Amelia Duarte de la Rosa, Special correspondent

WHILE aging is a natural phenomenon, the perception of age is also related to bio-psychic and socioeconomic factors. For any society seeking the prolongation of life in conditions of well-being, heath care for older adults is a major aspect.

A gradual increase in senior citizens is a visible process in the world population, brought about by a sustained decrease in fertility rates and extended life expectancy. However, in Latin American and Caribbean countries demographic patters vary as the result of unequal population structures. In the evolutionary context, groups with better conditions have a higher life expectancy rate and are able to control fertility, while the poor, with lower educational levels and in the main resident in rural areas, have high fertility and mortality rates.

With a high percentage of its population living below the poverty line, Haiti has an average fertility rate of four-plus children per woman, one of the highest in Latin America. According to UNICEF statistics, approximately two thirds of the population live in rural areas and life expectancy, which stood at 37 years in the early 1950s, currently fluctuates around 58 years of age.

In the country, mortality patterns in older adults, who represent 3.9% of the population, record infectious and acute degenerative disease, hypertension and heart disease. Most adults do not complete elementary education and live, like other inhabitants, without access to basic medical attention.

Institutionalization in senior citizens’ homes, treatment programs or primary medical attention for improving quality of life are virtually nonexistent. The Ministry of Public Health does not have articulated policies for providing protection, health security and specialized services for the elderly.

Due to high unemployment, few persons receive retirement pensions and it is commonplace for the majority, even persons aged over 70 years, to continue working in order to subsist. Others, victims of discrimination in terms of age and resigned to their comparative disadvantage in relation to younger citizens, stop working and are forced to beg.

"The situation of the elderly in Haiti is delicate, hardly anyone has family or state support and their quality of life is very bad," explains Cuban doctor Isel Fresnego who, together with nurse José Raúl Cedeño, has created a senior citizens’ club in Mont Organicé, a remote mountain commune in the country’s Nord Est department.

"We are trying to improve their quality of life, based on our community work experience in Cuba. However, making these links has been difficult because they are not used to receiving this kind of help, but little by little we are seeing results; we began with one person and now we have 15."

The specialist notes that, given the lack of specific health programs, it is important to educate elderly Haitians on diet, what they can and cannot eat, and teach them how to avoid certain disorders. "There is still a lot to do in relation to health and quality of life for the third age," she concludes.