Healthcare, Does it Exist?

As mentioned in the previous post, the healthcare system in Nigeria is very poor. Not only does Nigeria’s healthcare system lack proper medical knowledge, systems and equipments but it doesn’t even include the elderly, the fastest growing demographic in Nigeria. Not because they don’t need care but because Nigeria can not afford to provide care to its elders. Healthcare for the elderly is a lot more expensive than that needed by other demographics, because the care that they need is a lot more extensive than the care needed by say, mothers and children. For that reason, more resources and attention are spent on them versus on the elderly. This lack of proper distribution to the elderly in Nigeria, can be seen in the lack of social security, the nonexistence of health care programs services, and the newness of health insurance which is only accessible by the rich.

This distribution of resources is seen not only in the government but also in families. In a typical household, most of the income should be distributed to the older persons in the family considering that they have the greatest needs. But because not all families have the ability to cover medical expenses for the older persons that they are living with, due to other expenses that they may have, (ie. food, shelter, kids, education) many do not spend their income or attention on the elderly.

The lack of healthcare given to elders results in an increasing burden for many families. Those who do spend their resources to provide for the elder persons in their life are unable to distribute their finances to other deserving aspects of their life. Those who do not, have elders who die early from preventable diseases and disabilities.

It is, therefore, necessary that not only should Nigeria make some major changes in the adequacy of its healthcare system but they should make sure that it includes geriatrics and services providing for older persons. In addition, they need to increase the pension and benefits that older persons are supposed to be receiving but do not necessarily get so that proper medical care will be more accessible for them. As a nation, we should want the best for the elders in our midst, similarly to how parents want the best for their kids. After all, regardless of our age, we are all humans in need of love and care.

References:

Akanji, B. O., Ogunniyi, A. and Baiyewu, O. (2002), Healthcare for Older Persons, A Country Profile: Nigeria. Journal of the American Geriatrics Society, 50: 1289–1292. doi: 10.1046/j.1532-5415.2002.50319.x

Olanrewaju Olaniyan, Saheed Olayiwola and Sunkanmi Odubunmi, 2011. The Impact of Health Expenditure on the Elderly in Nigeria. Pakistan Journal of Social Sciences, 8: 212-218.

Welcome MO. The Nigerian health care system: Need for integrating adequate medical intelligence and surveillance systems. J Pharm Bioall Sci 2011; 3:470-8

More on Depression…

In Nigeria, when it comes to healthcare, mothers and children are of the highest priority. One may assume that Nigerian elders do not the get the attention that they deserve. If so, they are correct. Professor Oye Gureje, the president of the African Association of Psychiatry and Allied Professions (AAPAP), recently stated that the elderly population in Nigeria is amongst the highly depressed in the world. Depression, includes everything from mental illness, sleep, anxiety, sex, and stress disorders, disabilities, and suicide. As a whole, Nigeria ranked 85 out of 91 on a survey studying the wellbeing of older persons in countries. This puts the elders in Nigeria on the same level as those in Middle Eastern and war torn countries. Shameful right?

So the question you may be asking is why? Why are Nigeria’s elders so depressed? But a better question may be why not? Many of the reasons that they may have such high levels of depression may be due to the some of the things that I mentioned earlier. They lack quality social networks and support, they are not given the medical attention that they need, they are extremely dependent on others, unemployed, suffering from disabilities, poverty ridden and most importantly they are socially isolated.

Something needs to be done. There is no reason for so many elders to feel depressed and to be suffering from mental illness. More work needs to be done by the government to ensure that they are in good hands and are getting the attention that they need. I am not saying that attention that is currently given to mothers and children should be diverted. Rather, Nigeria needs to make sure health programs are in place for the elderly that is both accessible and affordable.

References:

Ajayi, Ola. “Nigerian Elderly Have Highest Depression Rate.” Vanguard. N.p., 11 Oct. 2013. Web. 24 Nov. 2013.

“Elderly Persons in Nigeria Are Highly Depressed – Prof. Oye Gureje.” Elderly Persons in Nigeria Are Highly Depressed – Prof. Oye Gureje –. HealthNewsNG.com, n.d. Web. 26 Nov. 2013.

