Project Proposal Prepared by
Keshari Kansakar
Submitted by
Child and Women Development Center

Background
:
Older People Sharing and Caring Project, implemented as a pilot project since April 2001 by Child and Women Development Center, has completed two years and is well into the third year. The project started in collaboration with the Council of Ex-Civil Servants with a goal to improve the status of older people and increase their feeling of
‘inclusiveness’ in urban areas of Lalitpur and Kathmandu districts. The target of the project was mainly the older people of Wards 9 and 22 from Lalitpur sub-metropolitan area. About 12 to 13 percent of the population of those wards consists of older people 50 years and above (approx. 2,000 older people) and comprise of different castes mainly
Maharjan, Shrestha, Sakya, Deula and Khadgi. Those are traditionally farmers, government and non-government service holders, business people, artisans, sweepers and butchers by occupation. Now all of these communities have diversified their occupation and unlike their grandfathers’ generation, all the children attend schools and are well educated.
Rapid urbanization, education and diversification of occupation have brought about unexpected changes in lifestyles, attitudes and behavior among younger generation while older people are very much traditional in their thinking and behavior and nostalgic about their past lives. The result is the generation gap—the lack of understanding between the older and the younger generation. Today’s grandchildren are much more exposed to outside world than their grandparents whose world then was confined to home life and hard work as they recall. They did not have opportunity to attend schools and had to struggle for survival when quite young. Today’s children are in a better position as they have more opportunities to receive education, and enjoy various means of travel and communications which all may contribute to widening their thinking and adapting new values and customs. which are different to the customs and values older people grew up with.
Today’s older people feel ‘social isolation’. In many families older people do not have much interaction with family members nor have good terms with them. The younger generation has many interests and concerns and they care less about the older generation, their interests and needs. As a result, older people feel neglected and spend most of their time alone, with limited interaction, for example, when they meet their contemporaries for a short time during the day. The health of older people is the lowest priority in the family and, unless seriously ill, older people are not taken to the doctors or cared for. Older people do not receive proper care and respect from the family. In a number of cases, older people are physically weak and have few if any, options; they accept their condition as it is.
They feel happy and comfortable when they find that younger generation love and support them, listen to them and respect them in some ways.
As is common in Nepal, the majority of older people in the project area live with families—at least one son and his family. But increasing numbers of older people are found to be living alone or with only their spouse despite having a son or sons. This suggests that traditional systems of taking care of older people within the family may be
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slowly breaking down. Even for those living with the family, the care and support do not seem to be adequate and the life of older people may be more difficult than it seems from outside. Today’s older people do not enjoy the same respect and care that the older people in the past used to receive. The widening generation gap is the major source of unhappiness for older people in the family.
Those older people who stay alone have harder time in sickness and even for day-to-day survival. The older people may not be that poor in the sense that they have house, land and some savings but for the lack of proper care and service they feel poor. Among those living in the family also, they cannot spend their savings according to their will.
For many older women when their husbands died all of a sudden, they even faced the problem of survival if sons refused to take care of them. Older women who had never worked outside home were then forced to find work. This is equally difficult in that employers are usually reluctant to hire older women.
Women and children’s issues have received much attention of policymakers lately but older peoples issues hardly even come into discussion. Policymakers and the general public are unaware of the situation of older people in Nepal—the difficulties they face, their rights, the support services needed for them including basic health services.
Moreover, the issue of older people is ‘hidden’ since the general conception is that older people are respected and taken care of by their family, so there is no need for outside intervention while in reality, most older people spend the rest of their life in difficulty, pain and in silence.
The achievements in the first and the second year:
Child and Women Development Center has carried out many activities during the two years of its project implementation. Qualitative research undertaken with selected communities of older people has helped us to understand the situation of older people in those communities. It has addressed some of the major issues identified by the research. In order to bring older people from exclusion, weekly religious programs are taking place regularly. About 60 older people attend twice a week religious programs regularly and listen to religious sermons and songs, watch religious movies, etc. and thus spend time with their companions. Spending their time in religious activities such as visiting temples, worshipping, singing religious songs is one of the favorite pastimes of older people in Nepal.
In order to alleviate medical problems of older people, a monthly health camp is held on the last Saturday of every Nepali month and many older people who could not afford to buy medicines on their own have been helped in those camps.
Special camps are also held occasionally. This has been one of the major attractions for old people as they get free medicines for minor diseases that are otherwise ignored by family members.
In order to create awareness on the plight of older people and to bridge intergenerational gap, a modest start has been made. Preliminary discussions were held with older people, and their family members including children. This helped us to let
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families know about the project objectives, understand their views regarding older people and generally helped to raise awareness of the importance of older people at the family and community level. There is a good rapport built with the community—the older people, their families, elected ward officials, and local volunteers.
