On The Edge: Why older people's needs are not being met in humanitarian emergencies

8/3/2019 On The Edge: Why older people's needs are not being met in humanitarian emergencies

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On the EdgeWhy older peoples needs are not beingmet in humanitarian emergencies

FredericDupoux/HelpAgeInternational


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The humanitarian system is poorlyequipped to ensure an equitableresponse for the most vulnerable.

Whilst issues specific to children,age, old people, women and thosewith disability are widely writtenabout, there are few mechanismsto deal with them.

Humanitarian Emergency Response Review (HERR),2011, an independent review published by the

Department for International Development (DFID).


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On the Edge 1

Introduction 2

Making older people visible in emergencies 4

What is the problem? 6

Fact file 9

What is our response? 10

What is the response of the humanitarian community? 13

Recommendations for assisting older people in humanitarian emergencies 16

Notes 17

Contents


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2 On the Edge

When disaster strikes, older people are amongthe most vulnerable to neglect, injury, death anddisease. Yet their needs are often overlooked.In crises, Age UK and HelpAge Internationalprovide support to older people who have beenaffected and ensure that their interests arerepresented and their contributions recognised.

In the past ten years alone, we have providedassistance to people in later life following naturaldisasters, conflict and displacement in areas

such as Darfur, Pakistan, and Ethiopia.

Together, Age UK and HelpAge Internationalare committed to increasing the impact of ouremergency relief work. But we cannot do thisalone. The UK Government, political leadersand UK-based humanitarian actors all havea vital role to play. This report sets out thescale and nature of the problem and makesrecommendations for change.

Introduction

Myths about older peoplein emergencies

Therearenoolderpeople

in developing countries.Low life expectancy figures mask the fact thatthere are millions of older people in developingcountries. The most rapid increase in the60+ population is occurring in the developingworld, which will see a jump of 225 per cent(to over 1.5 billion people) between 2010 and2050. Furthermore, 26 million older people areaffected by disasters every year.

Theextendedfamilyandcommunitywill always protect them.Migration and urbanisation means that theextended family is no longer as common

as it once was. Some older people do nothave families; others are caring for orphanedgrandchildren. People may not have theresources or ability to help others ata time when they are also suffering.

Ahumanitarianagencywilllookafterthem.

There are no United Nations agencies andvery few international non-governmentalorganisations (NGOs) dedicated to older people.

Theywillbecoveredbygeneral

aid distributions.Older people have particular nutritional,

cultural and health needs that are oftennot met by a general relief distribution.Sick and frail people might find it difficultto queue at or walk to relief distributionpoints, so they may not be able to accessgeneral aid distributions in the first place.

Theyonlyhavethemselvestoworryabout.Many older people are looking aftergrandchildren as their children migrate in

search of work or die through conflict andillness. We estimate that up to half of theworlds children orphaned by AIDS are caredfor by a grandparent.

I thought my children would come to see me after thedisaster struck the area, but I was wrong. They dontcare. I shouldnt expect anything from them any more.

Bass, 75, Pakistan, following the floods


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AntonioOlmos/HelpA

geInternational

I spend all my wages on rice, vegetables,medicines and my sons education.If I am sick and cannot work, the jobis given to someone else.Mohammad, 73, Bangladesh


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4 On the Edge

Making older peoplevisible in emergencies

People in later life are particularly vulnerablein emergency situations. Lack of mobility andsocial isolation can prevent older people fromaccessing relief assistance. They may not beable to queue for aid packages or travel longdistances to reach camps for displaced people.They often have specific needs that arent met;for example, related to their health, nutritionor livelihood.

This problem is compounded by the fact

that older people are often overlookedby governments and non-governmentalorganisations (NGOs) alike. Perumal in Sri Lankatold us that he had not bothered queuingfor food when assistance arrived after thedevastating tsunami in Asia in 2004. He said:I have been pushed out on earlier occasionsand have fallen on the ground. I know I willget nothing this time round too. The fastestget the food, the strongest wins. Older people

and the injured dont get anything.Age UK and HelpAge International areencouraged that the UK public is stillcommitted to helping people followinghumanitarian emergencies, despite thecurrent financial crisis. As the 2010 reportPublic Attitudes towards Development by theDepartment for International Development(DFID) notes: Although overall the proportionpersonally donating to charities decreased,

there was a significant increase in thosewho donated to charities which help victimsof natural or man-made disasters..

