Here be monsters

The needs of an aging population feature nowhere that I can find in any planning or policy document.

Before the world was fully mapped, there were large blanks, an emptiness that contained who knew what, and in an age of credulity and ignorance, all sorts of fanciful notions were bruited about. The least creative cartographers labeled the unknown lands as ‘Terra Incognita’; but those of a more lurid turn of mind often simply put ‘Here be monsters’ and left it to the imaginations of those reading their maps as to exactly what those monsters might be.

As things turned out, there never were any monsters or dragons holding maidens captive and it was all much more prosaic — Incas and Aztecs and native American peoples and an awful lot of trees in the Amazonian rainforest. The monsters disappeared in the face of some determined exploration by the likes of the Spanish, Portuguese and British governments all bent on transforming Terra Incognita into profit and colonial outposts.

Today, different but rather more corporeal monsters, poverty, hunger, disease, terrorism and warfare all menace us.

Very real monsters stalk the land in Pakistan and they tend to make the headlines rather more often than dragons ever did. Some inevitably get more coverage than others — food insecurity, the rising extremism and the eternal power crisis. There is the education emergency and the youth bulge emergency and the polio emergency and … the elder emergency.

The elder emergency? What elder emergency? Yes Dear Reader, there is an elder emergency, not tomorrow but not so far off either, and this may be the first time you have heard of it.

Pakistan is going through a period of accelerated social and demographic change. Although still predominantly rural, the population balance is galloping towards parity between urban and rural. The population is youthful, in 2011 estimated at 35.4 per cent aged 0-14 and the education monster is easy to see. At the other end of the scale, there are the elders, the 65-plus segment that clocks in at a seemingly unalarming 4.3 per cent, which is actually a reduction as against the 5.6 per cent it was soon after Partition.

As families migrate from the villages to the cities, they tend to leave behind the less productive members — the elderly, women with very young children for instance, and in my own home village close to Feroza, it has gone from being a lively and vibrant place 20 years ago to something akin to an undertakers’ waiting room. Old men and women look out across crumbling and poorly maintained houses, whilst below their knees and two generations separate, there are the new candidates for poverty, poor health and an indifferent education.

Older women deliver some of the childcare and younger mothers with saleable skills are increasingly joining the workforces in the cities. Agriculture is increasingly mechanised, plot sizes have diminished as they are divided and sub-divided and feeding a family of six from a couple of acres is an impossibility.

Despite what may be assumed, the population of elders is living longer and they are going to increase in numbers, though projections as to the growth of this particular monster are hard to come by, and the needs of an aging population features nowhere that I can find in any planning or policy document issued by either the provincial or federal governments. The assumption that ‘the family will care’ is going to become increasingly untenable if current trends continue and there is no reason to believe they will not.

The Elder Monster has already begun to make its presence felt in western societies and it is being projected that there is going to be a shortage of caregivers for the elderly in coming decades. The ‘baby boomer’ generation are now aging themselves. They have had fewer children than the generation before them and have increased longevity as healthcare and nutritional standards have risen. Matters are fast approaching crisis proportions in Japan where the population is both shrinking and aging at an unsustainable rate. More unproductive elders mean smaller tax revenues and increasing costs related to the elder population, particularly of health care.

Pakistan is probably a generation behind the West in the scale and nature of its Elder Monster, but it is time for the policymakers to start filling in some of those blanks in the planning maps. Monsters can be defeated, but it helps to recognise them from a distance.

Published in The Express Tribune, September 5^th, 2013.

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