It might be hard to come to terms with, but Bangladesh is an ageing society. The number of elderly people in the country – that is, those aged 60 and above – is growing at a faster rate than the number of people below the age of 18. We’re getting old.
But that still doesn’t acknowledge the full scale of what’s about to happen. In 2010, Bangladesh’s elderly demographic was 6.6% of the total population. By 2050, it’s projected to be 22.5%, making Bangladesh a fully-fledged aged society.
To put this in another way, at present only about one-twentieth of our population is over 60; in just 35 years, it’ll be about one out of every four people. It’s going to be one of the sharpest demographic shifts in Asia, and one of the sharpest shifts in population age in history, anywhere.
In a way, this is quite an accomplishment given our status as a poster-child for developing country problems – a monumental success in accomplishing birth control targets and prolonging life expectancy. On these terms, we win.
In almost every other way, we don’t. Bangladesh is not ready to become an aged society.
Our health sector is geared towards maternal and child health and containing infectious diseases, not towards frailty and arthritis. In fact, our healthcare providers are already straining to deal with the existing demands by the current elderly population.
Many low-cost, grassroots solutions have helped Bangladesh overcome its problems in the past (think ek chimti lobon, ek mooth gur …). However, the healthcare needs of the elderly are less likely to be catered to without expensive medication and equipment. Old age of course does not necessarily have to be synonymous with poor health, but young and middle-aged Bangladeshis aren’t exactly taking spectacular care of their bodies in terms of exercise and diet.
Then there are the mental health aspects of growing old, chief among them the dual threats of dementia and depression. Bangladesh’s mental health sector is woefully inadequate in dealing with basic psychological conditions – when the wave of elderly health issues comes, it’s going to pose a much larger challenge. Depression and loneliness among elderly relatives is a particularly easy issue to overlook, partly because overlooking it makes it easier for the rest of us to get on with our lives.
And Bangladesh is becoming old just as its traditional social structure starts to fall apart. People are less likely to live with their elderly parents now, they’re also less likely to support their elderly parents.
While young people become more independent, old people are discouraged from doing the same. There is a huge stigma attached to moving to old age homes or seeking other kinds of support, even though they can provide a sense of community and freedom to the elderly, whose usual friends’ circles tend to diminish due to death and loss of mobility. A social worker at one old age home told me that they used to organise weekly dance and music sessions for their residents, but had to stop after the children of the residents complained, outraged that their parents were enjoying themselves instead of being respectable and miserable.
A major topic of discussion in developed countries right now is the increasingly apparent difference between living longer and living better. Children, themselves in their 60s, are struggling with seeing their 80/90-year-old parents suffer for decades, seeing the people they know and love deteriorate steadily in mind and body, but continuing to tick on, hooked to drugs and doctors.
Expensive drugs, and expensive doctors. The costs will need to be borne by a population that currently has no culture of saving, and a government that has a poor track record of providing adequate support to those who need it.
Bangladesh is famous for its natural disasters and struggles with cholera and typhoid, but our new health hazard is old age. Whether we will be ready for it will determine the future quality of life of pretty much every single Bangladeshi citizen – everyone, young and old, rich and poor, will have to cope directly with the fallout.
And it’s hard to be optimistic. We can pat ourselves on the back for making significant progress in the areas of disaster and disease management – but that progress has come long after a lack of forethought resulted in large-scale suffering. When it comes to new problems, we seem to adopt our own perverse take on the Boy Scout motto – Always Be Unprepared. This time, the future consequences could be even more far-reaching than the catastrophes in our past.