Perceptions of and Attitudes towards Ageing in Zambia

This paper reflects part of the wider outlook on ageing in general in Zambia and was intended to investigate perceptions of and attitudes towards the aged and ageing in Zambia by members of the community who, by definition and chronologically are not classified as aged i.e. not yet 60 years and over. Focus Group Discussions (FGD) were used to collect the necessary information. At least one FGD was conducted in each of the selected districts and they comprised almost an equal number of males and females. Findings indicate that people rarely discuss ageing and where such discussions are made, they usually reflect pessimistic views, attitudes and perceptions towards the aged. Further, discussants indicated that while older people face serious challenges, there seems to be no commitment in terms of policies and programs on how to address the question of ageing. Based on suggestions provided by discussants, the paper provides avenues through which ageing and the challenges thereof could best be addressed.


Introduction
Population ageing has become a topical issue in both the developed and least developed regions and countries of the world. While so much has been invested to understand and to some extent mitigate effects of population ageing in developed and some developing countries, many least developed countries still find themselves debating on the subject and whether it is relevant given their relatively young age structure. However, there is comprehensible evidence that ageing of populations is a global phenomenon; manifest in some parts of the world and incipient in others (ILO/EASMAT, 1997). These manifestations are also evident in countries like Zambiawhere very little, in terms of attention and research has been devoted to appreciate and less still understand dynamics around the topic of ageing.
According to estimates based on the 2000 census of population and housing, the proportion of old people, 60 years and above was only about 2.4 percent of the total population of Zambia. In the year 2007, the proportion of older persons 60 years and above is reported to have adjusted upwards to about 3.7 percent of the total population (CSO, 2007). The growth rate of older people 60+ has increased from about 2.0 percent per annum in 2004 to about 2.4 percent per annum in 2008. From 2014 onwards, the population of people aged 60+ is expected to grow between 2 percent per annum to close or even over 4 percent per annum. Comparatively, this growth rate is much more than the rate of growth of older people in more developed countries (which currently is 2 percent and will decline to about 1 percent for the same period) and much more than the average obtaining in the region currently.
Even with such evidence, very little has been done, both at government and policy level and also in terms of research, to understand and appreciate the process of ageing and the various dynamics and effects including consequences both in the short and also the long term for the country. Undeniably, they have been some writings (e.g. Colson, 1975;Kamwengo, 2001Kamwengo, , 2004Phiri, 2004;Cliggert, 2005;Toner, 2007) on issues of ageing in Zambia. However, such writings are relatively few and have tended to be speculative in nature because they have largely been based on very little or no empirical evidence derived from any extensive and systematic investigation of ageing using either qualitative or even quantitative methodologies. In this respect therefore, this study is relevant because it adds to the body of knowledge on ageing in Zambia as well as help understand community perspectives on ageing which are critical to the well fare and well being of the elderly.

Objective(s) and Methodology
In particular, the current paper is based on investigating perceptions of and attitudes towards the aged and ageing in Zambia by members of the community who, by definition and chronologically are not classified as aged i.e. not yet 60 years and over. Data was gathered through a qualitative investigative process involving Focus Group Discussions (FGDs) from three districts namely Lusaka, Sesheke and Ndola; these districts are located in different provinces and represent both the urban and rural mixes. On average, at least one FGDs per district was conducted and each FGD had between 10 and 12 participants comprising almost equal numbers of males and females. Community perspectives were investigated basically for two sub-objectives or reasons: 1. Members of communities (who are not themselves classified as older persons) stay and live with older people and are privileged to appreciate and to some extent understand social, economic and environmental etc challenges that the older persons undergo; and 2. These people also represent "mirrors" for the future aged generation and their views are important because they will in-turn reflect how they may treat the elderly as well as provide solutions on how they may want to be treated in old age.

Limitation/s
Results for this study may not be generalized to reflect opinions of all people in Zambia; in fact, they should be limited to some extent, to places where the Focus Group Discussions took place. However, they entail in summary opinions held towards ageing and the aged in general. Secondly, there are very few or no studies on ageing in Zambia and the extent to which this article reflects local literature on the topic at hand is extremely limited.

