Inequities and inequalities in our response to a pandemic: The impact on the elderly

by Dr B. J. C. Perera

Specialist Consultant Paediatrician

It is just about a year since the current coronavirus contagion hit our planet like a violent cataclysm that came from nowhere. It was like a tsunami that descended on us from right out of the blues. Even now, even after one year, the COVID-19 pandemic continues to relentlessly rip through the global population, disproportionately affecting ethnic minorities, lower socio-economic groups, those with co-morbid disorders and most definitely, the elderly. All over the world it has brought the need to tackle health inequalities into sharp focus. However, in addition to the health perspectives, there are very many social inequities and inequalities in the way we treat certain sections of our populace that needs to be addressed during the pandemic.

One segment of the population that is greatly affected by such inequities and inequalities are the elderly of our land. It is now well known that they are a sector of society who are at the greatest risk of contracting the disease, who become terribly symptomatic and most importantly, are at highest risk of succumbing to the vagaries of this coronavirus illness. Their organs that have gone through over 60 years of their lives are not able to withstand the onslaught of the virus. Many of them have other diseases like diabetes, high blood pressure and ischaemic heart disease, just to mention a few, which make them that much more vulnerable to COVID-19.

Yet for all that, especially during this pandemic, it is definitely time now to reflect on the question as to whether we have done our bit towards the elderly from a societal standpoint. Have we made life easier for them? Have we been kind to them? Have we been gracious enough to undergo some little personal discomforts on our own to make the lives of the elderly even a little bit better? Have we been courageous enough to openly campaign for the welfare of the senior citizens of our country? Most importantly, have the general populace, the government and the corporate sector, made it a point to look after the elderly of our country? Most regrettably and ever so sadly, the answer to each and every one of those queries is a resounding and reverberating ‘No’.

It is no secret that many of our elderly people, especially the elderly couples, live on their own. Some may be individuals who are widowed and are living alone. Many of these people have to fend for themselves. When a pandemic like COVID-19 strikes, it makes life intolerable for most of them. Are there any concessions being made to look after the elderly during these troubled times? As even neighbours, have we had the sense of compassion to inquire about their welfare? During these trying times the senior citizens are expected to just wait at home, mainly for their own safety. That is well and good and is an adage expounded by the health authorities. However, have the authorities even thought of how the elderly are going to survive at home without assistance. They have to be provided with the groceries and other essential items that are required for daily living. As a result of not being provided with these essentials, they have to go out and get them. In the process, in groceries, supermarkets, banks, and public utility establishments, the elderly people too have to join the general queue, sometimes being exposed to the elements as well, to await their turn to be served. They may have to remain in these queues for considerable periods of time. If they have to go to several places to get things done, it may be a case of one queue after another. There are even reports of some of these elderly people fainting while waiting in queues. In some of the more developed countries, senior citizens are given dedicated times at supermarkets and malls, sometimes for about an hour when these establishments open in the mornings. When this was suggested to some of the big-time stores in Colombo, their excuse for not doing so was the fact that the other younger customers would complain. That is the kind of human kindness that has been doled out to these very deserving elderly people. In several countries of the West, younger people have got themselves together to physically help these seniors by doing household chores, running errands, getting the groceries, getting them hot food, and generally making life just a little bit easier for them.

In some situations, the head of the household is a senior citizen. Even when the government provides monetary benefits or goods, these heads of the households have to go themselves to collect the money and other articles that are provided. If you have ever had to go to a Grama Niladhari Office, a Post Office or a District Secretariat to get something done, even to collect the pensions, you will know how these unfortunate people are treated. To compound matters further, even many of the private medical facilities do not provide any decent concessions to the senior citizens. Even to get their essential medicines from pharmacies, these people have to join a queue with the other able-bodied creatures, and wait for their turn.

It is also essential to determine as to why some of the elderly are dying at home. OK, they have coexisting diseases. That is more the reason that they have to be looked after. Some of them are mortally scared of going to hospitals, getting admitted to wards and even being sent into quarantine. Things are made much worse for them as they may be forced into isolation, may even be locked-down and not allowed to move out, especially those who live in high-rise buildings or in congested housing schemes. Their frail muscles, bones and joints would further deteriorate due to lack of exercise and recreation.

All of us have a role in campaigning for social justice. The government and the people of this country simply have to look at social inequalities with the widest possible lens that it deserves. But if we wait for the dawn of a caring, considerate and just society, where inequity and inequality cease to exist, it will be a very long wait, perhaps till the cows come home. All of us need to put ourselves in the shoes of the unfortunates of our society. The time to act is right now and in that endeavour, we do have to act decisively.

It must never be forgotten that the elderly are mothers, fathers, grandfathers, grandmothers, uncles, aunties, brothers, sisters and cousins of somebody or the other of some of our own people. They are also friends of very many people of our populace. A large proportion of them, be it from the farmer and village communities or from the elite professional classes, have done their bit for our country in their time. They may be in their twilight years now but in their day, they have literally carried this country on their shoulders. Sadly, those shoulders that were quite strong eons ago are now so frail as to buckle under the onslaught of the coronavirus. In their day, they have definitely helped this country. It is now, just the right time for society to go that extra mile to help and look after these people. It definitely is ‘pay-back time’, on our part, for the senior citizens of our beautiful country.

When we make concessions for the elderly, look after them and show sympathy, empathy and kind-heartedness to them, those endeavours become meritorious acts that are promulgated by all the great religions of our country. From a humanitarian perspective, those actions become the very milk of human kindness. It was Charles Darwin, in his celebrated Theory of Evolution, who hypothesised the concept of ‘Survival of the fittest’. Today, our duty to the elderly of our land is to adopt the axiom, ‘Survival as a result of human kindness’.