Aging in South Asia
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6
COMMUNITY HEALTH CELL
326, V Main, I Block
Koramangala
Eangalore-560084 '
India
Aging in South Asia
K<
Ashish Bose • Walter Fernandes
Prayag Raj Sharma • Alfred de Souza
RafiquI Huda Chaudhury
Edited by
Alfred de Souza
Walter Fernandes
Aging in South Asia
Theoretical Issues and Policy Implications
Edited by
Alfred de Souza
Walter Fernandes
INDIAN SOCIAL INSTITUTE
New Delhi
Foreword
made possible with financial
The publication of this monograph was
Library of the Indian Social
assistance from the Fidel-Rosl Goetz
Institute.
© Indian Social Institute 1982
Published by:
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Social
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Printed by:
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The World Assembly on Aging in October 1982 will focus
the attention of the world on the situation of the aged in
industrialised and developing countries. The papers in this
monograph have emerged from the Asian Regional Confer
ence on Active Aging which was sponsored by UNFPA and
Opera Pia International. The Indian Social Institute was re
sponsible for selecting the delegates from South Asia and for
the presentation of their papers at the Conference in Manila
in January 1982. This Asian Regional Conference was envi
saged as a preparation for the NGO meeting in Vienna in
March 1982 at which delegates were to be chosen for the UN
Session in October. This monograph presents the version of
the papers which appeared in the special issue of Social
Action in January 1982. Though these papers present exten
sive census and research data on the aged, the concern is
primarily with their social, economic, cultural and political
significance. It will be noticed in the analysis that the situ
ation of the aged in India, Nepal and Bangladesh is not
necessarily worse than it is in industrialised countries; it is
certainly different. This difference cannot be understood apart
from the socio-economic and cultural factors which determine
the situation of the aged in the countries of South Asia.
Indian Social Institute
New Delhi
Alfred de Souza
Walter Fernandes
Foreword
The World Assembly on Aging in October 1982 will focus
the attention of the world on the situation of the aged in
industrialised and developing countries. The papers in this
monograph have emerged from the Asian Regional Confer
ence on Active Aging which was sponsored by UNFPA and
Opera Pia International. The Indian Social Institute was re
sponsible for selecting the delegates from South Asia and for
the presentation of their papers at the Conference in Manila
in January 1982. This Asian Regional Conference was envi
saged as a preparation for the NGO meeting in Vienna in
March 1982 at which delegates were to be chosen for the UN
Session in October. This monograph presents the version of
the papers which appeared in the special issue of Social
Action in January 1982. Though these papers present exten
sive census and research data on the aged, the concern is
primarily with their social, economic, cultural and political
significance. It will be noticed in the analysis that the situ
ation of the aged in India, Nepal and Bangladesh is not
necessarily worse than it is in industrialised countries; it is
certainly different. This difference cannot be understood apart
from the socio-economic and cultural factors which determine
the situation of the aged in the countries of South Asia.
Indian Social Institute
New Delhi
Alfred de Souza
Walter Fernandes
Contents
Foreword
Aging in South Asia as Marginalisation
in a Neo-Colonial Economy: An Introduction—
Walter Fernandes
2 Aspects of Aging in India—Ashish Bose
1
1
24
3
Old Age in Nepal: Some Preliminary Observations—
Prayag Raj Sharma
46
4
The Aged in Bangladesh—Rafiqul Huda Chaudhury
62
5
The Social Organisation of Aging among the
Urban Poor—Alfred de Souza
84
References
99
Aging in South Asia as Marginalisation in a
Neo-Colonial Economy: An Introduction
Walter Fernandes
This paper accepts the commonly given distinction between
physical and social aging but assumes that both the problem
of marginalisation of the aged and the definition of the above
concepts in South Asia are considerably different from what
the industrialised societies accept. In differentiating South
Asia from the industrialised nations we do not claim that the
five countries of the sub-continent, viz., Bangladesh, India,
Nepal, Pakistan and Sri Lanka can be treated as one unit in
every respect. These countries have similarities in their neo
colonial economy, in their social structure and in the status of
women- Besides, though the majority religions are different in
these countries, there is sufficient evidence to show that Bud
dhism, Christianity, Hinduism and Islam have had mutual in
fluence on each other and that the social structures of the
sub-continent are conditioned by this interaction.
However, differences are probably greater than similarities
both between these countries and within each country, though
they are more prominent in India, Pakistan and Sri Lanka
than in Bangladesh and Nepal- Because of their internal differ
ences, these countries have to search for a new identity that
can keep them united- This is seen both in the efforts of some
extremist elements to find unity based on a single religion
such as Islam, Buddhism or Hinduism, a single language
2
AGING IN SOUTH ASIA
such as Hindi, Urdu or Singhalese and by highlighting their
difference from the neighbouring countlies, especially India,
the biggest in the region (Brass 1975: 265).
Without forgetting these differences, this paper will con
centrate only on those aspects that are in common among
these countries in the marginalisation of the weaker sections
and situate the aged within this perspective- The economic
situation, the family and the other social structures need to be
studied for this purpose- After discussing the international
and national economic policies, we shall study their impact on
the aged, and pay special attention to the ‘low castes,’ the
tribals and women who are the most disadvantaged groups.
One major obstacle to any study on the aged is the paucity
of studies on the question in South Asia- Except for a study
on social welfare in Ceylon conducted 35 years ago (in which
the aged are mentioned) the paper presented at the Manila
Conference (January 1982) by Prof S.W.R. de A. Samarasinghe
seems to be the first study on the aged in Sri Lanka. The
same is true of Nepal and possibly of Bangladesh. As for
India and Pakistan, those few studies that exist are mostly on
the small minority of the urban middle class pensioners, and
others who have got some economic security (de Souza 1982).
Besides, most of the studies seem to assume that the concept
of marginalisation of the aged as developed in industrialised
societies can be applied also to South Asia. This concept is
based on retirement from a full-time job in an industrialised
society and does not seem to be fully applicable to South Asia
where about 90 per cent of the active population is in the
informal sector and lacks any social security and retirement
benefits.
Aging and status in the family
While accepting the distinction between physical and
social aging, we add that these concepts need to be modified
to suit the situation in the sub-continent. Physical aging, for
example, is conditioned by the status of nutrition and health
as well as housing and employment facilities in a country or a
social group within a country. 1 n the West the present trend
is to differentiate between the ‘young old’ i-e-, those below
75 and the ‘old old’ i-e-, those above 75 (Gallantin-Anderson
AGING IN SOUTH ASIA AS MARGINALISATION
3
1980). This distinction is necessitated both by the absolute
and the proportionate increase in the number of the aged in
the industrialised countries and by the longevity of life, which
is the result of better medical care, nutrition and security of
income.
In other words, in the rich as well as poor countries,
social aging does not necessarily coincide with physical aging,
but for different reasons- As mentioned above, in the indus
trialised nations, social aging coincides with retirement from
the active production process but physical aging as such may
begin much later. Consequently, the main preoccupation in
the West is with the integration of the aged in the main
stream of society once they retire from the industrial pro
duction process. Thus studies in the West speak about the
need of adapting the social, political and cultural life to the
needs of the aged who are becoming numerically important
but may not be having much political power (Berry 1980).
When it comes to South Asia and other poor countries,
social aging has to be interpreted in a different way. Apart
from economic aspects, one may need to introduce some cul
tural aspects that are common to most South Asian countries.
One such concept is that of change of role that forms part of
what Bose in the paper presented here, calls family cycle.
With their advancing age and the marriage of their children,
the parents play a new role in society and in the family. With
the arrival of the bahu (daughter-in-law) in the family, the
mother in the traditional society in India as well as most
other South Asian countries assumes the role of sas (motherin-law). This change of role involves a new status because of
the woman’s transition from her role of wife to that of the
trainer of the new daughter-in-law, i.e. socialise!’ and preser
ver of the family’s izzat (prestige) though some restrictions go
with this changed role (Vatuk 1980: 294).
What this means is that the aged continue to enjoy a high
status in the family and at times it may even be enhanced
with age. This seems to be one of the common features of
most countries in South Asia. Also the urban studies show
that the family still remains the main emotional as well as
social support of the aged and that their status in the family
remains more or less intact even after retirement which in
4
AGING IN SOUTH ASIA
volves sudden withdrawal from a full-time job and lowering
(and in some cases loss) of income. But in very few cases
does it lead to loss of status in the family, whatever its typeThe type of family itself may differ (Shah 1973: 69). It may not
always be possible to fit it in the bi-polar division of joint and
nuclear. But what is common to the South Asian countries is
that both from the point of view of economic and emotional
support, the family is essential for the agedIn that sense, the actual social behaviour in India seems to
be not fully in conformity with what the Hindu Scriptures
preach. The ancient Scriptures divide family life into four
stages and the final states are vanaprastha and sanyasa i-econtemplative life and withdrawal from active life. In fact,
ancient Scriptures describe the whole law of life as Varnashramadharina i-e-, the system in which the balance between the
castes is maintained and the four stages of human life are
properly observed (Prabhu 1958: 79-87).
Islam, Christianity, Buddhism and other religions too have
scriptural injunctions concerning various stages of life- But
there is little evidence to show that these rules were ever ad
hered to in their entirety except perhaps by some Brahminic
groups. However, religion, though not the entirety of its rules,
seems to play an important role in the lives of the marginal
ised sections, especially women and the aged- Often popular
religious practices seem to help them to get over the pressures
of daily life (Jacobson and Wadley 1977).
To restrict ourselves to the aged, all the studies both of the
urban pensioners and those in the informal sector show that
religion plays an important role in coping with the problems
connected with old age- In Bombay (Desai and Naik n-d: 83)
139 out of 600 respondents i-e-, over 23% mentioned religious
rituals as the main mode of spending their time. The Luck
now study (Soodan 1975: 130) indicated that about 55% of
the respondents used their spare time to visit temples or
mosques- Similarly, the study of the Delhi informal sector
(de Souza 1982) shows that nearly 20% of the respondents
turned to religion as a way of coping with leisureEconomic situation
However, as we shall see later, both the role of religion
AGING IN SOUTH ASIA AS MARGINALISATION
5
and the status in the family are conditioned by the economic
situation of the aged- This is true both at the international
and the national levels- To begin with the international order
the difference in the economic system is one of the main
reasons why it is difficult to transfer the concept of marginal
isation of the aged to South Asia in its totality- The sub-conti
nent has only a few elements in common with the rich
countriesTo begin with the aspects that are in common, the prob
lem of numbers will probably be felt also in the South Asian
countries at the beginning of the 21st century. The difference
between the age-groups becomes important in the industrial
ised countries where retirement is marginalisation because of
the experience of being all of a sudden without a job and
having less money to spend- In Europe the percentage of the
aged i-e- those above 65 years of age, has gone up from 8-9%
in 1950 to 9-7% in 1960 and 11-0% in 1970- This proportion
is expected to increase further because the share of the youn
ger population has been falling and the post-war boom babies
will begin to age in early 21st century (Bourgeois-Pichat 1981:
36-38). A similar situation is noticeable also in North America
(Davis and van den Ocver 1981: 17).
The South Asian countries on the contrary show an in
crease in the absolute numbers of the aged but their propor
tion to the total population either keeps decreasing or shows
only a marginal increase as the tables in Choudhury’s and
Bose’s papers indicate- The main reason for this is the suc
cess of the disease prevention policies of the 1950s when
efforts were made to reduce mortality. Malaria, cholera,
tuberculosis and other diseases which accounted for more
than 50% of the deaths were brought under control- Simul
taneously, efforts were made to reduce fertility and infant
mortality.
Only Sri Lanka seems to have succeeded in reducing in
fant mortality as well as fertility and, as a result, its popula
tion pyramid is considerably different from that of the other
countries. Health services and many social security measures
seem to have been instrumental in this demographic change
(World Bank 1980: 35)- As a result, life expectancy there ex
ceeds 70 years at birth and is close to that of the West-
6
AGING IN SOUTH ASIA
Life expectancy which was around 35 years at indepen
dence in 1947 in the other countries, is today a little over 50
years- However, it does not mean that people die young- Low
life expentancy is caused by the fact that in India and Bangla
desh 40% of all deaths in a year are those of children below
the age of five- Once this period is crossed, and in the case
of women once the reproductive age is over, life expectancy
is very high (Chen, Huq and D'Souza 1981: 55). In 1974, in
fant mortality in India was as high as 120 per thousand in the
rural areas and 80 in urban areas- If we speak in terms of age
specific mortality i.e-, number of deaths in a year in any speci
fied age-group per 1,000 persons, in 1969 it was 64-1 for the
0-4 age-group and after that it was below 10 till the age of 45
and exceeded the national average of 19-1 per thousand only
after 55 years of age when it became 24-4, went on to 41-4 at
60 and 56-2 at 65 and 122-2 at 70 (Census Commissioner 1972:
10). In other words, age-specific mortality of the 0-4 group
was higher than any other group expect the 70+age groupConsequently, once the childhood period is crossed, life ex
pectancy of the adults is not much lower than that in the
West (Djurfeldt and Lindberg 1980: 48-49).
Besides, existing data would indicate that mortality has
decreased also among the 60+ group- Their number increased
from 19-9 million to 23-6 million in 1961 and 92 million in
1971 ie-? an increase of over 65% in 20 years, though popula
tion increase between 1891-1910 (to which this generation
belongs) was marginal and was negative during the following
two decades (Census Commissioner 1972)International economic order
This brings us to the economic constraints caused by the
change in the demographic picture- Though infant mortality
has come down considerably, it still remains high- In fact, one
study (Khan, Prasad and Majumdar 1980: 66) shows that pre
cisely because of the high infant mortality, women refuse to
accept terminal methods of family planning in India- As a
result, change in fertility has been only marginal in the rural
areasOne major implication of this change in the demographic
picture is that the number of dependants has increased.■ In
AGING IN SOUTH ASIA AS MARGINALISATION
7
that particular constraint, South Asia is not different from the
industrialised countries- There too, because of increased longe
vity and decline in infant mortality, the number of dependants
is high. Tn Europe, for example, in 1970 children below 18
years of age and persons above 65 years formed over 40% of
the population (Bourgeois-Pichat 1981: 37). The number of
dependants was slightly higher in South AsiaHowever, there is a major difference between the rich
countries and South Asia. It is based on their economic sys
tem. The industrialised countries that developed in the 19th
century because of the existence of colonies still continue their
dominant position in the world economy. 6% of the world’s
population living in North America consumes 40% of its re
sources and 25% of the world’s population living in the rich
countries known as the North gets an unfair share of the world
resources. To give but one example, in 1978 when the world’s
population was estimated at 4-4 billion, the world’s gross GNP
was estimated at 88-5 trillion. This gives a world per capita
income of 82,000- However, because of the inequalities of the
neo-colonial international economic order,
Such an average is little more than a statistical artifact. Of the
88.5 trillion World GNP in 1978, roughly 87 trillion, that is, more
than 80 per cent of the total, was generated in the North, which
contains just over 25 per cent of the world’s population. The total
GNPof the South was 81.5 trillion, shared by almost three-fourths
of the world’s inhabitants. Income per capita, as a result, well
exceeded 86,000 in the North but was less than 8500 in the South
(Demeny 1981: 298).
Moreover, this consumption is possible because of the
poverty of the poor countries- The colonised countries
supplied the capital for the industrial development of
the colonial powers and markets for their finished
products when the Third World was formed of political
colonies- Today the poor countries supply the raw mate
rials whose prices do not rise in the same way as the
finished products and in many cases keep falling- Between
1951 and 1961 the price of coffee, cardamom and cocoa de
clined by between 20 per cent and 50 per cent and that of tea
8
AGING IN SOUTH ASIA
and sugar increased only marginally. During the following
decade the prices of these products registered a marginal in
crease (UPASI 1974: 560-567) and have been unstable in the
1970s. In the same two decades, prices in India rose by 129%,
in the neighbouring countries by about 200% and the prices
of finished products imported from the West by over 400%
(Government of India 1973: 304, 308)- However, despite the
Kennedy Round, Nixon Round, five sessons of UNCTAD, the
Cancun negotiations, other North-South dialogues and the
pressure coming from the ‘Group of 77,’ there seems to be
very litttle possibility of any change coming into the world
economic order.
It is important to bear this in mind while discussing the
question of the financial benefits and social security of the
aged. In the West, the main problem of the aged is their
social marginalisation after their retirement and the need of
re-integrating them in the political and cultural life of the
country and helping them get over loneliness caused by the
loosening of the parent-child bond and the consequent dis
tance between generations (Davis and van den Oever 1981: 5).
In the South Asian and other Third World countries it is a
question of the economic survival of the family as a unitBecause of the abundance of resources, the industrialised
nations can afford the type of social security which is beyond
the reach of the poor countries. There certainly is going to be a
problem in the West with the increasing number of the aged,
because a relatively small working force will have to maintain
a much bigger group of dependants through taxes meant for
social security- In USA, for example, viewed in the form of
taxes and other provisions for social security, the percentage
of old-age support burden on the 25-64 group had risen from
10-9% of all earned income in 1970 to 15-5% in 1978 and is
expected to rise further (ibid: 15)
This is the situation of the consumer society and an indus
trial economy. In Europe urbanisation has reached 70% and
is expected to reach about 80% by the year 2000 (BourgeoisPichat 1981: 30). This trend can increase the sense of isolation
of the aged and can create more demands for their integration
into the cultural and political life of the country- Buttheir
problem remains primarily social and psychological isolation
AGING IN SOUTH ASIA AS MARGINALISATION
9
and only secondarily economic survival. Income-wise, the
situation in USA seemed to be somewhat favourable to the
aged- In 1978, 50.9% of the aged depended on pensions and
social security and only 0-8% of the 65+ group on alimony
or support from their children. Besides, though the gross in
come of the 65+ group was smaller, on an average their per
capita income seemed to be higher than that of the 25-44 age
group because the latter had to support more dependants and
a bigger household than the former (Davis and van den
Oever 1981: 9-11).
One cannot speak of the social and psychological isolation
as the main problem of the aged in South Asia and other
Third World countries that account for nearly 75% of the
world’s population but less than 25% of its wealth. The result
of the neo-colonial economy is that the poor countries are
marginalised within the world scene and groups like the aged
feel primarily the economic problem of survival and much
less of emotional support because family ties still remain
strong. By and large, the homes for the aged are only for the
destitute and the majority of the middle class does not like to
send their parents there. However, with urbanisation and
migration, a few programmes are being initiated for the aged
from the upper and middle classes. But they are more an ex
ception than the ruleNational situation
However, reforming the international economic order alone
is not going to change the situation in the poor countries, be
cause what is true at the international level is equally true of
the national scene in this sub-continent. In South Asia, the
top 5% of the population controls 22% of the national income
while the share of the bottom 20% is less than 6% (ILO 1979:
14-15). Inequality in the ownership of assets is worse than that
of distribution of income. In India in 1972 the bottom 20%
owned less than 2% of its assets while the top 5% owned
nearly 50%. Landlessness is a major cause of poverty and in
equality in its distribution is glaring in South Asia- According
to the World Bank (.1980: 41-42), it is estimated that 53% of
rural households in Bangladesh, 40% in India, 86% in Pakistan
and a similar number in Sri Lanka and Nepal were landless.
10
AGING IN SOUTH ASIA
Though India is the world's tenth most industrialised nation,
the 1981 census (Census Commissoner 1981) estimates that 48%
of the country's population lives below the poverty (i-e., sub
sistence) line as against about 40% in 1961 (Dandekar and
Rath 1971: 18-21). The figures are estimated to be similar also
in the remaining South Asian countries (ILO 1979).
The problem of distribution of assets and income is closely
linked to malnutrition, poor health and mortality. In South
Asia, the bottom 20% have to spend about 85% of their in
come on food alone and yet they remain malnourished.
Measured by the norms set by the Indian Council of Medical
Research (ICMR and ICSSR 1981: 37-40), over 60% of the
Indian population cannot afford a nutritionally balanced dietMalnutrition is particularly prevalent among children in the
0-6 age group. It is estimated that over 40% of all children of
this age-group suffer from various degress of malnutrition.
We have already mentioned the high rate of infant mortality
in the sub-continent. Majority of these deaths are attributed
to malnutrition (Fonseca 1982).
However, the situation is not identical in all classes. While
infant mortality is not much higher than that in the West
among the upper classes, a study of women in the Delhi slums
(Singh 1977: 244) showed that over 45% of all children born
alive among the construction workers died before the age of
five- In other words, high mortality, malnutrition and pov
erty both in the Third World as a whole and of the weaker
sections within each poor country, are not an accident but an
essential feature of the present economic system which is
geared to the needs of a few rich countries at the international
level and of a few dominant classes within individual countries.
