Humanitarian financing and older people

Approximately 12.5% of the world’s population is aged 60 and above. In some countries, urban migration, high HIV prevalence, low birth rate, conflict and economic migration have resulted in significantly higher proportions of older people. Furthermore, demographic change means that the number of older people affected by crises and disasters is growing fast. By 2050, the number of people aged 60 and over will have tripled, reaching 2 billion. More than 80% of over-60s will be living in developing countries, where disasters are more likely and people have fewer resources to deal with their effects.

In 2012, with funding from the European Commission’s Humanitarian Aid department (ECHO), HelpAge International and Handicap International produced an analysis of Consolidated Appeal Processes (CAPs) and Flash Appeals during 2010–11. The aim was to assess how far humanitarian assistance meets the needs of older people and people with disabilities. This work follows a 2010 HelpAge study of funding for 12 emergencies during 2008–2010, which found a significant disparity between the needs of older people and the level of assistance they received. A Study of Humanitarian Financing for Older People, HelpAge, 2010.

Research findings

The research analysed all 6,003 projects submitted to 14 CAPs and four flash appeals in 2010 and 2011. While it is recognised that donor funding is not limited to these mechanisms, these projects represent a significant proportion of recorded assistance, and hence provide a good proxy for broader humanitarian support.

In 2010 and 2011, just 47 projects (0.78%) included at least one activity targeting older people, and only 18 of these were funded (0.3%). In about half of these projects (21), the targeting of older people accounted for less than 25% of total project activities. Most of the projects submitted were in three sectors (health, protection and shelter/non-food items), with notable gaps in sectors such as livelihoods, food security and water and sanitation. In 21 countries there were no projects in any sector targeting older people. Chad, Central African Republic, 16 countries in Western Africa, Yemen and Zimbabwe.  Seven donors out of a total of 21 provided funding for projects that included at least one activity targeting older people, and this constituted less than 1% of their total contributions. Only one donor, ECHO, funded such projects in both years. Two of the ten biggest donors to CAPs and Flash Appeals (the US and the UK) provided no funding for projects that included activities targeting older people.

Targeted assistance is not the only means by which older people receive support in an emergency, and general relief activities should benefit vulnerable groups provided they can access services. The research therefore also analysed projects which did not specifically target older people, but did mention them as a vulnerable group. Only 312 projects (5.2%) mentioned older people and people with disabilities, meaning that thousands of projects made no mention of the vulnerabilities of older people or how they are affected by a crisis. This finding indicates that there is no concerted effort to integrate older people into mainstream service provision.

The overall findings illustrate a broad lack of recognition of the specific needs of older people. Additional country-specific analysis carried out for the study provides us with further evidence of the neglect of older people in humanitarian programming.

Yemen

Yemen is one of the poorest and least developed countries in the world, and faces complex humanitarian challenges related to poverty, conflict and food insecurity. Current estimates suggest there are 310,000 IDPs and 223,200 refugees in the country. See http://www.unhcr.org/pages/49e486ba6.html.  Analysis of UNHCR databases in Yemen shows that 4% of the registered refugee population is over 60; the figure among IDPs is 6%. Preliminary Findings and Recommendations for Addressing Needs/Gaps in Working with Older People in Refugee and IDP Camps in Yemen, HelpAge International, 2010.  Applying these percentages gives an estimate of approximately 9,000 older refugees and 19,000 older IDPs in Yemen.

In November 2010 HelpAge seconded an age expert to the protection cluster to raise the profile of older displaced people and provide an insight into their needs. Older people faced significant health concerns related to access to services, chronic disease, mobility problems, disability, mental trauma and malnutrition, and limited awareness of livelihoods opportunities. Significant numbers of older people were caring for children, there were a large number of older women-headed households and many older people were living alone; community support for older people was declining, making it increasingly difficult for older people to meet their needs. Despite these vulnerabilities, the humanitarian response in Yemen has shown little sensitivity to older people’s needs. Of 188 projects submitted in 2010 and 2011, none included activities which solely targeted older people, and just 12 (6.4%) mentioned older people as a vulnerable group requiring assistance.

Kenya

In 2010 and 2011 CAP appeals were launched in Kenya to address the food and refugee crisis. According to the UN people over 60 account for 4% of the population. However, HelpAge research suggests that the percentage of older IDPs is as high as 15%, while the urban migration of younger people means that, in some rural areas, older people account for up to 40% of the population. Briefing – Crisis Affected Older People in Kenya and Somalia, HelpAge, 2011.  In the Dadaab refugee camp, there are close to 16,000 registered older people; UNHCR staff believe that 10% of people registered as 50–59 years of age are in fact 60 or over, meaning the real figure could be as high as 30,000.