We welcome the cross-party commitmentto overseas development and emergencyrelief in Westminster and are proud that theUK is already highly rated for its humanitariandeployments. DFIDs new priorities forhumanitarian and emergency relief shouldgo far in carrying this good work forward

In particular, we welcome DFIDs promise tohonour international commitments that firmlyroot our response in the principles of humanity,

neutrality and impartiality and its desireto work with others to establish a single setof common accountability standards, whichrequire participation of the most vulnerablegroups (women, children, old people anddisabled people).

Age UK and HelpAge International encourageDFID to do more for older people as a vulnerablegroup. We believe that older people should holdthe Government to account on the assistance

they receive, but the Government also has toensure that funds are allocated and targetedto those in greatest need. Strong efforts shouldbe made to improve the performance of theUN co-ordination system, so that it can deliveron its commitments to meeting the needs ofall vulnerable groups, including older people.As agencies working together, Age UK andHelpAge International ensure that older peopleaffected by crises and disasters receive the

assistance and protection they deserve and need.HelpAge International is the only internationalorganisation working specifically to ensure thatolder people receive emergency assistance.Age UK is proud to support HelpAgeInternational in this invaluable work and isalso proud to be a member of the DisastersEmergency Committee (DEC).

We know that we can achieve many thingsfor older people following emergencies.

We also know that by collaborating with otheraid agencies and DFID, we can achieve muchmore. The UK humanitarian community needsto work together to make older people visibleand ensure that their needs and contributionsare not overlooked.

Tom Wright CBE Richard BlewittGroup Chief Executive Chief Executive,Age UK HelpAge International


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KateHolt/HelpAgeIn

ternational

Most people who left Jada went to Chadbut me and my sister were too old to walkthere, and my legs get very sore, so wecame to this camp instead.Halima, age unknown, Darfur


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6 On the Edge

Older people are particularly vulnerable andface specific threats from man-made andnatural disasters. Their needs are very differentfrom those of children or the more able-bodied.Governments and NGOs need to recognise thesespecific needs and not assume that they willbe met through general aid programmes.

Restricted mobility andincreased vulnerabilityOlder age brings reduced mobility and musclestrength, impaired sight and hearing, andgreater vulnerability to heat and cold. Minorconditions can quickly become major handicapsthat overwhelm a persons ability to cope.

When communities flee to safety, many frail orhousebound older people are less able or willingto flee quickly or protect themselves from harm.Older people can struggle to obtain food, travellong distances or endure even short periods

without shelter.When they do flee, many people in later lifecannot move as quickly as others; nor arethey strong enough to carry many possessions.

Inappropriate foodEmergency food distribution programmesare often targeted at women and children.They are rarely adjusted to include the particularneeds of older people and their specific dietaryrequirements. Older people need micronutrients,protein and food that is easy to digest.

Rations can be too heavy to carry; packagingtoo difficult to open. Food aid can be difficultto prepare if people do not have cooking utensils.

Many older people report being pushed out ofthe way by more able-bodied people. After the2010 floods in Pakistan, 70-year-old Sultana toldus: As I was waiting in the queue for my turnto receive food, somebody punched me in theface and knocked me unconscious. All this, justto get ahead of me.

What is the problem?

Older people are often pushed out of the wayduring the chaos of emergency relief distribution.

Photograph: John Cobb/Age UK and HelpAge International


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On the Edge 7

Inadequate healthcareImmediately following a disaster, healthservices must focus on first aid. However, in themedium term, health services need to respondto the ongoing needs of older people. Walkingsticks and frames, hearing aids and glasses canmake all the difference in enabling older peopleto reach distribution points, access assistance,prepare food or collect firewood for cookingor heating. Sixty-year-old Ghulam in Pakistanhardly ever leaves his home: I am unable

to walk and have been bedridden for thelast two years due to my weak bones.