The above-mentioned activities—mainly weekly religious programs and health camps— will be carried out with the intention of making them sustainable in the future. We have gained more experience at the community level and now we need to put our experience to strengthen the relations between younger and the older generation as well as raise awareness on the plight of older people at the national level. There is a need to create an environment for the increased interactions between younger and the older generation so that there is better understanding between them and thus harmony in the family for the well being of both the generations.
With the experience gained in the first and the second year, Older People Sharing and
Caring Project will continue through the third year with the following goal and objectives.
Goal: Improve the status of older people and increase their feeling of 'inclusiveness' in the society.
Specific objectives:
 To help reduce intergenerational gap through increased interaction between different generations and enhance each other's understanding;
 To study the best health care model for the older people;
 Advocating for increased access to quality care services to older people through appropriate policy and program interventions by the government and concerned agencies;
 To make the project activities as sustainable as possible with the creation of older people forum at grassroots level to carry out the programs and advocacy independently.
Proposed activities:
Besides continuing with the activities from the previous years mainly religious and health programs, the focus will be more on the increased interaction between older people and the young generation, raising awareness at the local and the national level on the plights of older people in general, and advocating for increased access to health care services for older people in particular.
Interaction programs: There is a need to create awareness among younger generation of the importance of older people in the family and the community, the problems they face and increase the level of understanding between the two generations so that older people have homely environment and are properly treated by their families.
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One way to reduce the intergenerational gap is to open dialogue between older people and the younger generation so that they understand each other better. For this rapport will be built with children’s groups from different communities/localities and preliminary discussions regarding older people will be held with them. A modest start in this direction has already been made in the second year of project implementation.
Children’s room has been set in the same building where religious activity takes place.
There are reading and playing materials for children there to come and spend their time.
Children and the older people will be brought together in weekly sharing forums. They will also be brought together in interaction sessions during workshops/training.
Moreover, older people and their family gathering program and a special program respecting local older people will be organized to bring older people and the family members together and make the younger generation aware of the contributions of older people in the society. From this we expect better understanding between different generations and improved condition of older people in the community.
We expect better caring and loving environment for the older people at home as an outcome of this program. Moreover we expect older people to understand the younger generation much better. Children below 14 years of age will be the main targets of this program.
Advocacy: Besides the community level, there is a need to raise awareness on the particular issues of major concern to older people such as health care, medical treatment at discount prices to older people, problem with old age and widow allowance at the national level as well. Within a year at least two local level and one national level workshop will be organized involving different audiences including media, policymakers, and influential people. The media will include radio, newspaper and TV journalists. People who can influence the policy for older people will be invited from time to time in weekly forums to raise awareness on the issues of the older people.
Essay and debate competition regarding older people and their lives will be organized among children’s groups at local level. Series of publications will also be brought out in local papers on the major issues of older people.
There is a need to create a strong forum of older people at the local and possibly regional level for undertaking various activities and for lobbying. Selected older people will be given training to build their confidence and inform them of their rights. They will take the lead in organizing different programs and also encourage them to participate in different older people forums at national level.
Weekly sharing forums: Weekly religious sermons by Buddhist monk and the Hindu priest as well as religious singings, and occasional screening of religious movies, health education will be carried out as before. A ten-member committee of selected older people has already been formed to carry out the weekly religious programs so that the program will be continued with little supervision of CWDC staff. This team will be strengthened through training and local volunteers will also be included in the team.
This way, older people will also gain self-respect and self-confidence and young people
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start respecting older people more. These programs provide an environment for older people to meet friends and neighbors regularly and be happy in each other’s company and at peace.
At the demand of older people weekly religious program will be extended from two days a week to four days a week. Besides Sunday and Wednesday, there will be religious program on Friday as well. On Tuesday there will be literacy class for a limited number of older people by a volunteer.
Monthly health camps: Health care is one of the most basic needs of older people. Being sick is one of the major sources of unhappiness for them. Older people suffer from various diseases such as weak eyes, knee pain, back pain, leg pain, gastric, chest problem, high blood pressure, etc. The monthly health camp has been a great help to many older people who cannot afford to go to the doctor and buy medicines on their own. So this service will continue for the third year as well. However, an effort will be made to make this program sustainable.
Community health care support system: As mentioned above, older people feel lonely and isolated and need companionship. Moreover, there are also older people who cannot go out of their house. There is a need for some voluntary service to give some company (or counseling in some extreme cases) to those older people who lack mobility and who do not have family support.
