Ageing ungracefully

The Bureau of National Statistics, on the International Day of Elderly Persons 2020, projected that by 2045 the Maldives' elderly population, those aged 65 and older, will have increased five folds over 2014. The number is projected to increase from four percent, in 2014, to 14 percent in 2054 – effectively making the Maldives an ageing population. 

The following chart shows the distribution of population as in 2019, according to the Household Income and Expenditure Survey (HIES). A large proportion of the current population is in the 25 to 54 age group. This group will move to 55 and above in 30 years. 

This has multiple implications for the economy, and society, moving forward. 

The Ministry of Gender, Family and Social Services published the national policy on the elderly in 2017, which notes that the elderly are isolated from, or side-lined, in society due to ageism – prejudice or discrimination against a person based on their age. The stated vision of the policy is to establish a social environment that provides protection, cares about and is kind, towards the elderly, to ensure that they are included in society and to ensure their independence and good health. However, aged care in the Maldives is generally left with families, with children looking after elderly parents — while they themselves work to provide for those ‘under their care’. There are currently no state or private owned elderly care facilities in the country. 

Basic pensions for the elderly

This was a major source of income for the elderly and covers about 95 percent of the elderly population according to the Maldives Pension Administration Office (Pension Office). While this provides some financial security for the elderly, the fiscal implications of this will be compounded in the coming years, with the projected increase in the elderly population. A simple calculation, assuming that the MVR5,000 pay-out remains the same, which is unlikely as it is inflation indexed, the government will need to budget MVR5.13 billion in 2054 if the scheme is to continue unchanged.  

According to the Pension Office, Basic Pension benefits are very high, at 222 percent over the national poverty line and 338 percent higher than the international poverty line. As such, it may be assumed that the basic pension benefit provides an adequate income for the elderly. However, there have been cases reported where the elderly are manipulated or abused by family, relatives or care takers, to gain access to their basic pensions. 

Further, consideration also has to be given to whether this benefit, coupled with the benefits from the Maldives Retirement Pension Scheme, accrued until an individual retires, will be enough to sustain an individual after retirement. True, the benefits may be higher than the poverty line. However, one needs to earn an income much higher than the poverty line to live a dignified life, and to pay the high rents, especially in Malé.

For example, a 40-year-old who has migrated to Malé for education, health or employment opportunities, contributes to the pension scheme and has a stable job. He, however, lives in rented accommodation and does not earn enough to purchase private housing, nor is fortunate enough to be selected in the social housing schemes announced by the government. When this individual turns 65 and has to retire, where do they live? Is the payout from the pension scheme enough to sustain the individual's lifestyle then, with rent and other overheads? 

Ageism and other challenges

With increasing life expectancies, which in the Maldives is currently at 87 years, declining birth rates and developments in the field of health care, the number of the elderly has been increasing and will continue to do so. However, the elderly currently faces many types of discrimination in addition to ageism including lack of respect, difficulties in access to health care, and limits on the right to work and to own assets and incomes. 

This publication spoke to the organisers of G-Care, a not-for-profit group that seeks to provide care for the elderly in Malé and organise activities where they could be involved and engaged. According to the organisers, there are many elderly in Malé who want to be actively involved and socialise but are unable to do so. One of the reasons for this is the lack of lifts, or other accessibility facilities, in buildings which keep them isolated in their homes, finding it too difficult, or impossible, to navigate the many flights of stairs up and down.  

Another important aspect is the lack of adequate public transportation – they have to depend on taxis to get to activities and social outings but given the traffic congestion on the streets of Malé and the incessant beeping and horning whenever a taxi stops to take on a passenger, the elderly are reluctant to venture outside. Walking to their destination is also difficult, given the congestion and the lack of pedestrian space, bringing with it difficulties in navigating the streets, especially for the elderly. 

Many among the elderly depend on their families for social interaction, stuck as they are in their homes. However, with almost all members of the family working to sustain the generally high cost of living in Malé, and each busy with their own lives, they are left to fend for themselves, usually alone in high-rise buildings, with the television switched on, or even left to care for children. This increases the feelings of social isolation and also leads to high depression and anxiety, which is certain to have been exacerbated during the COVID-19 pandemic and the resultant lockdowns. 

What can be done?

The solution is largely with the state. Policies have to be put in place, especially longer-term ones, in view of the fact that the Maldives will be an ageing population. 

One of the positive aspects of decentralisation may be the devolving of responsibility to act to atoll and island levels. City, atoll and island councils, as well as the women's development committee could become involved in integrating the elderly, similar to the ward committees in Malé, and other islands, during the 1970s and 1980s. 

The general public also needs to be made aware of the benefits of exercise and mental health. According to HIES 2019, 73 percent of the population aged 65 and above currently suffer from a chronic disease. This is a percentage that speaks to the need for attention and specialised approaches — solutions in terms of specialised health care facilities to treat lifestyle diseases, awareness programs, accessibility policies such as mandating for wheelchair access not just in buildings but in public transport, and more.

Literacy rates in Dhivehi among the current elderly population is high, although literacy in English is low. The elderly, stuck in their homes, unfamiliar with modern technology, may find it challenging to communicate with others, especially given that we are having to resort to technology to keep in touch. eServices should be accounting for this statistic and creating applications and solutions with assistive, and accessibility, services built in; accounting for visual and mobility, even motor, impairments — voice-over technology and other similar innovations could easily bridge the language and ability gulfs.

The COVID-19 pandemic has brought with it its own form of ageism – perhaps reflecting callously that someone over some imaginary line has ‘lived a full life’. The nation continues to be  immune to the possibilities life will have to offer for someone who is 65 or older — tantamount to systemic myopia given that the life expectancy in the Maldives is currently 87, meaning one is left with no recourse but to spend 27 years, stuck inside increasingly shrinking physical, and mental, space and isolated from the world.

The nation owes these senior representatives better, if not for the services that they have provided to society and the nation, for the fact that eventually every young citizen will also need to face this march of time. Everyone deserves to face this march with grace and human dignity.