People in later life also need healthcare forthe treatment for chronic conditions that aremore prevalent in older age, such as coronaryheart disease, diabetes, stroke, respiratoryillnesses, rheumatism and dementia. Theseconditions deteriorate without routineassessment and treatment.

TraumaandisolationLoss of family members, carers and communityties can leave older people isolated. Many olderpeople live alone, especially widowed women.For many survivors, the most difficult aspectof disaster is coping with day-to-day lifeafterwards. Some older people report feelingdepressed at losing the status they once hadin their community. In 2003, Mohamed, his wife

and their ten children were forced from theirhome in West Darfur, Sudan, when conflictreached their village. Mohamed said: It wasa tragic day. I lost everything I had, includingmy animals. He and his family went to live ina camp for internally displaced people, wherethey became dependent upon humanitarianaid. Mohamed said:

I felt I was no longer respected

in society. I felt helpless in frontof my family and the rest of myrelatives in the camp.

Loss of livelihoodsEighty per cent of older people in developingcountries have no regular income. Less than5 per cent receive a pension. Many older peoplehave no choice but to work until the day theydie. However, older people are often excludedfrom cash for work or food for work recoveryprogrammes because most aid agencies target

younger adults. Micro-credit and other activitiesthat can help older people earn a living are oftenplanned without considering their capabilities.

When communities return home froma disaster, older people typically face difficultiesin accessing land and other scarce resources.Gamar lives in a camp for internally displacedpeople in Darfur, Sudan. He said: We have tostay here until things are safer and we canreturn home. But even when we do, to rebuildeverything is going to be hard. We will have tostart from the beginning. We wont even have

seeds to plant.

Gamar living in a camp for internally displacedpeople in Darfur, Sudan.

Photograph: Kate Holt/HelpAge International


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JeffWilliams/HelpAgeInternationa

l

The weather has changed completely.There used to be a lot more rain previouslybut now it is dry. The weather startedchanging about 30 years ago.Abdulla, 99, Ethiopia, following the drought


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On the Edge 9

Climate change means an increasing frequencyand intensity of floods, storms and droughts,resulting in scarcities of land, water and energy.

At the same time food crises are affectingmany countries around the world and arelikely to worsen with the continuing globaleconomic crisis. As if that were not enough,growing urbanisation is causing many morepeople to live in high-risk areas, such as floodplains. And one-third of humanitarian disasters

are caused by violent conflict. Increasingcompetition for water and agricultural landwill only exacerbate this. We are all faced withvarious problems that without concertedaction from governments and NGOs alike are only going to get worse.

Fact file

Ageing population

Currentlypeopleaged60andoverrepresent11.4 per cent of the total world population(794 million); by 2050, the number is predictedto rise to 22 per cent (2 billion).1

By2015,therewillbemorepeopleaged60 and over than aged 14 and under.2

Themostrapidincreaseinthe60+populationis occurring in the developing world, which willsee a jump of 225 per cent (to over 1.5 billion)between 2010 and 2050.3

By2050,morethan80percentofolderpeople will live in developing countries where disasters are more likely to occurand the effect to be greater comparedwith 60 per cent today.4

Demographicchangemeansthatthenumberof older people affected by emergencies isgrowing fast.

Emergencies and disasters

Disastersdisproportionatelyaffectpoorercountries 97 per cent of people killedby disasters live in developing countries.5

26millionolderpeopleareaffectedby natural disasters every year.6

Climate-relateddisastersareincreasing:the first four years of the 21st centurysaw an average of 326 disasters a year a doubling in 20 years.7

Olderpeopleoftenmakeupahighproportionof people in displaced peoples camps. In GuluDistrict of Northern Uganda, 65 per cent ofpeople still living in displaced peoples campsin 2009 were aged over 60.8

Only0.2percentofUNFlashAppealsfor humanitarian relief actually targetolder people.9

Sher says everyone lost everything followingthe floods in Pakistan.