The inequalities are much more glaring in the poor countries
than in the industrialised nations because of any lack of
social security- In that sense, there is a qualitative difference
between the poverty of the rich and poor countries- As a
result, the marginalisation of the aged is not identical in the
industrialised and Third World nationsIn South Asia, the situation of the aged differs according
to the class they belong to. This is true even of the pensioners
and to a much greater extent of those belonging to the infor
mal sector. As mentioned above, both the role of religion and
AGING IN SOUTH ASIA AS MARGINALISATION
1 1
the status of the aged in the family differs according to their
economic class.
To begin with religion, the Bombay study showed that it
was one of the ways of spending free time- 139 of the 600
aged said that they spent much of their time in prayer and
other religious activities- Most of them belonged to the poorer
sections like retired primary teachers whose pension was very
low and could not afford any other mode of spending their
time- 184 respondents spent time reading newspapers, more
than half of them former government officers whose pension
is higher than that of the other categories. Almost all those
who spent their time at the club belonged to the group of for
mer officers (Desai and Naik n-d.: 83). Also the Lucknow and
Delhi pensioners’ studies confirm this finding while in the
Delhi informal sector (de Souza 1982) over 20";, of the aged
among the poor found solace in religionOne cannot conclude from this that only the poor find
solace in religion to cope with loneliness- There is enough
evidence to show that all classes have recourse to spiritual
activities in their old age- What these data show is that the
upper classes have got many more ways of spending their free
time, while many aged persons belonging to the weaker sec
tions have to have recourse to religious practices not merely
in order to find solace from loneliness but even to make use
of their spare time, since they cannot afford any other diver
sion.
Similarly, the health status of the aged is conditioned by
their economic situation- The Bombay study (Desai and
Naik n-d.: 48) showed that among the higher level government
officers, only 2-5% suffered from major illness before retire
ment and 5% from minor illness, but 5% retired voluntarily
for health reasons before they reached the age of 58- Among
the low income teachers on the contrary, 5% suffered from
major illnesses and 10% minor illnesses- But only 3% retired
voluntarily, presumably because it was impossible for them to
continue working- The others continued working despite their
ailments since they could not afford to retireAlso medical care after retirement shows a similar differ
ence- Only thirteen out of 439 respondents went to hospital
when sick, seven of them former government officers. The
12
AGING IN SOUTH ASIA
remaining former officers had someone at home to look after
them. The figures show that a much bigger number of those
belonging to the lower income sections needed to be hospital
ised, but only six of them went there since they could not
afford the high expenses involved (ibid: 48). That is where
close family ties were a great help. What is said of Bombay
is equally true of the other cities like Lucknow and DelhiHowever, all these persons belong to the organised sector
and have got the minimum economic security required. Even
among these groups, a relatively large number had to continue
working since many of them, especially in the low-income
groups, continued to be the main income earners of the family
or their pension was not sufficient to maintain them (Soodan
1975: 49). Worker participation rate is over 55% in the urban
areas ‘in spite of the fact that they house the bulk of the re
tired personnel from Government and other concerns which
offer pensionary and other old age securities and benefits and
where the practice of taking out insurance policies against old
age must also be comparatively high’ (Mitra 1978: 599).
The situation changes completely when one is dealing with
the informal sector. Those working in this sector lack even the
minimum ecnomic security of a pension available to those
retiring from the organised sector which employs less than
10% of the working force. The 1971 figures show that 77-4%
of males in the rural areas, belonging to the 60+age group
and 55.3% in the urban areas were still in the working forceAmong women, the rate was 11.3% and 6-4% respectively
(Bose 1978: 396).
An overwhelming proportion of workers is in the rural
areas and the rest in the urban informal sector- Even when
they are employed, these groups are not assured a regular liv
ing income and have to think in terms of subsistence. Asa
result, economic inadequacy puts a strain on the resources of
the bread winners to provide for their dependants. The aged
parents may be the worst sufferers since the breadwinner
would think first in terms of providing for his children and
only after that for the parents (Delhi School of Social Work
1977). Because of this economic stress, the old among the
poor have to keep on working for as long as they can, for
bare survival (de Souza 1982: 6).
AGING IN SOUTH ASIA AS MARGINALISATION
13
The situation gets worse in the rural areas even compared
to the urban informal sector, as both Sharma and Bose have
pointed out in the papers presented here. What is called pro
gress and development seems to have led to the deterioration
of the situation of these categories. As Sharma says about
Nepal, before the political changes of 1951 and the later
attempts at industrialisation, the poorer people of Nepal had
been able to make their livelihood by selling their services to
the landowning high castes in a bilateral patron-client ex
change system. But this arrangement is fast disappearmg from
practice in the villages of Nepal now a days and the rural poor
are beginning to migrate to the urban slums.
In other words, for those few who can afford to retire,
social aging is a sudden traumatic experience. But it also con
tains some security in the form of pension and provident
fund. For the rural and urban poor working in the informal
sector, employment itself may be a game of survival and there
is very little possibility of saving for the future since, as men
tioned above, the bottom 20% living below the poverty line
have to spend 85% of their income on food alone. Conse
quently, they have to remain in the working force till they are
physically worn out and are unable to work any more- After
this, they die of old age which may be a ‘euphemism for
death due to starvation’ (Djurfeldt and Lindberg 1980: 94).
This may be true also of the urban poor working in the in
formal sector. As de Souza shows in the paper presented here,
as many as 82.1% of the aged among the poor who worked
did so for maintenance and survival, not in order to have some
extra comforts as most middle class pensioners did. More
over, other studies (Matthews 1981: 13-14) have shown that
most diseases affecting people in the informal or rural sectors
are what can be called “deficiency illnesses” caused by poor
hygienic conditions, lack of drainage in the slums, malnutri
tion and absence of good health services- This was found to be
much more true about the aged whose physical resistance to
diseases diminished with age- Moreover, given the cultural
distance between the doctors and the patients belonging to the
poorer sections, particularly the aged, and the consequent
near-snobbish attitude of doctors who belong by and large to
the upper classes, the poor, especially the aged, go to the dis
14
AGING IN SOUTH ASUV
pensary only when it is absolutely necessary (Matthews 1979:
139). Besides, as de Souza points out in his paper, the aged
even among the urban poor, go to the doctor only till the
symptoms of their disease disappear not till they arc cured,
because of the high cost of health services, poor transport
facilities, the difficulties of movement connected with old age
and the possibility of losing a day's wage since going to the
dispensary is a long and tedious process. As a result, the
health status of the aged is affected by their ecc-nor Tc condition
and by® the fact that though the urban inform. ! and the rural
sectors form an important segment of the country’ conomy,
most policies and services are geared to the needs of the
educated middle and upper urban and rural rich classesDevelopment policies
All countries of South Asia have a few social security
schemes for the destitute- Sri Lanka seems to have had the
most extensive type of schemes, till the change of economic
policies by the present government- Some states in India have
old age pension schemes for the destitute- But as can be seen
from the paper of Bose in this book, most of them are defec
tive.
Moreover, the economic policies of the government often
result in the marginalisation of the weaker sections- We have
seen how the loosening of the traditional master-client ties
has worked against the poor- One does not argue, however,
that the traditional ties were just and could be accepted by
those standing for human rights, since the relations did not
differ much from the feudal lord-serf bonds- However,
industrialisation has resulted in the loosening of these rela
tions without anything to replace the minimum material secu
rity found in the traditional unjust relations. Thus the change
has led to a worsening of the former servant’s material status
without any addition to his social standingMany studies have shown that this worsening of the situa
tion is probably the direct result of the policy of what is called
modernisation. It was taken for granted that transfer of (often
outdated) technologies from the rich to the poor countries
would automatically lead to progress- It was forgotten that
these technologies have got a definite history and that they
AGING IN SOUTH ASIA AS MARGINALISATION
15
developed within a colonial context (Fernandes 1980: xvi).
When these technologies considered more efficient are
introduced, ordinarily they result in the weakening and even
destruction of age-old knowledge and resources on which the
weaker sections have survived for centuries (Shiva and
Bandyopadhyay 1981: 119-121). This is the result of the eco
nomic policy that thought of modernisation as solution to the
problem of underdevelopment. What was forgotten was that
introduction of such technology without changing either the
international economic order or the ownership pattern within
the country would in fact result in the strengthening of those
who were already strong (Kurien 1967: 81).
Other studies show that also the remaining South Asian
countries that have attempted the Green Revolution or similar
policies have a similar story to tell. To take but one example,
In Bangladesh between 1963 and 1974 there was a five-fold increase
in the proportion of the population considered “extremely poor,”
that is, those with a maximum calorie intake of only 80 per cent of
the calculated minimum. In Sri Lanka, while rice continued to
account for 70 per cent of the poorest group’s expenditure, its actual
per head consumption fell drastically during the 1960s (ILO
1979: 9).
One consequence of these policies is increase in the extent
of landlessness which we have already mentioned and in the
number of uneconomic small and marginal holdings while
land distribution continues to be unequal. When one studies
these figures one can understand why the proportion of those
living below the poverty line has increased from around 40%
in 1961 to 48% in 1981.
This rural pauperisation seems to be an outcome of the in
dustrial policy of the governments. Concentration of resources
in a few hands seems to be the rule rather than the exception
inmost of these countries. Pakistan has most of its capital
and land in the hands of twenty big houses. In India, twenty
two business houses control over 50% of its industry through
interlocking of directorships, and 75 big houses keep increas
ing their share of assets and income while that of the smaller
houses keeps diminishing- Added to this is the hold of foreign
companies and the capital outflow as a result of royalty and
16
AGING IN SOUTH ASIA
technical Tees. Statistics show that in India and most South
Asian countries the outflow of foreign capital is 70% more
than its inflow (Sau 1981: 39-56). What this means is that both
in the urban and rural areas, with a small capital, a small
percentage of the population is able to control a very big
share of the assets and exercise power over the socio-econo
mic systemWeaker sections
As far as the aged are concerned, concentration of wealth
in a few hands and the consequent pauperisation of the weaker
sections lead to further marginalisation of the dependent sec
tions and further pressure to work till one's energies are ex
hausted since the real income of the poorer sections keeps
diminishing. Sharma mentions in his paper that in Nepal the
poorer sections who are displaced as a result of the capital
isation of rural economy are forced to migrate to the urban
areas within the country or to other countries, leaving behind
their older members to look after the women and the children
in the family. This is creating a situation where the elderly
are feeling more economically burdened and isolated from
their children who are unable to visit them often or call their
parents to live with them.
Apart from the additional financial and emotional strain on
the aged, the pauperisation of the rural areas also involves
the strain of migration and status-change in the case of the
weaker sections. Tn the Delhi informal sector study presented
here, de Souza indicates that a relatively large number of aged
persons in the informal sector depend on their chidren even
for their survival and that a smaller number than the other
classes have the final say in all decisions in the family. In other
words, though by and large old age leads to enhanced status
in South Asia, it is conditioned by their economic situation.
As Chaudhury says in his paper included here, parental con
trol over land which is the most important means of produc
tion in the sub-continent, ensures the aged parents’ participa
tion in decision-making. ‘However, this security is unavail
able to those unfortunate landless households who constitute
the majority.’
AGING IN SOUTH ASIA AS MARGINALISATION
17
Caste and sex discrimination
While the economic policies of the Government perpetuate
inequalities and the international economic order makes it
impossible for the countries of the ‘South’ to make progress,
within the countries of South Asia, the economic inequalities
are to a great extent identified with social inequalities. In
other words, those who have a socially low status are also
economically exploited. The governments’ policies of industri
alisation geared to the production of luxury goods and the
favoured treatment meted out to the capitalist landowners in
the rural areas, only create what are called the push and pull
effect that drives the deprived sections towards the towns
leaving their aged parents behind- In the cities themselves,
they can only enter the low-income informal sector.
What matters, as far as our study is concerned, is that the
weaker sections among the urban as well as the rural poor are
also predominantly, though not exclusively,-persons belonging
to what are called low castes. Studies in all the countries of
South Asia have confirmed the fact that the ‘low castes’ are
victims of what are called cumulative inequalities. These are
the ones who are affected by concentration of landed wealth
in a few hands-While 48% of the general population in India
live below the poverty line, among the low castes and tribals
their proportion is over 80%. More than 90% of the bonded
labourers in India are estimated to belong to the same group
(Marla 1981: 44).
When it comes to the aged, these are the groups that are
the most affected both by migration and by the fact that most
of them belong to the informal sector. As a result, they do
not have any benefits of retirement and lack social security.
These are the persons who belong to what Djurfeldt and Lind
berg have called above, the category that is euphemistically
said to die of old age and may in reality be dying of starva
tionThat the weaker sections belonging to what are called
‘low castes’ are the worst affected, is clear from most studies
of C'ties- Of equal importance is the fact that as many as 90%
of these groups migrated to the urban areas in search of jobs
and get integrated into the informal sector. They are doubly
disadvantaged.
18
AGING IN SOUTH ASIA
In other words, when we talk about rural-urban migration in India,
the chances are high that the migrant will be from a low caste or
an untouchable one, and will end up living in a slum or squatter
settlement when he/she reaches the city (Singh 1978: 329).
In fact, studies (Saxena 1977: 157) have shown that the
‘low castes’ form over 60% of emigrants from the rural areas
to the urban slums. While the upper castes tend to migrate
to nearby towns since they still have landed interests in the
village, the ‘low castes’ move to greater distances. This
creates a double distance from their aged parents. On the
one hand, the parents have to be left behind without the
possibility of regular contacts- On the other, the children
who migrate to towns do not find it easy to maintain them
because within the urban areas, their opportunities are limited
to the lowest-level unskilled jobs. They are forced to work
either as peons in offices, as construction workers or take up
other jobs in the informal sector that do not require skills,
bring very low income and do not provide for retirement
benefits. By and large, the white collar occupations in the
cities are predominantly in the hands of the upper castes
while the ‘lower castes’ are engaged primarily in manual
work (Desai 1981:68). As a result, the situation of their aged
parents may deteriorate.
Other studies have shown that poverty among the ‘low
castes’ and neglect of areas where they are a numerically
strong section, the Green Revolution which has led to me
chanisation and loss of jobs of the unskilled workers most of
whom belong to the low castes, hope of horizontal mobility
even within the informal sector have combined to provide the
pull effect for the young generations of the weaker sections
to move out to the cities leaving their aged parents behind
without any security. Once they reached the cities, they had
to keep working even in their old age for survival. Thus both
in the urban and rural areas, the worker participation rate
(WPR) among the ‘low castes’ is much higher than the rest
of the population. In 1971, for example, WPR among the
weaker sections was as high as 90% for males and over 50%
for females of all ages and was as high as 47% for the 60 +
age group and 20% for the 5-14 age group (Rayappa and
AGING IN SOUTH ASIA AS MARGINALISATION
19
Grover 1980:51-53). In other words, these groups are mal
nourished in their infancy, begin to work in their childhood,
are underpaid and lack job security in their adulthood and
can not think of retirement in their old age.
This situation of cumulative inequality is further intensi
fied when it comes to women- The low status of women seems
to be a common feature of all the South Asian countries- The
nuptiality patterns in all the South Asian countries and the
extent of widowed women in these countries (D’ Souza 1979:
350-354) shows a sex bias against women. Among the aged
one finds a much bigger number of single (widowed) women
than men, the reason being the lower age of women at
marriage- The Delhi School of Social Work study found
that the average age of men at marriage was 15-6 years higher
than that of women- That the situation is similar in Bangla
desh is clear from the data provided by Chaudhury in this
book. As a result, a much larger number of aged women than
men arc dependent on their children. This often results in the
deterioration of their social status- This situation of depen
dence in their old age has to be viewed within the context of
the low status of women. Indications are found in the extent
of malnourishment among girls, low educational standards,
limited job opportunities in the organised and informal
sectors, all of which make them dependent both in their active
life and old ageTo begin with children’s health, a study in Bangladesh
showed that ‘14.4% of female children were classified as
severely malnourished incomparison with only 5 per cent of
males. The percentage of moderately malnourished girls (59-6
per cent) also exceeded that of boys (54-8 per cent)’ (Chen,
Huq and D’Souza 1981:59)- Mortality was 63.9% for females
and 52-6% for males in the 0-11 months group, 33-9 and
23-3 in the 1-4 age groups, though neo-natal mortality among
females in Bangladesh was lower (67.6) than that among
males (78-2)- The reason for higher female mortality in the
0-4 age group seems to be less attention paid to the health
and nutrition of girls after birth- One indication was found
in the fact that the infection rate was similar for both sexes
but hospitalisation was ‘66 per cent more frequent for male
children than female children’ thus showing the discrimina-
10
AGING IN SOUTH ASIA
tory attitude of parents (ibid: 57,65).
Other studies in Bangladesh showed conditioning of aged
women to be dependent first on their sons and if they were not
available, on their husband’s family (Chen and Ghuznavi
1980: 148). A similar situation is noticed in India- To begin
with literacy, one finds in it the very embodiment of cumula
tive inequality. In 1971, literacy among upper caste urban
women was over 60% in the middle class, over 50% and
among males over 80%. But among the low castes and tribals
it was below 40% for men and below 20% for women. In the
rural areas, it was about 20% for ‘low caste’ and tribal men
and about 5% for women, but it was much higher among the
other groups (Social Welfare 1978:1 17-121; Yojana 1978i38,
40). Chaudhury’s paper presented here indicates a similar
situation in Bangladesh.
The consequences of the neglect of women's education are
felt in the types of jobs they hold and even in the WPR which
is low in most countries of South Asia- In Pakistan, the
National Impact Survey 1968-69 and the National Fertility
Survey 1975 showed low WPR among women in general but
it was much higher among the poorer sections. Besides,
discrimination was noticed in the types of jobs they held40% of all employed rural women were farm workers belong
ing to the poorest classes and 60% of all employed urban
women were in the informal sector as tailors, weavers or
domestic helpers- In the rural areas they are mostly agricul
tural labourers who do strenuous work such as paddy plant
ing which requires long hours of bending in wet fields and
water and carrying mud and walking long distances (Shah
and Shah 1980: 97-110). In other words, the avenues open to
women are limited- Since they cannot afford outside help to
look after their children, they have to limit their choice of
work to agricultural occupations in their neighbourhood
where they can take their children along with them—something
that is not easy in urban occupations (Gulati 1975:38-40).
This fact should be seen within the lower income earning
capacity of women, lower skills and loss of status at the
death of their husbands- We have already mentioned that
WPR is higher among the poorer sections- But by and large,
while even in the informal sector a proportionately larger
AGING IN SOUTH ASIA AS MARGINALISATION
21
number of men arc engaged in semi-skilled jobs such as
masonry, women are engaged mostly in unskilled jobs.
Moreover, while men give only part of their income for
domestic needs, poorer women use all their income for the
family. As a result,
to an extent, the question of withdrawing from the labour market
is not realistic for women in low income groups because their
earnings are used not for ‘extras’ but to meet the basic needs of
the family—food, clothing, health (de Souza 1979:21).
In other words, the difficulty of not being able to retire in
oid age is only a symptom of a deeper problem of discrimina
tion against the weaker sections in society and the fact that
women belong to the lowest rung of the hierarchical ladder.
The socio-economic system is organised in such a way as to
keep women dependent from the beginning. They lose their
social status at the death of their husband. This arrangement
only increases their situation of dependence in old age as all
the studies mentioned above have shownConclusion
This paper has tried to study the situation of the aged
within the socio-cultural and economic context. One conclu
sion that emerges from the data available is that the aged
cannot be taken as a group apart independently of the larger
socio-political context. One cannot deny that they are a
marginalised group. But their marginalisation in South Asia
is not identical to that of their counterparts in the industrial
ised nationsMost studies have concentrated only on the pensioners
who form a small minority in South Asia. Even among them,
the low-income groups experience a great amount of
insecurity- But the situation changes for the worse as one goes
down the socio-economic ladder, especially to the groups that
are victims of cumulative injustice- The situation of these
weaker sections seems to have deteriorated because of the
‘modernisation’ policies of the South Asian governments
that took the Western industrial system as their model and
thus played a role in integrating their economies in a subordi-
c'■■■■
■■’-T’-ict'.l
47/1. tFiisi i ;coi l; Marks Read,
Ban.’aloro r”.»001.
22
AGING IN SOUTH ASIA
inatc position within the international order- Within these
countries themselves, the upper classes have got most of the
benefits of development, the middle classes have shared in
some of them and the weaker sections have become poorer.
