Esther Clift is a Consultant Practitioner Trainee in Frailty with Health Education Wessex. This is the final part of a four part BGS blog series about her time in Africa. She tweets @EstherClift
“Healthy ageing” is defined by the World report on ageing and health as the process of developing and maintaining the functional ability that enables well-being in older age. What does that look like in developing countries?
I have had the privilege of travelling through some of Kenya and Uganda and I asked how people view their prospects, as they grow older. Some like Nathani in rural Jinja, Uganda, a retired academic and researcher with a PhD from Strathclyde University felt that his future was tied up in his land, and his children. He had both, and at 74 was fit and well, and held in high esteem by his community. He described his children as his wealth.
He had taught them to grow all their own food, and they had enough land. He observed life was harder for the landless, which includes women, although a widow would be expected to stay with her land. He described urbanisation as a significant threat to the well being of older people. James in Kisumu, Kenya, confirmed this. He was deeply concerned for his Mum, who is in her eighties. He described her as ‘hovering between life and death’. She is living alone in a rural area, but had had 3 recent hospital admissions, with no clear diagnosis, but ‘nursing care’ and discharged home again. James did not know what else he could do, nor where to turn for support.
The Global Strategy and Ageing plan from the WHO would seem to be timely! Specifically the Strategy focuses on five strategic objectives:
Commitment to action on Healthy Ageing in every country;
Developing age-friendly environments;
Aligning health systems to the needs of older populations;
Developing sustainable and equitable systems for providing long-term care (home, communities, institutions); and
Improving measurement, monitoring and research on Healthy Ageing.
Where the Millenium Goals are leading to a focus and funding for Maternal and Child health, there is a lack of global investment in medicine for older people. Where are the advocates for the growing population of older people?
Esther Clift is a Consultant Practitioner Trainee in Frailty with Health Education Wessex. This is the first part of a four part BGS blog series about her time in Africa.
It is well recognised that in much of East Africa the concept of ‘Heshima’ or respect for ‘Wazee’ is still widely practised. The term “Mzee” describes an older person, often with greying hair, but has a tone of respect and deference to it. I heard the term used widely, from young white men joshing their father, to students upholding a faithful teacher, but always with a tone of love and respect.
In the third part of a four part BGS blog series about her time in Africa, Esther Clift reflects on the scourge of Aids and the avialability of palliative care and how it compares with our own NHS.