Photograph: Mohammad Khalid Riaz/HelpAge International


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10 On the Edge

To ensure that the interests of older peopleare represented and met during crises, Age UKfunds HelpAge International to support localpartner organisations to deliver age-friendlyaid. HelpAge deploys specialist staff who providetraining and resource materials about olderpeoples needs to other aid agencies, givehealth and social support to older people livingin refugee camps, and work with communitiesin disaster-prone areas to prepare for futureemergencies by training and equipping

networks of older volunteers.

What we do following an emergency Identifyolderpeople

Carry out a rapid needs assessment,collect and analyse data broken downby age and gender.

ConsultthemAsk people in later life what they need,and represent their interests. In the recoverystage, set up Older Peoples Associations(OPAs) so that older people can supportthemselves and others.

Makedistributionsaccessible

Ensure that there are seats for those whocannot stand for long periods. Organiseseparate distributions for older women andmen where this is culturally appropriate.

Deliverage-appropriateemergencyrelief

Ensure that food and non-food items areappropriate for older people. For example,ensure that contents take into account thedifficulty that older people may have inchewing, digesting and absorbing nutrients;design packages so that they can be easilycarried and opened.

Provideage-appropriatehealthcareProvide specialist staff in existing health facilities,deliver basic training in gerontology, distribute

equipment such as mobility aids and glasses,and provide medication for chronic illnesses.

ProvidefinancialsupportOffer age-appropriate work, grants or loansfor those who can work, and cash transfersto those who can not.

Offerpsychologicalsupport

Employ psychologists and recruit home-carevolunteers to help older people recover fromthe trauma of disasters and conflict.

ProvideprotectionIf older people have been separated from

their families, or are already alone, ensurethat they are involved in family tracing andre-unification programmes.

Helpcommunitiespreparethemselvesagainst future disasters

Ensure that older people with historicalknowledge are included in disaster-riskreduction work so that they can help theircommunities to prepare for future disasters.

Many parts of Africa suffer from frequentdroughts. We have helped strengthen theresilience of communities with whom wework by providing drought-resistant crops inMozambique and water supplies in Ethiopia.This way we can help avert famines that haveso often plagued East Africa. The disaster-risk-reduction work of many NGOs, includingHelpAge International, was instrumental inensuring that the 2011 drought crisis in EastAfrica was not as severe as it could have been.

In Borana, Ethiopia, we built a reservoir anda water point. When residents still have waterin their own haro (water pond), they use this.But when these dry up, they now have othersources of clean water. Sixty-four-year-oldTeso said: Without the water, we wouldbe dead within two months once the harodries up. The haro are not enough for thepopulation. The well water is also cleaner.

What is our response?


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I am glad that you havent forgotten us.There are not only children in Ethiopia,but older people too.Teso, 64, Ethiopia, following the drought

JeffWilliams/HelpAg

eInternational


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12 On the Edge

Adna is the treasurer of an Older PeoplesAssociation (OPA) in Haiti. She has no childrenof her own, but looks after five adopted children.She used to have a small business selling clothesbut lost everything in the 2010 earthquake. Nowshe earns a living as a HelpAge carer in one ofthe camps for displaced people in Port-au-Prince.

Adna said: When I see older people in the streetbegging, it breaks my heart. When HelpAgecame it really made me feel like my dreams

had come true. Older people here would bein even bigger trouble if HelpAge wasnt here.Its a good thing, because we did not thinkof the older people before. Because of theOlder Peoples Assocations, older people willbe recognised by the government and canhave a bigger impact.

What we do throughout the yearHelpAge is building a strong evidence base

on the impact of humanitarian crises onolder people and using this research tohelp humanitarian relief and aid workersto understand how emergencies and crisesaffect older people. HelpAge is also developingtechnical guidance materials in key areas, suchas displacement, cash transfers and livelihoods,health and protection, drawing on good practicedeveloped by our own programmes and thoseof other agencies.