What seems also clear is that the situation of the weaker
section is going to deteriorate further unless corrective
measures are taken to change the course- Within the next two
or three decades the proportion of the aged to the total popu
lation will begin to rise and, as a result, the number of depen
dants will increase- Unless the policies arc changed to suit
the needs of the weaker sections, the poor will find it difficult
to cater to the needs of all their dependants and may end up
by favouring their children over the aged- in fact, indications
are that this is happening already and that the aged are forced
to keep working as long as their energies permit and then die
of semi-starvation or illnesses connected with itIn this context, speaking of the social, cultural and political
integration of the aged becomes meaningless in the South
Asian countries that still have a neo-colonial economy and
get an unjustly small share of the world’s resources and
incomes. The rich countries are not prepared to work towards
a new international economic order- Within the poor countries
themselves, a few powerful sections appropriate most benefits
of development and are not prepared to change the socio
economic system in favour of the poor- What is more, the
prosperity of the few rich depends on the poverty of the many
poor- In other words, some (countries or groups within a
country) cannot be rich unless others (countries or groups)
are poorBy saying this, one does not state that no policy need be
formulated for the aged- Lack of any such policy would in
fact further marginalise the older persons belonging to the
weaker sections. In this policy formulation, the needs of the
informal sector and of the hitherto neglected sections have to
get priority- If a policy for the aged is formulated without
taking the unjust economic order into consideration, then a
few aged persons belonging to the privileged classes will prob
ably get all the benefits and those from the weaker sections
will suffer still more harmIn other words, any discussion on the aged, to be meaning
AGING IN SOUTH ASIA AS MARGINALISATION
23
ful, has to begin by demanding a change in the international
unjust economic order and in the national socio-economic
polices to favour the weaker sections who are today the
victims of cumulative injustice and inequality- Only then will
the aged be able to look forward to a secure life with human
dignity. This is not a question of social welfare measures for
a few aged persons but of the human right of three fourths of
humanity to live a decent life-
Aspects of Aging in India
Ashish Bose
Any meaningful study of the elderly population must take
into account at least two sets of factors: (a) demographic,
economic and social factors which describe the physical well
being of the aged, and (b) the socio-psychological, moral and
spiritual factors which influence the quality of life of the older
age groups much more than of any other age group.
The object of this paper is to present briefly, on the basis
of the limited data available on the aged in India and the even
more limited studies on the subject, a profile of the aged and
highlight some critical issues. While doing so, we shall make
international comparisons wherever necessary and also keep
in mind the broader Asian perspective.
Role of the elderly
In a country like India where about 59 per cent of the
total population is below 25 years and only a little over 3 per
cent of the population is over 65 years, the problems of chil
dren and youth and consequently, problems of nutrition,
health, education and employment, dominate the scene. And
yet this statistical picture should not mislead one to believe that
the aged in India play only a marginal role. On the contrary,
in an average Indian household, it is usually the oldest male
member of the family who is the head of the household and
his decisions are rarely questioned. He owns the property, he
decides where and how to educate his children; he gets his
children married when they grow; in fact, he brings under his
The author was ably assisted by Mr. J.M. Raypudi and Miss
Sudakshina Ghosh in statistical and documentation work involved in
preparing this paper.
ASPECTS OF AGING IN INDIA
25
umbrella his entire family, regardless of the age of the indi
vidual members and considers it his bounden duty to direct,
advise and guide them till the moment of his death.
The spread of education, industrialisation, urbanisation
and so-called modernisation, has no doubt brought about
several cracks in this monolithic domination of the oldest
member of the household but still it will be a fairly safe
observation that the Indian family and society continue to be
dominated by the elderly. At the national level also, the poli
tical scene has long been dominated by the elderly and the
role of gerontocracy in Indian politics is a subject of frequent
criticism. In short, the influence of the elderly is far out of
proportion to their numbers, in almost every walk of life in
India—social, economic and political. But such a statement
should not mislead one to conclude that the elderly in India
are not subject to hardships and misery, physical as well as
psychological, as in other parts of the world, both developed
and developing.
Demographically speaking, the problem of aging is most
acute in Europe where the proportion of 65+ population in
creased from 8-7 per cent in 1950 to 12-3 per cent in 1975,
whereas in South Asia, the proportion went down from 4-1
per cent to 3-0 per cent- This is because of declining mortality
with very little decline in fertility. But as fertility levels go
down in South Asia, the proportion of the aged will increase.
In fact, the Indian data show a trend of slight increase with a
higher proportion of the aged (60+) in rural areas.
Data on expectation of life for a number of countries
bring out the sharp contrasts in the Asian situation (except
for Japan, Singapore and Sri Lanka). Female life expectancy
is higher than that of males in Asian countries except India.
In the age group 65+, however, the female life expectancy in
India is slightly higher than that of males- The sharp contrast
between the developed and developing countries is mainly
because of the much higher infant and child mortality (and
also overall mortality) in the developing countries.
Concept of family cycle
Among the significant advances in Demography in recent
years, we must mention the emergence of the concept of
26
AGING IN SOUTH ASIA
family cycle and Family Demography- The basic idea under
lying this concept is that families are affected by events such
as marriage, birth of children, launching of children into their
marriages, the ‘post-children' stage and ultimate dissolution
of the family by the death of one of the spouses- These events
in turn interact with social and economic factors like housing,
consumption and saving patterns, economic activity and social
welfare. In a study of the family life cycle of Japanese women
in 1940 and 1972, a Japanese demographer, Shigemi Kono,
working with the Population Division of the United Nations,
compared the family life cycle and demonstrated the pro
found impact of the improvement in mortality and the increase
in expectation of life of Japanese women, and also of the
adoption of the small family norm in the post-War years.
In 1940, a Japanese woman could survive only 14 years
after the birth of the last child- In 1972, she could survive 48
years in the corresponding situation. In 1940, seven years
after the birth of the last child, the death of the husband was
the normal expectation. In 1972, a husband could expect to
live for another 40 years. In 1940, the husband was expected
to die less than a year after the last child started grade school
and he would certainly have been dead for 15 years when his
last child got married. Normally, therefore, no parents would
have attended his/her wedding. In contrast, in 1972, there was
no probability of the husband dying before the last child either
got married or finished university education, since he would
die only when his wife was 67.1 years.
The dramatic changes in the life cycle in Japan are mainly
the result of the spectacular fall in Japanese fertility in the
post-War II period- I n India, as the first results of the 1981
Census have indicated, there is no evidence of a significant
decline in fertility. The fall in mortality in recent decades,
however, has been considerable though not spectacular- This
has meant a gradual increase in the expectation of life at
birth- A fall in mortality, however, has very little impact on the
age structure. So the proportion of the elderly has remained
more or less the same, unlike in the Japanese situation where
there has been a significant increase in the population 65 years
and over. The ‘empty nest’ couples (in the absence of child
ren ) to which Kono refers, prevail in the Indian situation
27
ASPECTS OF AGING IN INDIA
only among small elite groups of people in the big cities- A
large family sustained by high fertility and the extended
family pattern still dominates the scene in India- The Japanese
situation, on the other hand, is similar to the situation in
Northern Europe and America.
In a recent contribution on aging, Kingsley Davis and
Pietronella van den Oever (1981:4) compare the Indian and
American situations and refer to ‘the new phenomenon (in the
USA) which has appeared in the family—prolonged parental
survival beyond the last child’s coming-of-age .... Given
these changes, one would expect adults increasingly to plan
their lives in terms of themselves rather than their children-
Years from the birth of
first child to age
18 of last child
Years from age 18
of last child to
death of mother
Rural North
India, 1956
U.S. 1880s
cohort
U.S. 1950s
cohort
36.8
27.9
24.9
None
21.3
34.1
Family network
Table 1 based on census data gives an idea of the ramifications of the family network. It may be further noted that
Table 1
Composition of Households, India, 1971
Relationship to Head
Proportion per 10,000 persons
in households
Head
Spouse of head
Unmarried sons
Unmarried, widowed, divorccd/scparalcd daughters
Married sons
Brother
Unmarried, widowed, divorccd/scparatcd sisters
Father
Mother
Other male relations
Other female relations
Unrelated
Source: Census of India, 1971, Series I,
and Cultural Tables, pp. xiv-xv
1822
1403
455
2079
1673
254
78
35
265
632
1245
59
10000
Part Il-C(iii), Vol. 1, Social
28
AGING IN SOUTH ASIA
only 6-5 per cent of the total number of households in India
were single-member households- The age distribution of these
heads of households reveals that proportionately more elderly
women than men arc subjected to lonely lives (Table 2).
Table 2
Distribution of single member households by sex and age of head,
India 1971 (per cent)
Age Group
Rural
Male
Female
Urban
Female
Male
Less than 30
30-49
50+
25.5
37.9
36.6
100.0
35.7
44.1
20.2
100.0
5.7
25.9
68.4
100.0
7.3
28.1
64.6
100.0
Source: Computed from Table of Census of India, 1971, Series I. India
Part II-C (iii), Vol. I, Social and Cultural Tables. Table C-I,
Part A, pp. 2-4
The high incidence of single member households among
aged females (50+) both in rural and urban areas shows the
greater intensity of the problem of living alone on the part of
women. Life is thus harder for elderly women compared to
elderly men. The majority of single-member households,
taken as a whole, however, comprises men and not women
but for the age group 50+in rural areas, there are more
women than men as will be clear from Table 3.
Tabic 3
Sex composition of heads of single member households by age
group, India, 1971 (percent)
Less than 30
30-49
50+
All ages
Male
Rural
Female
Total
Male
Urban
Female
Total
85.0
65.2
40.7
56.2
15.0
34.8
59.3
43.8
100.0
100.0
100.0
100.0
94.3
84.0
51.2
77.0
5.7
16.0
48.8
23.0
100.0
100.0
100.0
100.0
Source: Computed from Table C-I, Part A, Census of India, 1971,
Part II-C (iii), Vol. I, Social and Cultural Tables
29
ASPECTS OF AGING IN INDIA
The high incidence of single member households among
the aged women in the rural population is indicative of
distress and destitution of women. It may be noted in this
connection, however, that in India as a whole, only 9.6 per
cent of the households in rural areas are headed by women,
while in urban areas only 3.8 per cent of the heads of house
holds are women. The clue to the higher incidence of single
member households among women is given by the high inci
dence of widows in the higher age groups (Table 4).
Table 4
Percentage of widowed persons by sex and age-group, India, 1971
Agc-group
60-64
65-69
70+
Male
Rural
Female
Male
17.8
21.0
30.9
62.0
64.0
79.9
14.0
17.5
27.9
Urban
Female
64.2
67.7
82.4
Source: Census of India, 197], Series J, India, Part II-C (ii), Social
and Cultural Tables, p. 5
As noted earlier, unlike the Western countries and also in
several Asian countries, the expectation of life at birth of
females is lower than that of males in India. At age 45 and
later, however, the expectation of life is higher for women
Tabic 5
Expectation of life, India, 1961-70
Age
Expectation of life at different ages
Male
Female
0
5
10
20
30
40
45
50
60
65
70
75
46.4
52.0
48.8
41.1
33.3
25.9
22.4
19.2
13.6
11.2
9.3
7.7
44.7
50.2 .
47.7
39.9
32.0
25.4
22.5
19.7
13.8
11.4
9.5
7.8
Source: Census of India, 1971, Paper 1 of 1977. Life Tables, pp. 14-17
30
AGING IN SOUTH ASIA
than that for men which is in conformity with the trend in
the developed countries. Another factor which explains the
high incidence of widows compared to that of widowers, is
the social custom of discouraging remarriage of widows,
particularly among the higher castes.
Family protection
We have already noted the small number of single-member
families in India, as revealed by census data- Not all these
families consist of elderly persons- Fora detailed picture of
the shelter offered to elderly people, one must turn to surveys
directed specifically towards elderly people. The social
protection offered to the aged by the family network is evident
from the following table taken from the survey of persons of
60 and over in Madras CityTable 6
Living arrangement of 60+ persons (per cent)
Alone
Only with spouse
With married son
With married daughter
With married son and daughter
With unmarried child
With siblings
With grandchildren
With other relatives
With non-rclatives
Men
Women
Total
2
10
39
10
4
25
5
1
5
1
3
1
39
23
5
7
6
4
10
2
3
5
39
17
4
15
5
3
8
1
100
100
100
Source: Madras School of Social Work (1972: 281),
In their survey of problems of Retired People in Greater
Bombay, K- G. Desai and R- D- Naik (1973:154) come to the
conclusion that the majority of respondents arc protected by
their families. As they put it,
Their health problems and their financial problems are taken care
of by their family members. They arc surrounded by their family
members and are also respected by them. Respect for old age is still
a ‘value’ for persons in our culture. Therefore, our respondents do
ASPECTS OF AGING IN INDIA
31
not feel isolated or rejected by the family. Our retired persons are
quite better oil'as compared to their counterparts in the Western
countries. We were believing that the joint family system is fast
breaking down in our cities. Our study does not support such a
notion. A large majority of our respondents are staying with their
children and/or near relatives. And family is their best insurance in
old age. We arc not trying to paint a rosy picture of our retired
people. They have their share of problems but most of these arc
taken care of by the family and hence our respondents do not
become problematic for the society. They are not so vulnerable as
their counterparts in the Western countries.
Il may be noted in this connection that the Bombay sur
vey covered only pensioners- Obviously, such people are quite
well-off even after retirement compared to the aged who did
not have any pension at all. When there is a pension, the
family also benefits from the pensioner and it is not, therefore,
a one-way process of helping out an old member of the family.
What happens when there is no pension and the children
and other relatives are too poor to take care of the old? It is
worth noting that in India, old age pension is, by and large,
confined to a small group of government employees while the
rural masses have no social assistance or social insurance
programmes except some old age pension schemes, launched
by some State governments in recent years, which are really
meant for destitutes. One should therefore, not generalise
from studies of pensioners in cities like Bombay. We shall
now refer to a study which concerns rural health but never
theless is very relevant to the issues we are discussing here.
Goran Djurfeldt and Staflan Lindberg undertook an inten
sive study of the introduction of Western medicine in a village
in Tamil Nadu State. They observe that of those who reach
adulthood, nearly 50 per cent seem to end their life dying a
‘natural death’ at old age. 'Such at least is the situation as
perceived by the villagers, even if, medically, various diseases
are contained in the folk concept of a natural death.’ This
sharply contrasts with the ‘medicated survival’ of old people
in the Western countries, and which ‘represents merely pro
longation of survival lime through complex and costly medi
cal procedures .... When a man or woman has reached 60
to 70 years, their body is worn out by a life of hard work.
Infectious and similar diseases are then easily contracted, and
32
AGING IN SOUTH ASIA
lead to death, as there is no advanced medical technology to
prevent it- Also the susceptibility of old people to disease
increases because they are under- and malnourished • • ■ ■
Death, then, is often an undramatic “natural event” at old
age’ (1980:53-55).
On the basis of their study of the conditions of work and
life in the village, the authors conclude (ibid:92):
Old people thus retire gradually, rather than abruptly as in
‘modern’ industrialised societies. This could be a rather ideal form
of retirement. But many old people lack the opportunity of a
meaningful existence. If they have no children to take care of
them, old age will be a hardship.
Djurfeldt and Lindberg give the case history of a man of
60 who worked as a permanent farm servant of a rich farmer
for twenty years- He was given his wages in kind (paddy) and
also his daily food. But a time came when his employer wan
ted him no more- The result was destitution. He was able to
manage only because his wife (50) was working. The landless
labourer thus turns into a destitute- They conclude with
sorrow (ibid:94):
We remember that ‘old age’ is the most common cause of death
among adults. We now understand part of the reality behind that
classification. Sometimes death in old age is a euphemism for death
due to starvation.
Role of sons in pension schemes
In this context, it may be mentioned that Uttar Pradesh
was the first State government to introduce an Old Age
Pension Scheme in 1957. Subsequently, similar schemes were
introduced in a number of other States. At the instance of
the Department of Social Welfare, Government of India,
evaluation studies were undertaken by academic scholars to
critically assess the working of these schemes.
Basically, these schemes are meant for the destitutes. For
example, in Uttar Pradesh, a destitute is defined as a person
who does not have any source of income (or income of less
than Rs 30 per month) and who does not have any son or
grandson whose age is 20 years or more (Department of
Social Work, Lucknow University 1978-79). In Kerala also,
33
ASPECTS OF AGING IN INDIA
the eligibility conditions are similar. The evaluation study of
Kerala points out that ‘the worst part of the pension scheme
is that it attaches so much importance to the son and son’s
son than the daughter. Actually, we found that more persons
stayed with the daughters than sons and the number of those
looked after by son’s sons was very small. As per the rule,
even those old persons living with affluent daughters are eli
gible for pension’ (Nayar 1980:38). It may be mentioned here
that due to the prevalence of the matriarchal system in Kerala,
staying with a married daughter is quite common, unlike in
Uttar Pradesh.
The Kerala evaluation study recommends that ‘in the
context of declining family bonds, the role of the son’s son in
looking after the old relative is minimal and should be re
moved from the means test’ (ibid:38).
In the absence of social assistance programmes for the
old, reliance on sons is the only strategy of survival. This is
particularly so in rural areas- Unfortunately there are hardly
any surveys of aged people in rural areas but the limited data
in some of the cities bring out the economic insecurity of the
aged- The following tables sums up the position.
Table 7
Percentage of aged having no income in different cities
Delhi*
Madras”
Lucknow’”
Source:
49.3
51.8
51.8
’Delhi School of Social Work (1977:124)
’’Madras School of Social Work (1972:436)
’’’Department of Social Work, University of
Lucknow (1975:55)
In fact, as. the Delhi study shows, economic dependency
increases with age. This study classifies the aged into three
categories and gives the income data as follows.
Table 8
Economic insecurity of the aged (Delhi)
Category
Not too old
Medium old
Very old
Age group
No income (per cent)
60-67
68-77
above 77
Source : Delhi School of Social Work (1977: 125)
38.8
56.7
67.9
34
AGING IN SOUTH ASIA
Role of grandchildren
The vital role of grandchildren in the lives of the aged is
brought out by the following figures quoted from the survey
of aged persons (60+) in Lucknow city.
Table 9
Activities on which the aged spend their time (Lucknow),per cent*
Activities
Male
Female
Look after grandchildren
Household work and odd jobs
Visit places of worship
Read religious books
98.1
92.5
33.6
49.1
96.6
94.3
55.7
11.9
•Multiple answers given i.e., more than one activity has been listed
by the respondents.
Source: Singh (1975: 130).
Aged persons according to the Delhi Survey can be put
into various categories of economic activity in keeping with
their health condition.
Table 10
Activities of the aged in Delhi
Activeness-Incapacity rating
Fully active and engaged in full-time gainful work
Fully active, engaged in part-time gainful work
Active but not engaged in gainful work
Partly invalid but engaged in some occupation
Partly invalid but not following any occupation
Totally invalid
Per cent of aged
22.2
3.2
50.2
1.1
18.5
4.8
100.0
Source : Delhi School of Social Work (1977: 159)
The fact that 50 per cent of the aged are active but not in
gainful work, shows the immense scope for working out pro
grammes for active retirement and active aging. It must be
noted, however, that this large percentage of the active aged
in Delhi is because of the higher levels of nutrition, education,
health, housing and income in Delhi. We have already dis
cussed the plight of the aged in the rural areas, especially the
position of landless workers who have nothing to fall back
upon after ‘retirement.’ The poor nutrition and low income
ASPECTS OF AGING IN INDIA
35
levels to which they are subjected right from the beginning of
their life lead to premature aging. In a country like India,
the focus should be on premature aging rather than active
aging. The tragedy of the situation is further heightened by
the fact that the aged in the agricultural sector and in the
unorganised industrial sector in the cities have to continue to
work in the absence of any economic security in old age- In
the developed countries, there is a sharp decline in the per
centage of the economically active population in the age group
65-69 compared to 60-65- This is not true of IndiaIt may be noted in this connection that the retirement age
for most government officials in India was only 55 years till
recently. The retirement age has now been increased to 58
years in spite of the increase in the expectation of life in
recent decades- The tragedy of the situation is that while
there is a good case for extending the age of retirement this is
not done because of the high incidence of unemployment in
the younger age group, especially among the educated youngThere is a constant clamour for not increasing the retirement
age, for not giving any extension to even fit and competent
government employees- This is another dimension of the prob
lem of the aged in India and highlights the need for looking
at the development of the economy as a whole and the prob
lem of all age groups and not merely confining the discussion
to the problems of 60+ or 65+ onlyBut the real issue is: Is there a retirement age in agricul
ture and in rural areas? The answer, of course, is a tragic
‘No.’
