Older people in Tanzania say medical staff in health centres often treat them disrespectfully by talking to them in a mocking tone. The findings are revealed at the end of the three-year Older Citizen's Monitoring (OCM) project, launched in 2002 in Arusha and Dodoma to monitor older people's access to health services - with successful results. 

The project aims to increase older people's participation in gathering information by forming critical networks. This will help develop their confidence to talk to governments and challenge authorities about their rights, including access to basic services. A group in Arusha have successfully lobbied local government to ensure free health care for all older people.

HelpAge International is simultaneously running similar projects in Bangladesh, Kenya, Bolivia and Jamaica. Partner organisations from all of these OCM projects will meet next week (16-20 May) in Arusha to share their findings and experiences. 

HelpAge International's partner in Arusha is the Arusha Retired People's Association (CHAWAMA). Members of CHAWAMA and local leaders at village and ward levels, were trained to act as project facilitators. They were given training in leadership skills, information on Tanzanian policies, lobbying and advocacy skills, and how to gather evidence on health services. These facilitators then formed older people's committees who took part in the monitoring process. 

"You are not ill, just old."

One of the primary areas of concern for older people in Tanzania is the quality of health care they receive, the cost of treatment, and the distance to and from services. One older person was told by hospital staff, "Go home. You are not ill, just old." As part of the project, they were asked to monitor and log their experiences during every hospital visit.
The findings revealed the following: 
40% said the tone of language used by medical staff was mocking. 
94% cent were charged for the consultation. 
30% cent were not aware of how to apply for free health care. 
Over a third had to wait 4 to 6 hours to see a doctor. 
Almost half had to pay for their own fare to get to the hospital. 

The lobbying power of older people

As a result of the project and the involvement of older people in the monitoring process, local government in the "Mosquito river" ward, has granted free health treatment to all vulnerable older people.

The free health service is funded through the Community Health Fund. Criteria for vulnerability include disability, severe health problems, and if an older person is living alone. The welfare committee at hamlet level makes the respective recommendation to the ward executive secretary, who then issues letters for these older people to grant them free access to the local health services. Once received the letter is valid for life. 

The project has also given older people a sense of respect and many said they now felt that their concerns were being listened to. They also felt that the project created support for older people at local village level and other areas of concern could now be addressed. 

"HelpAge International Tanzania will continue to lobby national and local government to ensure free health care for all older people. The success in Moduli district has shown the lobbying power of older people and their desire to ensure that their needs are met," says Abdul Jetha, Country Director of HelpAge International Tanzania. "The Older Citizen's Monitoring projects have enabled older people to monitor various poverty programmes, motivating them to claim their entitlements and become involved in consultation processes."