It is also ensuring that local partners aroundthe world are helping people in later life to setup Older Peoples Associations (OPAs), so thatolder people can help themselves and othersin their family and community, as well asintegrating disaster risk reduction in theirprogrammes. HelpAge is working withother humanitarian agencies and nationalgovernments in developing countries to helpthem mainstream ageing issues in their policiesand programmes.

Following the floods in Pakistan in 2010,HelpAge set up a number of Older PeoplesAssociations (OPAs). Sixty-year-old Sher said:

We made a list of the mostvulnerable older people, includingwidows and those living alone.We then selected the villagers

most in need of the cash grant.But the OPAs are not just forgiving money. People come totalk about their problems andas members we support them.


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On the Edge 13

What is the response of thehumanitarian community?

In recent years, various principles, guidelinesand policy levers have been agreed that have thepotential to bring about significant improvementsin the humanitarian communitys response toolder people in emergencies. We would urgeother humanitarian agencies and policy-makersto respond.

TheprincipleofimpartialityThe principle of humanitarian impartiality that everyone has a right to humanitarianassistance regardless of race, nationality,political ideology or affiliation, religion,gender or age is the basic tenet under thatalmost all humanitarian actors claim to operate.However, our research shows that the particularneeds of older people as a vulnerable groupare not usually included in consultations andassessments and do not receive appropriatehumanitarian assistance. NGOs need torecognise that the principle of impartiality

requires them to assess older people asa specific and vulnerable group.

Guidelines and minimum standardsThe most widely used are the SphereHumanitarian Charter and Minimum Standardsin Disaster Response. These lay down theminimum standards that aid agencies shouldaspire to meet following emergencies. The latestedition (April 2011) specifically mentions olderpeople as a vulnerable group, which is to bewelcomed. However, there is no process ofexternal monitoring so it is not possible to knowwhether or how widely this standard is actually

being implemented.

TheMadridInternationalPlan ofActiononAgeing(MIPAA)In 2002, 159 countries, including the UK, signedthe Madrid International Plan of Action onAgeing (MIPAA). Among other issues, signatoriesto MIPAA pledged that in emergency situations,older persons are especially vulnerable andshould be identified as such. MIPAA is not legally

binding, but it does give moral and politicalweight to the needs of older people.


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TheUnitedNationsThe United Nations (UN) plays a uniqueco-ordination role in the global humanitariansystem. Its co-ordination system has thepotential to ensure that older peoples needsare specifically met. However, in order to dothis, humanitarian actors will need to makesignificant and lasting changes to theirprogrammes and practices. Our researchshows that the humanitarian co-ordinationsystem focuses mainly on younger age

groups and fails to prevent age discrimination.Guidance provided by the UN Inter-AgencyStanding Committee (IASC) on humanitarianaction and older people addresses this issueand should be used widely.

TheUKGovernmentThe new priorities set out by the UK Governmenthave the potential to deliver significant changein the way that older peoples needs are metin emergencies. These priorities, in particular,a focus on vulnerable groups, building theresilience of communities to minimise theimpact of disasters, strengthening the linkagesbetween humanitarian relief and longer-termdevelopment work, and a commitment tobeing held accountable to older people as

a key stakeholder group, are all encouragingsteps forward.

Without a clear commitment from the UKGovernment to ensure that older peoplesneeds are recognised and acted upon bythe international humanitarian community,the risk remains that older people will bepushed aside.


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FredericDupoux/HelpAgeInternational

I love working for the OPA.I pray every day for HelpAge.Because of HelpAge, older

people feel like human beings.Adna, 50, Haiti, following the earthquake


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16 On the Edge

RecommendationsforMPs Helpconstituentsandthegeneralpublictounderstand the increase in the number of olderpeople who are vulnerable to humanitarianemergencies, and the impact that this willhave in future humanitarian emergencies.

Encourageconstituentstogivegenerouslyto DEC appeals when emergencies happen.

Advocatefortheneedsofolderpeopleinhumanitarian emergencies through partypolicy processes and by raising this issuein parliament.

Recommendationsfor the UK Government ContinuetousetheGovernmentsinfluence

to ensure that older peoples needs asa vulnerable group are recognised and actedupon in humanitarian responses at a UK,European and UN level.