Neglect of the agricultural sector
In a country like India where over 70 per cent of the
working force is engaged in agriculture, the problems of the
aging population must be viewed basically in the context of
agricultural development. An important study of the ILO by
Robert Savy (1972:iii) on social security in agricultural and
rural areas points out that ‘in the field of social security, the
agricultural sector has not kept pace with other economic
sectors, especially in the developing countries-’ The ILO
study reviews in detail the situation in regard to medical care,
sickness benefits, maternity benefits, old age benefits, inval-
36
AGING IN SOUTH ASIA
idity benefits, survivors' benefits, employment injury benefits,
unemployment benefits and family benefits in different
countries of the world and then proceeds to discuss the future
pattern of agricultural social securityThe review of 20 Asian countries, which organised old age
benefit schemes, points out that six of these countries have
completely excluded farming from the protection afforded- In
some countries, there are comprehensive schemes which apply
to all residents irrespective of their occupation and whether
they are wage earners or not- In some other countries, there
are schemes specifically meant for all workers, including
agricultural workers- In Japan, for example, there area num
ber of schemes for the aged. There are other countries where
the provident fund schemes are based on the principle of
compulsory saving. For example, in Sri Lanka, India and
Malaysia, there are such schemes for plantation workersRobert Savy concludes his review as follows (ibid:255);
It is now clear that there have been no radical changes in this re
spect on a world scale. A social protection policy for agricultural
and rural workers is just as necessary now as it ever was, and the
efforts that have been made on that score are patently insufficient.
Savy warns against following
points out (ibid:256):
the Western
model- He
In the industrialised countries, no one really questions the general
need for such protection any longer, but it is sometimes regarded as
less vital in other countries .... There is certainly a temptation to
reserve the first social protection benefits for industrial workers in
order to promote adaptation to the industrial and urban world. This
has, in fact, been the most common approach and the example of
Africa is characteristic. But the risk is thereby increased by
widening the gap in working and living conditions between town
and country, of encouraging the haphazard drift towards the towns,
of accelerating the decline of the traditional social structures
before a modern system has been established, and of causing urban
sprawl and its concomitant of shanty towns full of out-of-work men
and women. Of course, this is not just a matter of social security
policy; it is the relative place of industrial and agricultural deve
lopment within the overall system of development, that is at issue
here. Nevertheless, by consolidating the situation of industrial
wage-earners, who are already a privileged minority by virtue of
the level and regularity of their income, social security may further
increase tension between the various groups to the detriment of that
ASPECTS OF AGING IN INDIA
37
balanced political and social development which is so vital for
economic progress. This is a further reason why social protection
to meet needs of rural societies should be rapidly initiated.
There is no doubt that in predominantly rural and agri
cultural countries like India, social assistance and social secu
rity programmes must not leave out the major chunk of the
poor—the landless agricultural workers, the marginal farmers,
workers in the unorganised and household industries and
workers in the poverty-based service sector- Inasmuch as a
part of rural poverty is extended to urban areas through rural
to urban migration, the problems of the poor in the urban
sector should not be ignored-
It may be noted that out of a total working force of rough
ly 220 million (1981 Census), only a few million workers are
protected by pension, provident fund, gratuity and insurance
schemes- All permanent employees of the Central and State
governments, defence personnel, employees of public sector
undertakings, railways and post and telegraph workers, indus
trial workers, plantation workers, mining workers and only a
fraction of workers in the private sector and statutory organi
sations enjoy some form of old age benefits-
The Life Insurance Corporation of India (a Government of
India Undertaking) had 22 million policy holders according to
the latest data (23rd Report, March 1980)- This number looks
impressive only in absolute terms but certainly does not meet
the demands of 684 million people enumerated in the 1981
Census of India. The Employees State Insurance Scheme
(ESI) for industrial workers was launched in 1952 and has
since been extended throughout the country and covers about
6 million persons throughout the country (Annual Report
1976-77).
The ESI Scheme looks after the aged dependants of the
industrial workers in times of sickness- There is a move to
extend this Scheme gradually to non-industrial workers alsoBut it cannot be said that the clinic and hospital infrastructure
under the ESI Scheme (this is true of the entire health infra
structure) is geared to the requirements of the aged-
38
Aging in south asiA
Perception of the aged of their problems
Health problems and financial difficulties overshadow the
problems of the aged as will be evident from the following
table based on a survey of pensioners in Kerala State:
Table 11
Worst things about being over 65 years (Kerala)
Poor health and concern over health
Financial difficulty
Ignored by kin/loneliness/boredom
Fear of death
Helplessness
46.1
38.5
7.3
5.8
2.3
Source: Nayar (1980: 16).
Interestingly enough, when the aged respondents were
asked about the best things about being over 65 years, the
most common answer was that they perceived ‘being nearer to
the end of life’ as a good thing.
Table 12
Best things about being 65+ (Kerala), per cent
Being nearer to the end of life
Looked after well by kinsmen/surrounded by family
members/peace of mind
More Jeisure/no work
Not having to earn one’s living
Other responses
50.5
22.5
13.7
9.1
4.2
Source: Same as in Table 11.
In spite of the great supportive role of the family in taking
care of the aged in India, it is becoming increasingly clear that
problems of health and financial security cannot be left to
the family alone. The Government and voluntary agencies
must lend a helping hand in a big way- This is not a case for
switching over from the present system of social protection
afforded by the family to a system of institutional arrange
ments for taking care of the aged—the failures of such an
arrangement in the developed countries are well-known. The
emotional support of the family must not be eroded.
It is heartening to note that the aged in India still receive
respect and warmth of affection from the young- In a survey
39
ASPECTS OF AGING IN INDIA
of pensioners in Delhi, questions were asked to elicit the opin
ion of respondents about the warmth and respect they enjoyed
from family members, relations etc. The details are given
below.
Table 13
Perceptions of the aged in Delhi
Warmth
Indifference
respect
or
cordiality
Family members
Relations
Caste/community members
Neighbours
Former Colleagues
Society in general
80.8
63.4
63.6
66.9
68.1
46.9
15.6
30.4
21.6
22.4
17.8
16.0
Coldness
Total
3.6
6.2
14.8
10.7
14.1
17.1
100
100
100
100
100
100
Source: Jaganadhan and Palvia (1975: 137).
Of course, these figures should be interpreted with cautionThe pensioners and that too in a city like Delhi, really belong
to a privileged group of the aged- But it cannot be said that
even in rural areas the young people are hostile to the old and
that there has been a fundamental change in the attitude of
veneration towards the old. It must also be noted in this
context that the ‘old’ in India take pride in their age and
efforts to tone down their age by calling them ‘senior citizens,’
etc-, are regarded as comical and devoid of any depth of philo
sophy- This leads us to the profound role of religion in the
daily lives of the elderly in India- The attitudes of content
ment, peace and tranquility are values which are deep-rooted
in Indian society, and the roots are indeed deep when we
consider the aged.
Positive role of religion
Regardless of religion and caste, religious prayers have a
positive impact on the aged, as revealed by the Lucknow
Survey. The details are given in Table 14-
40
AGING IN SOUTH ASIA
Table 14
Faith in religion (Lucknow)
Religion and caste
Per cent of aged who have faith
in religious prayers
Hindus
Low caste
Intermediate caste
Upper caste
Muslims
Christians
Sikhs
Total:
73.8
74.3
70.0
73.7
72.0
73.9
70.6
73.3
Source: Singh (1975: 137)
Robert W. Kleemier. in his study of mental health of the
aged based on medical statistics of France, Netherlands,
Denmark, Sweden, U-K. and U.S-A-, concludes (1960:268):
The United States has much to learn about the care and treatment of
its mentally frail aged, but it has much to teach also. The current
picture is sometimes depressing, but progress is being made and
should continue at an accelerating pace. Certainly, the research
efforts under way should point to bright future development, but
with a steadily mounting population of aged people, there is no
time for complacency, (emphasis added.)
This was written in I960. There is no reason to believe that
things have improved vastly for the aged in the developed
countries of the world, for that matter, anywhere in the worldLike Kleemier, we would like to conclude that India has
much to learn about the care and treatment of the aged, but
it has much to teach also.
India has to learn so much from the experience of deve
loped countries in the field of social assistance and social
security programmes, the special schemes for the aged in
regard to housing, health, education and recreation, the insti
tutional arrangements for the aged, the automatic procedures
for safeguarding the real income of the pensioners against the
onslaught of inflation and a host of related issues- India must
fight the battle for the old at all age groups, especially in the
early years of life when malnutrition and undernutrition, apart
from taking a heavy toll in infancy and childhood, also lead
ASPECTS OF AGING IN INDIA
41
to premature aging of the population in a biological sensePeople can expect to live long only when they are healthy in
the early years of life. India has also to fight for the eman
cipation of women who remain at a disadvantage right from
birth to death. The plight of widows is particularly deplorableFinally, it is not enough to give pension to the organised sector
of the labour force and leave out the much larger agricultural
sector from social protection through State assistance- The
landless workers in agriculture and the urban workers in the
unorganised sector constitute the bulk of the poor in IndiaSocial assistance and social security programmes are almost
non-existent for these people.
The developed countries in the West can likewise learn
several things from India—the reverence for age, the premium
put on wisdom and experience as opposed to knowledge and
information, the unshakable foundations of the institution of
family, the social protection offered by the extended family, the
pride of parenthood and the great expectations on the part of
parents from their children and grandchildren, the claim of
love and affection which transcends the immediate blood
relations and engulfs the entire family network, the respect for
the institution of marriage and the social disapproval of
divorce, and above all, the philosophy of contentment in old
age and the contempt for farcical attempts on the part of the
old to look young and act young, the realisation that the
mindless pursuit of consumerism will not bring happiness and
the aged must find inner strengthto sustain them in old age,
the need for looking beyond in the quest for peace and finally,
the abiding faith in God, religion, prayer and meditation
which alone can enrich the concluding years of lifeThe developed countries in the West cannot go back to the
traditional extended family system nor can the developing
countries in Asia opt for a system of total institutional care
for the aged- There must be a half-way house where the effi
ciency of modern institutions can merge with the warmth of
the family ties of the olden days. Perhaps the aged should
look to voluntary and religious institutions to build this half
way house for them and bring in harmony between the State
and the family.
42
AGING IN SOUTH ASIA
Plan of action
We shall conclude by suggesting a plan of action.
/. Counteract premature aging. A detailed study must be
undertaken to analyse the causes leading to premature aging
in India, to be followed by a concrete programme to fight
premature aging. Action for the aged must be initiated with
programmes for children and the young in the fields of nutri
tion, health and education2. Greater concern for the destitute. The Old Age Pension
Schemes for the destitute in operation in different States must
be revamped and extended all over India. The amount of
pension must be increased to counteract the erosion of real
income because of steep inflation. This is true of all categories
of pensioners as well as non-pensioners but undoubtedly the
destitutes are hit the hardest.
3. Institutional care of the aged when family protection is
not available. It is necessary to create at least a minimum in
frastructure of institutional care for the aged in India through
the collaborative efforts of the Government, religious organi
sationsandvoluntary agencies. The present infrastructure is
woefully inadequate. Clinics and hospitals must also impart
an orientation towards the aged in order to meet their special
requirements. There is a tremendous scope for voluntary
organisations to do solid work in the field of health care
(including mental health care) for the aged.
4. Extension of Employees' State Insurance Scheme to
take care of the agricultural workers. In a predominantly
agricultural country like India, it is manifestly unjust to con
fine social assistance and social security to industrial workers
in big cities only. It is not easy to bring unorganised workers
and agricultural workers in rural areas under the umbrella of
social insurance. But this cannot justify inaction. The ESI
Scheme should be suitably modified and extended to non
industrial workers in a phased manner5. Compulsory insurance for all. As we have seen, the Life
Insurance Corporation, in spite of its spectacular expansion in
recent years, still covers only a small number of persons.
Again, innovations are called for so that the insurance
schemes can bring into their orbit poorer sections of the
ASPECTS OF AGING IN INDIA
43
population, in both urban and rural areas.
6. Mobilising retired teachers to attain one hundred per
cent literacy by 2001. The 1981 census has revealed the low
level of literacy, especially among females in the rural areas.
A concrete programme should be drawn up to involve almost
every retired teacher in India in the great task of making
India a fully literate country at least by 2001 A-D. Involving
retired teachers does not necessarily mean their re-cmployment in accordance with bureaucratic rules but galvanising
their energy and dedicating it to a worthy cause. Religious
organisations and voluntary agencies have a vital role to play
in this regard7. Introduction of the concept of part-time work. A great
deal of the human resources in India is wasted because of
unimaginative concepts and rules governing work. This is
especially true of educated women who, on becoming house
wives, fail to contribute to the development of the country
except through their household work, because of the absence
of the system of part-time work in the organised labour mar
ket in the urban areas. This is also true of elderly persons.
It is tragic that in India, millions of people are too old to
work but have to keep on working because of economic
insecurity. On the other hand, there are millions of elderly
persons who are fit to work but are denied opportunities for
work. The tragedy is heightened because there are also
millions of young people who are looking for work and find
no work. The case of the elderly thus gets diluted. While in
national aggregate terms, this may be true, there are numerous
pockets of labour shortage, there are numerous occupations
where enough skilled people are not available and there are
numerous situations where part-time work put in by the
elderly will be welcome. One could also make a good case,
in purely economic terms, for the part-time employment of
the elderly workers in various walks of life. No revolutionary
measures are called for in improving the state of affairs—a
redefinition of job description would suffice. This would bring
about a fundamental change in the attitude towards the chal
lenging task of an efficient mobilisation of human resources
for economic and social development in the country.
<8. Focus on women in programmes for care of the aged.
44
AGING IN SOUTH ASIA
Women face greater hardships than men in the struggle for
survival in old age. As we have already seen, the life expec
tancy is higher in the older age groups, the incidence of wid
owhood is high and the financial insecurity great. Rural to
urban migration continues to be predominantly male mi
gration. Women are left behind in the villages and have to
fend for themselves. The problems are particularly acute in
hill areas where even elderly women have to collect fuel and
fodder from the distant hills to keep their daily life going.
They have to carry huge loads on their backs. This leads to
premature aging. Programmes for the aged should adequately
take care of the special problems of women.
9. Mobilisation of ex-Army personnel for health work in
rural areas. Most of the doctors in India are urban-oriented
while most of the soldiers have a rural base. After retirement,
the army personnel can play a ‘modernising role,’ especially in
matters of community healh, environmental sanitation, health
education, etc. A lifetime’s military experience imparts to
them higher organisational abilities compared to trained medi
cal doctors. The credibility of the ex-soldiers is also high in
villages where they come from and where they eventually
retire. Under the new Health Guide Scheme (formerly known
as Community Health Worker Scheme, first launched in 1977),
preference is given to ex-army personnel while selecting
Health Guides. But it is possible to launch a Comprehensive
Health Plan for rural areas of India, drawing heavily on the
talent and time of ex-servicemen. A small honorarium,
instead of a regular salary, would meet the financial require
ments of such a scheme. This will be a good example of
‘active’ aging.
10. National Board for Care of the Aged. A number of
steps should be taken to anticipate in India the problems of
old age, destitution, physical and mental ill-health, alienation
from family and society and related problems. The Indian
Council for Social Science Research (ICSSR) should sponsor
a series of studies on the aged. The Ministry of Social Welfare
and the Central Social Welfare Board should coordinate their
activities with voluntary bodies, religious organisations and
other institutions interested in the welfare of the aged and
draw up a comprehensive programme for the aged, which
ASPECTS OF AGING IN INDIA
45
could be incorporated in the Seventh Five Year Plan (1985-90)
of India. A National Board for Care of the Aged on the lines
of the National Children’s Board should be constituted. This
should not degenerate into a bureaucratic centralised machinnery for the disbursal of funds but be the symbol and hope of
a fair deal to the aged in a welfare state.
3
Old Age in Nepal: Some Preliminary
Observations
Prayag Raj Sharma
There has been no study focusing on any aspect of the
problem relating to old age in Nepal. A rich anthropological
literature on Nepal is available which covers a wide range of
topics and regions. But this contains very little information
directly concerning the problem of old age in Nepal. This ne
glect probably reflects a general state of thinking in Nepal which
fails to acknowledge aging as a serious problem deserving at
tention. It would have been useful to discuss this problem at
least at the village level, but even data of this kind arc lacking.
In these circumstances, the best one can do is to introduce the
problem in very broad terms on the basis of census data and
personal impressions of the Nepali society, derived from field
work, especially among the Nepali-speaking Hindus of the
hills.
This paper is organised in four parts- The first paper gives
a demographic sketch, based primarily on the census report of
Nepal for 1971, along with a short discussion of the economy
of Nepal- The problem of old age, particularly in developing
countries like Nepal, is inseparable from the overall economic
condition of the country- Next, a brief account of some rele
vant cultural and social values is given so that the problem can
be better understood historically- Finally, the question of old
age is reviewed in the light of the social changes taking place
The author has benefited much from comments of friends and col
leagues on an earlier draft of this paper, especially Dr Chaitanya
Mishra, Mr Chaitanya Krishna Upadhyay and Dr Ludwig Stiller.
However, he is alone responsible for the views expressed in this paper.
OLD AGE IN NEPAL: SOME PRELIMINARY OBSERVATIONS
47
ill Nepal's urban centres, and their implications for policy and
planning. The discussion of these issues will be in the frame
work of family values obtaining in both urban and rural areasIt may be borne in mind that neither the urban centres have
a fully modernised economy and life style, nor have the tradi
tional villages of the rural areas remained unaffected by the
new ideas and values associated with modernisation.
Demographic profile
It is by no means easy to reach a commonly accepted de
finition of old age in Nepal. Economists and demographers
put this age at 65—their five-year age breakdown goes up
to the year 65 in their enumerations. The government of Nepal
however has fixed 60 as the retirement age for all its employeesIn keeping with the trend in some countries, it appears likely
that this age may be further reduced by a few years- In an
agricultural country such as Nepal, the actual productive age
of a person can extend up to seventy years- In more well-to-do
families, active economic life usually stops a little earlier depen
ding on the social status of a person. In this paper, however, we
have accepted the criterion of the Government to define old
age i-e-, 60 years- One of the proverbs which says that when
one reaches sixty one needs the support of a walking stick,
endorses this normThe demography of Nepal shows that the ratio of age
distribution in all cohorts conforms to the general pattern of
South Asia as a whole-1 Gunnar Myrdal (1968:1403) in his
Asian Drama sums up the situation thus:
In the countries of South Asia the proportion of the population that
is under 15 years of age ranges from 37 to 44 per cent, in the devel
oped countries from 23 to 30 per cent. Persons over 60 years of age
account for only about 4 to 5 per cent of the total population in the
former as against 12 to 17 per cent in the latter countries.
This reveals an age profile that results from high fertility
rates combined with low life expectancy that are character
istic of this region of Asia1. The country monograph on the population of Nepal published by
ESCAP fully upholds this observation for itself. See ESCAP (1981: 28).
48
AGING IN SOUTH ASIA
The total population of Nepal according to the enumera
tion of the 1971 census was 11,555,983-23 The age/sex distri
bution of the population is given in Table 1. The percentage
of the people aged sixty and above in Nepal, according to this
enumeration was a little over 5 per cent of the total population.
The life expectancy rate in Nepal is still one of the lowest in
the world and, according to a sample estimate for 1976, it was
43-4 years for the males and 41.1 for females (Bourini 1977).
There is a distinct trend of a steady increase in the 0-14 and
60+ age groups, while the 15-59 age cohort registers a grad
ual decline. This reveals the major problem of a high depen
dency ratio in the population of the developing countries such
as Nepal.
The increase in the population of people aged over 60 is
attributed by demographers to a declining mortality rate
and/or return of domiciled Nepalese from abroad especially
those of advanced age (ESCAP 1981: 27).
Table 1
Age/Sex distribution 1971
Age Group
0-4
5-9
10-14
15-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65+
Male
Female
Total
790,598(13.6)
885,801(15.2)
703,023 (12.1)
547,493 (9.4)
466,022 (8.0)
456,297(7.8)
385,696 (6.6)
386,381(6.6)
301,998 (5.2)
245,521 (4.2)
204,304(3.5)
132,983 (2.3)
138,441 (2.4)
172,645 (3.0)
843,512(14.7)
857,452(14.9)
594,192(10.4)
499,966 (8.7)
503,653 (8.8)
473,990 (8.3)
425,705 (7.4)
358,407(6.2)
307,463 (5.4)
215,577(3.8)
196,530(3.4)
124,716(2.2)
155,789 (2.7)
181,828 (3.2)
1.634,110(14.1)
1,743,253 (15.1)
1,297,215(11.2)
1,047,459 (9-1)
969,675 (8.4)
930,287(8.1)
811,401 (7.0)
744,788 (6.4)
609 461 (5.3)
461,098 (4.0)
400,834(3.5)
257,699 (2.2)
294,230(2.5)
354,473 (3.1)
Figures in parentheses are sex-specific percentages.
