In 2010 HelpAge International undertook an analysis of UN Consolidated Appeals (CAPs) and Flash Appeals for 12 emergencies in an effort to understand the degree to which the needs of older people were recognised and addressed in humanitarian programming. The study aimed to ascertain whether levels of humanitarian assistance were commensurate with the numbers of older people and their needs, and therefore whether the principle of impartiality that humanitarian assistance is provided according to need is being upheld.
Approximately 11% of the worlds population are people over 60 years of age; by 2050 this figure is expected to rise to 22%, and with it an increase in the overall number of older people affected by emergencies. It is commonly assumed that the help older people require in disaster situations will be delivered by general relief programming or as part of family and community support. Yet analysis of OCHA appeal documents, situation reports and needs assessments shows that the specific needs of older people go largely unaddressed.
This article examines the level of funding being directed towards older people in emergency contexts, and highlights ways to mainstream assistance for older people into humanitarian responses.
Humanitarian financing and older people: research findings
The study analysed CAP and Flash Appeals in 12 humanitarian crises since 2007, covering a total of 1,912 projects. The findings show a distinct lack of targeted programme activities for older people despite specialised requirements such as nutritional support and chronic disease management. There is minimal reference to older people within proposals compared with other vulnerable groups (e.g. women and children). While CAPs and Flash Appeals represent only a portion of donor funding in a crisis, they provide a good proxy indicator of the level and nature of official funding.
- Across the 12 emergencies only 0.2% of funded projects (five) included an activity specifically targeting older people.
- Comparatively, 43% of funding went to projects (273 projects) targeting women and children.
- In five of the crises studied (Afghanistan, Burkina Faso, El Salvador, OPT and Honduras), not one project in any sector explicitly referred to or provided targeted assistance to older people.
- In financial terms, the CAPs and Flash Appeals raised a total of $4.2 billion in the 12 crises. Of this, $8.2 million (0.2%) was allocated to projects that included an activity that specifically targeted older people.
Clusters are responsible for coordinating humanitarian action and ensuring that key gaps are filled, including for cross-cutting issues such as age. Yet the research shows that some clusters are still failing to ensure that the specific needs of older people are included within assessments and subsequent responses.
- Several clusters did not highlight older people as a vulnerable group in need of support.
- Others did not include any activities specifically targeting older people.
- A total of seven health cluster projects in five countries targeted activities to older people, as did five in the protection cluster, in three contexts.
The humanitarian financing research illustrates the extent to which agencies ignore and fail to respond to the needs of older people in emergencies. However, addressing these needs demands not only more financing, but also an understanding of what specific targeted activities should look like.
The conflict in Georgia in 2008 displaced an estimated 80,000 people, a large proportion of them older people. For others, ill health or mobility problems meant that they were unable to flee. Those who remained behind in their villages were often left with no water, electricity or heating, in situations of extreme hardship and economic insecurity. Whilst a number of agencies involved in the response recognised the vulnerability of older people, this did not translate into programmatic action. The Flash Appeal made no mention of them in its priority areas, and the Joint Needs Assessment conducted by the Georgian government, the UN, the European Union (EU) and the World Bank failed to recognise older peoples particular needs. Out of 112 projects submitted to the Flash Appeal only three mentioned older people as a vulnerable group.
Case example: Pakistan floods
Older peoples needs went largely unaddressed in the response to the floods that struck Pakistan in 2010. Despite evidence of malnutrition among older people needs assessments did not disaggregate groups by age, and the health clusters use of 49 years of age as its cut-off point for data collection made it impossible to assess properly the health situation of older age groups and to identify and address age-specific health concerns. Of the 86 projects submitted to the Pakistan Initial Floods Emergency Response Plan, 13% recognised older people as one of a number of vulnerable groups. However, only 1.2% of submitted projects targeted the specific needs of older people. In the revised Flash Appeal of November 2010, following the secondment of a specialist in ageing to support the clusters, 20% of the projects submitted mentioned older people as a vulnerable group, and 6% included an activity that addressed older peoples needs, for example building age- and disability- appropriate latrines, psychosocial activities and protection.
The specific needs of older people
The number of older people affected in any emergency varies depending on the context. For example, the proportion of older people can be high in IDP and refugee camps. In the Gulu District of Northern Uganda, 65% of those remaining in camps in 2009 were over 60 years of age. Additionally, in areas of high HIV and AIDS prevalence or conflict, there is an increase in skipped generation households, where older people become the primary caregiver to children who have lost one or both parents.
