Moqbul Hossain, a sexagenarian, has been suffering from venous leg ulcer for more than 30 years. Venous leg ulcer is a medical condition in which the victim suffers from poor blood circulation around the affected part of the vein.
Unable to walk normally anymore, the 68-year-old man of Kurigram district, located some 340 km north of the capital, is compelled to be hospitalized for at least two weeks at a stretch for temporary healing every month.
“It’s so agonizingly painful and there is hardly any proper care that I receive at the hospital,” Hossain narrated expressing utter dismay over the lack of basic treatment facilities and ignorance of the caregivers.
Hossain, lying on a dilapidated hospital bed in Kurigram’s Chilmari Upazila, narrated how he has been leading a miserable life with no sign of improvement in sight.
Usually, thousands of old people like Hossain suffer from many other social isolation and mental disorders which are often ignored taking it as a granted reality that old-age problems are merely medical problems.
Psychological and physical pains are common when older people feel helpless and are left alone. Such a situation substantially increases anxiety and depression among such vulnerable group of old-age people who seek long-term care for comfort.
The lack of trained human resources in medical caregiving for elderly people will put Bangladesh in a huge challenge as the segment of the elderly population is growing faster than ever before.
Major General (Rtd) Jiban Kanai Das, Country Director of a UK based organization- Sir William Beveridge Foundation, working in Bangladesh, told Bangladesh Post, “There is a huge lack of professionalism with regard to elderly care in Bangladesh. As life expectancy is increasing, we need to be prepared to address the common problems faced by the old age population like depression, memory impairments also known as dementia, Alzheimer's disease, and other progressive neurological disorders.”
The former army official said that the problems cannot be treated in hospitals alone. It requires long-term effective management of social care, rehabilitation with medical support given by highly trained caregivers.
The trend in the elderly population growing faster is not a magic. Bangladesh outperformed many of its neighbours in the south and south-east Asian region in the Human Development Index (HDI) and attained most of the UN Sustainable Development Goals (SDGs).
Such an outcome in HDI performance is the result of heavy investment by the government in focused areas like health, nutrition and education as well as keeping safety-net programmes for the vulnerable population.
The continuous focus on addressing the priority areas in the last few decades clearly improved people’s livelihood. As a result, Bangladeshis on average now live longer than their South Asian neighbours. The life expectancy in Bangladesh is 73 years.
Sadly, with the burden on the increased elderly population, the nation is not ready yet at least in terms of providing professional support and care to the elderly population, whether health or social problems.
Professor Samnun Taha, specialized in treatment of elderly people (Geriatric Medicine) at Senior Citizen Healthcare Hospital in city’s Baridhara, told Bangladesh Post, “Elderly people themselves are vulnerable to health problems because of their distinctive physiological characteristics. Among them, there are certain groups who are particularly vulnerable, for instance, the elderly with no education, old people who are living on their own and the elderly people who belong to the poorest segment.”
He said, “Evidence suggests that care for the elderly people largely remains unrecognized or overlooked. Lack of adequate healthcare facilities, poor financial support, socioeconomic insecurity and negligence are common problems among older citizens in Bangladesh.”
To better understand the problems of the burdens of the ageing population in Bangladesh, a study was done recently which reflects on the quality of life of the elderly population.
The study titled - health-related quality of life (HRQoL) - measured the mental, physical and social functioning capacity of the ageing people in certain sample areas. The study was carried out to help policymakers to provide need-based affordable and effective healthcare services for older citizens in Bangladesh.
Elderly people: context Bangladesh: Previously the society of Bangladesh took care of the elderly but now the situation is becoming changed due to change of social, psychological and economic standpoint. Social, economic and political viewpoint elderly population is now growing rapidly and it’s a big concern for Bangladesh. According to the National census between 1974 and 2011 the growth of elderly people is gradually increasing. In 1974, the
populations between 60-64 years were 1682629 and in 2011 the numbers were 3218974. At the same way aged between 65-69 years population were 735255 and 1998760in 1974 and 2011 respectively. In the same period of time populations of elderly over 70 years were 1639056 to 1998760. Report shows that percentage of elderly people age between 60-64, 65-69, 70-75 and over 70 years were 37%, 21% 20% and 22% respectively. According the report of Bangladesh Bureau of Statistics the trends of elderly population increase gradually. Figure 1 shows the gradual increased percentage of elderly in Bangladesh
The study found that most of the older citizens were suffering from anxiety or depression, 81.6 pc, closely followed by pain or discomfort, 81.4 pc.
The study found that HRQoL was significantly higher in males than females. It observed that about 59 pc of participants who volunteered in the study had some or extreme health-related problems.
Older female individuals suffered more health-related problems than older male citizens. Male participants reported significantly higher anxiety or depression-related problems (59.03 pc) followed by pain or discomfort (55.79 pc) related health problems.
In contrast, female older citizens suffered more from mobility (53.25 pc) and self-care-related issues (54.72pc) than male citizens did.
Abul Haseeb Khan, Executive Director of Resource Integration Centre (RIC), a pioneer in capacity building and social protection for the elderly population in Bangladesh, told this correspondent, “Aging itself is a disease involving steady degeneration of the mind and health system. However, it cannot be associated simply with medical problem. As one reaches old age, he or she needs comfort, care and love which are of course not a job of a nurse.”
Haseeb’s organisation has vast experiences of working with many international action platforms like HelpAge – International where they campaign for establishing rights of the elderly population in every country.
“There are many vulnerabilities older people in Bangladesh face living in a poor society where public healthcare and rehabilitation for the older people is literally non-existent. Older people also face flood, cyclones and other extreme weathers constantly putting their lives at risk,” said Haseeb.
He added, “Our work focuses on improving care for older people. We train parents, caregivers, midwives, nurses, community health workers in treating conditions that impact older people. We are also helping improve local health infrastructure and referral systems so that older people can get better care faster.”
All the experts who shared their views with Bangladesh Post pointed out that there is a need for formal recognition of institutional training and developing separate policies to educate and train manpower on caregiving for the older population.
Contacted, Professor Mohammad Ali Khan, Director General of Directorate of Medical Education, DGME, told this correspondent, “We are in the process of developing a training curriculum on creating professional human resources for elderly people’s caregiving.”
Such institutions, once developed, can widely address the problems of depression, social withdrawal, distrust in others, irritability and aggressiveness, changes in sleeping habits, loss of inhibitions, delusions and many other ageing problems.