Community attitudes and perspectives towards ageing
Though with very little evidence in terms of definite numbers, people in communities are cognizant of the fact that in recent times, past and present, there seems to be an increase in the number of older persons in neighborhoods; this observation was also supported with views that essentially also, while the number of older people is observed to be increasing, numbers of younger people is noticeably decreasing. This view however was not universal and in effect contested by other respondents. Some members of the FGD had this headed for say: "I agree with the big man; us the young ones are reducing in number because of AIDSfor instance, most of my young former classmates are dead, while their parents are still alive" (FGD, Masala -Ndola) The topic of ageing remains a controversy and highly sidelined. Even where it is discussed, much of what people position it is more on the negative than the positive side. Evidently, very few people in Zambian communities discuss or even talk about ageing as a subject matter. Basically, when ageing is discussed, it is clear that focus is on three perspectives, and these are negative: firstly, the topic itself is classified as really "not interesting"; secondly, ageing is considered as time to suffer for those considered as old and, thirdly, since older persons are thought to be people with "nothing tangible to do in life" then what they do best is engage in witchcraft -at least from the African perspective and especially for older women. However, while such negativity exists much to the detriment and dignity of the aged, other different and quite interesting views are also prominent. Some sections of society seem to express great interest in not only discussing and proposing possible solutions to problems aged persons are facing but also pilot in creating awareness on issues around ageing with a view to better their livelihoods and coexistence in society. However, such efforts are often hindered by lack of the means to do so. The following excerpts from some discussions suffice: "For me, I see that as a topic that most people are not interested in, people would rather talk about other things, like taking children for under five clinics and so on" (FGD, Masala -Ndola) "Yes, because of the problems these people go through every day, yes, ageing is now seen as a time of suffering. It is a time of suffering and old people are not respected. If they were respected the government would have been supporting them" (FGD, Mwandi -Sesheke) Compared to the past, the old and issues of the aged drew particular interest and attention than nowadays; the old were treated with a lot of respect not only by their children but by many sections of society; the topic of ageing also received some form of attention of one sort or another. Children for example were expected to keep their old parents; currently they seem to have options and some choices they make are detrimental to the development of aged persons. However, even where children are alive, there seems to be no capacity for them to take care of their old parents. Several reasons are seen to be contributing to the alleged suffering of the older persons in many Zambian societies. These include among others: lack of employment for children, western cultural influences, poverty, lack of wealth, stress, worry and generally, neglect by children. Some excerpts from the discussions had the following statements: "Old people are suffering regardless of whether they have children or not. This is because their (children) are unemployed, they are also suffering" (FGD, Mwandi -Sesheke) "These sufferings are causing people to age quickly because of stress that is, thinking too much and worrying about how they will feed with no food available. And nowadays, for you to be respected in society, you need to have wealth. If you don't have, you are considered to be nothing" (FGD, Matero -Lusaka) Attitudes towards ageing and the aged by the community are good determinants of aged person's well being. Firstly, ability to keep an old relative and to some extent a stranger is a litmus test to the general existence of filial loyalty and family responsibilities. In this study, some community members acknowledged that they were keeping some older people and most of which were actually their relatives; only one person in the discussion reported keeping an older person who was not a relative. While the desire to keep older persons is culturally imbedded in many Zambians, current economic and living conditions were not permitting. Living conditions for example determine whether or not it is prudent to keep an extra person even when one wants to. In addition to challenges in the economy, it is also generally viewed that older persons are very difficult people to stay with. They are thought to be choosy with food especially but other requirements as well; they are also thought to be very demanding and as a result, only a handful of people would keep up with such choosy and demanding life styles. On the other hand however, it is widely recognized that though older persons are indeed difficult and choosy sometimes, they are very helpful in certain circumstances where younger people may not have the necessary expertise, wisdom and experience. For example, some feel that merely staying with an old person is a blessing on its own; old people help in taking care of the children and in some cases, they educate young ones through storytelling and advise. Older persons are also thought to be boring in addition to being unnecessarily difficult and choosy. They are seen to be engulfed in their own problems and much less what other members of society may have; they mostly talked about how they wished they were dead given the many problems they were going through in life. As a result, such levels of complaints make other people distance themselves from older people and hence the perceived loneliness; further it is a wide held view that older people spent most of their time crying and remembering how good things were when they were younger, much to the displeasure of younger age groupsand hence few quite would be interested in keeping or looking after them.
Other reasons have also been sighted explaining why very few people are willing to keep or look after older persons. A very unfortunate aspect about ageing in the Zambian context is a case where older persons are accused of practicing witchcraft and anyone who associates himself or herself to these people is also sometimes isolated by society or the community they live in. In some extreme examples, being old is sometimes almost equated to being cursed; the accusation of witchcraft makes older people's lives especially challenging and as a result very few people would be willing to take care of older persons unless they were very close relatives. Accusations of witchcraft also further exacerbates the lack of respect older people go through on a daily basis. An excerpt from the FGD stated as follows: "I can do that, though very few can do that because of lack of respect for the aged. Most young ones do not have respect for the aged, so how can they keep them? Because of that reason, I cannot keep an old person because even my neighbors will be saying that am keeping a witch in the neighborhood" (FGD, Masala -Ndola)

Perceived social and economic challenges facing the elderly
The section above mainly concentrated on aspect s around the subject of ageing in terms of attitudes and perceptions. In this section, information was solicited on what members of the society thought were the socio-economic challenges that old people faced and what were the likely causes.