Source: Population Census, 1971, I, p. 06-01: Central Bureau of stati
stics
2. The latest census of Nepal was just held in June 1981, but its
result will not be known for sometime yet. The population estimate,
however, is expected to be around 14 million people in this enumeration.
49
OLD AGE IN NEPAL: SOME PRELIMINARY OBSERVATIONS
Table 2
Percentage increase/dccrcasc in the population of three board age
categories in three censuses of Nepal
Age
Males
Females
Both Sexes
0-14
15-59
60+
0-14
15-59
60+
0-14
15-59
60 +
Census Yr
1952/54
Census Yr
1961
Census Yr
1971
39.9
55.3
4.5
36.9
57.0
5.5
38.4
56.1
5.0
41.2
53.7
4.8
38.6
55.4
5.6
39.9
54.6
5.2
40.9
53.6
5.4
40.0
54.2
5.8
40.4
54.0
5.5
Source: Population of Nepal, ESCAP, 1981, p. 29. The total population
of Nepal according to the censuses of the years 1952/54 and
1961 was 8,256,625 and 9,412,996 respectively.
Economy
It might be useful here to note a few salient points of the
economy of Nepal so as to contextualise the problem of old
age. Nepal is listed among the ten least developed countries of
the world in a recent World Bank Report (1979). Its per capita
income is believed to be around US S120. It is a poor country
in terms of its internal resources with about 79 per cent of the
country being hilly and mountainous terrain- Only about 12
per cent of the land out of a total area of 145,391 sq kms is
now under cultivation (Rana 1973: 191). Barring a little forest
area which has survived great pressures from cncroachers,
there is little scope in the future for the expansion of culti
vable land in Nepal. Nevertheless with so little land, it is a
rural society with up to 94-4 per cent of its economically active
population dependent on agriculture and income from farming
activity (Thappa 1980:115). Though traditional methods are
used in agriculture and the emphasis is on cereal production,
the agricultural sector makes the largest contribution (65.1 per
cent) to Nepal’s GDP (Gaige 1970: 51),
Modernisation and development efforts were started in
this Himalayan kingdom in the early fifties, but owing to the
country’s poor resources, scarcity of capital and population
increase, their impact on the total economy has been minimal.
50
AGING IN SOUTH ASIA
Less than 6 per cent of the labour force is in the industrial
and service sectors, and the cash income from office jobs used
to provide, and still does, many agrarian households with a
scarce resource. In a report on agricultural development, K.H.
Zevering (ARTEP 1980:1) has predicted that ‘the number of
households in Nepal, relying wholly or partly on income from
agricultural production, will increase throughout the foresee
able future-’ Charles McDougal's comment on the village and
household economy in Far Western Nepal is significant.3 He
writes (1969: 39):
An importanl finding of the present study is that the average house
hold’s recurrent, annual expenses tend to exceed its locally derived
income. By locally derived income I mean local agriculture income,
income from the sale of any product produced in the district (re
gardless of to whom it is sold), and income from wages earned or
remuneration received in the district.
Members of such households experience a dire need to
make up the deficit in their annual households budget by sell
ing their labour outside their districts, which they do by migra
ting to Nepal’s Terai or to India mostly in the dry winter
season (ibid:39). Migration takes on many forms depending
on whether the migration is seasonal, semi-permanent or per
manent. Migration is now a universal phenomenon character
ising the rural life of Nepal and affecting all ethnic groups
and castes. The emigrants to India from Nepal, according to
the Demographic Sample Survey (1978), numbered 28,000
persons (Thappa 1980:124). Similarly, the inter-regional migra
tion is said to have involved 4.5 per cent of the population in
the 1971 enumeration (ibid:127). Among some of the groups
for whom migration is necessary for survival, the younger and
able-bodied members of the family are obliged to seek jobs
outside their districts, leaving behind their older members to
the family to look after the women and the children.4 This is
creating a situation where older men feel more economically
3. The book is based on the field work he did in 1967-68. There has
been little improvement in the village economy of Nepal since then.
Actually the economic growth rate is said to be declining due to popu
lation increase. Agricultural productivity per unit is also said to be
falling.
4. ‘The greater proportion of elderly persons living with their daughter(s)-in-law in the Nepalese village is a reflection of the fact that
51
OLD AGE IN NEPALI SOME PRELIMINARY OBSERVATIONS
burdened. In some other cases, the older people are left alone
and isolated, alienated from their sons and their family, as the
latter move out of the home in search of better prospects, not
knowing when they might be able to help their parents and
call them to live with them. This becomes quite evident from
the Nepali demography of migration which shows a general
deficit of males in the age group 20-49 years in any region of
Nepal, since these are the most economically active years of
one’s life during which migration mostly takes place (Thappa
1980:24).
Social groups
Nepal encompasses within a narrow strip of land an amaz
ing number of ethnic, linguistic and culturally diverse groups.
Their economic activity, however, has much in common since
it is based on agriculture, though a few groups have also earn
ed distinction in trading, another form of traditional econo
mic activity, and a few others have opted for military careers.
It is quite possible that these economic variables have influen
ced to some extent their social organisation and family struc
ture. No doubt cultural practices and beliefs affect attitudes
to, and the perspective of. old age among the different social
groups but then the influence of economic factors is crucial
since there is broadly speaking a convergence in values across
religious and cultural groups of South Asia.
Caste Hindus form the predominant social group accounting
for 70 to 75 per cent of Nepal's total population and comprise
three regional and ethnic groups among them viz., the Ncpalispeaking Hindus, the Newar Hindus and the Hindus of the
Terai. This group is predominantly employed in agriculture,
trade and office work, while a host of other smaller groups
have settled in regions recognised as their traditional habitats
in various parts of Nepal- Among these, the more prominent
groups such as the Gurung, Magar, Rai, and Limbu are
described as martial tribes whose preference is for a military
married >ons often leave their wives with their parents when they
migrate out of the village temporarily.’ See Moni Nag, Benjamin N.F.
White and R. Creighton Peet, 'An Anthropological Approach to the
Study of the Economic Value of Children in Java and Nepal, in Hans
P. Binswanger et al (1980: 266).
COr.rj’A’JTY T’.' T'1 'T’.L
47/1. (.Fill 1 i
Marks f\ad,
Fnr.naloro - rC* 001.
52
AGING IN SOUTH ASIA
career either in the British, Indian or Nepali armies- It is esti
mated that more than 50 per cent of Gurung young men aged
21-40 years from several villages in central Nepal are serving
in the army (Andors 1976: 5). On the northern borders of
Nepal along the southern slopes of the Himalayas or in its
trans-Himalayan valleys, lives the high altitude-dwelling Tibe
tan population. Forthem agriculture constitutes only a margi
nal subsistence activity which must be supplemented by tradeAll these activities including subsistence agriculture are affec
ted by qualitative shifts in the population. The young and
the economically active people are under great pressure to
leave home in search of a cash income and this leads to the
aged members of the family having to eke out a subsistence
living at homeFor example, the Helambu Sherpas in the north of Kath
mandu have been affected by population changes related to
new patterns of employment (Goldstein and Beall 1981: 48-55).
Social change among the Tibetan population of Nepal has
been rather rapid as new economic opportunities became avail
able. Thus the Tibetan group has entered vigorously in the
trade in foreign luxury goods and has even expanded business
activities to distant Bangkok and Hong Kong. Similarly, the
Sherpas of the Solu and Khumbu regions of Nepal have taken
over the lucrative business of organising porterage services to
trekking and mountaineering groups that come to Nepal from
various countries. This tourist-related business keeps young
Sherpas for long periods away from their homes in the villages
where their parents and older members of the family remain
to look after the family home and property.
It is probable that the situation of old people might be far
worse in the case of the landless and the untouchable castes
of Nepal. In the wake of the revolution of 1951 and before
Nepal’s pre-industrialised economic life had been disrupted,
the poorer people of Nepal had been able to earn their liveli
hood by selling their services to the landowning high castes in
a bilateral patron-client exchange system. But this arrange
ment is fast disappearing from the villages of Nepal. Increas
ing rural proverty has had an adverse effect on the family life
of the poorer people, as has been noted in a village study in
western Nepal by Patricia Caplan. She writes (1972:20):
OLD AGE IN NEPAL: SOME PRELIMINARY OBSERVATIONS
53
Poorer households, which have less land and rely on other sources,
such as agriculture labour, for their living, derive little benefits
from living together and tend to break up.
In Nepal strong family ties have been characteristic of mid
dle-class families. Landowning households lived together be
cause this ensured greater economic returns to the family that
worked together. The landless and untouchables, on the con
trary, had to earn their livelihood on the basis of the individual’s
skill and labour. There was no need for a joint family in their
case since the nuclear family could respond to employment
opportunities with greater flexibility.
Concept of old age
Everywhere old age is treated by Hindus with a show of
respect, and elderly members in the family and the community
are held in high esteem. Like austerity, renunciation or educa
tional attainment, old age is recognised as the virtue of a per
son. Deference to old age is a basis on which Hindu society in
Nepal has sought to build up a social order with its charac
teristic pattern of values, discipline and social organisation of
the family. This ideal of a social order which recognises the
social value of old age is expressed in cultural and social
practices in everyday life. In the distant past, young students
as part of their moral education, were taught to recite prayers
in which one’s father, mother and teacher were invoked in
images which reflected the wisdom of God Himself. This
perception of old age is expressed in Hindu mythologies, and in
fact the entire Vedic heritage of learning has been transmitted
down the ages in a teacher-disciple tradition. Vedic seers
(rishis) and the first singer-composers of Vedic hymns are
presented as people endowed with age and wisdom and
pictured with streaming silver-white beards. Some of these
rishis are claimed as the founding ancestors of the lineages
(gotra and pravara) of the twice-born castes with whom an
unbroken connection is genealogically established.
Such rishis are worshipped by the community annually on
the day of the Rishitarpani which falls on the Shravan full
moon (August). A Hindu householder as part of his daily
morning worship, is obliged to offer oblations to the ancestors
54
AGING IN SOUTH ASIA
of his family and thus the concept of continuity and tradition
becomes closely associated with respect and veneration for
age.
Old age as an event is marked by social and religious cele
brations (chaurasi and janko) among the Newars as well as
the Nepali-speaking Hindus. Janko is performed at the age of
seventy-seven years, seven months, seven days and the same
number of hours and minutes, and the person who achieves
this distinction is taken around the town in a chariot.
In the village of Nepal, councils of village eiders used to
play an important role in the community, and this was very
much the case with the village panchayats, a body of live per
sons elected on the basis of their prestige and age. In contem
porary Nepal the panchayat has been made a more formal
political and administrative organisation, but informal
bodies of village elders have not been completely replaced by
it. These informal organisations appear to have functioned in
a far more institutionalised way in ancient and mediaval
Nepal (Vajracharya 1973:284-89, 326-31; Vajracharya and
Shrestha 1978). In the inscriptions and other historical docu
ments, one comes across frequent references to the panchalikas and gosthis which were local bodies set up for religious
and social purposes. The gosthis appear to have dominated the
conduct of Nepali cultural life for a long time. The Newar
guthi its modern equivalent is a unique institution ensuring the
organisation and continuity of the social and cultural life of
these people at the family as well as at a wider community
level. Of the various kinds of gtithis which are in vogue, every
Newar is certain to be a member of the dewali guthi and the
sii guthi (Nepali 1965:127-29). The membership in'the former
is automatically gained by being a member of the lineage
group, while the second is optional in the sense that a family
may choose to be member of one sii guthi instead of anotaer.
Some of the guthis are caste guthis, while others are set up to
organise publicly celebrated festivals. The economic support
to the guthi has traditionally come from land endowments or
from the individual contribution of each of its participating
members.
The membership of a guthi ranges from a dozen people to
as many as several hundred, depending on its role and the
OLD AGE IN NEPAL: SOME PRELIMINARY OBSERVATIONS
55
functions exercised by it. The most pragmatic guthi is perhaps
the sii guthi, in which membership for a Newar is compulsory,
which is responsible for the disposal of the dead of a family
and arranging its funerary rites at the crematorium. For a
Newar not to be a member of any sii guthi would almost be
like being an outcaste from society.
In the organisation and control of the guthi is where the
elderly men of the society exercise their power. The member
ship of the guthi committee is decided strictly by the norm of
seniority by age. The eldest person in the committee is made
leader of the whole group and is called the thakali who pre
sides over all the guthi affairs with unquestioned authority.
The guthi has great power over its members and can enforce
its rules of discipline and impose fines on defaulters when
necessary. The number of a standard guthi committee includ
ing the thakali is eight persons who are all ranked and named
according to seniority.5 They are all prominent members of
the guthi group and their presence on important guthi occa
sions is essential. Where some of the guthis are organised and
known to behave like a patrilineal descent group such as the
Jana Baha guthi of Kathmandu, the thakali is required and
acts ritually like the eldest patrilinc at the ceremony (Locke
1975:1-23)
:
i
' • • . :
Social context
• .*
••
• •
.
It is believed that in the agrarian societies of Asia there is
a preference for joint or extended families. However, there is
considerable diversity in family structures which is determined
by caste, income group and location in urban or rural areas.
In general the incidence of joint or extended families is inverse
ly related to income level, and in Nepal extended families
rarely exceed four generations and are usually supplemented
variations of the nuclear family. It is necessary to understand
the structure of the family because this is important for the
5. Gerard Tofiin describes a significant custom observed in key
Newari feasts of dividing the parts of the head of the sacrificed animal
among the eight office holders of the guthi committee underlining their
order and rank. The other members of the guthi are called noku, soku,
pyeku. naku, khuku, nheku and chyaku. Gerard Toffin (1979: 329-38).
56
AGING IN SOUTH ASIA
social organisation of old age in the more traditional context
of less developed countries.
The Nepal society has always been a patrilineal societyLynn Bennett (1977:258), describing the features of this society
among the Nepali-speaking Hindus, says:
The cardinal value and first organisational principal of the patrifocal
model is: (1) the solidarity of agnatic males. . . .(2) the superiority
of males over females (of the same generation), and (3) the superiority
of age over youth, which has the corrollary of reversing (4) so that
senior consanguincal females arc superior to junior males.
Solidarity among agnatic male members of the family does
not prevent it from splitting eventually and the value of solidar
ity is expressed only in symbolic gestures and rites. A typical
extended family in Nepal would probably include grandfather,
grandmother, their married and unmarried sons, son’s wives,
their children and sometimes even children’s wives. Basically,
all of these many family members are descended from one
person i.e., the coparcener, who splits and sets up his own
household separately. It is quite natural if such a person, be
cause of his primacy in the new family, retains authority and
full decision-making powers in all family affairs. The wife's
authority within the household is only a participation in her
husband’s- According to Nepali Law a father may deny the
request of his son to partition as long as he is alive. 6
But as the head of the family grows older and ceases to be
a productive and earning member, he withdraws from the
decision-making roles gradually, whereupon his sons take over
this role from him. But his place as chief householder and his
nominal authority over all matters of the family is never
questioned even at this time, and sons are obliged to consult
him on all important matters concerning the family. The fami
ly structure among the Hindus of Nepal has always ensured
that aged parents occupy an important place as long as they
live.
With earning sons active in the family, old parents experi
ence a change in the tempo of life. The father spends his time,
6. Muluki Ain of 1963. H.M.G. Ministry of Law and Justice, Kath
mandu, ninth imprint, 2038 (1981), part 3, chapter 13, entry no. 10 p. 135.
OLD AGE IN NEPAL: SOME PRELIMINARY OBSERVATIONS
57
more often than not, in gossiping with peers while the mother,
on the other hand, looks after her grandchildren and does the
less strenuous household chores. For both of them it is a time
for participation in religious ceremonies in the family and the
temple.
The social and religious values of Hindus seek to harmo
nise life not only in this world but also in the world hereafter
and the obligations of a householder to honour dead ancestors
and to ensure continuity of the family line are expressive of
these values in actual life. It assigns the family a role extend
ing beyond the immediate to the past as well as future, mak
ing it the structure for continuity and integration (Prabhu
1954: 219). This value system is the foundation of filial piety
and the responsibility of supporting and caring for aged parents
is not easily shirked without incurring strong social censure
from both family and kin group.
Notwithstanding the ideal, cases are not lacking, however,
in which sons have broken away from their parents and set up
their own family arrangements by forcing the division of prop
erty. Even then, as Patricia Caplan (1972: 21) points out, sons
remain close to their father and the dependence of aging
parents on their sons has been brought out in a recent study
(Andors 1976:31) of family patterns of the GurungsTheoretically, land is inherited equally by all sons. The normative
rule, however, is for the youngest son to inherit his parents’ house
and garden plots. The expection is that by the time the youngest son
is old enough, the rest of the brothers will have separated from the
house and taken their shares of land, leaving the youngest to take
care of the parents in their old age ... In some cases aging parents
or parent may be taken care of alternatively by different sons.
Property rights enunciated in the Nepali Law also function
as a kind of social security system for old age- When partition
does take place in the family and all the sons get a share of
their property, the aging parents, too, receive their share so as
to remain independent of their sons- Property of this kind is
called jiunf which is legally different from the other property,
that is patrimony, in that it cannot be automatically inherited
7.
The Muluki Ain of 1963, part 3, chapter 16, entry no. 3, p. 149.
58
AGING IN SOUTH ASIA
by the sons upon the death of their parents unless it has been
so willed to them. It is expected that the hope of inheriting this
parental property would encourage sons to care for them as
long as they live.
Implications of social change
The political transformation of Nepal in 1951 set in motion
diverse social and economic processes of change that have pro
foundly affected the Nepali people's traditional life-style- Edu
cational expansion has been rapid reaching the remotest
corners of the country- In 30 years, the literacy rate has shot
up from a bare 1 per cent of the total population to 19 per
cent today- Development and modernisation have been promo
ted by industrialisation, expanding transportation communi
cation networks, foreign trade expansion and agricultural
development- The government also earmarks substantial out
lays for various social service schemes-8 In 1963 and 1964,
legislation was passed to initiate new social and land reforms
programmes with the aim of reducing exploitative social and
economic relationships (Regmi 1976)Economic diversification and the development of new
professions have opened up new job opportunities and trade
and commerce has expanded- Many new urban centres have
grown up in terms of economic activity in the last thirty years,
and the proportion of the urban population of Nepal increased
from 2-9 per cent in 1952 to 4 per cent in 1971The land-reform programme is said to have achieved no
great measure of success, yet its implementation was not with
out value for bringing about limited change in the feudal
agrarian structure of Nepal- For the first time a ceiling was
imposed on landholdings and tenancy rights of the tillers were
made permanent and legally secure. This was enough to bring
change in the old social order, especially for the landowning
middle class families who now found the income from land
substantially reduced under the new tenancy laws- Increasingly,
people have been looking for an alternative source of income
outside land either in trade or in salaried employment- The
8. For a historical study of the planning and development efforts
in Nepal, See Ludwig Stiller (1979).
OLD AGE IN NEPAL: SOME PRELIMINARY OBSERVATIONS
59
social reforms under the new Muluki Ain (Legal Code) of 1963
have, similarly, forced people to come to terms with the new
egalitarian ethics and made unacceptable the old discrimina
tion on the grounds of casteThe political change of 1951 was a sudden and traumatic
event, and it gave a severe psychological shock to people who
were already getting old at the time of this transition whereas
younger people seemed more eager to learn and change. Old
people consider the younger generation to be rash, impudent
and disrespectful of traditional values and this may create a
feeling of insecurity since the values of the young appear to
militate against respect for the authority of the old within the
family and the community.
It is estimated that only one per cent of the population of
Nepal lives on salaried employment, yet in absolute numbers
this is the largest single economic group outside agriculture.
The group is concentrated mostly in urban areas and they live
in nuclear families or variations of the nuclear structure.9 The
trend in urban areas towards the nuclear family is altering the
position of old people in the family and this is seen particularly
in the erosion of their traditional authority- In the urban
salaried families arrangements for aging parents to live with
their married sons has become a source of uneasiness to older
people and, together with physical isolation, there corresponds
a psychological alienation within the family itself because of
the tension between two different value systems- Nevertheless,
though the relations between married sons and their aged
parents may be marked by stress, the obligations of sons to
wards their parents is a cultural norm that is recognised by all.
The age of the retirement in government service is 60 years.