The specific needs of older people fall into four main areas:
- Appropriate healthcare (e.g. treatment for age-related chronic diseases, mental health conditions, visual impairment).
- Nutritional support that takes into account specific age-related needs (e.g. for protein and micro-nutrients).
- Appropriate livelihood support for older people including those with reduced strength and mobility.
- Protection requirements (e.g. tracing and family reunification for older people separated by displacement; skipped-generation families).
One major challenge to effective humanitarian response results from the assumption that general distributions of food and non-food items and the provision of shelter or healthcare services provide adequate support to older people. In reality older people often find it hard to access general distributions; as with other potentially vulnerable groups, there is a need to complement programming with specific targeted activities.
Concrete steps to identify and respond to the most vulnerable
Unless older people are counted and their needs and contributions made visible from the outset of a crisis, agencies will continue to assume that all older people are equally and similarly vulnerable, and will disregard the contribution that they can make to recovery efforts. In particular, concrete action should be taken to:
- Disaggregate assessment data by sex and age in sectoral and multi-sectoral assessments. This will allow for a better analysis of the differing impact of crises and disasters on older men and women compared with other age groups, as well as a differentiation between the old (60 years-plus) and the oldest old (80 years-plus). The Inter-Agency Standing Committee (IASC) Phase II Cluster Evaluation notes that hardly any documents at country level including needs assessment contain age and sex disaggregated data.
- Identify who amongst the old are the most vulnerable, for example older-headed households caring for young children; older people who are isolated or without community or family support; and older people who are very old and frail, who suffer from chronic illnesses or who are living with disability.
To support the development of more effective needs assessments HelpAge has been engaged at both the global and field levels, ensuring that assessment frameworks include older people, as well as providing technical support in the field to the protection cluster to increase awareness, knowledge and skills in identifying and responding to protection risks for older people. This support has resulted in the inclusion of older people as a special category in needs assessments in some emergency contexts, including Kyrgyzstan and Pakistan.
Concrete steps can also be taken in programme design and development to ensure that older peoples needs are addressed:
- Design and implement humanitarian response programmes that are age-sensitive. Examples include ensuring that relief distribution points are accessible for mobility-challenged older people and providing direct delivery of relief goods for those who are housebound; consulting with older people at every stage of programming; identifying older people who are at risk of malnutrition and providing them with supplementary food; and ensuring that shelters and latrines are easily accessible, with rails and ramps for people with mobility problems.
- Promoting intergenerational programming so that older people are not isolated from younger generations. For example, older people have a role to play in supporting the education and care of younger generations, and sharing traditional knowledge and coping strategies to support livelihoods and early recovery. Conversely, younger generations can help older people reconstruct their shelters or return home after displacement.
- Livelihood recovery and support programmes should include older people, who often make an active contribution to their families livelihoods late into old age. Such approaches not only address the needs of older people and their dependants, but also enable older people to continue to make a contribution to family and community wellbeing.
- Community understanding of vulnerability can play a critical role in the identification of those most in need. Community referral systems should be established to identify those most in need, and enable them to access services. In Haiti HelpAge has established a system of friends within IDP camps, who identify and refer the most vulnerable older people and inform them of their entitlements.
As an overall picture of humanitarian response, the research conducted on humanitarian financing and wider HelpAge experience demonstrate that sectoral or cluster responses that build on the capacities of older people, as well as supporting their needs, remain inconsistent, unpredictable and far from proportionate to the scale of what is required.
The provision of targeted assistance to complement general programmes is already well established for children and women. There is substantial learning in the sector that can be used to design and inform complementary and/or tailored programming for older people. This research indicates that this learning has yet to be mainstreamed by the international humanitarian sector.
Despite the historical lack of inclusion of older people in humanitarian response, concrete steps can be taken to ensure that they are taken into account within general emergency relief. This will ensure that we are providing for all vulnerable groups and that the humanitarian principle of impartiality is upheld, with aid distributed without distinction and according to need.
Jo Wells is Humanitarian Policy Coordinator at HelpAge International. Marcus Skinner is Humanitarian Policy Officer and Jessica Dinstl is Programme Officer.