Sun, 26 Aug 2001

Gray creeping in to RI population

Still a country with one of the youngest populations in the world, Indonesia is now, inevitably, getting a bit grayer. The youth of the 1970s and 1980s will be reaching retirement age in the next 20 years. The Jakarta Post's Maria Endah Hulupi, Hera Diani and Bruce Emond examine if we are ready for what lies in store.

JAKARTA (JP): Every day when "Jenny" drives to work in Central Jakarta, she passes her widowed mother-in-law's home. She says she feels "guilty" when she does not stop in to visit the woman, "Betty", who, in her 80s, is physically fit but gradually going senile.

She is fond of her mother-in-law, and the provision of a trained nurse, plus daily catered meals, is not a financial burden on the family because both her and her husband work.

More of a problem is the emotional toll. "I have learned to pretend that every question she asks is the first time she has asked it. I might tell her the same story three times in 10 minutes because she forgets she has already asked it .... "

Jenny said the family would put Betty in a home if they believed she would be happy about it, but they know she would never accept it. She would see it as "abandonment".

Her experience may be common to many more of us in the coming years.

With the progress made in national development since Indonesia became a republic 56 years ago, people are living longer. Average life expectancy is now about 68 years for both sexes, compared to 45 for men and 48 for women in 1970. There are about 15 million over-60s in the country, about 8 percent of the more than 200 million population, according to Rozy Munir from the National Population Agency (Baknas).

That number is projected to jump to 11 percent in the next 20 years.

The implication, according to the former minister of investment and state enterprises development, is a greater burden on people of productive age.

He said that right now, every 100 Indonesians in the productive age group of 15 to 60 years are taking care of 59 others, meaning both the young and the aged.

As a comparison, the ratio in the United States is 100 to 33.

"If we want to reduce the burden on productive age people, we must have an integrated effort. Beside focusing on how to anticipate the increasing number of senior citizens, we also have to reduce the maternity rate," Rozy said.

He acknowledged the country's attention to senior citizens was still poor.

"Public service facilities have yet to accommodate them, like public toilets, the streets, public transportation. Geriatricians are also still very few," Rozy said.

Senior citizens, he said, are the responsibility of both the state and the family, and the country must look to how other societies deal with their elderly.

"If we want to put them in a nursing home, we have to prepare the home so it won't be a place just to eat and sleep. It should be near nature, because old people want some peace," he said.

Rozy noted that the increased number of senior citizens had already affected the workforce.

"Many families assign daughters to take care of their parents or grandparents. Many also hire young women or women relatives ... That means violating their rights to have careers, that's discriminative," he said.

A continuing problem is that Indonesians, unlike people in countries like Japan, do not save for their old age.

Some communities already have initiatives to ensure that their elderly residents are not left abandoned, such as through fund gathering in religious and social activities.

Rozy advised the young to start planning ahead so that they can live to a ripe and comfortable old age.

Baby boomers

It's the baby boomers born in the relative calm of Indonesia in the 1950s who will be losing their youth in the next few years. The problem is that traditional care-givers -- the family -- may not be around to take care of them as Indonesian society changes.

"Families have become smaller and more mobile to fit the modern era," said social psychologist Drajat Soemitro from the University of Indonesia.

Old people may well find themselves home alone, especially with the flight of young people from rural to urban areas. And in developed countries with their own increasing aging populations and declining population sizes, the UN predicts migrant workers from developing nations will be a hot commodity.

Sociologist Mayling Oey said the country must start anticipating the effects of the increasing aging population now.

The government, she added, must provide many services for senior citizens, and it will take enforcement of tax laws to ensure there is enough money in the budget for their needs.

As for the private sector, Mayling said it had yet to react to future needs, such as new health facilities and nursing homes.

"They can build more hospitals or produce equipment that will help senior citizens, like walkers which are now very expensive and still imported. Young people should start to make new inventions to help old people."

A geriatrician with the University of Indonesia, Czeresna H. Soejono, said that although welfare of the elderly is one of the government's declared three top priorities, little has been done and no funds have been allocated to improve their welfare.

The first geriatric division was set up at the state-run University of Indonesia in 1996. It has slowly grown over the years even without government support. But there is still an acute lack of professionals; Soejono said there are only six geriatricians.

He stressed the importance of educational programs, focusing on health promotion and prevention for elderly people, for doctors and health practitioners at the community level and families. He said it was the cheapest and the most practical program for crisis-stricken Indonesia.

The process toward ideal geriatric services requires years of development. Britain and the U.S. needed 50 years, while Australia took 30 years to educate the public on the issue.

"Even now, demands for such services have soared significantly. We are running out of time and the well-being of millions of elderly is at stake. Being sick and weak is not a quality life and we certainly don't want our aging parents to live that kind of life," he warned.