There are hardly any old age benefit schemes available in
Nepal other than the pension given by the government to its
employees. The maximum pension rate in Nepal is a third of
the maximum salary a person received but this is hardly ade
quate, given the rise in the cost of living index, if a man has
no other sources of income. Pensions range from a maximum
USS 77.58 to USS 4.74 per month. Though there has been no
9. The average family size for Nepal is 5.6 persons according to the
1971 census.
60
AGING IN SOUTH ASIA
attempt to assess the extent of the problem of old age in Nepal
by government or private research agencies, one can see quite
easily that retirement benefit schemes for old people in the
organised sector are quite inadequate.
Unlike those who are employed in the informal urban
sector and in rural occupations who have to work for as long
as they can, people who retire in the organised sector have the
problem of utilising their enforced leisure time. Few have been
given opportunities to learn useful skills and develop interests
outside their office job which they can use to start new careers
after retirement. On the other hand, with limited economic
resources and the general economic backwardness of the
country where employment opportunities in the organised
sector are scarce, it is difficult for old people to be involved in
income generating activities. A common trend among old
people both men and women is to spend more of their leisure
time in activities connected with religion, such as temple
visiting and attendance at religious discourses,, It must not be
forgotten that in a culture in which religious influences are
pervasive, religion is an important resource for the manage
ment of psychological stress, alienation and loneliness.
In conclusion, I would like to make some observations on
the social justice of the retirement regulations for workers in
the organised sector in a country as poor as Nepal. The ser
vice rules have been based on norms prevailing in the devel
oped countries where the conditions of life are quite different.
In the present economic situation of Nepal where most families
have only one earning member, his retirement at a relatively
early age deprives the family of a crucial source of income
without compensating for this loss. In a labour surplus econo
my in which there is a persistent scarcity of employment
opportunities, there is no knowing if, on the retirement of the
head of the household, his son or brother might get the job.
Historically, this was not so in Nepal before the new
administrative service rules were introduced. A father’s job
was inherited by son or brother so that the economic basis for
the maintenance of the family, which at that time was land,
remained in the family. This was to some extent possible at a
time when the demand for employment in the organised sector
was relatively stable and jobs were not so specialised. In the
OLD AGE IN NEPAL: SOME PRELIMINARY OBSERVATIONS
61
feudal economic and political structure, jobs were centrally
created and filled on specific orders or consent of the King, the
highest ruling authority in the system. Ascriptive values were
given greater consideration over objective merit in recruitment.
Thus loyal families maintained a hold over jobs which were
handed down from generation to generation within the family
and these jobs were concentrated either in the army or in
offices that developed at the centre around the chief political
authority. This situation has no doubt changed considerably
in Nepal but it shows how, in this transition period between
two types of economic and social systems, a low-income
country like Nepal suffers from the worst aspects of both.
The Aged in Bangladesh
RafiquI Huda Chaudhiiry •
Aging is not considered an important issue in Bangladesh
since the population of the country is overwhelmingly youngMore than 40 per cent or the population is concentrated in the
young age-group (i-e-, 0-14) whereas the population of 50
years and above accounts for 10 per cent of the total popula
tion. Although elderly persons constitute a small fraction of
the total population, their number is increasing with rising life
expectancy. The expectation of life at birth in Bangladesh has
increased from 26-32 years in the 1930s to 47-55 years in recent
years (Davis 1951; BRSFM 1974: Samad et al- 1979). As a
result of this dramatic improvement in life expectancy, more
and more people arc surviving at higher ages (see Appendix
A). For example, compared to the level of 1951, male and
female population aged 60 and above increased by 30 and 24
per cent respectively in 1974. The proportion of people at
higher ages (i.e-, 50 years and above) will continue to grow
in future with improvement in mortality. For example, the
proportion of people aged 50 and above to the total population
is expected to double from 10 per cent in 1980 to nearly 20 per
cent in 2025 (see Appendix B).
This small but growing number of elderly persons deserves
national attention since there is no institutional support for the
aged and physically disabled persons in Bangladesh- Parents
in our society have no insurance against illness or accidents
and as such social security benefits such as old age pensions or
THE AGED IN BANGLADESH
63
unemployment insurance are totally absent- Only a handful of
people in the insignificant formal sector of economy is entitled
to pensions1 In this situation, the majority of aged persons
depends on their children, particularly male children, for old
age security. In peasant societies children arc usually con
sidered as a source of security and economic support to their
parents, particularly in times of distress, sickness and in old
age- However, the traditional support base of elderly people
is becoming shaky due to rising inflation and increasing pau
perisation (Alamgir 1976)- Moreover, the traditional joint
family is breaking into nuclear2 units as a consequence of
modernisation and/or population pressure and poverty- This
process of nucleation of the family may have also affected the
traditional bond of relationship between parentsand children.
Unfortunately, there are no data available cither at the local or
national level to highlight the problems of the aged in Bangla
desh.
This paper is a preliminary effort to present a socio
economic profile of the aged in Bangladesh, their living arrange
ments and sources of support, the patterns of dependence on
children and the nature of their future prospects in societyDATA
The data used in this study are mainly of three different
types: urban, semi-urban and rural-3 A person aged 50 years
and above is considered here as an aged person-1 The living
condition of an elderly person is expected to vary by residential
background- One would expect to find more traditional support
1. Of the total civilian labour force 23 per cent were in the nonagricultural sector in 1974 (Census 1974). Of those who were in the
non-agricultural sector, nearly 80% were accounted for by the
tertiary sector, wholesale and retail trade and not working. Of the
remaining, a small fraction was entitled to pension.
2. According to the 1975 Bangladesh Fertility Survey data about
70% of the households were nuclear. The corresponding figure, accord
ing to the 1968 National Impact Survey, was only 54% (BFS 1978;
National Impact Survey 1968).
3. These data were collected by the Diabetic Association of Bang
ladesh. I am grateful to the Association, particularly its President
Professor M. Ibrahim for allowing me to use these data.
4. The age limit was selected in view of the prevailing life expec
tancy at birth in the country.
64
AGING IN SOUTH ASIA
for the aged in rural than in urban areas, because the impact
of modernisation resulting in the breaking of family ties may
be felt more in the latter than in the former areas- This strati
fication scheme will help us to account for the variations in
living conditions of the aged having a different residential
background- The urban sample was drawn from the patients
attending the Diabetic Centre of the Diabetic Association of
Bangladesh, Dacca, for the last 25 years- The Semi-urban
sample was drawn from Jurian a suburb of Dacca city. The
rural sample was drawn from village Lionhatti- It is located in
the central region of Bangladesh- There were altogether 900
respondents with 300 from each of the areas-3 The data were
collected in 1979To supplement these data, we have also used extensively
data on the aged provided by the Census and those collected
from village Muyiarchar-5
6 Table 1 shows that among the res
pondents there are more men than women. The former consti
tute 69 per cent of the respondents. This pattern is more or less
the same for all the study areas- This is also true for the country
5. A word about the representativeness of the samples may be
mentioned here. The urban sample may not be considered a representa
tive sample of the aged in an Dacca city because the patients attend
ing the diabetic centre are relatively better off economically than
those who are non-diabetic. Morever, not every aged person has equal
chances of getting diabetic. However, utmost care was taken to select
as far as possible urban respondents from different socio-economic
classes. This may not be an ideal substitute for a representative sample
of the aged in Dacca city. But it may still provide an interesting con
trast of living conditions of the relatively better off aged in the
Capital city with those in the semi-urban and rural areas. The
samples drawn from semi-urban and rural areas may be considered
representative of the aged of these areas because almost everyone there
who had attained the age of 50 years and above was included in the
samples.
6. The village Muyiarchar lies to the north-northeast of the coun
try tn the district of Sylhet. In this village study, an aged person is
defined as one who has attained the age of 55 years and above. The
data were collected by the Fazlul Karim, a doctoral student at
Dacca University, under the guidance of the present author. The
study was financed by the Bangladesh Institute of Development
Studies. I am grateful to Mr. Karim for allowing me to use the
data.
65
THE AGED IN BANGLADESH
Tabic 1: Age and sex distribution of the respondents by localities
Age
Dacca City
F
N
M
M
Jurian
N
F
Lionhatti
M
F
N
Total
M
F
N
50-54 64.60 35.40 113 67.15 32.85 137 70.33 29.67 91 67.16 32.84 341
55-59 84.91 15.09
53 81.67 18.33 60 76.0 24.0
50 80.98 19.02 163
60-64 78.18 21.82
55 63.16 36.84 38 54.9 45.1
51 65.97 34.03 144
65-69 55.81 44.19 43 71.43 28.57 35 50.0 50.0
30 59.26 40.74 108
70-74 89.47 10.53
19 71.43 28.57 14 64.3 35.7
28 73.77 26.23 61
75-79 92.31
80 +
100.00
7.69
13 57.14 42.86
7 76.2 23.8
21 78.05 21.95 41
—
4 66.67 33.33
9 37.9 62.1
29 50.0 50.0
42
Total 72.67 27.33 300 70.0 30.0 300 63.33 36.67 300 68.67 31.33 900
M = Male; F — Female
as a whole (see Table 2)- There are more men than women in all
age-groups in Bangladesh, except for those in the group 20-29
years- The highest sex-ratio of 126 is seen to be in the 50 years
and over age-group, indicating perhaps that more men than
women live beyond the age of 50 in Bangladesh. The finding of
proportionately more men than women at higher ages is not
an accidental phenomenon- This is expected in view of higher
mortality of women than men in almost every age-group
(Chaudhury 1980)Tablc 2; Sex-ratio by age group 1974
Age-groups
Sex ratio
<5
99.3
101.2
5-9
10-19
-
117.0
20-29
95.2
30-39
106.9
40-49
119.6
50+
126.3
All ages
107.7
Source: Bangladesh Bureau of Statistics, Government of the People’s
Republic of Bangladesh; Bangladesh Population Census
Report, 1974, National Volume, p. 27
AGING IN SOUTH ASIA
Marital status
Mere than SO per cent of the male respondents were
cc-netrth married and about 19 per cent were widowersHcwcver. in case of female respondents 59 per cent were
c. .
married and 40 per cent were widows- The incidence
ct' widowhood is considerably higher among female than
.. "ong male respondents- This pattern holds true for all the
loc-tdties under study (sec Table 3).
Table 3: Marital distribution by sex and localities
Dacca City
Marital Status
M
F
Jurian
Lionhatti
M
M
F
F
Total
M
F
1"otal
90.8 48.7 76.1 53.3 73.7 70.0 80.5 58.5 73.6
7.8 50.0 23.8 45.5 25.2 29.0 18.6 40.4 25.4
1.0 0.9
1.1 1.0 0.9 0.8
1.3 1.2 —
218
82 210
90 190 110 618 282 900
100 100
100 100 100 100 100 100 100
Currently married
W idowed
Separated divorced
N
Total
%
M = Male; F = Female
The data in Table 3 are in conformity with the national
pattern- In the age-group 60 years and over, 72 per cent of the
women and 9 per cent of the men were reported to be widowed
in the 1974 CensusTable 4: Percentage of population by current marital status, sex and
age, 1974
Age Groups
50-54
55-59
60+
Married
Widowed
F
M
F
M
95.8
95.4
90.2
60.3
52.9
27.3
3.0
3.7
8.9
39.0
46.2
72.1
M
Divorced
F
0.2
0.1
0.1
0.4
0.5
0.2
Sources: The same as in Table 2.
Various reasons could be adduced to explain male/femalc
differences with regard to widowhood- Of these reasons,
particular mention may be made of age differences between
husband and wife and differences in chances of remarriage
for widowers and widows. Marriage in Bangladesh takes place
early 16 years for girls and 24 years for boys on an average.
THE AGED IN BANGLADESH
67
There is usually 8-10 years age difference between husband
and wife in Bangladesh and in our samples (urban, semiurban and rural), this difference was 11 years. Asa result,
the husband dies before his wife because of merely the aging
process. Moreover, various studies have shown that widows
are much less likely to remarry than widowers (Chaudhury
1980). This may also explain the finding of a higher proportion
of men being currently married than women at higher ages. In
a country with moderate but fluctuating levels of mortality,
with marriage at an early age, with higher chances of remarri
age among widowers and with a considerable age difference
between husbands and wives, widowhood may be expected to
be more frequent for women.
Education
The level of education for the aged is lower than that of the
national level. For example, according to the 1974 Census,
the literacy’ rates for men and women were 30.9 and 13.2 in
the rural areas. The corresponding figures for the aged (65
years and over) men and women were 26.6 and 2 3 respec
tively. Similarly, the literacy rates for men and women in the
urban areas were 52.0 and 33-3 in 1974- The corresponding
figures for the aged (65 years and above) men and women were
43.5 and 9-8 respectively. If we omit the 5-14 years age-groups
from our analysis,8 we find an inverse relationship between
age and level of literacy particularly prominent for women
(see Table 5). The explanation for the finding of an inverse
relationship between age and level of literacy is not too hard
to seek. For the older people, given the socio-cultural situation
of the country, it was inevitable that very few men and women,
particularly women, learned to read and write- But over time
comparatively more men and women have received an educa
tion, as is evident from higher level of literacy at the young
adult ages7. 'Literacy’ is defined as the ability to both read and write in any
language. These rates were calculated for the population 5 years and
above.
8. The relatively lower rate of literacy in the age group 5-14 compar
ed to the level, particularly in 15-19 age group, is due to the higher
base population of the former than the latter age-group.
AGING IN SOUTH ASIA
Table 5: Percentage distribution of the literate population by age, sex
and rural-urban residence 1974
Age
Rural
Urban
Male
Female
Male
Female
5-9
10-14
15-19
20-24
25-34
35-44
45-54
55-64
65 +
13.4
39.7
54.1
42.9
34.5
30.8
29.2
28.1
26.6
9.2
26.7
22.4
16.6
11.9
8.4
5.7
3.4
2.3
23.8
54.3
61.6
66.1
59.8
54.3
53.2
47.3
43.5
21.4
47.8
50.5
42.5
32.5
25.9
19.5
14.0
9.8
5+
30.8
13.2
52.0
33.3
Table 6: Occupational distribution by sex and area
Dacca City
M
F
Jurian
M
F
Lionbatt i
M
F
Total
M
F
— 15.37 1.06
Executive
32.11 1.22 10.47 2.22 1.58
Teacher/Physician
_
_
_ _
Engi neer/Advocate
5.04 3.65
1.78 1.06
—
— 1.05
— 5.54
—
Clerk
7.79
6.66
—
Proprietor (business) 9.17
6.66 1.11 2.10 0.90 6.14 0.71
Agricultural labour
— 24.73 0.90 7.76 0.35
—
— 0.47
Non-agricultural
— 44.28 1.11 4.73 1.81 16.82 1.06
labour
0.91
Cultivator/landowner 2.29
— 10.00
— 53.15 0.90 20.55 0.35
pension-holders
— — 16.18 1.77
39.45 1.22
6.66 4.44
(retired persons)
— 91.46
— 91.11
— 90.0
— 90.78
Housewives.
— 1.05 — 1.29 0.35
— 1.22 2.85
Menial
— 3.15 5.45 2.91 2.48
2.29 1.22
3.33
Others
—
— 8.42 — 5.82
8.57
—
0.91
Not stated
218
210
190 190 110 618 ■ 282
82
N
100 100
100 100 100 100
100
100
Total
%
It may be observed from Table 6 that the majority of male
respondents in the city area consists of pension-holders,
whereas the male respondents in the semi-urban area are
primarily wage labourers. Their counterparts in the rural area
THE AGED IN BANGLADESH
69
are mainly the landowning farmers and landless agricultural
labourers- The female respondents are overwhelmingly house
wives, irrespective of their residential background- The diff
erential occupational patterns by locality reflect structural
differences in the economy. The chances of participation in
the formal sector of the economy are higher in Dacca city and
retired persons working in this sector are entitled to pension
which provides some security to the respondents in the city
area. But no pension is provided to those working in the semiurban and rural areas where people have to work for their
livelihood even in old age. In the semi-urban area the adult
males were engaged in the tertiary sector of the economy and
this is also reflected in the occupational pattern of the respon
dents; whereas in the rural area, land is the most important
source of living and men having land are engaged in farming
and those who arc landless work mainly as agricultural
labourers- Female participation in directly productive activities
outside the home is very limited for the country as a whole
and this is also reflected in the study areas.
Number of children and their living arrangements
Analysis of data obtained from village Muyiarchar on
number of children of the aged and the living arragements of
the children show the following pattern. Elderly persons on an
average had 5 living children, 3 sons and two daughters- The
majority of children (81 per cent of sons and 68 per cent of
daughters), particularly the unmarried ones (at least 90 per
cent) were living with the parents or in the same village or in
the neighbourhood. However, the majority of the mariied
children, particularly the daughters, lived outside the village.
This is consistent with the exogamous pattern of marriage
prevailing in Bangladesh. Analysis of the data from the other
study areas also shows a similar pattern of living arrangements
of children. For example, 58 per cent of children in urban,
semi-urban and rural areas live with their parents. The
corresponding percentages for unmarried and married children
are 77 and 43 per cent respectively.* This is expected in view of
the fact that the maried male children usually form separate
•For urban, semi-urban and rural areas together.
70
AGING IN SOUTH ASIA
households after their marriage and they live in the same court
yard where their parents live or, in the neighbourhood or in
the same village- The physical separation, however, does not
mean severing ties with the parents- Even though the married
children form separate households and live separately after
their marriage, they still retain their ties with their parents
very closely and they engage in several different social and
economic pursuits jointly and they remain virtually interde
pendent.
LIVING ARRANGEMENTS OF THE AGED
Household head
The majority (90 per cent) of the male respondents were
heads of their own households who lived in their own houses.
The corresponding figure among the female respondents was
only 11 per cent (see Table 7)- In the village Muyiarchar,
female headed households accounted for 13 percent of all
households. This is expected in view of prevailing patriarchal
and patrilocal kinship system in the country. In this system,
the eldest male member is the head of the family and a girl
upon her marriage joins her husband in her father-in-law’s
house and descent is also traced through the male member of
Table 7: Relationship of the respondents with the head
of the household
Relationship
with the head
Dacca City
M
F
Jurian
F
Lionhatti
M
F
M
Total
F
(618)
(282)
12.19 83.81 10.0 87.37 10.19 89.97
32.93 10.48 30.0 8.95 19.09 6.96
— 1.82 0.16
4.88 0.48
3.33
— 0.48
1.11 1.05
1.82 0.49
—
— 0.53
0.16
1.23
7.31
2.38
6.66 1.05 2.72 1.13
— 1.05
— 1.13
1.22 2.38
—
— 48.88
— 63.63
40.24
100
100
100 100 100
100
10.99
26.59
3.19
1.06
0.35
5.35
0.35
52.12
100
(218)
98.17
Head
Son
1.83
—
Daughter
—
Grandson
Grandson-in-law —
—
Son-in-law
—
Other relations
—
Husband
100
Total
M
(82)
M = Male; F=Female
(210)
(90)
(190)
(HO)
THE AGED IN BANGLADESH
71
the family. The female headed households are rare in Bangla
desh but they are increasing because of poverty or they have
had no grown-up son or no son at all (Chaudhury 1980). Most
of the female heads of households are destitutes who arc
engaged in begging for their livelihood- The proportion of
male respondents who arc heads of households is highest in
Dacca city, followed by rural and semi-urban areas- This
may be related to the differential economic position of the
respondents according to locality- The male respondents of
Dacca city have higher income0 and a high proportion of them
are pension holders (see Table 6). This relatively better
economic situation of the male respondents of Dacca city
compared to respondents of semi-urban and rural areas may
explain the finding of a higher proportion of male headed
households in the former than in the latter areasThe higher proportion of male heads of households also
indicates that elderly persons want to retain their position to
make their voice heard and to ensure their security. This can
also be verified indirectly; very few of the aged have distributed
their land among their children (see Table 20) because if the
land is distributed parents fear they would not be looked after
when they become inactive or incapacitated.
Living with son
A son is the most important source of physical and econ
omic security (not to mention psychological security) to
parents- An absolute majority of respondents who were not
heads of households lived with’their sons, followed by sons-inlaw and grandson- Very few of them lived with daughters
because it is contrary to the cultural expectation in a patriar
chal society like Bangladesh for parents to live with married
daughters- This residential pattern holds good whether we
examine it by sex or residential background (see Table 8).
9. The median monthly incomes of the male respondents for urban,
semi-urban and rural areas arc Taka 500 and Taka 470 respectively.
The absolute majority of female respondents have had no cash
income.
