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| Sunday, 6 February 2005 |
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Features |  |
| News Business Features Editorial
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What about the elderly? by Carol Aloysius Jane Nona is 72. When the sea waves of the recent tsunami crashed into her little hut at Lunawa, they devoured not only her home, but the rest of her family; her son, daughter-in-law and two grandchildren and most of her close neighbours. Fortunately for her, she was trapped between two large rocks that somehow withstood the lash of the angry waters, and was rescued by a neighbour.
Babun Appu 74, asks the same question. Since his entire family has been washed into the sea, this former fisherman, crippled with arthritis and blind from cataract, says that with no one to look after him, read to him and help him to the toilet, life is not worth living any more. More than one third of Sri Lanka's population, is said to live in the coastal areas.Whether it is in Lunawa, Panadura, Puttalam or right along the coast, the fate of these persons, is under threat, especially in the case of the elderly (and disabled) persons who have survived the tsunami. Not just because of their age, but because they more than most other internally displaced groups, are likely to be overlooked in the rehabilitative programs that are targeted to give the survivors of the tsunami a new lease of life, if only because they are fewer in numbers or are too feeble to articulate their needs.
"Since my interest is mainly in elders and the disabled, I made it a point to carry-out some case studies on how the tsunami has affected such persons. What they told me was more than just an eye opener. It showed me that unless we act fast, many of these elderly persons will die or become permanent invalids", she says. What she saw in these camps, was a range of age related illnesses that had been compounded by the tsunami, despair and a strong desire to end their lives. "Many of them had elephantitis, varicose ulcers, leg ulcers, swollen feet and various chronic diseases such as diabetes, asthma, hypertension, and dental problems. I also noticed that several of them (both men and women) were suffering from bilateral cataract and incontinence. Most of these persons couldn't articulate themselves and mentioned vague symptoms which were not inter connected. This was compounded by the fact that several of them were in depression, and had feelings of guilt; of being a burden to others; and of loneliness. The food they were served did not suit them, as many of them had dental problems, and they complained they had no privacy or a place to observe their usual religious observances. They also complained that they had lost their medical cards and could not remember the medications they had been receiving for their various chronic ailments." What the health ministry did within the first week of the tsunami was to draw up a health card asking MOHs in each of the camps to get basic information such as the MOH area, name of patient, relevant past medical history and medications used for existing health condition (if the patient could recall them). The same card provided separate cages to be filled up on signs and symptoms of diseases, recommended treatment, and care providers. "This was to give us some sort of a record of the patients in these camps as most of the patients had lost all their medical records", says Dr. Perera. She was also disturbed to find that many of these elderly persons who were already on prescribed drugs for hypertension, diabetes, asthma or other chronic diseases were refusing to take the drugs given to them in the camps. "No one advised them or told them that it was safe for them to use substitute drugs. I found them simply carrying these drugs in their hands or keeping them under their pillows without using them". Diabetic patients who needed insulin injections, complained that there was no place to store them, as yet since the neighbours in whose refrigerators they had kept the insulin, had perished. We have advised health personnel at these camps to spend time talking to these patients and to advise them. Even if they don't need medication, they do need love and empathy, since they have all been victims of a terrible disaster." Asked about their life-style prior to the tsunami, many of them had told her that they would read the papers, listen to the radio, talk to their grandchildren or visit neighbours. "Now all this has changed for them. Not only are they living in unfamiliar surroundings, they miss their loved ones and their carers. Many old people also complained that they had lost their spectacles and so couldn't read their bana poth. We need to do something about it, like organising eye camps and getting them free spectacles." Another discovery she made was that elderly persons had very few entertainment programs, specially tailored for them, so as to divert their thoughts from their present plight. "Most of the recreational programs concentrate more on children and younger women. A sing along session, some activities where they would learn new skills and perhaps a few games that will encourage social interaction could go a long way in the healing process for these elderly persons", she says. She also found that very few elders were involved