CWDC had already initiated this concept of voluntary service with local volunteers.
During the first year of the project, five young local volunteers from different localities were selected to conduct once a week home visit of older people in their community.
But now only two local volunteers are still continuing this activity once a month. They were given minimum incentive of Rs100 per visit after submitting their visit report to
CWDC. Since this concept is new, there is a dearth of trained volunteers who can deal with older people. So local volunteers and concerned persons from the government and non-governmental organizations will be trained in providing support to older people in the community. They will be appointed in different localities to keep in touch with older people especially those living alone, to give them company, listen to them and remain abreast of their problems and help them solve in possible ways. They will be provided minimum cash incentive per visit and a training opportunity locally and nationally as they become available.
For this activity CWDC has received limited funds from the Ministry of Women,
Children and Social Welfare. Under this activity, a regular staff nurse and local volunteers will carry out home visits and give company and medical advice especially to older people living alone and those without mobility.
Study of best health care model for the older people: Review literature from other countries that have similarity with Nepalese culture with older people as Nepal health care and other service providers (public, private and voluntary organizations) will be sensitized on the health situation, needs, concerns and capacities of older people through interaction programs including older people themselves and solutions and
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recommendations will be sought. This will be tied with awareness raising program mentioned above.
Networking: With the experience gained in the initial project areas, project activities will be extended to other nearby localities. We will be encouraging other local NGOs to undertake such activities by themselves in their localities. CWDC will provide technical support to carry out such programs in different localities. One local NGO from the nearby area has already contacted CWDC and shown keen interest in the activities and the staff has been involved in the training. Other NGOs also will be contacted and the sharing forums with like-minded organizations will be held to learn from each other’s experience.
Expected results:
General public and policymakers will be aware of older people's concerns and there will be pressure for better action;
Older people will have self confidence and feel less isolated;
Older people are better respected at home by family members;
Better understanding developed between older people and younger generation especially children.
Monitoring and evaluation: Monthly review meetings will be held with the project staff, advisory committee and the older people themselves. Frequent review meetings will be held with actual beneficiaries, i.e. older people themselves who attend the programs to monitor the progress and get their feedback and suggestions to improve the program. At the end of the program, stakeholders themselves will undertake an evaluation of the project activities.
Sustainability: The project has been able to save the rent and other expenses. The Exstaff Council has provided the rooms for office and for religious program. A children’s room has also been set up there. CWDC membership drive will be launched to collect funds. Different local sources and international donors will also be sought to raise money for older people programs.
Staff: Besides the current staff of project coordinator, there will be full-time research cum administrator, who will carry out the discussions with older people and the younger generation on the issues of older people at different localities. Local volunteers with some training and incentive will be appointed to carry out home visits of lonely and sick older people.
Constraints: How to create a homely environment for the older people within the family is quite challenging. Since it is a very sensitive issue, we have to be careful not to antagonize family members. The proposed interaction program however is expected to create positive impact in this respect. For those older people living alone, how we can help them is also a major issue. In this respect we want to have a modest beginning by training local volunteers to undertake this task. Since there is a misconception that older people are taken care of by their families, there are no special services for older people
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such as counseling, treatment, day care, etc. But since there is considerable number of older people living alone, we have to learn through our experience of such services.
Budget
Older People Caring and Sharing in Nepal
Budget Breakdown
Description
Exchange rate $1 = 75 NR
Cost
(Nepal
Rupees)
Cost (US
Dollars)
Salary costs
Programme Coordinator
Research & Administrative Assistant
Staff Nurse
Office Assistant
Project Advisor (30 days per year)
Programme costs
Weekly interaction programs (refreshment expenses)
Intergenerational programs (interaction programs, essay and debate competitions)
Health camps and home visits to housebound older people
Training of volunteers for 5 days (fee for resource persons, snacks and stationary)
Training on leadership, confidence building, counselling for older people and local volunteers
Study of appropriate healthcare models (stakeholder analysis, literature review, and interactions between older people and health care providers)
Advocacy workshops: 2 local level and one national level workshop for different stakeholders on health needs of older people
Travel costs
Office Costs
Communications
Stationary
Repair and maintenance (computer, furniture, etc)
Audit fees and bank charges
Staff meeting costs (refreshments)
Total Project Cost
Global Giving Administration (10%)
Grand Total
130,000
78,000
65,000
39,000
45,000
25,000
30,000
70,000
70,000
50,000
50,000
70,000
10,000
15,000
5,000
10,000
10,000
8,000
1,733
1,040
867
520
600
333
400
933
933
667
667
933
133
200
67
133
133
107
10,400
1040
11,440
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