72
AGING IN SOUTH ASIA
Table 8: Relationship with head of the household (for those aged who
arc not heads of the households) by sex and areas
Relationship
with head of
the households
Dacca city
Jurian
M
F
M
F
(4) (39) (34) (37)
Lionhalti
Total
M
M
F Total
F
(24) (28) (62) iU04) (166)
Son
100 69.23 64.71 72.97 70.83 75.00 69.35 72.11 71.07
Daughter
— 10.25
Son-in-law
— 15.38 14.71 16.21
2.94
8.11
—
7.14
1.61
8.65
6.00
8.33 10.71 11.29 14.42 13.25
2.70 8.33
7.14
4.84
2.88
3.67
—
4.16
—
1.61
0.96
1.20
— 2.56 14.71
—
8.33
— 11.29 0.96 4.81
100
100
100
100
Grandson
—
—
2.94
Grandson-in-law
— 2.56
—
Other relations
Total
100
100
100
100
100
M = Male; F=Female
Note: Women who are dependent on their husbands are also excluded.
DEPENDENCE ON CHILDREN
Although the majority of the aged remain heads of house
holds, they are dependent on their children for various
reasons- in this paper we will examine the extent and nature
of this dependency by asking questions such as (i) simple depen
dence; (ii) economic dependence; (iii) kind of help being
received from children; (iv) specific reason for help, etc- some
of these aspects are examined below.
Respondents were asked whether they are dependent on
their children or children were dependent on them and/or
both?
Jt can be seen from Table 9 that 40 per cent of the
respondents were dependent on their children. This percent
age for dependency on children is higher for females (61 %) than
for males (31%). This holds true even when allowance is made
for age and marital status (see Tables 9 and 12). This is ex
pected in view of the fact that very few women respondents
have an independent income of their own and, therefore, they
are either dependent on their husbands or their children,
73
THE AGED TN BANGLADESH
Table 9: Responses to the question ‘Arc you dependent on your
children?’ by age and sex (per cent)
N
Female
Yes
N
58.74
Male
Age
Yes
50-59
23.55
361
60 +
42.41
257
Total
31.39
618
Total
N
Yes
143
33.53
504
64.02
139
50.00
396
61.34
282
40.77
900
particularly sons, for their livelihood- There appears to be a
positive relationship between age and dependency on children.
This finding is also expected in view of the fact that as one
grows older, the more one becomes inactive or incapacitated
and the more one is likely to be dependent on children.
It should be further noted here that dependence on
children varies by locality. For example, male respondents
arc less dependent on children in Dacca city than those who
are in semi-urban and rural areas (see Table 10). This may be
explained by the higher income level of male respondents in
the city than in the semi-urban and rural areas (see footnote 9).
Income is inversely related to dependency i.e-, the higher
the income of an aged person, the lower his/her dependency
Tabic 10: Distribution of responses to the question 'Arc you dependent
on your children?’ by residential background and sex of the aged
Residence
Male
Yes
N
Female
Yes
N
Dacca
22.01
218
60.97
82
Jurian
37.14
210
68.89
90
Lionhatti
35.79
190
55.45
110
on children- For example, only 17 per cent of the respondents
having incomes of Taka 1000 and above per month are depen
dent on children compared to 54 per cent among those who
have no cash income (see Table 11).
74
AGING IN SOUTH ASIA
Table 11: Distribution of responses to the question ‘Are you dependent
on children?’ by income groups, male respondents only
Monthly
Income (in Taka)
Yes
N
Nil
53.65
123
<300
35.93
167
301-500
31.32
501-1000
17.64
83
119
1001 and above
16.66
126
Further examination of Tabic 10 shows that female respon
dents were relatively less dependent on their children in rural
areas compared to urban and semi-urban areas. A partial
explanation to this finding may be related to the variation in
the proportion of widows. In these localities, widows constitute
29, 50 and 46 per cent of the female respondents in rural,
urban and semi-urban areas, and they are preponderantly
dependent on their children (see Table 12).
It can be seen from Table 12 that the dependency on
children varies by marital status- Widows and widowers arc
more dependent on their children than those currently
married- Widows are more dependent on their children than
widowers, because widows have little or no economic inde
pendence and, in the absence of their husbands, they have
no other alternative but to depend on their children,
particularly sonsHelp from the children
The respondents were asked whether they received any
help from their childrenIt can be seen from Table 13 that the absolute majority
(76 per cent) of the respondents received help from their
children- Female respondents received more help than their
male counterparts, in all the study areas, though the extent of
help received by the aged from their children is the lowest in
the city area- This may be explained by higher income and
greater pension benefits of the city respondents compared to
their counterparts in the semi-urban and rural areas-
Dacca city
Marital
status
Male
Yes N
Married
21.71
198 52.5
Widow/Widower
29.4
17
Divorced/Separatcd
Total
Female
Yes
N
Male
Yes
N
40 30.0
68.3
41
—
3 100.0
1
22.01
218 60.97
Total
Lionhatti
Jurian
Female
Yes
N
Male
Yes
N
Female
Yes
N
Male
Yes
N
Female
Yes
N
160 66.67 48 34.28
140 57.14
77 27.91
498
58.78
165
32 46.95
115
65.78
114
20.0
"5
33.33
3
60.0
50 73.17 41
39.58
48 53.12
—
1
50.0
2
—
—
82 37.14 210 68.89 90 35.79
—
190 55.45
1
110 31.39 618
61.34 282
THE AGED IN BANGLADESH
Table 12: Distribution of respondents to the question, ‘Are you dependent on your children?’ by marital and residen
tial status of the aged
76
AGING IN SOUTH ASIA
Table 13: Distribution of responses to the question, ‘Do you receive
any help from your children regularly?' by residential status
of the respondents
Responses
Yes
No
NR
Total
N
0/
Zo
Dacca city
M
F
Jurian
M
F
Lionhatti
M
F
Grand
Total
Total
M
F
55.04 67.07 82.85 94.44 81.05 88.18 72.49 84.04
36.69 25.60 17.14 3.33 16.84 10.90 23.94 12.76
— 2.22 2.10 0.90 3.56 3.19
8.25 7.31
218
82 210
90 190 110 618 282
100
100 100
100 100 100
JOO 100
76.11
20.44
3.44
900
100
It should be mentioned here that even those parents who
did not receive regular help from their children also admitted
to have received financial assistance from their children
occasionally.
Help from children by economic class
Examination of the data in Table 14 shows an inverse
relationship between economic status of the aged and degree
Table 14: Distribution of responses to the question, ‘Do you receive
any help from your children?' by monthly income of the
male respondents* (per cent)
Income (in Taka)
Yes
No
No Income
Less than 300
301-500
501-1000
Above 1000
90.24
80.23
55.42
68.06
60.31
123
167
83
119
126
•Female respondents are excluded in view of the limited number
of women having a cash income.
of help received from children i.e., the higher the economic
status of the parents the less the help they received from their
children. For example, nearly 90 per cent of the respondents
having no cash income received help from their children as
against 60 per cent among those whose monthly income was
Taka 1000 and above.
A similar pattern of relationship between economic status
and degree of help received from children emerges when
economic position is determined by land ownership status.
77
THE AGED IN BANGLADESH
For example, we find that 90 per cent of the landless parents
received help from their children compared to 73 per cent
among those who claimed to have land- This pattern of
relationship between economic status of the aged and the
extent of help received from children holds true even when
allowance is made for residential background of the
respondents.
Type of help
Regarding the type of help being received by the aged,
mention was made of cash, goods, nursing, etc- Financial
help constitutes the most important aspect of help being
received by parents from their children (see Table 15). Sons
are the main sources of financial help while daughters provide
nursing services to their parents- The financial assistance is
provided for the maintenance of parents and to fulfil various
social and religious obligations such as feasts, festivals,
marriage ceremonies, etc., and to defray the educational
expenses of brothers and sisters- This has been borne out by
Table 15: Type of help being received by parents from married sons
and daughters by locality (per cent*)
Type of help
Financial
Goods
Nursing
Others
Total responses
Dacca city
Son
daughter
son
Jurian
daughter
son
Lionhatti
daughter
57.78
28.64
10.55
3.01
20.27
40.54
35.13
40.54
54.67
27.10
12.61
5.60
7.14
42.85
40.10
9.89
55.26
15.78
17.86
11.05
9.63
31.85
48.14
10.37
199
174
214
182
190
135
•Percentages were calculated on the basis of total responses.
data collected from village Muyiarchar (see Table 16). Tt is
considered to be a duty on the part of an earning son whether
he resides within or outside the village to help parents
financially even if this was not requested.
Other forms of assistance
Children provide not only financial assistance, but they
also help in kind by providing goods and services. We may
78
AGING IN SOUTH ASIA
Table 16: Responses to question.‘For what specific purposes children
usually help you financially, either regularly or occasionally?’
Purposes
Number
o/
/o
32
12
16
4
3
2
5
43.2
16.2
21.7
5.4
4.0
2.7
6.8
Maintenance/gift
Education of brothers/sisters
Feasts, festivals and marriage
Purchase of land
Repairing of house
Repayment of loans
Cultivation
form an idea about the extent of this help from data obtained
from village Muyiarchar. The elderly persons of this village
were asked to identify the types of help in kind they received
from their children.
It can be seen from Table 17 that nearly half of the respon
dents (44-6 per cent) received different kinds of food from
Tabic 17: Responses lo question, ‘Other than financial help, what
other forms of help do you receive from children?’
Types of help
other than financial
Number
o/
/O
Food
Clothes
Household items
Cosmetics
Stationery
Utensils/crockery
Furniture
Other consumer durables
33
14
10
2
6
5
1
3
44.6
18.9
13.5
2.7
8.1
6.8
1.4
4.0
Total
74*
100.0
*3 cases were excluded as they were childless.
their children. The other important items received by the
parents included clothes, groceries, stationery, etc., which are
no less important than the monetary assistance received
from children for the welfare of the family.
Participation in family decision-making
The views of elderly persons are given due recognition in
family decisions, as can be seen from Table 18. More than
79
THE AGED IN BANGLADESH
four-fifths of the respondents reported that they were consulted
by their children when important family decisions were takenParents were mostly consulted in decisions concerning family
expenditure (sec Table 19).
Table 18: Responses to the question, 'Do your children consult you
in taking any important decision relating to family affairs?’
by locality
Yes
Res ponses
N
86.33
84.33
82.66
82.4
7.0
8.33
8.66
9.5
Locality
Dacca City
Jurian
Lionhatti
Muyiarchar
Non response
6.66
7.33
8.66
8.1
Total
N
300
300
300
74*
Of
100
100
100
100
*3 cases were excluded as they were childless.
Table 19: Distribution of responses to the question, 'What are the
most important matters of decision on which your advice is
usually sought?’ by locality (per cent*)
Matters of decision
Dacca
Jurian
Ljipnhatti
Family expenditure
Marriage of children
and grandchildren
Education of children
and grandchildren
Number/timing of children
Agricultural/profcssional
affairs
Others
Total responses
50.29
57.82
62.28
14.62
17.34
9.32
12.57
1.17
5.44
8.50
4.23
11.86
15.20
6.14
342
8.16
2.72
294
7.62
4.66
236
‘Percentages arc calculated on the basis of total responses obtained.
Parental control over land
Land is the most important means of production in Bangla
desh- Parents’ control over land is a very powerful mechanism
through which they control the labour of their children and
ensure economic support in old age and participation in family
decision-making. Table 20 shows that the absolute majority
of the parents did not distribute their land among their
so
AGING IN SOUTH ASIA
children- This pattern holds true even when allowance is made
for the effect of age and residential background.
Tabic 20: Distribution of responses to the question, 'Have you distri
buted your land among your children?’ by age and locality
(excluding the case with no land), in per cent
Age
Dacca City
N
Yes
50-59
60+
Total
2.26
13.71
7.78
133
124
257
Jurian
Yes
N
11.26
23.07
15.45
142
78
220
Lionhatti
Yes
N
Total
Yes
N
7.69
14.78
11.92
7.08
16.40
11.49
78
115
193
353
317
670
Table 21 reveals that the principal reason for not distri
buting land among the children was the fear that, once this
Table 21: Responses to the question, ‘Why land was not distributed
among children?’by locality (excluding the case who have
no land), in per cent
Responses
They will not get attention/
care from children
Monetary support from
children for family
expenses will be reduced or
withdrawn
Children will not look after
them when they become
inactive
They will not be respected/
consulted in family
decision-making
Others
Not answered (N.A.)
Total
%
N
Locality
Dacca City Jurian Lionhatti Muyjarchar
21.52
24.19
13.53
21.1
24.05
25.80
17.64
25.0
32.91
29.57
42.94
30.8
21.52 20.43
—
—
—
—
100.0 100.0
237
186
15.88
4.70
5.29
100.0
170
23.1
—
—
100.0
52
was done, the children would not come forward spontaneously
to help their parents when they grew old and inactive, followed by the apprehensions that the monetary support from
children for the maintenance of the family would be reduced
or withdrawn and they would not receive proper attention
and care- A considerable proportion of parents also main-
THE AGED IN BANGLADESH
$1
tained the view that once land is distributed they would not be
respected and consulted in family decision-making by their
children. Thus it appears that the parents tend to hold on to
their rights over property for as long as they can in order to
ensure their economic security- However, this security is
unavailable to those unfortunate landless households who
constitute the majority.1011
Future scenario and concluding remarks
From the above findings, one may tend to draw some
inferences about the future prospects of the elderly citizens of
Bangladesh. The number of elderly citizens is growing every
year with increasing life expectancy. We have found that a
sizeable proportion of elderly persons particularly those who
are landless with little or no income and widows who are
dependent on their children, primarily male children, and
received help from them both in cash and kind for their
livelihood and old age security- Many of these categories of
people also stay with their children. This dependence on
children Tor social security in old age is also considered an
important factor for high fertility in Bangladesh.
Given the poor economic situation of the country as
reflected in high levels of unemployment,” poverty and land
lessness, one would tend to expect the majority of the elderly
citizens to depend on their children for their old age security
in the absence of any other alternative support. But the
crucial question is—could this security be ensured to a grow
ing number of the aged by poor sons of poor fathers and in
a situation when the traditional family system is disinte
grating? Since no definite answer can be given now, we may
tentatively conclude that old age in Bangladesh should not be
contemplated with equanimity. Some institutional support
10. In rural Bangladesh 37 per cent of households do not possess
any arable land (Bangladesh Bureau of Statistics, 1979.)
11. About 33 percent of the agricultural labour force in rural
Bangladesh is unemployed (Planning Commission 1980); 37 percent
of the rural households do not possess any arable land (Bangladesh
Bureau of Statistics 1979) and at least 60 per cent of rural families
are poor by conventional indices of poverty and malnutrition
(Khan 1977).
S2
AGING IN SOUTH ASIA
must be found to provide help to the growing number of the
aged before it is too late.
The government of the People's Republic of Bangladesh
has shown some concern by allocating grants to an institute
of gerontology set up by a group of retired government offi
cers in Dacca. The objectives of this institute arc to provide
recreational facilities, vocational training, health counselling
and conduct research on the problems of the aged. However,
these activities, no doubt benevolent, would be centred in the
capital city and cater to the needs of a few privileged aged
persons living there. But to benefit the majority of the aged,
these activities must cover old men and women living in the
rural areas.12 The government therefore should put an end
to its bias in favouring the urban elites and come forward
with concrete plans of action to help the growing number of
the aged in rural areas, particularly those who arc poor.
Appendix A:
Census years
1951
1961
1974
Percentage of population 60 years and over for different
census years, by sex
Percentage of population
Male
Female
4.6
5.5
6.0
4.2
4.9
5.2
Per cent change
Index 1951 = 100
Female
Male
100
120
130
100
117
124
Source: Bangladesh Bureau of Statistics, Population Census 1974
12. More than 85 per cent of the population of Bangladesh lives
in rural areas.
1975
Agc-group
M
2025
2000
F
T
M
5.30 5.42 5.18
5.31
5.33 5.50
5.70 5.61
5.80
6.62 6.54 6.70
9.55 9.53 9.56
4.38 4.47 4.29
4.54 4.56 4.52
4.99 4.85
5.15
5.66 5.40 5.94
9.93 9.47 10.41
T
60+
1990
1980
M
F
F
T
F
T
M
F
T
M
THE AGED IN BANGLADESH
Appendix B: Estimated proportion of people in the age-groups 50-59 and 60 and over to total population in 1975,
1980, 1990, 2000 and 2025
T=Total; M = Male: F=Femalc
Source: Bangladesh Bureau of Statistics, Statistical Pocket Book of Bangladesh 1979
oo
5
The Social Organisation of Aging
among the Urban Poor
Alfred de Souza
This paper presents the major findings of an empirical
study of old people in eight resettlement colonies of Delhi.
The scope of this study was to explore the social organisation
of old age among the urban poor with specific reference to
the changing structure of the family in the low income groups
as a result of the process of urbanisation and the family
development cycle- The family of the urban poor is nuclear,
as several studies have reported, with variations that are
nuclear in structure.
In its orientation, this study was concerned not merely
with the problems of old age, which are deeply personal in
character, but with their social significance and their implica
tions not only for the family but also for society in general.
While the findings of this study are limited to old people in
the informal urban sector, they have wider theoretical and
An earlier version of this paper appeared in the Economic Times
(Delhi and Bombay), July 5, 1981. This paper is based on a larger
study, ‘The Changing Family Structure and Welfare Needs of the
Aged from Low Income Groups,’ which is published under the title,
The Social Organisation of Aging Among the Urban Poor (Indian
Social Institute, 1982). The research on which this paper is based
was supported by a grant of the Department of Social Welfare,
Government of India; the responsibility, however, for the views ex
pressed here is entirely that of the author and not of the Depart
ment of Social Welfare.
SOCIAL ORGANISATION OF AGING
85
policy significance for social welfare services for the aged if
appropriate allowances are made for the diversity in social
and economic variables within a shared cultural matrix.
This paper is based on survey data on 1969 households in
eight resettlement colonies of Delhi: Seelampur, Raghubir
Nagar (Phases I-III), Madangir, Wazirpur, Dakshinpuri,
Jahangirpuri, Patparganj Complex and Raghubir Nagar
(Phase IV). In addition, an intensive study was made of 304
old people selected randomly from the household census pop
ulation—an average of 38 old persons per resettlement colony.
Case study material was collected on 60 old people and, since
the concern was with the relationship between family structure
and the problems of old people, a purposive sample of 152
family members was interviewed in order to understand the
attitudes to old people within their family and the dynamics
of interpersonal relations that change with the family develop
ment cycleSocio-economic profile
Of the random sample of 304 old people (146 men and 158
women) who were intensively studied, 80 per cent had resided
in Delhi for over 20 years, and only 5-6 per cent had been
born in Delhi itself. Most of the old men and women in this
study were migrants who intended to settle permanently in
Delhi and had come from the rural areas (70 per cent) in
search of employment rather than for better employment. A
majority of them came from the neighbouring States of
Haryana (6-6 per cent), Rajasthan (20 per cent) and Uttar
Pradesh (35-5 per cent), and there was also a relatively large
group of displaced persons (20.7 per cent) who had come to
Delhi after Partition.
In Rajasthan and Uttar Pradesh, both relatively under
developed States with low levels of urbanisation, the tendency
of migrants is to move outside the State to cities such as
Delhi, Chandigarh and Calcutta. It has been noted (Singh
and de Souza 1980: 14) that the most highly urbanised states,
except Tamil Nadu, do not experience significant out-migra
tion of the rural poor to cities outside the State. Thus the
data show that migration to Delhi is a selective process which
is determined by the levels of urbanisation and employment
86
AGING IN SOUTH ASIA
opportunities within the State and the city of destination,
though the choice of city tends to be largely determined by
social networks and "resource persons’ (Gore 1970: 50;
Majumdar and Majumdar 1978)- Even though rural migrants
may settle down in cities for a long period, as the old people
in our sample, they continue to maintain communication links
with their kin group in their native village either by periodic
visits on social occasions connected with marriage or at the
time of festivals or by the remittance of small sums of money
(de Souza 1978)The concentration of both men and women was in the
age group 58-90 and the proportion of males exceeded that of
females in all age groups except 64-66 years and 75 years and
above- Though the expectation of life at birth during the
decade 1961-71 was 47-1 for males and 45-6 for females, it is
clear that once men and women survive the critical period
0-5 years, and women the child bearing years, they can expect
to live to 70 years and above (Djurfeldt and Lindberg 1980: 48).
Theie were 133 (84 2 per cent) widows in our sample as com
pared to 41 (28-1 percent) widowers- This can be explained
by the substantial age difference between men and women at
marriage because of the cultural preference of early marriage
for girls, as well as the taboo against remarriage for widows.
Thus, when one is thinking of social welfare services for the
old, sex-specific differentials in marital status are important
variables which should be taken into consideration.