in doing anything useful in the camps. "I saw younger women cooking and parents making lists of their children's requirements. Most of the older folk just sat in their corners staring into space. We have to get them involved in extra curricular activities and make use of their skills - they can for example look after the young children in the camps which will be of mutual benefit. Both old and the young need our care most, as they are the most vulnerable groups in our society", says Dr. Perera. So what does she have in mind to help elderly displaced persons? The first priority is to compile data. There is no data on the exact number of elderly IDP's, she says.According to the Centre for national operations (CNO) and Social Services Department, such data was still in the process of being complied. "We have already got the figures of those under five years and of women but not of the elderly", said a voice on the phone from the Social Services Department, indicating that elders continue to occupy a low priority in the list of survivors. Day Care centres for the elderly set up close to the camps if necessary, could also fill the gap in providing recreation and save them from the interaction to elderly survivors of the tsunami. "This will relieve the monotony of spending the entire day in a camp and ease their mental problems as well, as they will not be lonely then", she feels. Another suggestion is to encourage people to 'adopt' an elderly following the adopt - a granny - scheme which HelpAge has already introduced and which the health ministry has linked up with. "If people can adopt children, why not an old person who is equally vulnerable and needs to be taken care of", she asks. For those elders who are addicted to hard drugs and who are alcoholic, she suggests that keeping them gainfully occupied and giving them responsibilities, will not only divert them from substance abuse, but raise their self esteem. Some of them who are fluent in all three languages can act as interpreters. Others who are educated can teach the kinds in the camps. Still others who are good at sewing or carpentry can put these skills into use. She suggest too that a skills training program be initiated in the camps so that when they finally get back to their homes, these persons can be gainfully occupied and earn their own income without being a burden to others. As she points out, "what is important for those helping these survivors to realise is that we have with us a captive audience of old persons living under a single roof This is the best time for any message of health, any religious programs, or life skills program to be passed on to these persons before they leave the camps." Any future program directed towards them should be to empower the older persons, she says. "We call it Active Aging. We have already formed a National Committee on Aging and we are collaborating with HelpAge in carrying out such programs. We talk to our participants about healthy aging. We have already trained volunteers in our health programs from each of the MOH areas on how to conduct and set up day care programs and teach elders about personal hygiene, basic health care and also new skills that are income generating". Dr. Perera's department has also trained these volunteers the basics of geriatric care. Volunteers learn to bathe, feed, dress, elders, take them to hospital, treat a simple injury and give them physiotherapy. Recent case studies undertaken by government and non government organisations have reinforced this urgency of alleviating the plight of the elderly survivors of the tsunami. As Dr. S.N. Nanayakkara, a family physician says, "These persons have emerged from the tsunami both physically and mentally traumatised. Living in camps and sleeping on hard floors can aggravate the health problems they already have like arthritis, and cause fresh ailments such as muscular skeletal disorders. They are also vulnerable to any disease that breaks out. Since they are in a state of shock many would have lost their appetite and developed psycho somatic disorders. It is important that they are taken out of their camp environment quickly and placed at least in foster homes preferably in the community, where they can receive love and attention and have someone willing to listen to their woes and empathise with them". Is anyone out there willing to take up this challenge? |
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| Produced by Lake House |
Today, as she languishes in a welfare camp at Moratuwa along with
hundreds of other victims of the tsunami, Jane Nona says she has no
interest in living. "I have lost everyone who is dear to me including
my caretakers. Why should I alone have been spared? Who will look after me
now since my son and daughter-in-law are gone?", she asks anyone who
cares to talk to her.
"Right now everybody seems to be paying attention mainly to the
needs of affected children and women in the camps. Not enough attention is
being given to the elderly who are also a very vulnerable group",
says Dr. Deepthi Perera Director of Youth, Elderly and Disabled Persons of
the Ministry of Health. She had just returned from an inspection tour of
the coastal area, also known as the 'Filaria Belt' and had visited the
camps at Lunawa, Panadura and Moratuwa including others, when this writer
met her early this week.