Oguntula, Sade. “Nigerian Tribune.” Nigeria Elderly People Ranked High on Depression. Nigerian Tribune, 17 Oct. 2013. Web. 26 Nov. 2013.

3 D’s: Disability, Depression, Dependence

As we all know, when you get older your body does to. Literally! Everyday tasks get a slight bit harder as your body is unable to keep up. Despite the aging of the body, many elderly people are still able to retain their independence and continue to do their favorite daily activities. 

In developing countries, like Nigeria, aging really does take it toll. When elderly people are faced with bodily issues, because of the lack of resources, education and access to health care facilities, it is often impossible for them to get the care that they need to prevent them from ending up with a disability. So the rates at which disabilities that affect their ADL (activities of daily living) for many Nigerians are very high.

High rates of disabilities are often seen in Nigerian women, those who are illiterate and lack education, poor, living in rural areas and have had a lower quality of life throughout their life. People who have or are at high risk for disabilities, typically show high rates of depression. People suffering from high rates of disabilities, depression or both typically are more dependent on others and need more formal or informal care. Though in developing countries, with increasing modernization and lack of institutional care, many elders are not able to gain access to better care.

With this knowledge, Nigeria and other developing countries, need to do many things to ease the life of its elders. For one, Nigeria needs to provide better economic, education and  healthcare for its young to give them better health prospects in old age. Secondly, Nigeria needs to provide better healthcare for elders who are sick and have mental illnesses and institutional care for those that who lack the kin network to provide informal care or have severe disabilities that need professional care and supervision.

References:

Gureje, O., Ademola, A. and Olley, B. O. (2008), Depression and Disability: Comparisons with Common Physical Conditions in the Ibadan Study of Aging. Journal of the American Geriatrics Society, 56: 2033–2038. doi: 10.1111/j.1532-5415.2008.01956.x

Gureje, O., Ogunniyi, A., Kola, L. and Afolabi, E. (2006), Functional Disability in Elderly Nigerians: Results from the Ibadan Study of Aging. Journal of the American Geriatrics Society, 54: 1784–1789. doi: 10.1111/j.1532-5415.2006.00944.x

I. S. Abdulraheem, A. R. Oladipo, and M. O. Amodu, “Prevalence and Correlates of Physical Disability and Functional Limitation among Elderly Rural Population in Nigeria,” Journal of Aging Research, vol. 2011, Article ID 369894, 13 pages, 2011. doi:10.4061/2011/369894

“Nye m (Give Me)”: The Lack of Support Given to the Nigerian Elderly

The elderly population in Nigeria is growing at an extremely fast rate, similarly to other developed and developing countries around the world. This quick growth of the elderly population raises a lot of concerns for many Nigerians, specifically the elderly. Traditionally, in past generations, elders were afforded great care and respect from their families, friends, and communities. Although, it is this  kin network that is still supporting the elders today, as noted in a previous post, the amount of respect and care given to elders is declining and as a result so is their quality of life.  

Some of the reasons for this decline include the rise of modernization, industrialization, individualization and many other economic changes. Today, adult children, especially males, live very far away from their elderly parents. But for those living within a close proximity to their parents, many adult children have become more concerned with providing for their own immediate families, children’s needs and maintaining their own financial prospects and security. The changing economy of Nigeria, effects the amount resources that adult children of the elderly are able to allocate to their parents. As a result, elderly parents are dissatisfied in the little financial, emotional and social support that their children are giving to them. 

In conclusion, the Nigerian government needs to step up and provide more assistance and support to its elderly, especially since this population is growing very quickly and is living much longer than it has in the past. This is necessary because despite the fact that the elderly are still given support from their children and extended family members, the support they are given is often inadequate and irregular. To supplement this lack of support, more programs and institutions need to be put in place to support the elderly and ensure that they are still given access to a decent quality of life. 

References:

Okumagba, Paul O. “Family Support for the Elderly in Delta State of Nigeria.” Stud Home Comm Sci 5.1 (2011): 21-27. 

Peil, Margaret. “Family Support for the Nigerian Elderly.” Journal of Comparative Family Studies 22.1 (1991): 85-100. Web. 9 Nov. 2013.

Unanka, Godwin O. “Family Support and Health Status of the Elderly in Imo State of Nigeria.” Journal of Social Issues 58.4 (2002): 681-95. 