As is the case of families in the informal urban sector,
most of the participants in this study were residing in nuclear
families, or, following Kolenda’s typology, ‘supplemented
nuclear’ families. Even among the urban poor the joint
family remains an ideal, though in practice the vast majority
of families is nuclear in structure- The joint family is charac
terised chiefly by relations of mutual obligation which are
activated particularly in times of crisis and by the family
development cycle. Thus the cultural norms of the joint
family tend to be observed even when the structure of the
family is nuclear; it is the duty of sons to look after their pare
nts in their old age, and the widowed woman will expect to live
with one of her sons until her death- This accounts for the
cultural preference for sons that has been repeatedly revealed
SOCIAL ORGANISATION OF AGING
87
in studies of fertility behaviour (Khan and Prasad 1978) as a
very important aspect of the social security of parents in their
old ageMost of the widowed women (63 3 per cent) lived with one
of their sons: 8-2 per cent of the women who had no sons lived
cither alone or with their married daughters, a pattern of
residence which would be rare in rural areas but acceptable
in an urban environment as a mode of coping with economic
stress. In our sample, 10 out of the 11 women who lived with
their daughters, were widows- A high percentage of old men
and women in our study belonged to the Scheduled Castes,
and, as several scholars have pointed out, their family struc
ture tends to be nuclear or variations of the nuclear family.
It was found that 72 per cent of the old people in the study
were illiterate, 55 per cent of the men and 90 per cent of the
women- They were engaged in low status occupations and
scavenging- The low level of education of the urban poor
places almost insurmountable restrictions on the kinds of
occupations available to them- The tendency of rural mi
grants is to continue in the informal urban sector their caste
specific occupations and, though there may be limited hori
zontal occupational mobility, the urban poor are concentrated
inoccupations of low status which require unskilled labour.
Majumdar (1978: 43), has noted that unskilled workers in
construction and industry were engaged in the same occupa
tion even after 12 years of residence in Delhi- However, he
points out (ibid: 45) that the low castes and Scheduled Castes
who generally cluster in the lowest status occupations in
industry, construction and services have wider scope for
horizontal social mobility even though ‘vertical mobility as a
movement from one stratum to another is still very limited-’
A high proportion of the men were involved in skilled arid
unskilled work in the construction industry and scavenging; on
the other hand, a large number of women was employed as
domestic workers- Domestic work is not the preferred occu
pational choice of women; but given the narrow range of
occupations open to them, domestic work is chosen because
it provides the conditions that are culturally demanded:
domestic work is done under the supervision of women; it
does not require specialised skills or education; and it is
88
AGING IN SOUTH ASIA
usually part-time so that additional income can be earned by
working in several middle class homes- The occupations of
these old people tend to be precarious and a high proportion
of the men and the women had work that was occasional,
irregular or part-timeThe monthly income of these old people shows that they
were at the subsistence level with 63-8 per cent of the men and
women (N=127) earning a monthly income of'less than Rs
200; 32-2 per cent Rs 201-400 and 3-9 per cent above Rs 400.
There was considerable disparity in the monthly incomes of
men and women and this was reflected in the levels of finan
cial dependence on the family. It was found that 29-9 per
cent of the old men and women in the sample (N = 304) were
totally independent financially while 70-1 per cent were totally
(57.9 per cent) or partly (12-2 per cent) dependent on others
for their support- Out of 158 women, 17-1 per cent considered
themselves totally independent, 10.8 per cent partly indepen
dent and 72-2 per cent totally dependentNutrition and health
There is a complex relationship between nutrition, health
and environment, particularly in the informal urban sectorIt was found that the diet of the old people in this study was
both inadequate in quantity and nutritionally unbalanced. The
diet consisted mostly of cereals, such as wheat and dal, and
potato; meat, eggs and milk were rarely included in the dietVarious studies (e-g-, Singh and de Souza 1976: 96) have
shown that the poor tend to spend 75-80 per cent of their
monthly income on food and yet their diet remains inadequate
and unbalanced- Food habits, as is well known, are deter
mined by cultural preferences and thus wheat and dal form of
staple items of diet in North India. However, the old people
interviewed stated that they were mostly non-vegetarians and
would have liked to have meat, but they were unable to
afford it except rarely. Thus the diet of the old people in the
sample reflects a general cultural pattern and, more impor
tantly, the limitations imposed by poverty. It was also observed
that the old people had the same diet as the rest of the family
even though the elderly, because they tend to eat less, require
food of more nutritious quality.
SOCIAL ORGANISATION OF AGING
89
There was a relatively high level of dissatisfaction with the
quantity and quality of the diet and this was generally attri
buted to their lack of purchasing power to buy more and
better food. On the whole, women were less satisfied with
their diet than men. Thirty per cent of the women stated
that they were dissatisfied with their diet in contrast to 17.8
per cent of the men. Though questions about satisfaction
with food may not be significant when one is dealing with
diets of the urban poor in which there is little scope for
variation, the level of dissatisfaction may indicate certain
broader aspects related to the differential perception of men
and women.
While men may be dissatisfied with food because of
quantity, women may be dissatisfied not only because of
quantity but also because of psychological factors related to
the preparation of food. In keeping with the cultural pattern
of the subordination of women that females eat after males,
old women may receive food in insufficient quantity (Gore
1968: 170). The level of satisfaction maybe related to the
preparation of food which is linked to the status of women
within the family, and the dissatisfaction with being replaced
by the daughter-in-law in the kitchen may easily be trans
ferred to the food itself.
The health status of old people in low income groups.is
part of the vicious cycle of hard work, poor nutrition and illhealth. The illnesses reported by both men and women were
symptomatic in nature, such as cough and cold, pain in the
body and dysentery. Neither men nor women reported more
serious illnesses like tuberculosis (0.4 per cent), high blood
pressure (1.8 per cent), heart disease (0.4 per cent), diabetes
(0.7 per cent). Thus the illnesses experienced by the old people
in the sample appear to be the consequence of a general
debility that can be related to. the social structure and what
Djurfeldt and Lindberg (1980:99) have called the ‘poverty
panorama.’
In general, there are four factors which determine the
health status of old people among the urban poor: (i) the
nature and condition of their work; hard work combined with
poor nutrition leads to a state of general debility and most of
the old people were suffering from what may be called
90
AGING IN SOUTH ASIA
‘deficiency' illnesses: (ii) environmental conditions: the reset
tlement colonies, in spite of the good intentions of the plan
ners, are characterised by the lack of basic amenities such as
water, latrines and drainage, with the result that the environ
ment itself becomes a health hazard: (iii) inadequate and
unbalanced diet, as we have already noted above; and (iv)
the availability and quality of health services.
A majority of the old men and women went to Govern
ment dispensaries located within the colonies or to Govern
ment hospitals for treatment of their illnesses; about one-fourth
of both men and women also went to private medical practi
tioners for consultation. The pattern of utilisation of health
services showed that traditional and modern medicine,
Government dispensaries and private doctors were used in
combination rather than exclusively.
It would appear that the definition of an illness directs the
individual concerned either to traditional healers or modern
allopathic doctors; and, further, that when an illness is identi
fied as being 'serious,' the tendency is to consult a private
doctor even though the fees may be relatively high.
Among both men and women, there were complaints
about the ineffective and adulterated medicines they received;
however, this reflects cultural perceptions of ‘effective’
medicine which very often is identified not with pills or
mixture, but with injectionsThe ineffectiveness of medicines received, about which the
old people complained, has to be attributed largely to the way
in which poor people utilise medical treatment rather than to
the quality of the treatment itself. Because of the relatively
high cost of medicines and consultation with doctors, the
tendency of the poor is to discontinue treatment as soon as
they feel somewhat better, but before they are completely
cured. As an earlier study of slum and pavement dwellers
Singh and de Souza 1980: 65) noted, ‘since medicine and
consultations are very expensive, they take medicines only
until the symptoms go away, and as a result, most of the
leading ailments. .. become chronic in nature-’
In studies of old age in Western societies, the focus has
been on social isolation and loneliness, and segregation from
society. In our study, it was found that among those who
SOCIAL ORGANISATION OF AGING
91
reported experiencing loneliness, there were more women than
men- This could be explained, apart from the distinctive
female psychology, by the fact that a high proportion of the
women in the sample were widows, most of whom were totally
dependent upon their family.
How do the old people cope with the loneliness and
emotional stress they experience? It has been pointed out by
Djurfeldt and Lindberg (1980: 171) that religious medicine
as it as practised in the rural areas by traditional healers
‘seems to be a highly efficient form of psychiatry.’ One of
the more important factors which explains the psychothera
peutic efficiency of religious medicine is the faith of the indi
vidual. Our field data show that old people draw on their
religious resources to cope with their emotional problemsThe capacity to adjust to the difficult situations of their life is
enhanced by their belief in the concept of karma which
governs the attitude to life of most Hindus. The concept of
karma promotes adjustment because events take on the char
acter of inevitability over which the individual has no controlTo cope, therefore, with events that bring about emotional
stress, the tendency of people from the lower urban class, as
also in the rural areas, is to have recourse to spiritual healers
and the practitioners of traditional medicine- Carstairs and
Kapur (1976) report that both men and women in their study
of Kota, who had at least primary education, preferred to
consult modern doctors, but when they identified their illness
as ‘spiritual’ their tendency was to resort to traditional healers
such as the mantarwadi (‘a master of the zodiac and of the
potent secret mystical verses termed mantras’), patris (shamans),
astrologers or medicine men.
Coping mechanisms
The strategies used by the old people to cope with the
problems of old age, particularly psychological stress, must
be seen in the broader framework of family structure, kinship
group and neighbourhood ties. Both men and women, parti
cularly those who were totally dependent, were assisted by
sons not staying with them, financially and in other ways. A
great effort was made by old men and women to keep in close
touch with their sons who were not staying with them and,
92
AGING IN SOUTH ASIA
even though interaction was most intensive not with relatives
but with the friends in the neighbourhood, this should not be
interpreted as a matter of preference but rather the acceptance
of constraints, such as cost of transport and long distances,
in maintaining contact with their sons or relatives.
It is the social environment that facilitates the integration
of old people through the coping mechanisms of the family,
the kinship group and the neighbourhood ties. It is in this
structured environment that the interaction of old people
takes place, though socialisation with relatives and neigh
bours is marked by significant differences in intensity. In the
case of both men and women, frequency of interaction is
highest with neighbours and relatively low with relatives, a
majority of these contacts being only occasional. In a
majority of cases, except perhaps in that of the Gujjars of
Raghubir Nagar, relatives do not form part of their immediate
neighbourhood and, though there may be close tics with them
of mutual obligation, the constraints of transport make such
contacts occasional.
In contrast to theories of ‘disengagement’ that have
developed in the context of Western society, it was found
that the primary mechanisms of coping with loneliness and
isolation were simultaneously mechanisms for the social
integration of old people in society. It must be pointed out,
however, that integration of old people in the neighbour
hood takes place within the framework of caste and ethnic
preferences. Thus the structure of the family, the kin group
and the neighbourhood are activated at different times for a
variety of purposes such as coping with the problems of
physical and economic dependency, unemployment as well as
social integration in society.
Theoretical significance
The findings of this study raise several issues that have
theoretical significance for the conceptualisation of old age
and social welfare services, and the organisation of old age
among the urban poor. The tendency in the formal or organ
ised sector of the economy is to define old age in terms of a
mandatory age of retirement whether it be 55, 58 or 60 years.
In low income groups engaged in occupations in the informal
SOCIAL ORGANISATION OF AGING
93
or unorganised urban sector, old age is not defined by retire
ment criteria, but rather in terms of withdrawal from employ
ment because of general debility related to the aging process.
In the definition of old age, particularly for women, cultural
criteria related to the family development cycle are of special
importance. Thus, a married woman, irrespective of her age
is culturally defined as ‘old’ as soon as the eldest son is
married and the daughter-in law comes to live with his parents
(Vatuk 1980).
The family development cycle brings about changes in the
status and roles of both old men and women because there is
a transition from the role of ‘provider’ to that of ‘depend
ant.’ The degree of dependency varies according to the
economic situation of the old person and in general, it is
characterised by a loss of role and limited participation in
decision-making in the social, economic and cultural spheres
of family activity. Thus, ‘consistency of status’ within the
family for old people, particularly at subsistence levels of
living in the informal urban sector, is determined by the level
of economic dependence on the family. In the case of women,
the loss of role brought about by old age is reinforced by
widowhood which leads to cumulative dependence.
With old age and increasing dependence on the family, a
certain ‘blurring' of roles occurs, even though the cultural
distinction between men’s work and women’s work is main
tained. Thus, old men participate in child care and domestic
chores, such as marketing, cooking and cleaning. In the case
of women, female roles are continued though old women may
be replaced by the daughter-in-law in kinds of work (e.g.,
cooking) that are culturally related to the status of women in
the family.
Studies of old age in Western countries emphasise the
social isolation and loneliness of the aged and have developed
theories of ‘disengagement,’ with corresponding policies for
the social reintegration of the aged into social and economic
life- The findings of this study, while they do reveal that old
people experience loneliness, the feeling of not being wanted
and even depression, suggest that old people among the urban
poor are socially and economically integrated in society
through a set of interrelated ‘coping mechanisms’ of which
94
AGING IN SOUTH ASIA
the most important are the family and the kin group as
primary resource structures, neighbourhood ties and social
welfare services.
In sociological studies of the family, the preoccupation has
been far too much with defining typologies of the family
rather than with developing an analytical understanding
of the family as a ‘mutual help' arrangement (Epstein and
Jackson 1975)- Among the urban poor, though the structure of
the family is nuclear, kin group ties are activated on different
occasions to cope with the social, economic and cultural
needs of old people depending on the family. As Kolenaa
(1968) has noted, families of low income groups tend to be
structurally of the ‘supplemented nuclear’ kind with flexible
arrangements to use the resources of the wider kin group.
However, since the cost of activating the kin group may
be high because of cost of transport and long distances in
volved, the neighbourhood becomes an important mechanism
for the integration of old people in society, though this inte
gration takes place within the framework of caste and ethnic
solidarities.
Social welfare services, particularly social assistance for the
aged among the urban poor, tend to be premised on the
assumption that only the aged who are destitutes need to be
supported. Thus, social assistance schemes for the aged
function as ‘substitutes’ for the family and do not enlarge its
capacity to look after the social and economic needs of the
aged.
Particularly in a cultural situation in which the value
system gives a great importance to parent-son obligations,
social welfare services must be directed not to individuals, but
to individuals within the family. Thus, in low income groups
in the informal urban sector, social welfare services which
could have functioned as an important element in the network
of coping mechanisms, remain largely ineffective in accom
plishing their stated goalsThe conceptualisation of social welfare services as ‘des
titution allowance’ reveals to some extent the fact that old age
has the characteristics of ‘organisational marginality.’ The
concept of organisational marginality is determined by cultural
criteria regarding the maintenance and care of the aged. In
SOCIAL ORGANISATION OF AGING
95
our culture, the family is considered to be the primary agent
not only of early socialisation but also of the maintenance and
care of its aging members. Thus, voluntary organisations
involved in welfare services for old people appear to be rela
tively more handicapped in raising funds for this purpose.
The concept of organisational marginality would also seem
to have influenced the allocation of grants in the Five Year
Plans. Epstein and Jackson (1975) have pointed out that the
tendency of the Plans has been to allocate considerably larger
outlays on family planning than on social welfare. In the
Fourth Five Year Plan Rs 315 crores were allocated to
family planning in contrast to only Rs 41 crores for social
welfare- As Epstein and Jackson point out (ibid: 17), 'Indian
planners seem to over-estimate the importance of family
planning programmes, while under-estimating that of social
welfare; the Fourth Five Year Plan allocates eight times as
much expenditure to the former than the latter item of public
expenditure (PC 1970:52, 410). The problem of the aged
seems to be ignored altogether; no funds are allocated under
that heading. Yet, expenditure on social security, particularly
for the aged, may prove to be a more efficient means than
family planning programmes in popularising the “small
family norm.”’ In the Draft Fifth Five Year Plan, the outlay
on Family Welfare Planning was Rs 576 crores while the
provision for social welfare was Rs 229 crores. This was
reduced in the final Plan document to only Rs 86 crores.
Policy implications
Apart from their theoretical significance, the findings of
this study could have wider relevance for policy formulation
and programme design for social welfare services to the aged
from low income groups. As we pointed out earlier, the
family is the primary vehicle of social security and social
assistance to the aged. However, current social assistance
schemes for the aged, since they have the character of a
‘destitution allowance,’ do not strengthen the capacity of the
family to look after the aged, but rather have the effect of
replacing the family.
Social welfare should also, therefore, reconceptualise
programmes designed for the aged of low income groups so
96
AGING IN SOUTH ASIA
that the family rather than the individual develops the econom
ic capacity for the management of old age. The Draft
Fifth Five Year Plan 1974-79 states that an objective of
national policy is that ‘welfare programmes for women and
children in need of care and protection as also assistance to
the aged and the handicapped would be further expanded and
strengthened with the ultimate objective of developing a
comprehensive social security programme.’
This paper shows that in the network of coping mechan
isms developed by the low income families to look after the
aged, the kin group and neighbourhood ties are of crucial
importance- This suggests that social welfare policy for the
aged should utilise the resources of the neighbourhood in
catering to the social, economic and cultural needs of old men
and women.
This will also have the advantage of promoting self-reliance
in the local community rather than encouraging total depen
dence on government assistance- The Draft Fourth Five Year
Plan points out that ‘the key to the success of social welfare
programmes lies in each community taking an integrated view
of community welfare and accepting the obligation of looking
after the interests of all its members, and especially of those
who need the help most-’
This study has shown that to meet their health needs, old
people in the informal urban sector use Government dispen
saries and hospitals as well as, to a lesser extent, private
medical practitioners, both traditional and allopathic.
Because of the high cost of utilising Government hospitals.
the tendency of old people is to patronise dispensaries located
within the resettlement colonies.
Health policy for the aged should be characterised by two
interrelated components: (i) the setting up of subsidised health
care for the aged with special units in hospitals and with free
or highly subsidised medicines; (ii) the training of both in
digenous and allopathic doctors to handle the specific illnesses
associated with aging- Subsidised health care would represent
an indirect transfer of resources to the family.
In developing social welfare services for old people in low
income groups, Government policy should be to give greater
scope to voluntary organisations at the national and local levels
SOCIAL ORGANISATION OF AGING
97
through a system of appropriate grants-in-aid. Thus, voluntary
organisations should be allowed to develop specialised services
for old people in terms of the differing environmental condi
tions and the changing needs of old peopleRigid guidelines will only hamper administrative organisa
tion and strategies for the aging which voluntary organisations
might be able to develop- As the Planning Commission recom
mended, voluntary organisations ‘should be given freedom to
administer and execute, to change and adapt and to find their
own solutions for the many problems which must arise from
day to day within each community. The primary task of
agencies at higher levels is to create conditions in which
agencies directly responsible for carrying out schemes can
best succeed.’
Similarly in the Draft Five Year Plan, it is stated that ‘A
higher place is assigned in the Fifth Plan to the role of
voluntary organisations is social welfare programmes. Such
organisations will be encouraged by providing grants-in-aid
with the increasing emphasis on improvement of standards
and expansion of welfare services rendered by them.’
Old people ought not be treated as a homogeneous category
in which men and women arc lumped together purely on the
basis of chronological age- Rather, a distinction should be
made with reference to income groups, formal or informal
urban sector, residential pattern and, most importantly, between
men and womenOld age has different implications for men and womenFor example, the effect of the family cycle is more traumatic
for women than for men, because of their deeper involvement
in female roles in the domestic sphere- Thus, the change of
role induced by the marriage of the elder son implies a greater
identity crisis for the woman rather than the man- Further,
widowhood has a much greater impact on women because it
makes them totally dependent on their sons, thus involving
not only emotional deprivation but also a loss of status within
the familyFor these reasons, old age policy should differentiate be
tween men and women and, among women, between those who
are widows and those currently married. Policy orientation
towards women should place special emphasis on income
98
AGING IN SOUTH ASIA
generation and the kinds of self-employment that are feasible
in the informal urban sector, so as to lessen their economic
dependence.
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The marginalisation of old people in South Asia, a
consequence of neo-colonial economic and political relations,
is inseparable from the overall economic conditions in these
' countries. In the specific conditions of poverty and lack of
social security, the family and ^e -kin network function as
jhe •ma.in- resources to ena^l.q^srfd.-people to cope with eccno' nii’c. social and psychological stress': •Since the perception of
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industrialised countries of the West, policies to support the
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Dr Alfred de Souza is Director of the Indian Social Institute
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