In the thick trees on the outskirts of Kisumu City in Kenya, a hut is as isolated as the 76-year-old woman who owns and lives in it alone. Without a child of her own, Mary Atieno had called people “son” or “daughter” from the community she had built in church, a religious camaraderie that COVID-19 halted abruptly.
The neat arrangement of the hut, not more than three adult’s steps wide, shows how “self-contained” Mary’s life has been: at the corner of the house is a traditional three-stone stove where she prepares her meals, and close to it are a few plastic cups and plates; on the furthest end, is a papyrus reed that serves as a bed, with a small torn blanket. To an outsider, Mary could use some help on the materials needs to cater for some comfort and food; those are furthest from her concern.
“I have not been able to go to church since the government banned gatherings to control the spread of that disease, and I am extremely sad,” said Mary.
“That disease”, is COVID-19 and it hit people like Mary much more than any other due to medical and social challenges. According to the World Health Organization, most people infected with the coronavirus experience mild to moderate respiratory illness and recover without special treatment. However, WHO states that older people over 60 [PDF] are more likely to develop serious illnesses. Kenya’s Director General at the Ministry of Health, Dr Patrick Amoth, said that older people are particularly vulnerable to severe COVID-19 due to underlying medical problems like cardiovascular disease and diabetes.
Childless, widowed and without a social support system, Mary’s sadness from not going to the church goes beyond her inability to see her friends and stay in touch with her community at the church.
She talks of a “sister” at the church, a congregant who would carry food supplies like cornflour, sugar, and vegetables. While she did not demand it, Mary had become dependent on this generosity, and now that it is not coming, she has to make arrangements.
“I will try farm for people and get some income,” she said.
Farming, a tasking activity, is what Mary says she can think of, as she is not “used to disturbing people.”
During her conversation with Danish Development Research Network (DDRN), Mary said she is coaching her body” that she will eat only once a day when the food is available. Cutting the number of times she eats is a coping mechanism for many older people, according to a Rapid Needs Assessment (RNA) [PDF] that nonprofit HelpAge International conducted in 2020. According to the survey, nearly four out of five (76 per cent) of older people reported reducing the quantity of food eaten since the outbreak, while more than half (52 per cent) have had to reduce the quality of food eaten.
It is hardly surprising that most of the older people (57 per cent) interviewed in the survey recorded food as their biggest concern, followed by livelihood (14 per cent) and shelter, at 11 per cent. When Human Rights Watch interviewed residents in Nairobi, the majority reported COVID-19 related lockdowns led to extreme hunger and job losses.
In its report, Human Rights Watch notes a 75-year old grandmother in the Kenyan city who cares for grandchildren with mental health conditions who faced difficulties in finding medication and food.
“When the lockdown came, my small-scale detergents sales business became difficult,” she said. “I was not able to continue buying medication. I was borrowing food, begging, and buying food items on credit.”
The devastation that COVID meted on the economies of many African countries compounds the material lack. Economists at World Bank forecast that nearly half a 4 billion people in Africa will live in extreme poverty by the end of 2021. Data is scant on what percentage of people over 60 with any form of pension, but generally, older people rely on remittances for their income. The younger people, such as the kind woman who gave Mary groceries, lost their income due to COVID-19. Even before the pandemic, the World Bank termed unemployment in Kenya as the highest in East Africa.
Mary does not know this gloom and dread, but she knows that she is not getting the help to provide her with the most basic needs, such as food. Even her peers who have families have also faced more abuse during the pandemic. The WHO reports that around 1 in 6 people 60 years and older experienced abuse in community settings in 2020. The abuse was mainly psychological (12 per cent) and financial (7 per cent).
So in her hut, she worries—a lot. The full extent of the effects of this pandemic is still unknown. Still, studies in places like China have already reported increased anxiety and depression in the general population. Even outside of crisis times, the elderly population have relatively high rates of depressive symptoms. The Covid-19 pandemic has stripped older adults like Mary of human contact, meaningful activity and purpose. Younger people have found a way to navigate the uncertainties of life.
Raising the alarm
Still, Mary can neither afford the technology – such as a smartphone— nor know how to use platforms such as Zoom or WhatsApp to maintain contact with people.
Kenya, like many African countries, tried to offer some form of social welfare. In 2020, the government paid 4,000 Kenyan shillings (About US$37) every two months to more than 1.1 million people through an existing cash transfer program. In addition, it initiated a new, pandemic-specific cash transfer program that paid beneficiaries 1,000 Kenyan shillings ($9) per week and reached 332,563 beneficiaries from April to November 2020, according to government figures. Noble as it was, only a handful of people got this help as corruption marred its implementation.
Organisations are raising alarm that the typical approach to the pandemic is medicine and public health, which has contained the virus, alright. However, the approach has also caused older people to suffer and die by eroding their physical and mental health. HelpAge International said: “Governments and the international community cannot justify the continued neglect of older people. We need to see them take action and ensure that we build forward better to include older people in response plans and data collection to build resilience for the future and uphold their rights. We must all have equal opportunity to recover.”
In a statement sent to DDRN, Human Rights Watch urged international financial institutions and bilateral donors to “significantly increase the financial support and technical assistance available for expanding social protection in Africa.”
Verah Okeyo is a global health journalist and communications specialist based in Kenya. She tweets on @iamverahokeyo
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DDRN South-North dialogue webinar:
The impact of Covid-19 on the elderly
Time: Thursday 17 January 2022,10:00 am (GMT+1)
Presenters: Verah Okeyo, Kenya; Andrés Yépez, Ecuador and NGO Globale Seniorer, Denmark. Place: Online (Zoom), Register by e-mail: email@example.com