Self-Exit Amongst Nigerian Elders

Suicide is considered a taboo globally and in many cultures. When one does commit suicide, regardless of whether or not it was fatal, people start to look at this person, their entire life and family differently. Worse than death, people do not know how to deal with or react to a suicide. Because of this, the questions and negative comments surrounding the person’s death or attempt of suicide can make the period after a suicide traumatizing for the victim’s survivors.

In Nigeria, a country where people are expected to be grateful to be alive, appreciate the life they have and to fight on against all odds, suicide is seen in a particularly negative light.The result of one study, that researched the attitudes of Yoruba college students, found that in comparison to Americans they had extremely negative views towards suicide. Many stated that they would be ashamed had they lost a family member to suicide and that those that commit suicide must be crazy and angry people.

Despite these negative views, suicide does occur and is actually quite common amongst Nigerians elderly population. Many older Nigerians have also admitted to attempting suicide or having suicidal thoughts. So despite the stigma that suicide is given, it occurs quite often amongst older people as it does in other age groups. Suicide for elders is usually a result of extreme depression, isolation, loneliness and exclusion, the same reasons that put elders in other countries at risk of suicide.

Often questions like: How could someone want to take their own life? or How horrible could his/her life been to make them do this? Were they crazy? are asked after a person’s suicide. Often, elders that have died or attempted suicide are ostracized and seen as selfish for hurting their families and causing them shame and embarrassment, without insight to see what drives them to seek this option.

Instead, questions regarding how they can help prevent and what leads people to suicide should be asked. Since there is so much stigma and negative perceptions surrounding suicide, there needs to be more prevention programs, education and support given to Nigeria’s elders to lower the rates at which suicide is used as an easy exit from their hurt and pain.

 

References:

Lester, David, and Adebowale Akande. “Attitudes about Suicide among the Yoruba of Nigeria.” The Journal of Social Psychology 134.6 (1994): 851-53.

Ojagbemi et al.: Suicidal behaviour in old age – results from the Ibadan study of ageing. BMC Psychiatry 2013 13:80.

Pritchard, Colin. “Changes in Elderly Suicides in the USA and the Developed World 1974-87: Comparison with Current Homicide.” International Journal of Geriatric Psychiatry 7.2 (1992): 125-34.

Your Too Old To Be Having Sex!

Myth or Fact? Older people, ages 65 and over, do not have sexual intercourse.

Myth. Older people, of all nationalities, have sex. 

Surprised? It could be a little weird to think that your parents, grandparents or great-parents may still be engaging in the act, but chances are that they are. After all, they are human.

This fact also applies to elderly Nigerians. Just like people of other age groups and nationalities, older Nigerians are also having sex, though their habits and perceptions towards sex may differ slightly.

Unlike younger people, older Nigerians are more hesitant to have sex because of physical and physiological challenges. Because of the declining strength in their bodies, men are more likely to seek sex if they have external resources, ie. drugs, to help them enjoy sex. 

Unlike men, women are less likely to actually seek sex. Many older women saw sex as an abomination and stated that having sex can have negative spiritual and physical consequences like death. Instead of focusing on sex, and satisfying one’s self, many women stated that it is more honorable for a woman to focus on being a good grandparent, an example to the young ones in their communities and more importantly strengthening one’s spirituality. Whether or not this perception of sex actually affected their frequency of engaging in sex is unknown, but the attitudes expressed by different older Nigerian  women were very consistent. 

In conclusion, older people are having sex, though most likely at decreased frequencies than younger people. Whenever you question the sexuality of older people, remember that like young people, old people have, are and will always be human beings with sexual needs that will continue to exist as they age.

References:

Ekundayo, Opeyemi O., Abimbola A. Akanni, and Ayobami O. Oyedeji. “Sexual Behavior of the Elderly at Ile-Ife, Nigeria.” Gender & Behavior 10.1 (2012): 4563-573.

Ojo Melvin Agunbiade & Titilayo Ayotunde (2012) Ageing, sexuality
and enhancement among Yoruba people in south western Nigeria, Culture, Health & Sexuality: An International Journal for Research, Intervention and Care, 14:6, 705-717

Saka MJ, Saidu R, Jimoh A, Akande T, Olatinwo AW. Behavioral pattern of menopausal  Nigeria women. Ann Trop Med Public Health, 2012; 5:74-9. 