Categorically, several challenges form the core issues the Zambian older persons face on a daily basis. Firstly, due to their perceived frail bodies and state of physical and mental being, many elderly persons are thought to be challenged in terms of their abilities to adequately take care of themselves. In addition, the elderly persons are most of the times never accorded income generating, training or employment opportunities since these are mostly skewed towards younger ages. Given such scenarios, it is inevitably thought and generally concluded that the elderly lack capacity to meet daily costs of living, which are usually high and they also have little or no access to basic amenities such as decent accommodation for example. The excerpt below is an example from the FGDs: "There are a lot of challenges; they can no longer do things for themselves. For instance, they can't build their own houses, farming and all sorts of things that young people can do. In general, they cannot take care of themselves" (FGD, Mwandi -Sesheke) There seems to be also other social ills that older people seem to experience from day to day as they live in their communities. Family abandonment is very common and is seen both as a cause and an effect of the challenges facing older persons in society. It is an effect because when a family abandons an elderly relative, it becomes a challenge for the older person to fend for him or herself given their almost nonexistent opportunities in terms of training and employment; and, it is also a cause since the state of being abandoned literally spells more challenges for the person affected especially when and if they were dependent on the family, relatives or close friends. It has become common place for families to neglect their own old relatives and this is a very important social concern and also a challenge that older people face in many Zambian communities. Abandoning older relatives is a practice that has to a large extent been influenced by the community especially in instances of tramped up accusations of witchcraft; this actually is more eminent with female older persons than males. In addition, older persons experience extreme cases of humiliation by being laughed at whenever in public places, and this mostly is a vice seen to be perpetuated by younger people or children. There is no credibility in defending such occurrences, but one reason sighted as fueling this xenophobic attitude is that the Zambian society is predominantly youth and acceptance of the elderly as people forming part of the core of society has been a challenge which unfortunately sometimes translates into acts of humiliation against older people. Note the following: "Humiliation is one other big problem these people face every day. Most people think all old people are into witchcraft, and this depresses these people a lot. Some people even go to an extent of just laughing at old people" (FGD -Masala, Ndola) HIV/AIDS is one other very important factor affecting older persons in society. The subject of HIV and the effect it has on the old people has been discussed extensively in several pieces of literature especially for Africa (Rapid Funding Envelop, 2004;Help Age International, 2004 andUNICEF, 2004). In this article however, it also comes out as one very important aspect among the many issues facing the aged but most importantly also identified by younger members of the community as well. HIV/AIDS is said to be more on the side of cause factors of the challenges the elderly are facing though arguably, it has just compounded the already precarious situation of the older people. HIV and AIDS have changed and shifted the roles of the older persons from that of being grandparents to firstly being, caregivers and secondly parents to their grandchildren and in some instances great grandchildren. As a result of such changes, the elderly are now kept busy looking for food and other socio-economic amenities for orphans and vulnerable children in their custody. In the same way, some older people are thought to be infected by the virus that causes AIDS also because they now care of people infected and because they have no good knowledge on how to protect themselves against infection, they get the virus also; some older persons are thought to be infected due to allegations that they are engaging in un-protected sexual relations in older to support themselves and the orphans they are looking after. In the following excerpts from the discussions, this is what was stated: "I do believe that AIDS has changed the roles of the aged in societies. Previously, they just used to sit at home waiting for their children to provide for them, but now, their children are dead because of AIDS, so if they just sit at home they will die from hunger, they are now actively looking for food" (FGD -Masala , Ndola).
"Sometimes through having many problems, some old people sleep around for money so that they can buy food, soap and so on and hence contract the virus and eventually get sick" (FGD -Mwandi, Sesheke)

Knowledge of policies and suggested solutions for the aged
A very important lacuna in the recognition of the importance of the subject of ageing is the knowledge on the existence of policies and programs on ageing. This study also endeavored to investigate knowledge on the existence of policies and programs on ageing in the Zambia community. This was especially important because, as stated in the objectives, this information source (discussants) is a potential cadre of future and current policy makers; it was also important to understand their views on solutions they would suggest to challenges posed by the elderly people in society.
