World Africa

In Ethiopia, the elderly get new help from an old tool

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As Ethiopia has begun to age, its traditional end-of-life insurance groups are adopting a new purpose: helping elderly residents live their daily lives when they no longer have family members nearby.

Over 70-year-old Etenesh Yimer at her tiny house on the outskirts of Addis Ababa. She is one of the oldest members in her idir, and one of the poorest ones. She receives food and medicines from the idir, other members pay her monthly membership fee because she cannot afford it.
Monika Rębała
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A World Living Longer: Global aging is one of the greatest challenges of the century. And this is not just a “Western” problem. Politicians and policy makers around the world are rethinking healthcare networks, urban design, nursing care, and pension systems to prepare for it. The elderly themselves are key players to help turn this from challenge to opportunity.

For more in the Monitor's look at global aging issues and solutions, please visit our series homepage.

Established around 100 years ago, the Ethiopian idir is a kind of grassroots life insurance. Idir collectives help Ethiopian neighbors organize funerals for their closest relatives and provide solace in grieving.

But as Ethiopia has begun to age, the idir has started to serve a new purpose beyond end-of-life services: helping elderly residents live their daily lives when they no longer have family members nearby.

“The number of older people left alone has increased, because their children have left for other cities or countries and don't visit or support them anymore,” says Etalemaha Mekbib, the treasurer of a 700-member idir on the outskirts of the capital Addis Ababa. Her association, whose main purpose was once to fund all the arrangements of the funeral, now also pays calls to the elderly in their homes, accompanies them to hospitals, and helps them pay their monthly idir fees or buy basics such as soap or coffee.

Although Africa is the world’s youngest continent, people here are living longer too. And by most accounts Africa is not doing enough to prepare for it. Although in African culture the elderly enjoy a vaulted social status, with extended families taking care of them without question, traditional support systems have become strained. Rapid urbanization, modernization, and the AIDS epidemic have devastated family structures, leaving elderly with little support. Some are even on the streets.

For the vast majority of elderly in Ethiopia, says Gebre Yntiso Deko, an anthropologist from Addis Ababa University, “their pension systems are their children.” He says governments should act now to prepare, by funding adequate nursing care and creating pension schemes.

In the absence of that, the idir is serving as a vital social network since they are present even in the smallest villages. “We have to come up with new ways to help elderly people,” he says.

“People in an idir are like a family,” says Ms. Mekbib, dressed in a traditional white Ethiopian scarf in her living room on a recent day. “They are neighbors, they know each other well, so they know when someone needs help.”

Elderly, alone

Just outside Ethiopia's sprawling capital, extended families have long lived in round, thatched-roof huts with mud-plastered walls, and the elderly are cared for by their children and grandchildren. Among some ethnic groups the elderly are given special status, feted regularly for their knowledge in farming, animals, and weather. In others, they are viewed as having mystical powers.

But rural-urban migration, and modernity generally, has meant that many older people find themselves doing what once was unthinkable – living alone, and having to fend for themselves.

Seventy-year-old Kifle wanders the streets of Addis Ababa all day long. He earns a living changing money for bus drivers who don’t have time during their chaotic routes. For each birr – Ethiopia's currency, worth about 5 cents – changed, he gets a tiny stipend of 10 to 20 Ethiopian cents in return. That's not enough to survive, so he begs for money on the streets too.

He comes to Addis Ababa once every two to three months, from a village in the Tigray region, 300 miles north of the capital, where he is a farmer. “My children send me here, they want me to find money not only for my living, but also to support them,” he says, sitting on a sidewalk in the center of the city.

In Ethiopia, like in most countries on the continent, there is no universal pension system, with only a small number of the working population contributing to pension schemes.

Some governments are starting to address a growth in elderly poverty. The government of Zanzibar, an autonomous part of Tanzania, is currently testing a pilot project for a universal pension scheme for senior citizens. It is the first fully state-funded program in East Africa. Since April, all people above 70 have received 20,000 Tanzania shillings each month in cash (around $9).

“I didn’t expect that it would happen during my life time,” says Fatma Hassan Makame, who at age 81 walked two kilometers (about 1.2 miles) from home to collect her first pension, waiting in a long line in front of a school on the outskirts of Zanzibar City for several hours.

It’s only in an initial phase, and many new pensioners say it barely covers the basics. But for beneficiaries it is nothing short of revolutionary. And such policies will become more critical as Africa ages. The United Nations estimates that the number of people above 60 Africa-wide will increase four-fold, to 200 million, by 2050. And according to the World Bank, the life expectancy has already increased an average by 30 percent in the last 15 years.

A traditional safety net

Most governments have not yet put plans in place to address this. On the outskirts of Addis Ababa, Etenesh Yimer, who wears her graying hair pulled back in a pretty black scarf, once tried to get money from the state.

She came to the capital as a teen, and spent her working life as a servant in wealthy homes. Now she is too old to work, and receives almost no support from family. She has a son that visits but whenever she discusses her needs to buy food or medicine, he leaves. As for the government, they told her they no longer support the elderly – and she never tried again for another cent. “The neighbors support me,” says Ms. Yimer from her home that is so dark it feels like a basement.

Fortunately, idir take up some of the slack. Generally organized around neighborhoods, idir have historically been used to help families to organize funerals for their relatives, and to console in grieving for three days. Members of an idir, which can include hundreds of people, make monthly financial contributions, usually ranging from between 10 and 50 birr per family. They are also obligated to provide assistance to the idir in the form of attending funeral services and aiding mourning families.

When a member of an idir dies, a chairperson of the group chooses others from the idir to attend services and assist the mourning families. Women usually are asked to prepare injera, a traditional Ethiopian bread, and to serve coffee for the mourners. The idir also gives relatives the money needed to cover funeral expenses.

The role of the idir started to become more flexible amid the AIDS crisis that wiped out the middle generation, leaving many old people with orphaned grandchildren to take care of – and then no one to take care of them. Now they are playing a major role in Ethiopia’s aging.

Asegedech Sitotaw Arega lives on the outskirts of Addis Ababa in a two-bedroom apartment. She and her son used to live in the center, but the authorities decided to resettle residents because they wanted the land – a chronic problem in this fast-growing capital.

She misses her old idir, which over the years came to be family. But she never questioned whether she would join the idir in her new neighborhood. “If we didn't have idir it would be difficult,” she says. “People help us when I'm sick, they cook for us, do the laundry.”

In other words, it is her only backup.

This project has been funded by the European Journalism Centre (EJC) via its Innovation in Development Reporting Grant Program.

For more in A World Living Longer, the Monitor's look at global aging issues and solutions, please visit our series homepage.