Triple Jeopardy??

Young people literally have their whole life ahead of them. Despite being told to enjoy our youth and enjoy the ride, most of us wanted to grow up quickly because being older seemed more fun. After all, who didn’t want to be those cool older kids? Getting older seemed exciting and the privileges associated with coming of age are usually more than welcomed. For example, in the United States, turning 16 is a highly celebrated and anticipated age marked by being able to get a driver’s permit. Then there is 18, the year one becomes a legal adult, can vote and in some cases enters into the exciting, new world of college. Turning 21, is the age that allows many young adults to drink legally and in some states even rent a car. If one looks at it this way, getting older doesn’t seem half as bad, especially when it comes with new found freedoms that one didn’t have before.

So why do many societies value being young over being old? For many, getting older means a decline in physical and mental health. It also includes, unemployment, loss of status, power, finances and maybe even poverty. For elderly people in third world countries, such as Nigeria, becoming older is extremely taxing. Old age is associated with a lower quality of life, especially if you are already poor. Quality of life, which entails physical, social, psychological and environmental aspects of one’s life, are particularly affected by one’s socioeconomic status. The quality of life lead by the elderly in Nigeria are also affected by their gender, health, social network and social support prior to and during old age.

Older persons in developing countries, like Nigeria, need many political and social changes to be made in order for their quality of life to be improved. Elders of low socioeconomic status and living under poverty tend to be malnourished, in poor health and lack access and funds to decent hospitals. Having less family and friends nearby also significantly lowers their quality of life. Living in areas where sanitation, safety and access to necessities is difficult to attain can also affect the nutrition, health and the overall quality of life experienced by many elders.

Women in Nigeria are especially affected by old age. Nigeria, at large, is a patriarchal society, with many traditions and customs that reinforce the value of men and negate women. As part of custom, assets such as property and money, are passed down from the husband, who is seen as the head of the family, to his children. This leaves many women dependent on  her husband and if widowed, her children for money and support.

Similar to how being old and black in the United States is seen as a double jeopardy, being old, poor and living in a poor country is a triple jeopardy. Many changes need to be ensured to make sure that our elders are given the quality of life that they deserve.

R-E-S-P-E-C-T! : What It Means to Nigeria’s Youth

Nigeria, is a country located on the Western region of Africa that has many traditions that have been upheld for centuries. Some of their traditional values, such as religion, have been adapted for the modern-day Nigerian, especially since post British colonization. However, one of the aspects of Nigerian culture that has gone relatively unchanged is their high regard for respect, especially towards their elders. Greeting one’s elder is considered a highly specialized task. In the Yoruba tribe, males are expected to prostrate and lie on the ground, while females are expected to bow or kneel before their elders while greeting them. For the Igbos, one must acknowledge the presence of a senior by extending a greeting like ‘Good morning’ or by shaking their hands firmly with two hands. Generally amongst all tribes, “elders in Nigerian culture are afforded great respect by the youth” (Purefoy).

However, it is this “culture of respect” that seems to be deteriorating. The youths of Nigeria seem to have more negative views and disregard for their elders. From their study on the perceptions that youths, ages 15-30, have of the elderly, Okoye and Obikeze (2005) found that “A large majority of the participants believed that the elderly behaved like children and are sickly” (447). Being seen as a burden than as a group of people to be respected and revered, is a view that not only the young people have.

Those in government seem to have forgotten the elders as well. Cities in Nigeria, specifically Lagos, one Nigeria’s biggest cities and its former capital, has made life very difficult for elderly Nigerians. One elderly man, of 80 years, stated that “Today in Nigeria people have no plans for the aged” (Purefoy). Places similar to Lagos, are undergoing quick urbanization much to the disadvantage of the elderly. And despite their complaints to meet with government officials to have these changes halted, their voices go unheard. One man commented that “our elders are reaping what they have sown. The elders — the youth of yesterday, they are the elders of today — so they are responsible for this misfortune that they are having” (Purefoy).

These types of changing attitudes pose a great concern for the elderly people of Nigeria. The lack of respect that they are given by the youth both in their community and in their government may significantly affect the care and quality of life that they will be afforded in their old age.