Results from interrogations on the knowledge of the existence of policies and programs on ageing show that at least three-quarters of people in the three districts were not acquainted to or categorically had never come across any policy, program or document that discusses or deals with ageing and issues of the aged. Though some knowledge of the existence of some ministry that deals with the aged and some cash transfer program exist, very few or none had come across documents that have issues of the aged addressed; this may be a problem of literacy, but such could not be this universal. The following excerpts attest to their insinuation: "We have no idea about such issues or organizations or policies that cater for the aged maybe because we are in a rural area" (FGD, Mwandi -Sesheke) It is well established that very few people in the Zambian community have information or knowledge on the existence of policies programs or projects on ageing. To a certain level, quite a few know that there are homes for the aged which try to help the aged persons. In any case, what was pertinent also is what was perceived as the best possible solutions suggested given the current situation faced by older people in society.
Problems of ageing could be solved through providing short and long term solutions. In the short run, society and the country at large should be made to be aware of the presence of older people because ignoring such a moment phenomena would be at society's own peril. Awareness of the aged and understanding their needs, aspirations and expectations was crucial to solving their problems. The entry point to creating such awareness could be in conducting more focused research to specifically appreciate issues of the aged and ageing in general. The community is also key in tendering and helping the aged. Communities needed to become more sensitive and flexible enough to issues of ageing and the aged themselves; if such a situation is encouraged, it would then be possible to help the aged persons both in the short and long run. The following example suffices: "The communities should also become sensitive towards the aged. It is very unfair to call every old person a witch. Most old people are old because they kept themselves very well when they were young, and even those that have a tendency of laughing and calling old people witches will grow old one day if they keep themselves very well" (FGD, Masala -Ndola) In the short term also and where possible, elderly persons could be given money through cash transfers though the sustainability of such a project is highly questionable. In addition to providing money, government and other donors could help through donations in kind in terms of blankets, clothes, food etc to the older people. For the immediate and mid to long term solutions, older people needed to be legible to apply for loans directly to the government or other cooperating partners to enhance their independence through self reliance and hence dilute the dependency on either government or families. Problems facing the elderly especially those who had formal employment include largely destitution partly due to delays in the payment of their terminal benefits; in view of this, it was suggested that as a short to intermediate solution, government and other government institutions needed to speed up the process of paying retirees so as to curb the suffering and destitution among older people. The excerpts below from FGDs attest to the assertions above: "They should be given loans so that they become self reliant. If the government cannot do that maybe donors can help" (FGD, Matero -Lusaka) "The system of pensions should be changed, when old people retire, they should receive the pension at least a month after their retirement. There is nothing easy in this country" (FGD, Mwandi -Sesheke) Other possible solutions have been suggested to help solve problems of the aged persons in the Zambian society. The creation of jobs for example should be structured not only to carter for young people but for the elderly as wellcreating jobs for all ages in society. Filial loyalty is still rife in many African societies and Zambia in particular, as such, if and when jobs are created for young people for example, it would be possible for these young people to take care of their elderly relatives and hence help reduce their suffering. Currently, many young people are not working, and are also finding it very difficult to look after their elderly relatives since in most times than not, they cannot take care of themselves adequately. In the same vein, there is need to also create jobs specifically tailored to be done by the elderly; these jobs should be accessible for people in both urban and rural areas.
It is an open fact that currently, there are very few organizations working in the area of ageing. Of course, the church has always been instrumental in helping the aged; however, much of what the church does is really on handouts and in effect not enough and only suitable in the short term. In view of this situation, more organizations should be encouraged to start working with the elderly in order to improve their welfare. While it is appreciable for organizations to work with children, youths and women, isolating and deliberately ignoring the elderly was no solution to society's problems and less still to the elderly people themselves; organizations should be encouraged to take a holistic approach and indentify critical issues affecting society and ageing is one such issue requiring intervention. In addition, not only should organizations be encouraged to have programs for the aged but also encourage the aged themselves to form organizations or cooperatives that would help champion their cause and reintegrate and make known their plight to society. Such organizations would be very instrumental to network and help solve some of the problems that the elderly go through from time to time. FGD discussants had this to say: "If we had jobs, we would really help the old people. The government should therefore create jobs for the youths so that they can look after their parents" (FGD, Masala -Ndola) "The best thing that can work is the issue of forming cooperatives. If the government can assist old people form organizations, they can really help the old people a lot" (FGD, Masala -Ndola) Other suggestions, in addition to the ones discussed above are mostly targeted at the government as an institution and how it had an important role to play to ensure the welfare of the aged in society is uplifted. Government is the main key stake holder and requires a spirited proactive approach in dealing with all issues affecting the general citizenry and the old people in particular. In the same way, the United Nations needed to monitor to ensure the government of Zambia paid particular attention to the aged and the subject of ageing in general. Strengthening the ministry that deals with issues of vulnerability especially for older persons is one of the ways of intervention. The Ministry of Community Development and Social Welfare is mandated to look after interests of disadvantaged people in society including the aged and those with certain physical or mental challenges; as such, this ministry requires adequate funding to meet aspirations and expectations of a large cadre of persons with various needs which are in most times than not quiet challenging and diverse. In strengthening this ministry, government needed to establish more homes for the aged so that as the number of old people is growing and since cases of family abandonment of the aged is also on the increase, such homes would be very critical in reducing or curbing destitution amongst the aged in society.
