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The Situation of Older Refugees
.I.
BACKGROUND 1.
In a speech to mark the International Day of Older Persons in 1997, the
High Commissioner stated that, "The elderly are among the most
invisible group of refugees and displaced persons., I hope to change
that.” She stressed that UNHCR needed to increase its efforts "at
improving awareness, policy planning and projects for older refugees”. 2.
A survey conducted by UNHCR in 1997 indicated that older refugees make up
a much larger proportion of the UNHCR caseload than previously assumed. It
had long been believed that older people were more likely to choose to
stay in their place of origin, or, unfortunately, to perish in flight or
to pine away and die in exile. In fact, older refugees make up about 10
per cent of the population of concern to UNHCR reaching, according to
government statistics, 30 per cent in the case of Armenia. In many
situations they are over-represented in refugee populations. The majority
of this older population are women. Of course, definitions of
"older” reflect average life expectancy of the region concerned;
they range from the age of 46 in Ethiopia to 73 in Venezuela. 3.
A 1998 UNHCR evaluation entitled UNHCR
Assistance to Older Refugees, undertaken at the specific
direction of the High Commissioner to identify problems and propose
solutions, identified three crucial factors all these people have in
common: they are in situations of social disintegration, negative social
selection and chronic dependency. II.
FACTORS AFFECTING THE SITUATION OF OLDER REFUGEES A. Social
Disintegration 4.
The main factors behind the erosion of social support systems, whether
formal or informal, are economic decline, resulting in a drastic reduction
of living standards for the poorest with refugees among the hardest hit
and the separation and dispersal of families as a result of war, flight
and economic or security pressures, resulting in a rise in the number of
unaccompanied elderly persons in need. In many cases, families have had to
make painful choices about abandonment in order to survive. 5.
In Eastern Europe, the comprehensive pension, health care and social
welfare systems of the socialist era have not survived the transition to a
market economy which has led to a dramatic drop in the standard of living
of all those who had to depend on welfare provided by the State,
principally, of course, the elderly. Hardest hit of all are the victims of
forced displacement such as those in the former Yugoslavia and in the
Caucasus region who lost not only the value of their former entitlements
but also their homes and all their economic assets. 6.
While the problems in Eastern Europe have been more frequently reported,
the gradual but no less painful erosion of traditional support networks in
developing countries and its impact on refugees is much less well known.
Economic decline, social mobility and the pace of social change have
eroded traditional community values in refugee settings. The elderly no
longer enjoy the same authority, care and attention they had in the past.
Also, the degree of support and respect the elderly receive is by no means
uniform, but depends very much on their social status within the
community: not all elderly are elders. 7.
As a result, unaccompanied elderly refugees in developing countries may
face situations of utmost misery and destitution. In both the Sudan and
Yemen, the poorest among them may live a totally marginalized existence as
beggars and may never even come to the notice of UNHCR and aid agencies.
Due to bad nutrition, appalling living conditions and lack of medical
attention, they are invariably prone to illness and their life expectancy
is severely curtailed. B.
Negative Social Selection 8.
The term of negative social selection is used in the former Yugoslavia to
describe the manner in which camps and collective centres have been
observed to empty over time. Those who are young, healthy and able bodied
are the first to depart, leaving behind the more vulnerable members of the
group: the sick, the handicapped, single mothers with young children and
the elderly. At the end there remains a hard core of mostly elderly
persons who have nowhere to go and no one to take care of them. In this
way, some collective centres in Bosnia and Herzegovina, Croatia and Serbia
have become geriatric wards in all but name. 9.
This phenomenon is not limited to the former Yugoslavia but is, to a
greater or lesser extent, a spontaneous process characteristic of camps
and collective centres everywhere. In the Sudan, for instance, negative
social selection has been an important factor in nullifying UNHCR’s
20-year efforts to help wage-earning settlements become self-sustaining.
As shown in a recent report, these settlements now comprise a
disproportionate number of small children, single-headed households and
elderly who live in extremely poor conditions and remain wholly dependent
on the continuation of assistance provided by UNHCR and WFP. 10.
