020b; ILO 2018). The world body also recorded that the spread of coronavirus in care homes etc has taken “a devastating toll on older people’s lives, with distressing reports indicating instances of neglect or mistreatment.” It pointed out that the older persons living in refugee camps, informal settlements and prisons “are particularly at risk, due to overcrowded conditions, limited access to health services, water and sanitation facilities, as well as potential challenges accessing humanitarian support and assistance” (United Nations 2020b).
During the current pandemic conditions, the older persons in many countries face age discrimination in the choices on health care, in deciding the urgency and priority of medical attention, and life-saving remedies. The deteriorating COVID-19 situation may also lead to a drop of critical services for other illnesses, further increasing risks to the lives of older persons. It is true that while the pandemic cases have grown in number even after months, overloaded hospitals and medical services contend with challenging decisions around the choices and use of facilities. According to WHO, the recovery from the pandemic is an occasion “to set the stage for a more inclusive, equitable and age-friendly society, anchored in human rights and guided by the shared promise of the 2030 Agenda for Sustainable Development to Leave No One Behind” (WHO 2020b). However, it is a challenging task for nations and international organisations to provide the older people with the much-needed support to access their social security and other safety measures. No doubt, COVID-19 has vitally affected their life-world situations in a bewildering way. Even as the pandemic persists in recurrent stretches across countries, medical prognosis goes to the level of unsure conjectures if this dreadful coronavirus could be contained now or in the near future. In any case, the longer the bouts of infections, the harder for the elderly across the world. However, not many of them can live in contemplation, as Gabriel García Márquez wrote, that the secret of a good old age is simply an honourable pact with solitude!