India: Grey Is The Dawn

IT'S9 in the morning as Hasina, 65, finds her way slowly to the Day Care Centre, a voluntary organisation for the elderly in Shahidnagar, Ghaziabad. She and her 70-year-old sister will remain there till 4 pm, going through the day's routine activities like breakfast, and lunch in the company of several others like them, in their years of failing health aggravated by poverty. Unlike them, septuagenarian Mithan Lal, a widower, comes from a financially secure family but is unwanted at home. So he prefers to spend his time at the centre, having the papers read out to him, listening to music, sharing the odd sentiment and returning home with his sense of dignity intact. It's not a story any of us are unfamiliar with. What we are yet to realise is that Mithan Lal or Hasina's tale is a warning of an aging bomb waiting to explode.

October 1, the UN International Day for Elder Persons, passed unsung, overshadowed by the country's golden jubilee festivities. But if the 50th year of Indian Independence is a celebration of achievements, there's one milestone that's been glossed over—of a young nation aging faster than the country can keep pace with. It will be a grey nation of 75 million 60-plus senior citizens that will keep its autumnal tryst with destiny in the 21st century, multiplying to an alarming 113 million in the next 20 years, putting tremendous strain on basic resources and posing a social problem of great magnitude.

Blame Bismarck, scream the doomsayers. Until 1889, when Prussia's Iron Chancellor introduced the world's first national contributory pension scheme for the 65-plus when life expectancy at birth was about 37 years, states were not responsible for their citizens' declining years. But the late 20th century, with healthier living conditions, better medicare, eradication of infectious diseases and less physical grind at work, has brought with it the ultimate luxury of aging, pushing up average life span from 30 four decades ago to 60 now, the burden somehow laid squarely on the state's shoulders with aging finding a place on the national agenda.

Consider this. According to the Registrar General and Census Commissioner of India, the number of aged comprised 6.8 per cent (37 million) of the population in '91. Projected figures for 2011: 8.14 per cent (96 million); 2016: 8.94 per cent (113 million). Estimates suggest that by the middle of the next century there'll be a fifth whole grey India—we've already added on three times the population since Independence—and in the mad scramble to get a share of the limited services, in a strange kind of social Darwinism, the elderly will be left out. Constituting about 7 per cent of the population (60 million, larger than the figure for all of Australia), increasing urbanisation, intergenerational friction and social change have made elder care problematic; longevity has brought with it attendant problems of disability and psycho-physical deterioration.

Evident in the case of Rani Kapoor, 75, a resident of Delhi's upmarket Greater Kailash. A widow, she lives alone in her palatial mansion, her son paying her occasional visits from abroad. Money isn't her problem, it's the loneliness along with increasing bouts of illness and depression that she has to contend with. But she doesn't want to join her son who has to follow the demands of his career.

Says Major General S.S. Sandhu, director general, Helpage India, an NGO engaged in advocacy for the aged: "Migration, the breakdown of the joint family, more women seeking jobs and the small family norm have led to fewer caregivers. And with 90 per cent of the population beyond the pale of any social security systems in the form of pensions and medical facilities, and 40 per cent living below the poverty line, the future of the country's senior citizens looks bleak with a marked deterioration in the quality of life."

Agrees Rekha Das, 60, who stays in an ashram at Mathura. Hailing from an upper middle-class Delhi family, she is today forced to spend her days at the ashram because she doesn't want to be a burden on her daughters, nor carry the 'stigma' of living in an old age home. Separated from a husband who has no source of income, she says angrily: "He was a private practitioner who fell mentally ill. Today there is no security in the form of pension or medical relief. All those who have framed our policies so far should be taken to task for not giving people like us any measure of security." Today she has had to change her lifestyle to adjust to the ashram's strict norms, physical and emotional problems sitting heavy on her frail shoulders.

However, most experts in the field discourage the concept of state care. For to provide even a semblance of social security to the current 60 million, the state would need at least Rs 60,000 million per annum, eating into the very vitals of our budget. Anand Bordia, joint secretary, Ministry of Welfare, agrees. "Why depend on the government for everything? Society also has a role to play in providing a better quality of life for the aged. What needs to be done is a re-evaluation of value systems and create community awareness about family and societal support." The draft for the National Policy on Aging, to be announced towards the end of the year, according to Bordia, is ready. That the State is looking at NGO networking to deal with the problem was obvious when Union minister of welfare B.S. Ramoowalia, face to face with senior citizens, admitted in TV programme Awaaz (July 10) that "anything that is run by the government lacks the spirit of commitment and service and it is voluntary service that is required. The government can merely supplement NGO effort." "What is required is more community-based activity in every village, town and city," says Bordia.

