Support structures are essential for elderly people given that they are generally more dependant. Loss o f family, friends, professional and community support in emergencies may therefore have a significant impact on the elderly. This section highlights some support structures for elderly people.
The role o f the family for the well-being o f the elderly is universally acknowledged. However this must not be idealised as there is evidence that the presence o f the family, even under normal circumstances, does not guarantee that the elderly are always properly looked after (Rwezaura, 1989; Apt, 1990, 1993; Ingstad & Bruun, 1994). A major common feature o f the extended family is the collective responsibility for all household members. Also in Rwanda families and friends play a major role in support and care for the elderly (Thomas & Atkinson, 1995). Traditionally, elderly people live in extended families structured by patrilineal descent. They have their own living quarters in the family's compound and look after themselves for as long as possible. Sometimes grandchildren live with them and assist with the daily work. When they are no longer able to provide for themselves, the elderly are taken care o f by the son's family (Marzi, 1994).
Urban migration has been observed to have drastic consequences on the support to rural elderly. The ability o f modem families in developing countries to care for elderly relatives in an urban environment is seriously impaired by limited financial resources, crowded housing and increased employment o f women (Apt, 1990). Moreover, age-selective migration to urban areas may imply the loss o f a major source o f economic and social support for rural elderly (Okojie, 1988; Sen et al, 1993).
Also in Rwanda, the practice o f reciprocal support had already been eroded before the war broke out as a result o f disintegration o f traditional family structures due to economic and demographic problems. Increasing materialistic dependency on children has weakened the authority and status o f elderly people in the Rwandan society (Marzi, 1994). A deteriorating social status o f the elderly has also been signalled in other African countries (Rwezaura, 1989; Bruun, 1994).
Although the traditional family structure is changing, extended families continue to be the primary support system for African elderly and emotional ties and economic support among family members still remain strong. Those without children are especially vulnerable to the problems o f acquisition o f basic needs and decreasing functional ability. T his is likely to present more difficulties for w om en than for men, since most older women are widowed and thus more dependent on children (Apt, 1990; Cattell, 1990).
If the needs for social support outlined above are o f concern to elderly people in normal situations, then it follows that the same needs will constitute an even greater burden to the elderly in refugee circumstances. The degree o f social support that elderly people receive in unstable situations partly depends upon the nature o f social structures in the normal situation and the extent to which they have been disrupted. I f social cohesion had never been strong, or if many families have split, caring behaviour is likely to be reduced. An extensive anthropological study o f U gandan refugees in Sudan provided evidence o f eroded social behaviour, in particular in respect o f reciprocal family obligations which w ere observed prior to exodus (Harrell-Bond, 1986). In contrast, a survey among Ethiopian refugees in Sudan revealed that most older aduhs lived with and were cared for by family and friends. Only 6% of them reported an unmet need for assistance on a regular basis (Godfrey & Kalache, 1989).
Although sickness, loss o f property and death limit the flexibility o f the family structure in providing support, this is not the only explanation for greater lack o f support to elderly seen in unstable situations. Social upheaval can change the position o f people in society and elderly people are vulnerable in this respect. For instance the loss o f property in an emergency setting is likely to cause the elderly a loss o f status. While traditionally the elders had control over strategic as well as scarce resources such as land, livestock, essential skills and ritual powers, the majority o f refugees have lost such resources. This has resulted in the elderly losing not
only their dominant position, but their social status and prestige as well (Mupedziswa, 1989). Most elderly people have been stripped o f the status associated with old age and most refugee communities have not, for th e most part, opted to re-instate traditional figures o f authority. Instead their positions have been taken over by NGO staff and th e young. Cross-cultural findings from various Asian countries suggest that involving older people in family decision making and greater social integration can, in part, mitigate psychological distress among the elderly, resulting from financial strain (Ferraro & Su, 1999).
A participatory appraisal am ong elderly people in ‘post-war’ R w anda revealed that despite the eroded traditional status o f the elders, the family still offered the main social support structure. Besides this, elderly people received some assistance from the community (neighbours and other relatives). Family support depended upon th e following factors: 1. The presence o f family members.
2. The relative wealth o f the family and community. 3. The proportion older adults to younger people.
4. Relations within the family and community (Thomas & Atkinson, 1995).
Besides the family, other form s o f support have been reported from refugee situations in African and Asian countries. Elderly people formed mutual support groups to care for each other and to repatriate together. Churches also play a role in supporting the elderly. Remarkable are reported alliances between lone older persons and unaccompanied children (pers. com. Cook, 1995). T his may be entirely altruistic or deliberately developed strategic- social relations to secure ca re and food.
Relief agencies are another potential source o f support for elderly. Unfortunately these organisations are not always aware o f their needs, and the elderly as a group might be less able to put themselves forw ard for assistance. Moreover, elderly people may need assistance to use the offered services such as visiting clinics.
The well-known relationship between social status and health h as also been noted in refugee communities as social or political status can directly influence access to food (Davis, 1996). Low self esteem can also play a role however, as some elderly tend to put themselves last (Strachan, 1986).
Despite the feet that even physically impaired older people are in many cases still quite productive (child care, light household tasks, advice), they are often seen as being a (economic) burden for the family (Pankhurst, 1984; Squire, 1991). This can even result in “scape-goating” and children stealing from parents (pers. com. Cook, 1995). Also Keen (1992) mentioned the tendency to a shrinking o f generosity, an increase o f theft and in some cases abandonment o f the old and the very young in severe famine.