Following our March 2005 feature on urban provision for senior citizens, Matt Perrement reports on efforts to improve the lot of older people in rural Shaanxi.

Eighty-three year-old Lao Wang is one of three generations living together under the same roof, a family composition that is fairly typical in this area. Her two grandchildren are at middle school, and their parents, both farmers, have to make ends meet with a cash income of less than CNY 1,000 (USD 120) per year. School fees alone eat up 40-50% of that income.

Living conditions here are not easy. Most houses are fashioned from a mixture of mud, patches of brickwork and some interior plastering. In places the floor is no more than compacted earth, and furnishings in the guest area comprise a few low stools. Outside toilets collect waste in open pit latrines.

Illness among the elderly is common at the end of a working life tilling the land, but the nearest medical facility to Lao Wang’s home village of Xishan (西山) is more than 30 minutes drive along dirt tracks. There is no public bus service. Common ailments among older people in the households I visited included heart problems, hypertension and arthritis; but combined isolation and poverty mean that many receive little or no treatment. This despite the close proximity of Xi’an, China’s ancient capital, which offers an abundance of material comforts just three hours away.

But poverty has never got in the way of a warm welcome in China. Xishan’s entire population of 1,556 has turned out for one of the most impressive, if simple, receptions that I have ever seen. Tracksuit-clad, flag-waving schoolchildren line the road, forming a human tunnel through which the visitors pass. Older members of the community – 196 villagers are over the age of 60 -- bang drums and clatter cymbals. Fireworks also add to a sense of occasion.

The occasion is a review visit by HelpAge International which, since September 2004, has facilitated the establishment of Old People’s Associations in four locations across Shaanxi Province, and enabled them to make small loans of around CNY 1,000 (USD 120) to families that include an elderly relative. The three-year project is sponsored by the European Union, and also works in rural areas of Hunan and Sichuan.

Given that the family remains the mainstay of care for older people in rural areas, boosting the household income is essential to improving care, including access to health care. The project, notes HelpAge Regional Project Manager, Joseph Pannirselvam, is also a way of bolstering the social status of older relatives. ‘Older people were beginning to be seen as burden,’ he notes, but the Old People’s Associations have helped to restore their position in village society.

An Association is established for every 100 older people in the project sites, with larger villages having two Associations. In Xishan, close to 90% of the older population have joined up. Regularly meetings are held to discuss and make decisions on loan applications that are distributed from a revolving fund of EUR 6000 (USD 7,760) per Association.

The loans offer the prospect of raising incomes above bare subsistence. One farmer tells us that providing food for his family all the year round ‘shouldn’t be a problem’, but that meat is only served once every two months. Their loan, which buys three goats, may at least improve the family diet.

Income generated from the sale of milk and lambs could, in the longer-term, allow Lao Wang to receive the corrective surgery for a cataract that has left her partially blind, or fund a university education for one of the children. Most of the adults in Xishan have not studied beyond middle school.

But much depends on the ability of villagers to make prudent investments and repay loans, enabling the scheme, which is hoping to attract additional finance, to sustain itself. Interest rates, are modest, at 3%, and will not add much to the loan principal; but raising enough cash to make a lump sum repayment may prove problematic. With milk sales only bringing in CNY 4 (USD 0.5) from a daily yield of 5 kg, it will be necessary to sell five lambs in order to repay a CNY 1000 loan. The first batch of loan results should be available in Autumn 2005.

The project also trains local health workers, sensitising them to the needs of older people and building links between the community and service-providers. If the welcome for project staff and accompanying officials is anything to go by, there is already a deep sense of appreciation.

Low government revenues in rural areas and urban bias in central resource allocation have meant that social service provision has tended to start in cities and extend only gradually to the countryside. The HelpAge project, says Regional Representative Eduardo Klien, is trying to develop a rural model that can be replicated more widely. Its approach appears to fit the context, reinforcing the traditional value of respect for the elderly in order to strengthen informal, family care for older people.

April 12, 2005