Government resettlement policies can contribute to the negative selection
process by discriminating against elderly applicants who may not pass
medical screenings and be left behind in countries of first asylum,
painfully separated from the rest of their kin. Reports received from
UNHCR Branch Offices in different parts of the world indicate that this is
a common problem. C.
Chronic Dependency 11.
Many refugee situations produce over time a residual caseload of solitary
older persons who have not found a durable solution, are unable to secure
state benefits or family support, and may become dependent on UNHCR for
long periods of time. This has been the case with many Russians and
Armenians who became refugees in the 1920s. UNHCR has been providing the
destitute elderly among them with allowances in countries as far afield as
Argentina, Egypt, Morocco and Venezuela. Many of the 170 frail elderly
persons in Cairo who now rely on UNHCR assistance originally came to Egypt
as orphans and remain stateless. Whilst they were self-supporting as
healthy adults, they are now dependent on support from UNHCR. Most are
women who never married. 12. The
Office faces a dilemma. While it must continue to assume its
responsibilities for older refugees by ensuring that the experience of
exile is not compounded by an old age marked by poverty and destitution,
it must seek to avoid chronic dependency on the part of the elderly.
Wherever possible, the Office addresses the protection challenge of
ensuring that elderly victims of forced migration are able to regularize
their status and obtain access to all possible benefits, entitlements and
rights. However, this is not an easy task in countries undergoing rapid
economic change, where all residents face a marked decline in living
standards. Outreach to elderly people with mobility problems is essential;
legal counselling sessions can be made available to them in their places
of residence such as old people’s homes, collective centres or private
accommodation. 13. The
problem of residual elderly caseloads could increase in severity as the
ageing of populations and global trends towards social disintegration may
well lead to a rise in the number of unaccompanied older refugees. III.
THE WAY FORWARD 14.
While the plight of older refugees can be severe, they should not be seen
only as passive, dependent recipients of assistance and therefore somehow
socially redundant. Older refugees can be valuable resources to their
communities, transmitters of culture, skills and crafts so important to
reaffirm the traditions of the dispossessed and displaced. Older persons
are highly motivated to make an active contribution to the well-being of
their next-of-kin and only become totally dependent in the final stages of
disability or illness. Older persons have taken the lead in return to
countries as far afield as Croatia and Liberia. The tragedy of older
people who have been forcibly displaced is not so much that they become
dependent on others, but that they have been robbed of the means to
provide for others in the manner they would wish. 15. To
address the problems of older refugees, the following strategies have been
identified as being most critical to their well-being: integration of the
elderly into all aspects of programme planning and implementation;
targeted community services projects with competent linkage partners; and
advocacy on behalf of the elderly during crucial phase-out stages. A.
Integrating the elderly in all aspects of programme planning and
implementation 16.
Assistance programmes can be designed in such a way as to include the
elderly as much as possible in all activities and provide them with the
means and the opportunities to restore and realise their potential. Such
initiatives, targeted at the active elderly, are quite different from the
also necessary measures designed to ensure proper care and medical
attention for frail elderly who have become incapacitated due to sickness
or old age. 17.
While the elderly clearly have special problems, there is little to be
gained from establishing yet another separate refugee category with a
distinct set of guidelines and interventions. Rather, a more targeted
inclusion of older refugees in all aspects of programme planning and
implementation would help the active elderly to be more self-supporting
and would promote better community care initiatives for the very old. 18.
Rarely have training programmes, income-generation schemes, micro-loan
projects or even community development projects been designed so as to
deliberately include older refugees, tap their potential and ensure that
their voices are heard. The reason for this is partly a question of
attitude which perceives preoccupation with the elderly as a low priority,
since their needs are supposedly met by the community as a whole and they
appear to have little of substance to offer. 19. In
many cases where the middle generation is absent for some usually tragic
reason, grandparents can find themselves in sole charge of their
grandchildren. Such families live in desperate poverty due to the lack of
an employable breadwinner. The physical and mental strains are enormous as
the grandparent struggles to cope, often neglecting his or her own needs
in the process. The existence of these problems, which appears to be
widespread in refugee situations, is eloquent testimony of the need to
adopt a more family-centred concept of care rather than one in which
certain groups are singled out for special treatment. 20.
