Caring for Older Populations in Gaza

By Edith Muleiro, MedGlobal Communications Intern

By 2030 there will be 1.4 billion older people. By 2050 there will be 2.1 billion, meaning one in five people will be over 60 in low and lower-middle income countries. These numbers are rising at an exceptionally fast rate in the low and lower-middle income countries where 80% of the global older populations reside. As the world faces unprecedented numbers of people in need of humanitarian aid, the unique vulnerabilities of older populations within humanitarian crises must be prioritized. 

Humanity and Impartiality are two of the four universal humanitarian principles that MedGlobal operates by. These principles work towards eliminating health disparities and inequalities which may arise, for example, through the unequal distribution of resources, including goods and services. When these disparities are combined with existing structural inequities, communities are left vulnerable and underserved, a vulnerability that is magnified in an emergency crisis. Currently, the principle of impartiality does not include age as a grounds of neglect. However, this does not negate the fact that older people are often neglected within humanitarian responses. Research gaps demonstrate a lack of attention to issues affecting older people in human rights law, conferences, and within the work of humanitarian organizations on a global scale.

One of the main factors that create vulnerability within communities is isolation, a factor that disproportionately affects older populations. Up to 1 out of 3 older people feel lonely in some countries, and this affects both their mental and physical health. Health inequities arise from isolation and loneliness when these conditions limit access to services. In Gaza, the world watched this May as an example of isolation and its detrimental effects developed. The bombardment in Gaza made aid inaccessible by making it impossible to reach areas or individuals because of destroyed infrastructure, roads, and limited means of transportation. For older populations with limited mobility, access to aid and information can be critical to survival. Older people make up around 5% of the population in Gaza.

An older male patient has his blood pressure checked by a health worker in Gaza.

One of the major barriers which humanitarian organizations face when tailoring programs and providing aid for older people is the lack of research regarding their needs in emergency contexts. Despite evidence showing that older people may be more likely to suffer in humanitarian crises from preventable causes, such as lack of information, access to transport, and other services, there are few programs with a specific focus on older populations. HelpAge, one of the few NGOs which focuses on older people, found that of 1,912 aid projects only 18 had activities that focused on the needs of older people. These gaps in information and programs lead to enhanced vulnerability of older populations. 

After the May bombardment in Gaza, MedGlobal launched a robust emergency response to meet the needs of vulnerable populations. The bombardment alongside the ongoing COVID-19 crisis expanded gaps in the health sector and inhibited accessibility for all populations in Gaza. The attacks by Israel took at least 253 lives, including 66 children, and 17 older people, and injured almost 2,000. HelpAge released a statement during the May bombardment highlighting the severity of the situation for older people. During a bombardment, one’s ability to move down a flight of stairs and flee to safety may quickly determine their survival. Many lost their homes, were unable to flee, or were at risk of being exposed to COVID-19 in overcrowded shelters. A spokesperson from the El-Wedad Society, Oday Al Meghari, said, “The El-Wedad Society, as the primary organization in the Gaza Strip and Palestine looking after the needs of older people, is facing tremendous difficulties in providing protection and care in these difficult circumstances due to the lack of resources and scarcity of funding.” 

“MedGlobal believes that healthcare is a right for every human being, so we are dedicated to supporting those in need and guaranteeing safe access to high-quality healthcare services. We are working tirelessly in Gaza to reach out to those who can’t access healthcare services, especially in rural and marginalized areas.”

-Alaa, MedGlobal Gaza Program Manager

For those that lived through the bombing, the inability to flee caused psychological trauma for themselves and their families. In a study conducted in August by HelpAge, 78% of participants reported feeling anxious ‘most or all of the time’ in the 2 months prior and 52% reported feeling depressed ‘most or all the time.’ The HelpAge study also found that 97% of older people in Gaza have at least one health condition and 86% have at least one disability. Older people face far greater obstacles to accessing health care than the general population due to limited mobility, the effects of the harsh economic situation, and aid oversight. Despite these vulnerabilities, 74% of older people in Gaza reported they receive no humanitarian assistance. The majority of older people and their families live in poverty and have limited to no access to medicine due to the shortages the Ministry of Health is facing. MedGlobal has prioritized the creation of a multidisciplinary, multi-sectoral, and rights-based approach to address the needs of older people and has integrated this into the Elderly Health Program. Recognition of the acute vulnerability of older populations in Gaza motivated the MedGlobal team to start a specific program based on older people’s health. We have also launched a program in Lebanon. These programs take an important first step towards prioritizing older people and building data around their needs to fill the gaps mentioned above.

An elderly woman in bed received medical care from a MedGlobal health worker in Gaza.

“Yesterday we received a call from WHO praising the importance and the necessity of the project, as no organizations are targeting this vulnerable group. Alaa and I notice this during our daily work on the ground. We observe firsthand how much support elderly people need – not only medical but also psychological. They deserve to have access to this support, it’s their human right. Here at MedGlobal, we do all we can to support them.”

– Rajaa, MedGlobal Gaza Country Representative

MedGlobal’s Elderly Health Program in Gaza is carried out through home visits, for which 1 physician, 1 nurse, and 1 psychologist has been hired. These home visits will be carried out for 400 patients, with 400 initial consultations and 800 follow-ups. These home visits will also allow the team to identify more serious cases which will be transferred to other hospitals. The team will also provide medical equipment, like walkers and sanitary and hygiene materials. Lastly, MedGlobal will improve awareness about elderly health care and preventative measures for 400 caregivers. These types of initiatives serve to meet the needs of older people in Gaza and also add to global data on older populations. In addition to the services provided for older people, the MedGlobal Gaza team also works to reach the rest of the population in Gaza with emergency health services by providing medications, medical supplies, and equipment to health facilities in Gaza. MedGlobal works alongside the Union of Health Care Committees (UHCC), MAP UK, and Union of Health Work Committees (UHWC) to improve health services for 10,000 beneficiaries.

“Elderly people are one of the most vulnerable groups in the Gaza Strip. The vast majority of them are still living under harsh circumstances as they belong to underprivileged families who are passing through food insecurity and poverty. The inaccessibility to proper healthcare is still a burden since community support is not widely available. Provision of the medication and sanitary kits make the difference as they prevent further health deterioration. Also, the psychosocial support alongside awareness sessions for the elderly and caregivers are tools to get them out of the depression trap and save their dignity and self-esteem.”

– Alaa, MedGlobal Gaza Program Manager