HelpAge conducted a range of needs assessments in Kenya during 2011, including assessments of older IDPs in Turkana, Mandera and Wajir, two assessments of older refugees in Dadaab (one through a secondment to UNHCR) and a nutrition survey in Dadaab. These assessments highlighted a range of concerns. In Dadaab, older people were found to be suffering from malnutrition due to exclusion from food distributions, low diet diversity and infrequent eating. Nutrition and Baseline Survey of Older People in Three Refugee Camps in Dadaab, HelpAge, 2011.  Additional concerns for older IDPs, refugees and older drought-affected people included a lack of appropriate feeding programmes for malnourished older people; limited or no treatment for chronic diseases; no appropriate outreach or referral services; large numbers of older people living with mobility and disability problems; no support for older people in owner-driven shelter construction; and a significant number of older women caring for children and living alone.

The needs of older people in the severe drought conditions of 2011 appear to have been ignored. In 2010, out of 141 projects in the Kenya CAP just one protection project (put forward by HelpAge) targeted older people. It was not funded. In 2011, out of 111 projects in the Kenya CAP, two targeted older people (neither was funded), and only nine of the 252 projects mentioned older people as a vulnerable group in need of assistance. In neither year did a health, nutrition or food security project target older people.

Addressing older people’s needs in emergencies

These findings paint a bleak picture for older people in emergencies. Across sectors and countries partners are consistently failing to assess, plan and integrate the needs and capacities of older people into their responses. When they do, more often than not the projects are not funded. One explanation for this is lack of knowledge and capacity to assess and analyse the different needs of vulnerable groups, and integrate them into humanitarian responses. Yet efforts to mainstream age are essential to the broader agenda of impartial assistance, and solutions are often a question of subtle change, rather than any huge diversion of resources.

In light of on-going humanitarian crises in Yemen, Kenya, the Sahel, South Sudan and elsewhere, it is important to consider what such modifications may look like. More comprehensive guidance can be found on the HelpAge website (www.helpage.org). In the health sector, agencies should ensure that older people have access to the services and medicines they need; drugs for chronic diseases should be included in emergency health kits, time should be set aside for older people’s treatment in health facilities and clinical care should be combined with outreach and follow-up by community health workers. In the nutrition sector, older people should be included in nutritional assessments and supplementary and therapeutic feeding programmes, and they should be able to access food distributions; failing that, a clear system should be in place for others to collect rations for them. Agencies should also ensure that food rations address older people’s nutritional requirements, including micronutrient and protein-rich food, and food that is easy to chew and digest. Protection programming should ensure that older people of all ages and levels of vulnerability participate in surveys and assessments, including the housebound and older people caring for children, living alone or heading the household; livelihoods programmes should include older people who are willing and able to work in vocational training and other programmes.

Beyond these programmatic modifications, broader changes are required to ensure that older people’s needs are identified and responded to in humanitarian crises. First, they must be consulted and included. Accountable humanitarian programming that responds to the needs of older people is only possible if they are regularly consulted and participate in the design, implementation, monitoring and evaluation of activities. Older people of all ages and capacities must be identified and included in consultation and feedback processes to allow them to prioritise their needs and explore their own capacities. This may involve home visits, including older people in community meetings and decision-making bodies, focus group discussions and specific sessions to ensure that older people are fully informed of the entitlements and accountability mechanisms available to them. These initiatives should take account of aural, visual, mobility and literacy problems.

Second, agencies need to collect and use Sex and Age Disaggregated Data (SADD). This is a vital tool for effective understanding of the differential impact of disasters on boys, girls, women and men of all ages. Where existing sources of disaggregated data are unavailable, this should be highlighted to ensure that further assessment and information collection can address these gaps. During response, needs assessment, registration and morbidity and mortality figures must also be disaggregated by sex and age to enable and support inclusive analysis on which to develop and implement programmes and from which to monitor results.

Third, clusters and donors must ensure that adequate attention is paid to vulnerable groups. Unlike themes such as early recovery or the environment, neither age nor gender can be viewed as ‘issues’. Both are first and foremost about the needs of people, and ensuring that all phases of response address these needs is central to the delivery of impartial assistance. Capacity-building initiatives which aim to improve awareness of the needs of vulnerable groups and enhance the capacity of partners to respond should be supported. Finally, as the research findings show equitable financing is vital. Funding proposals should include clear analysis of the groups targeted by a project and why, as well as discussion of the potential impacts and implications of the response on other vulnerable groups.

Marcus Skinner is Humanitarian Policy Coordinator at HelpAge International.