2019 - MOTION 1 -
Elderly as distinctly vulnerable population
MOTION
To assure that this population has access to relevant healthcare, and insure inclusion, MSF should recognize the elderly as a distinctly vulnerable population; seek to understand their special medical and social vulnerabilities in the context of humanitarian crises.
Ukraine FAD, The joint MSF Sweden and Norway GA
BACKGROUND AND EXPLANATION
According to data from UN population division, the number of older persons — those aged 60 years or over — is expected to more than double by 2050 and to more than triple by 2100, rising from 962 million globally in 2017 to 2.1 billion in 2050 and 3.1 billion in 2100. Globally, population aged 60 or over is growing faster than all younger age groups.
With an aging global population, more elderly are impacted by conflict and natural disasters MSF has recognized the special vulnerabilities of women and children when health care is disrupted during conflict. The elderly with parallel risks albeit different needs are less visible and thereby receive less attention and relatively fewer appropriate services.
Increased age is often associated with increased frailty, morbidity, disability and decreased resiliency. They are both less able to flee and seek safety, and less visible to those who might help them. Isolated and unable to access medical humanitarian aid directed at the general population and the aid so conceived doesn’t necessarily address their needs. Thus they are marginalized and excluded.
FEEDBACK (Final)
The motion about Elderly as a vulnerable group is acknowledged as a very relevant motion. MSF considers many groups to be vulnerable; sex workers, children under 5, children between the ages of 5-15, woman, disabled etc. We confirm that the elderly are a potential vulnerable group and it is important when identifying vulnerability that it is linked to the context (contextualized) where we operate.
Elderly people are found in all our programs; Non communicable diseases (NCD) treatment, mental health, surgical projects etc. MSF OCB has several experiences (and initiatives) where this group has been specially included in assessments and operational target groups, a clear example being testing during the Covid-19 pandemic.
Some NCD projects are targeting the elderly. One example is the former project in East Ukraine, where MSF performed home visits for elderly people with NCDs in an area where the younger population had left. Another example is the home-based care in Beirut, Lebanon where house visits are conducted to elderly patients who have difficulty coming to consultations.
In the Covid-19 pandemic the elderly are both the most vulnerable group (in terms of risk and in terms of accurate attention received) and the ones with significantly the highest case fatality in COVID-19. In several of the high resource countries, OCB rapidly implemented interventions to support senior homes in order to reduce transmission, show solidarity and support staff in dealing with this pandemic as well as being sensitive and responsive to the mental health impact provoked by COVID-19 and the government’s reluctance to react adequately. This happened in USA, Brazil, Belgium and Italy and as well in Ukraine and Ecuador. It was also accompanied in Belgium by a report – Left behind in the times of COVID-19 – and a parliamentary session as advocacy for a more appropriate and dignified support and management of these senior homes. This is the first time OCB has worked in such an environment (senior homes). MSF OCB was able to quickly adapt and to focus on, and answer to, these specific needs of the elderly, even if it was a new environment.
Another example has been to support elderly (and other vulnerable) groups in migration, refugee camps and in open settings such as for homeless people. This has been done either by providing them with temporary shelter sufficiently equipped to prevent them from getting infected or infect others and benefit from medical care and HP (health promotion) if required, or by supporting shielding within the families. This was performed in communities such as in Bangladesh, Belgium and Lebanon.
Elderly do have specific medical and non-medical needs that are not addressed by disability, but it was important to bring in the experience and connect to the Disability and inclusion project in MSF Norway. In this way to ensure to include all angles related to elderly. The Disability and inclusion project recently announced the following on their website:
A motion on the elderly as a distinctly vulnerable group passed at the last OCB Gathering. The project of inclusion of persons with disabilities has been contacted by an OCB board representative to share its experiences from transforming a successful motion into a cross-movement initiative, discuss common points and trigger tighter collaboration. Concern for the elderly caught in humanitarian crises is already partly covered by the project: according to the World Report on Disability (2011), the prevalence of moderate and severe disability among people over 60 in low-income countries is 43.4%. Because of the increased interest of MSF in this group and the new prospects of collaboration, you can expect more to come from us on that matter in the future. As a brief introduction to the topic, read the paper Ending Neglect of Older People in the Response to Humanitarian Emergencies.
Even if it is evident that in many situations we already target the elderly as a vulnerable group, there is still work to do on this motion. The Covid-19 was an excellent example and a drive for OCB to pay more attention to the needs of elderly people. The pandemic has presented major challenges in the field (and HQ), with teams having to make difficult priority choices in the face of a multitude of constraints and problems (travel stop, insufficient HR, lack of supply, confusion, unknown disease and not knowing what to expect, inappropriate measures from government, other organizations etc., population defiance, security issues etc.). All of this has inevitably led to a delay in discussing this motion more in depth.
We are on track and we do plan to look more carefully at this motion in the future. Some issues on our list are to sensitize our staff in future trainings to the specific issues faced by the elderly as a vulnerable group.