Male children in particular maintain ties with their parents by sending remittances back to Nepal to ensure that they are looked after, but as migration increases with concomitant increase in female as well as male members of the family seeking employment overseas, the number of elderly without family support will increase. Furthermore, as younger generations move away from their birthplace for employment opportunities, more and more of the elderly are left to live alone. This in turn leads to an increase in mental health problems like loneliness and depression.
LACK OF SERVICE PROVISION
The issue of loneliness of the elderly is not just a problem of rural areas; high levels of loneliness and low levels of social wellbeing is widely reported in over-60 cohort in bigger cities like Kathmandu Valley. Furthermore, men receive more social support than women. The traditional ideals that dictate that women be shy, sequestered, devoted, faithful, and restrained may explain this difference. If this is the case, there is a need for further investigation with particular focus on elderly females.
Lack of social security and health insurance and preference for living in a nuclear family are gradually forcing Nepali elders to take refuge in government-run shelters. This had led to an increase in demand for old people’s homes in Nepal. But so far, there is just one old people’s home run by the government; established in 1973 inside the premises of Pashnupatinath, it has a limited capacity of 230 people. The burden of welfare for the elderly in Nepal often falls on the shoulders of their children and as such, the government feels next to no obligation to provide care facilities for the elderly. This is evident by the shortage of government-run old people’s homes.
As the issue of ageing is a relatively new topic in Nepal, little research has been conducted in this area and there is a dearth of data on old people’s homes. This is further compounded by the fact that the Social Welfare Council, responsible for the registration and monitoring NGOs, has no separate category for NGOs working with the elderly. NGOs working in the field of ageing in Nepal therefore fall under community development or health categories, depending on the work being undertaken. It is difficult, therefore, to ascertain how many of these programs were officially targeted at the elderly. The past two decades have seen an increase in NGO activity, with over 30,000 NGOs being registered with SWC, working for social development; there is also evidence that some of these strive to meet the needs of the elderly.
More needs to be done to take proper care of the growing elderly population in Nepal.
Ageing Nepal is a singular operation in the NGO sector completely devoted to ageing issues. NEPAN is another organization working on ageing-related matters along with other socio-economic development programme NGOs in Nepal. According to NEPAN (2007), there are about 50 day care centres, 20 old people’s homes and more than 100 elderly clubs being run by over 50 different organizations. GCN estimates that 1,500 elderly people live in old people’s homes but this does not take into account the increasing number of elderly being cared for in community hospitals.
There are other private concerns, for example Morang Old Age Home, whose owner Jagat Aryal is himself over 65. The home has 41 residents, both male and female, aged over 65 and the center is run without government funding or I/NGO assistance. This type of enterprise needs to be encouraged. However, care must be taken to monitor the quality of these services and ensure their continued financial support.
Furthermore, as Ageing Nepal, NEPAN and other NGOs working in this sector collectively argue, international agencies have a role to play, but the role of the government must not be overlooked and needs to be more fully explored. It has also been suggested that the government ministries and line agencies that oversee programmes on ageing and population establish a network to improve communication and enable greater dissemination of ideas.
However, those living in old people’s homes in Nepal are perceived by the wider society to have families who do not care for them; hence they are marginalized. A study on parasitic infection amongst the elderly found a higher than normal level of infection in the government-run old people’s home, suggesting overcrowding, poor sanitation and lack of care. Whilst this study was limited in scope, it found levels of infection to be lower in private homes. Questions surrounding the quality of care in homes such as Pashupathi Briddhashram as well as other old people’s homes have started to emerge in media. At the government-run Briddhashram only the most basic of needs are met, and yet there is high demand for this type of provision.
The under secretary for the Ministry of Women, Children and Social Welfare (MWCSW) notes that the government’s old people’s home has limited funds that only cover minimum requirements and that if further funding was available, both the quality of provision and life expectancy of residents would improve. Whilst the work of different agencies in looking after the needs of the elderly is to be encouraged, care must be taken to monitor the quality of these services and ensure the NGOs are provided with adequate financial support. The MWCSW, along with the Social Welfare Council, has an important role to play in this regard.
CONCLUSION
The pensions system in place is mainly accessed by former military personnel, police officers and civil servants and reaches a small percentage (less than 10 percent) of the elderly population. There is also a provision of old-age allowance for those over 70 but it is nominal, not even enough to meet basic requirements. The social welfare system in Nepal needs to improve on this provision. The responsibility for disseminating pensions and increasing old age allowances to meet the basic requirements of the elderly has been devolved to the local level through the Ministry of Local Development (MLD).
But it is equally important that MWCSW plays an active role in ensuring the needs of the elderly are met through the MLD and that roles and responsibilities for these agencies are made clear. The MWCSW, along with the Social Welfare Council, has an important role to play with NGOs and INGOs in supporting timely development of appropriate plans, policies and services to meet the needs of the elderly in Nepal.
The author is a University of Liverpool-based researcher on aging
bijan.pant@liv.ac.uk
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