If anyone knows about the reality of Pakistan’s cycle of floods, heatwaves and droughts, it is the older generation. They have lived through decades of climate fluctuation and change.
Yet this year has taken things to a whole new level. In April, parts of Pakistan had near-record temperatures of 49C with 30 percent of the country affected by extreme heat. This is particularly challenging for older people who struggle to regulate their body temperatures, especially if they are on medication. It is even worse for the many thousands who, despite their age, spend most of their days outdoors working as farm workers, daily labourers and street vendors.
When the monsoon came, it was a short-lived relief from the soaring heat, as the intensity and magnitude of the rains soon became catastrophic. Sindh and Balochistan, where HelpAge is responding to support older people and their communities, received five times more rainfall than the average in the first two weeks of July alone. Families fled for their lives in panic, with many older people struggling to keep up with them.
Mohammad Salih, 75, from Shaheed Benazirabad district in Sindh, escaped the floods with his family, but he couldn’t move very quickly. When they got to the school that had been designated as a shelter, it was full. The family is now living under the open skies. Many older people like Salih feel like they are a burden on their families. Thousands of others have been abandoned. My colleague told me about a sad encounter with a man at a railway station recently. The man, looking miserable and lost, said he had helped his family escape but now couldn’t find them. He had lost all his money, home, crops, animals and food.
Outside the public sector workforce, only 2.3 percent of older people in Pakistan receive a pension, so if they are not able to work, they are entirely dependent on aid or on their families to survive. Malooka Khatoon, 70, fled for her life with her husband when the floods came to their village in Balochistan’s Jhal Magsi district. They lost all of their livestock and their crops and now have returned to live in a tent, outside their shell of a home with no roof or walls. “Before the floods, we were busy farming and earned a decent living, but now, we have lost everything except our lives,” she said. “We are depressed and really worried about our losses.”
Malooka contracted hepatitis from the muddy water and has been unable to access the medication she needs. Her story isn’t unique: Thousands of older people live with chronic health conditions, like heart disease, diabetes and respiratory problems, and have similarly struggled to survive after their medication was swept away by the water. They can’t replace them, as supplies in hospitals and health centres have also been washed away.
Meanwhile, many older people who were forced to stand in water for a long time now have respiratory problems, including asthma, even if they previously did not suffer from these conditions.
Most humanitarian organisations do not take age as a factor of vulnerability when assessing who is in most need. This is reflected in a general lack of understanding of older people’s needs by those providing aid. Even when there is understanding, it is rarely translated into tangible action. Aid that is provided in emergencies is often inappropriate or delivered in the wrong way. Food that is difficult for older people to digest is distributed at times. People often have to travel to reach the food distribution points. In some cases, it is even dropped out of a plane. This can be particularly difficult for older people who obviously lose out to the more physically able.
Humanitarian relief agencies should not adopt a one-size-fits-all approach but should go into affected villages, find the people in need, register them and then deliver aid. This would ensure that older people are not overlooked and that they can be treated with dignity.
There are other issues to address, too. Shelters are often without electricity, which means that those who have difficulty seeing or are injured will struggle in the darkness. At HelpAge, we always ensure there is a flashlight in distributed aid to overcome such challenges.
Then there is medication. Mobile health teams are often set up in response to disasters but while they provide medicines for diseases such as diarrhoea, they are rarely equipped for chronic long-term illnesses. One way around that is to provide cash so that older people can buy the medicine they need, if it is available. Cash is important as it gives people the dignity and independence to make their own choices and buy what they need. They may need to buy incontinence pads, for example. Or they may just need a goat for milking. Cash gives them the choice.
During emergencies, older people often lose important assistive devices, such as glasses, walking sticks and wheelchairs. These are essential to their wellbeing, and aid agencies must ensure their availability in shelters and other facilities. And it’s not just the physical, tangible help that they need. Many older people have lived in their homes their whole lives and are traumatised when they are forced to leave: They need psychosocial support too.
With more climate-induced disasters expected, we should act now to also learn from older people’s rich historical and local knowledge of geography, flood paths, rain patterns, agriculture and livestock diseases. At the same time, national disaster management authorities and humanitarian NGOs must collect data on older people so that age-appropriate solutions are implemented to address the needs of the elderly when they are impacted by such crises.
Pakistan’s seniors have been through hell and worse these past few months. They – and elders around the world – must be saved from having to go through this again.