Neither UNHCR, nor its implementing partners have specialist resources in
geriatric care, one notable exception being HelpAge International (HAI).
UNHCR and HAI are working in partnership to explore ways in which all
activities can be made more deliberately inclusive of the elderly. It is
hoped that relevant training modules and best practices guidelines can be
developed together for dissemination to UNHCR and implementing partner
staff. A notable example of the cooperation which already exists is in the
continued refinement of nutritional guidelines for inclusion of older
refugees in special feeding programmes. In traditional feeding programmes,
children under five and pregnant or lactating mothers have been targeted.
Alerted by the incidence of malnutrition among older refugees in the
United Republic of Tanzania camps, where the frail elderly are unable to
collect the water or firewood necessary for food preparation, HAI
developed community care projects to encourage neighbours to help those
alone or caring for young grandchildren. HAI also worked with UNHCR to
develop the criteria to assess an older person’s nutritional status and
consequent eligibility for special feeding. For young children, simple
measurements of weight to height or arm circumference can determine
nutritional status. The natural ageing process with body shrinkage may
disguise the hunger of the old. B.
Community Services’ Input is Vital 21. The
neediest among the elderly are often the least visible and a proper
assessment leading to a well-designed programme requires a targeted effort
under the supervision of qualified UNHCRstaff. Well meaning programmes
without adequate guidance from Community Services Officers can become
merely a conduit for material assistance without proper follow-up or
thought given to ways in which the refugees’ self-help attempts might be
better supported. One very successful example is the network of refugee
monitors established through a local NGO in Vladikavkaz which proved
indispensable in identifying beneficiaries who might otherwise never have
come to the notice of the Office. Comparable achievements have also been
noted in Bosnia and Herzegovina and Croatia where UNHCR’s community
services input is strong and a sound home visiting and referral system in
place. 22. At
the other extreme is the situation in the refugee camps and where there
has been no community service structure of any kind. The evaluation,
referred to above, stated, drawing from specific examples, that as a
result of the lack of refugee consultative and self-help structures
created by community services, older refugees in need may be completely
over-looked and uncared for. Only the voices of the most vocal and active
refugees are heard. Thus UNHCR may not be sufficiently aware of the
disastrous consequences brought about by negative social selection in the
camps. 23.
Securing accurate information on the socio-economic circumstances of the
refugees and their quality of life is a vital by-product of well-managed
community services programmes. Such information is notoriously difficult
to come by, but is essential for the proper design of assistance
activities in all other sectors, including the enhancement of community
participation and self-help initiatives. Community services projects are
not a luxury but a necessity upon which much else can depend. This must be
remembered by both donors and UNHCR itself, as UNHCR is faced with budget
reductions and forced to make difficult choices about essential services. C.
Phasing Out Responsibility 24. The
issue of the limit of UNHCR responsibility regarding assistance is always
problematic. Currently, the extent of UNHCR involvement in repatriation
and reintegration is being debated. Nowhere is this more graphically
illustrated than in phasing out programmes that benefit the elderly,
particularly when there is a residual caseload of abandoned older persons
who have no alternative means of support. In order to phase out, support
and long-term care arrangements must be established through local NGOs,
relevant government ministries or in conjunction with the international
development agencies such as WHO, UNDP and the World Bank. One example of
this phase out is in Bosnia and Herzegovina, where UNHCR and ECHO support
relevant ministries which are planning the closure of the collective
centres. In conjunction with other longer-term development agencies, they
are determining means to encourage residents to return to their place of
origin and ways to continue assistance to collective centres converted to
old people’s homes. 25.
