Injured, ailing, and alone: A health emergency unfolds for the aged in rural Rajasthan

By Bharat Dogra

Seventy-year-old Jaitram, who previously worked as a mason, fell while working. The injury he sustained continues to cause him pain, and he is no longer able to work. His eyesight had deteriorated but improved somewhat after a cataract operation, though he still needs cataract surgery on his other eye. His wife Khamani has been very helpful to him, but a new emergency recently emerged in the family when she became very ill. Her typhoid fever worsened, and she had to seek treatment at several places for about three months. This experience has left them exhausted.

Jaitram and Khamani live on their own in the remote village of Kakrawar, located in Gogunda block of Udaipur district (Rajasthan). As both are elderly and ailing, meeting any health emergency becomes very difficult because hospitals are located far away and their financial resources are extremely limited.

Daali Bai and Khaman Lal, another elderly couple living in this village, recently realized that even reaching a big hospital in Udaipur with an Ayushman card did not help. After a fall injury, Daali Bai still cannot walk, and there is much uncertainty regarding how she can handle this new situation in her old age. However, her husband Khaman Lal says bravely, "I'll always be available for any help she needs." Earlier, when his wife had suffered a partial stroke, Khaman had been very helpful. This elderly couple is also assisted by the fact that their children live with them.

In Saandar village of this block, Bada cannot get up or walk after a hip fracture. His wife Gulli Bai tries to take as good care of him as possible, but she also has to work when opportunities arise to ensure the family can meet essential expenses. Additionally, she is hard of hearing, which makes things more difficult.

In Kukarkhera village, an elderly villager named Lalaram has been injured and cannot walk. His wife Kalkibai struggles to help him. Their son has not been able to help much, but their grandson brings rotis or other food for them.

Shankar is about 90 years old. He lives with his wife Bhamri in Majavri village of Gogunda block. The two are on their own, and sometimes it becomes difficult to handle a sudden emergency, Shankar says.

In Majaria village, Bhanwarlal is 90 years old. Economically, his family is reasonably well off, but his problem, as he told me, is that he has to live entirely alone, and it becomes difficult to spend the entire day, even though family members arrange to send food.

In the same village, Babu Bai is also living entirely alone. She has children, but they have migrated. She is finding survival very difficult. She says that she cooks food only once a day and manages on leftovers whenever she feels hungry.

Some elderly persons are living with partially disabled or ill children, and thus more of the burden of running the household falls on them. Sawa Prajapati of Majaria is in such a situation and feels the burden more acutely since his wife passed away some time back. He has hearing problems as well as vision problems that could not be corrected even after cataract surgery.

These are only a few examples of elderly persons I met during recent visits to some remote villages of South Rajasthan who periodically find themselves in very difficult conditions from which they struggle to emerge. In extreme cases, a person who is suddenly injured in a fall may resign himself to waiting for death in a bed-ridden condition, or a person with deteriorating eyesight may resign herself to blindness or near blindness, although in most cases recovery is certainly possible with some help.

Hence, a strong case can be made for programs that can reach out to elderly persons facing extreme difficulties related to various factors and situations in remote villages. One possibility is to identify a few elderly persons from each village who are in the most difficult situations and implement a program to help them in various ways. Another approach can be to reach out to accident victims so that timely help that can prevent permanent disability may be provided. While extending such help, a community-based initiative could also be started to both encourage and assist the community in taking better care of elderly persons. One component of this could be encouraging and motivating people to take better care of elderly persons while simultaneously providing a community fund to facilitate this.

In some clusters of villages in South Rajasthan, a program for improving care of elderly people called Prabal Yatra is already actively trying to help elderly persons in remote rural areas in various contexts, within its resource constraints. By facilitating medical care, arranging cataract surgeries, helping accident victims, improving safety and nutrition conditions, improving access to various government benefits and welfare schemes, encouraging community efforts and meetings, as well as through other means, this effort has been trying to provide practical help while increasing awareness and public empathy for neglected but important issues relating to older people in rural areas. Certainly, elderly people in remote villages need community and outside help, particularly when they suddenly find themselves in various kinds of emergency situations.

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The writer is Honorary Convener of Campaign to Save Earth Now. His recent books include Protecting Earth for Children, When the Two Streams Met, Planet in Peril, and A Day in 2071

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