Enactment of legislation that addresses the concerns of the aged and matters around ageing in specificity was also key in resolving ageing and the consequences thereof. It is alleged that aspects of the aged and ageing are only attended to passively and not strongly represented in the Zambian law; the old are looked at just as some vulnerable group -like women, children and to some extent, those with physical or mental disability or challenges. Enactment of laws and regulations specifically addressing matters of the aged would therefore also compel the government and families to take care of the aged especially that failure to do so would result in legal litigation of one kind or another. It has been contended that enactment of laws to specifically address matters relating to the aged and ageing in general was good in itself; however, this could be better if such pieces of legislation are also enshrined in the supreme law of the landthe constitution.
While the United Nations has been very instrumental in championing issues of the aged, there was need to also structure some Millennium Development Goals (MDGs) to have specific objectives relating to matters or rather issues on ageing. Currently, it is felt that MDGs were concentrating on many important aspects affecting humanity especially those living in the developing world; however, the same principles have not been extended towards the aged fully and yet they are also part of a special group with specific needs requiring some specific specialized intervention. While it is evident that the aged are also within special groups addressed by MDGs, enactment of targets (goals) to improve their welfare is also a necessary step to salvage their problems at both at national and international level. The following excerpts from FGD are some examples: "The ministry that looks after issues of the old should be given more money. The problem is that these people (government) do not move around, and they do not see the suffering people are going through, how can they help then? They should come here and see how these people are neglected" (FGD, Matero -Lusaka) "Like I said in the beginning, millennium goals and the constitution should be changed and ensure that policies that will be made to cater for the aged will be implemented" (FGD, Mwandi -Sesheke)

Summary and Conclusion
The Zambian society in general recognizes the fact that implicitly and though without much evidence, the number of older persons is on the increase. However, discussing ageing is still a distant phenomenonand where the subject is discussed, classification of the older persons is mostly in negative connotations: for example, they are suffering, they are witches, troublesome, boring and mostly with really nothing to offer. Society is also cognizant of the fact that the aged people are faced with numerous challenges which are both social and economic; older persons face among other problems the following: unable to care for themselves, lack of employment opportunities, face abandonment and destitution, are humiliated because of being old and are also heavily affected by effects of HIV and AIDS.
Unfortunately, and rightly so, society and the public in general seems to have no information on the existence of policies, programs and plans addressing issues of the aged persons. This mostly is a government problem which up to now has only crafted a draft proposal on ageing even after ratifying several international protocols including the one on ageing.
The following are both suggestions and recommendations to deal with ageing in Zambia; they could be considered both as solutions for the immediate, intermediate and long term.
-In order to make known the importance of ageing and the likely effects if left unattended, there is need to encourage or conduct spirited focused research on ageing; this has a potential to help coin polices based on evidence and would make many communities sensitive towards ageing; -The need to create a society for all ages by ensuring access to employment opportunities for all is a very critical undertaking since it has the potential of reducing dependency on both government and families; -Encourage organizations in Zambia to also venture into helping to solve problems associated with ageing and not only concentrating on interest groups like children, youth and women; further, encourage old people to form organizations that would in turn focus on sensitizing and help championing issues of ageing and aged persons is very critical; -Encourage the government of Zambia to enact legislation incorporating in detail issues of ageingthis should be enshrined in the constitution also; and, -Millennium Development Goals should be structured to have objectives and goals that are tailored towards the aged; in their current form, MDGs are not specific to ageing and concentrate more on the development of a young society.
With reference to the Madrid 2002 conference on ageing, the pursuant of integration of the aged and availing opportunities especially on training and employment would be a positive step towards building a society for all ages in Zambia.