Longer lives and a falling birth rate are demanding a rethink of the fundamental ways government and society have so far tended to its old. Says Sandhu: "India had a tradition of looking after its old. A large family was an insurance policy against a lonely old age. The young are no longer able to look after the old, primarily due to economic constraints. The small family norm has made it difficult for one person to bear the burden of supporting three generations simultaneously and the tradition is eroding fast with the aged being left out in the cold."

Registrar General and Census Commissioner of India M. Vijayanunni echoes this. "India's in the middle of a demographic transition. Fertility rates are dropping after the '60s and '70s (1981-91 census) boom and if it plummets further between '91-2001, the percentage of young will shrink. The more successful family planning is, the more acute the problem will get. Tomorrow's aged are already born—1960-1990. This huge burden will be visible with the age pyramid bulging at the top (see graphic) by the fourth decade of the 21st century, indicating a higher proportion of middle-aged and older people and a lower proportion of the young. The aged will cross 100 million, increasing the age dependency ratio.

THIS will make India part of a historical first—a country with a big old population, also poor. Magnifying ethical dilemmas over use of scarce resources. Financing pensions and health-care could be a nightmare. Yet a country can't let a 113-million old population languish in neglect. It can't choose between the consumptive old and the productive young—it has to find a middle path.

Developed countries have fallback options by way of better social security systems, dole, old and pay-stay homes. In India, the segment covered by social security is negligible—1-2 per cent. The organised sector (public and private) covers less than 10 per cent. The rest will have to fall back on meagre government resources. And those footing the bill, the productive workforce, will stay much the same, pulling a heavier weight than ever before.

While demographers are still groping for solutions, the concerned few are weighing options to make the burden lighter and allow the aged to live in dignity. Says Sandhu: "We've suggested to the government that a large number of people who've retired at 58 are capable of working till 70. So about 10 per cent of jobs in the private sector should be reserved for senior citizens." The idea being that if people live longer they should also be fit for work longer, reducing dependence on earnings of the middle rung (14-55 age group).

An Action Plan based on the proposed National Policy hopes to empower the senior citizenry in several ways: to provide easy access to medicare for those over 65; special queues in public areas, seats reserved in public transport; proper housing, insurance and financial security and a mechanism by which each corporate entity will contribute a certain amount for social development.

What's also needed is a fresh look at retirement schemes. The World Bank caused a stir about a year ago with its study entitled Averting the Old Age Crisis which argued that the strong present reliance on pay-as-you-go state pensions is doomed by demography. The public share in total retirement income, it says, should be reduced to around 20 per cent and its main role confined to reducing 'poverty among the old'.But every country has to have its own evaluation system based on the social structure, says Bordia. What's required, according to Vijayanunni, is the formation of support organisations to cater to the grey segment on the lines of the American Association of Retired Persons, a highly effective 33-million member lobbying organisation set up in 1958. With an annual subscription of $8, it offers its members insurance services, credit cards, discounts, low-price prescription medicines, and even a training programme to help the really  needy aged find jobs. Other smaller organisations like the Seniors Coalition also do their bit.

Vijayanunni's suggestions seem prophetic with the recent launch of India's first such support group—Suvela International in Delhi. A non-profit public trust, Suvela's main endeavour is to provide support to middle-class senior citizens because, says spokesperson Dr Bijoyananda Patnaik: "The middle class is the one most affected by the small family norm. With children away at jobs in different cities, they may have the resources but not the means to channelise them in the right direction. So we have cases where senior citizens are abandoned, reduced to penury by signing away their property too soon or wither away from loneliness and emotional insecurities." Suvela's approach is three-pronged—providing financial, legal and medical advice. Through seminars and panel discussions they hope to create awareness among senior citizens regarding their rights and hope to build up a pressure group, which as Patnaik puts it, by sheer strength of numbers will be a formidable vote bank by the next century.

The thrust finally is on planning meticulously for the future and rebuilding family values. What the elderly need at the end of the day is care and dignity. Awareness is on the rise as the first post-Independence generation prepares to retire. The new situation calls for new initiatives and with a little cooperation from the old and the young, the state and voluntary organisations, a social crisis may be averted if not the numbers.