Experience with local NGOs has shown that these NGOs may not become
independently viable unless UNHCR engages them early on in a concerted
capacity-building effort which goes much beyond the occasional briefing or
workshop. National NGOs need to be thoroughly trained in project design
and fund-raising techniques and helped in setting up a sound
administration and in identifying and liaising with potential donors. To
assist this process, UNHCR is formulating a strategy to enhance national
NGO partners’ effectiveness. This is a field-up process and key
components include working with Governments on procedures on the setting
up and registering of NGOs, development of guidelines, tools and training
modules, as well as pairing national and international NGOs to plan
individual handover strategies. 26.
UNHCR’s cooperation with social affairs ministries remains limited. This
may be because UNHCR’s main counterpart is often a ministry dedicated
solely to refugee affairs, or, as is often the case, the social affairs
ministry is one of the weakest and most under-funded ministries. In
Eastern Europe, preference for implementation through NGOs has meant that
existing government service outlets, such as social welfare centres, which
could have played a useful role in outreach services for the elderly, are
often ignored. If UNHCR wishes to phase out responsibly, it must ensure
that residual caseloads of needy elderly persons become the responsibility
of competent government departments. 27. As
part of its phase out strategy, UNHCR should also seek to ensure a
successful transition from relief to development in the social assistance
sector. For the elderly, whether refugees, returnees or displaced persons,
this means that they should have access to the same services which are
available to locals and that relevant welfare structures should be helped
to develop the capacity necessary to cope with any added demands. However,
in countries affected by war, economic decline or structural adjustment,
welfare provision is usually gravely under-resourced and usually occupies
a very low priority. In these circumstances, UNHCR can only hope to
influence government policy on welfare provision and funding if its
interventions are closely coordinated with sister agencies that are
habitually engaged in offering support and advice in this field,
particularly the World Bank, but also WHO and UNDP. These and other
agencies have in recent years become closely involved in assisting
Governments to manage health care and welfare reforms and to set up major
poverty alleviation programmes. The Framework for Cooperation between
UNHCR and the World Bank of April 1998 is a sound basis for establishing
these linkages. 28. In
large, complex programmes, UNHCR’s phase out strategy should be subject
to a multi-year plan in which the gradual withdrawal of its services in
the social assistance sector is linked to the implementation of government
welfare reforms and poverty alleviation programmes supported by the World
Bank and bilateral and multilateral donors. This requires complex
negotiations that need to be engaged well in advance. IV.
1999 – THE INTERNATIONAL YEAR OF THE OLDER PERSON 29.
This year represents an ideal opportunity to create awareness of the
situation of older refugees within UNHCR, implementing partners and the
donor community through promotional activities and advocacy. In doing so,
UNHCR seeks to strengthen protection of and assistance to older refugees
in an integrated framework, which views them as part of families and
communities. 30.
Activities associated with the Year, which will take place both at
Headquarters and in the Field, will as far as possible build on existing
structures and respond to the needs of older refugees in the following
ways: (a)
Promotion/advocacy/awareness raising: to be conducted in conjunction with
other agencies, such as WHO, and specialist NGOs, such as HAI, which are
developing their own programmes for 1999. Enhancement of inter-agency
linkages will assist a consolidated transition of responsibility. At the
promotional level, public information materials such as posters, videos,
brochures and display materials will be prepared as a kit which can be
used by all field offices to stimulate awareness; (b)
Policy and practice development: to strengthen UNHCR and implementing
partner capacity for integrated programme planning and implementation, a
specific training module and best practices guidelines will be developed.
Older person case studies will be incorporated into existing training such
as People-Oriented Planning(POP) and protection, as well. A key component
is the incorporation of older refugee issues into the newly developed
Operation Management System (OMS). Regional workshops for Central and
Eastern Europe and in Africa will be a fora for examining common problems
and solutions; and (c) Strengthening service delivery in the field: the main elements of service delivery in the field are a strong community services and protection presence. Continued strengthening of community services staff and upgrading of skills and technical backup will be provided to individual country programmes. Copyright
© 2002 Global Action on Aging
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