Older people in Tanzania say that medical staff in health centres often treat them disrespectfully by talking to them in a mocking tone.

The findings are revealed at the end of the three-year older citizens' monitoring (OCM) project, launched in 2002 in Arusha and Dodoma to monitor older people’s access to health services – with successful results.

Aims

The project, supported by the UK Department for International Development, aimed to increase older people’s participation in gathering information by forming critical networks.

These networks have helped to build older people's confidence to talk to governments and challenge the authorities about their rights, including access to basic services. A group of older people in Arusha have successfully lobbied the local government to ensure free health care for all older people.

Activities

HelpAge International’s partner in Arusha is the Arusha Retired People’s Association (CHAWAMA). Members of CHAWAMA, and local leaders at village and ward levels, were trained to act as project facilitators. They were given information on Tanzanian policies, and trained in leadership skills, lobbying and advocacy skills, and how to gather evidence on health services. These facilitators then formed older people’s committees, which took part in the monitoring process.

Primary areas of concern for older people in Tanzania are the quality of health care they receive, the cost of treatment, and the distance to and from services.

One older person was told by hospital staff, “Go home. You are not ill, just old.” As part of the project, older people were asked to monitor and log their experiences during every hospital visit.

The findings revealed the following:

• 40% said the tone of language used by medical staff was mocking.
  
• 94% were charged for the consultation.
  
• 30% were unaware of how to apply for free health care.
  
• Over one-third had to wait four to six hours to see a doctor.
  
• Almost half had to pay for their own fare to get to the hospital.
  

Achievements

As a result of the project and the involvement of older people in the monitoring process, the local government in the Mosquito river ward has granted free health treatment to all vulnerable older people. The Community Health Fund funds this service.

Criteria for vulnerability include disability, severe health problems, and if an older person is living alone. The welfare committee in a hamlet makes a recommendation for free health treatment to their ward's executive secretary, who then issues a letter to the older person, granting them free access to local health services. Once received, the letter is valid for life.

The project has also given older people a sense of respect and many said that they now felt that their concerns were being listened to. They also thought that the project created support for older people at a village level and that other areas of concern could now be addressed.

The future

“HelpAge International Tanzania will continue to lobby national and local government to ensure free health care for all older people. The success in Moduli district has shown the lobbying power of older people and their desire to ensure that their needs are met,” says Abdul Jetha, country director of HelpAge International Tanzania.

“The older citizens' monitoring projects have enabled older people to monitor various poverty programmes, motivating them to claim their entitlements and become involved in consultation processes.”