EnsurethatdatacollectionforDFID-fundedemergency programmes in times ofhumanitarian crisis assesses the needs ofall vulnerable groups, is disaggregated byage and sex, and includes older age groups.

ContinuetousetheGovernmentsinfluenceto strengthen the capacity of the UNco-ordination system to respond to ageas a cross-cutting issue, including the

dissemination and implementation of the UNInter-Agency Standing Committee guidelines,Humanitarian Action and Older Persons: Anessential brief for humanitarian actors (2008).

Includeolderpeopleintheanalysisandplanning of development programmes andin emergency preparedness programmes.

Recommendationsfor humanitarian actors Makeolderpeoplevisibleinresearch,planning

and implementation of humanitarian andemergency relief responses, ensuring that theyare given equal recognition as a vulnerablegroup, and that their specific needs are met.

Ensurethatdatacollectionintimesofhumanitarian crisis assesses the needs ofall vulnerable groups, is disaggregated by

age and sex, and includes older age groups.

Ensurethatprogrammestaffarefamiliarwiththe UN Inter-Agency Standing Committee(IASC) guidelines, Humanitarian Action andOlder Persons: An essential brief forhumanitarian actors (2008).

Makepreparationsforthegrowthinthenumber of older people living in countries thatare vulnerable to humanitarian emergencies.

Recommendations for assisting olderpeople in humanitarian emergencies


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On the Edge 17

1. Based on US Census and UN figures(2011 and 2010)

2. Based on US Census and UN figures

(2011 and 2010)

3. Based on US Census and UN figures

(2011 and 2010)

4. Linking Population, Poverty and Development,UNFPA, 2011

5. World Disasters Report, IFRC, 2007

6. World Disasters Report, IFRC, 2007

7. Fast Facts, Bureau for Crisis Prevention

and Recovery, UNDP, 2008

8. A Study of Humanitarian Financing forOlder People, HelpAge International, 2010

9. A Study of Humanitarian Financing for

Older People, HelpAge International, 2010

Notes


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Age UK is a charitable company limited by guarantee and registered in England (registered charity number 1128267 and registered company number 6825798).The registered address is 207221 Pentonville Road, London N1 9UZ. Age Concern England (registered charity number 261794) and Help the Aged (registeredcharity number 272786), and their trading and other associated companies merged on 1 April 2009. Together they have formed the Age UK Group, dedicatedto improving the lives of people in later life. The three national Age Concerns in Scotland, Northern Ireland and Wales have also merged with Help the Agedin these nations to form three registered charities: Age Scotland, Age NI and Age Cymru.

Tavis House16 Tavistock Square

London WC1H 9NA0800 169 80 80

www.ageuk.org.uk

Age UKInternational work is a core pillar of the work ofAge UK. We have a vision of a world in which olderpeople flourish and a mission to improve the livesof older people, not just in the UK, but all aroundthe world.

HelpAge InternationalHelpAge International helps older people to claimtheir rights, challenge discrimination and overcomepoverty, so that they can lead dignified, secure, activeand healthy lives. Our work is strengthened throughour global network of like-minded organisations the only one of its kind in the world.

Age UK and HelpAge International

Age UK and HelpAge International work togetherto support older people to lead more fulfilling livesin over 40 developing countries. We run long-termdevelopment and short-term emergency reliefprogrammes.

Disasters Emergency Committee (DEC)Age UK is a member of the Disasters EmergencyCommittee (DEC), a network of humanitarianagencies in the UK. When a DEC appeal isdeclared, Age UK raises funds and awarenessof the issues faced by older people during

emergencies; HelpAge International implementsthe emergency relief programmes overseas.

Further informationFor more information about the international workof Age UK, email [email protected] orview the international section of the Age UK websitewww.ageuk.org.uk/international

For more information about HelpAge International,email [email protected] or view the HelpAge

International website www.helpage.org

For more information on the Disasters EmergencyCommittee (DEC), email [email protected] or viewthe DEC website www.dec.org.uk

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On The Edge: Why older people's needs are not being met in humanitarian emergencies