‘Count Me In’. The Role and Contributions of Older People during Covid-19; Reflections from Pakistan.
Pakistan is the sixth most populous country in the world and is projected to be the third most populous by 2050. Its population aged 60 and over was 14.9 million in 2020 and is projected to reach 40.6 million by 2050 (UN Population Division, 2021). Official sources report that there had been 20,000 deaths attributable to COVID-19 by 21 May 2021 (Worldometers, 2021), but this is likely to be a substantial underestimate of the real levels of COVID-19 mortality (Ahmed, 2021). As in India, the country is now experiencing a pronounced second wave. According to the Ministry of Health, people aged 60 or more account for around 40% of the total number of COVID-19 inpatients (Bureau of Statistics, 2020). Although older people are a priority group for vaccination, progress to date has been very slow, with only 1.7 per cent of the population receiving at least one dose by 20 May 2021 (https://covid.gov.pk/stats/pakistan). It is important to speed up the vaccination roll-out in Pakistan to safeguard older people and to ease pressure on the health system.
COVID-19 has given rise to economic insecurity especially for those older people who were previously working informally and in small businesses, and depended on these for their livelihoods. These small businesses have been strongly hit by COVID-19 (Ayesha, 2021). Only around 20 per cent of people aged 60 or more in Pakistan receive any form of old age pension (Qureshi, 2021).
Consequently, the most important institution that supports and provides services to older people in Pakistan remains the “Joint Family System” (Khan, 2014). It is claimed that older people in Pakistan who are embedded within this joint family system focus on religious activities and spending time with grandchildren. As part of this, their contributions towards infant care, family patronage and helping with household chores are significant. Other social activities like providing volunteer services for public welfare by retired health care professionals, both male and female, have been widely observed during the COVID-19 pandemic (Geo TV, 2021). Field observations demonstrate that in family structures where partners are working as front line medical staff, grandparents have stepped up to provide additional childcare (Ayesha, 2021). Similarly, many retired medical professionals including doctors, nurses, midwives, community health workers and social workers have returned to work on a voluntary basis.
Some countries have given older people a lower priority for COVID-19 vaccination due to claims that they make few, if any, social or economic contributions. Of course, vaccination should be a human right and those at most risk of dying must come first. Nevertheless, the available evidence from Pakistan demonstrates the many important contributions made by a substantial proportion of its older population.
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