Friday, December 1, 2023

Botswana’s elderly left in the forest to die


The headlines are sadly, maddeningly familiar.

The Mmegi headline states: “Letlhakane teen (18) rapes granny (80)”.

The Voice newspaper headline screamed “Triple murder accused denies raping old lady”. And the intro reads: “Despite his feared reputation, notorious Nkange native Habana ‘Gaddafi’ Million, 27, sent court into fits of laughter when he claimed the 61-year-old woman he is accused of raping was in fact his girlfriend.”

The safety and welfare of Botswana’s elderly people however is no laughing matter. When it comes to caring for its geriatrics, Botswana has been caught flat footed by the double whammy of HIV/AIDS and the collapse of the extended family social welfare safety net.

An official rummage of the wreckage for survivors of the demographic blitz by Policy makers and experts has invariably focused of children who have been orphaned by the HIV/AIDS scourge. The vulnerable elderly who have been left without family support after burying their children have slipped through the cracks of research and policy formulation. Botswana seems to have adopted an undeclared Japanese style senicide of leaving its elderly people in the forest or other remote and desolate area to die. Well maybe not literally, but vulnerable elderly Batswana has been left to their devices. University of Botswana Head of the Department of Law Dr Bonolo Dinokopila recently pointed this out, although not in so many words.

Dinokopila told a recent Global Innovation Workshop on Ageing, Frailty and Resilience organised by the University Of Botswana School Of Madison and the University Of Birmingham (UK) at the Sir Ketumile Masire Teaching Hospital Auditorium that despite their rapidly growing population, Botswana’s elderly people face an uncertain future because their needs and interest are largely invisible on Botswana policy agenda.

The objective of the workshop was to explore ageing, frailty and resilience in Botswana in the face of demographic transition.

Dinokopila decried the absence of laws that specifically protect the rights of older people to maintain and promote their status, wellbeing, safety and their security. He said this has resulted in abusive situations such as marginalization, discrimination, neglect, isolation, poverty and depression.

He noted that those receiving old age grants were also open to financial abuse by other family members and may not fully benefit from such income. Their desperate situation is not helped by security and welfare agencies such as the police and social workers who are not integrated to deal with specific issues affecting elderly people.

Dr Dinokopila further stated that health challenges for the elderly were aggravated by small pension schemes that covered very few people due to the informality of most livelihood activities and employment. He said most societies were predominantly rural and much of the population operated outside the security of formal sector and wage-dependent markets.

Clinical Psychologist, Ms Thato Molefi said elderly people were entitled to free health care in public health institutions but struggled to access quality care because of capacity constraints and age-related barriers.  She said Health services tended to be clinic-based and focused on acute conditions and that the health system does not have the capacity to deal with complex needs of older people with multiple continuing conditions. She also blamed healthcare workers’ negative attitudes towards older people in that manageable health issues were overlooked or attributed to the ageing process, resulting in low levels of functioning, poorer health outcomes and diminished quality of life.

Pabalelong Hospice Sister, Ms Vinayi Chalil, also drew attention to long-term chronic conditions associated with growing old, such as heart disease, cancer, respiratory, hypertension, disorders and dementia. She stated that problems such as HIV epidemics, poor education outcomes, unemployment, and lack of access to basic services and general poverty and working age group affected the youth to provide care for their elders. “Older people’s pensions are also often shared within households to supplement other social grant and wage income,” observed Ms Chailil.

All in all, the workshop agreed that Botswana’s traditional system of caring for the elderly is bursting at the seams.

Dr Sethunya Mosime, senior Sociology lecturer at the University of Botswana says “The stresses of care giving, particularly long-term care giving for someone whose problems may be extremely demanding, can be overwhelming. While important new research reminds us that, for some, even dementia care giving can be well managed and yield positive experiences, many people who find themselves thrust into the role are ill-equipped for it. Many who never harm the person they are caring for find instead that it takes a terrible toll on their own physical and emotional health. Physical and emotional illnesses are more common, and these dedicated caregivers do not have time or energy to attend to their own health care needs. For example, an older person relying on her children to provide meals, transportation and help her with financial decisions finds it difficult to complain when one of her children takes advantage of her. If, for instance, the child takes her money, hits her or neglects her care, the parent may be threatened with loss of support from the child if the parent complains. The child may also use threats of violence to keep the parent in line. It is imperative that we consider the safety and remember the need to provide compassionate care for the victims

Chawa Enyatseng, Director of There 4U Adult Care in Tlokweng, which is Botswana’s first nursing home told Sunday Standard how she came up with the project after witnessing the abuse suffered by Botswana’s geriatrics.

“What prompted me to start up a nursing home in the country was mainly because of the abuse that I saw the elderly going through on a daily basis from their caregivers which was either their relatives or even maids at home.  I am a registered nurse and in my experience as a home based care nurse I would come across elders who were not given medication on time, who weren’t fed properly, who were lonely most of the time and who sometimes were even locked in the house. You would find cases where elderly patients who have hypertension are given medication and told to come back after six months, six months later they have a stroke. That stroke is simply due to lack of supervision. The old family dynamic of family always being there for each other has since dissipated. The elderly aren’t properly taken care of as they should be which is disheartening. I urge people who can’t care for their elderly to take them to nursing homes, we were the first nursing home in the country and slowly there have been many others after us, if an adult feels like they can’t properly care for their parents or grandparents because of the everyday pressures of life then why not take them to a place where they will be properly taken care of.”

Research in most countries has revealed that elderly women tend to suffer disproportionately more from abuse, and may suffer more physical and psychological damage from it. The abuse, takes the form of physical, psychological or sexual harm, neglect or financial exploitation. The research suggests that the problem is also bigger than most people realize because elderly abuse is the most under-reported domestic abuse worldwide, with its victims and witnesses often staying silent.

Botswana’s elderly women are suffering the worst of it because the country has not invested in creating knowledge about the welfare of its elderly people, let alone elderly women. Most researchers on gender issues concentrate on “the girl child” or “domestic violence.”


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