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China Human Rights Net > CSHRS > Magazine > Text
Growing Old with Dignity: Care for the Growing Elderly Population
 
 

By Miao Hong

 

 

Gong Shihai helps Huang Lanxiang Combing her hair.

  Gong Shihai, a 73-year-old peasant, had never dreamed that he was married for the first time in his life at a township senior citizens home, 40 kilometers southeast of Wuhan, capital of central China's Hubei Province.  

  He had led a lonely and childless life in the small village of Zhazhou, within the reach of Donggou Town of Ezhou City, where he farmed 1.2-mu land and each month received a fixed amount of 70 yuan from the government.

  Sometimes, Gong's nephews would offer him rice and cooking oil. They wanted to take care of him, but like other able-bodied laborers in rural areas, they left to find jobs in large cities. Gong had to manage everything by himself.

  In the village, Gong was one of the ten single aged people who benefited from the government's "five guarantees" system. These childless and infirm elderly, known as rural wubao laoren in Chinese, are guaranteed food, clothing, housing, medical care and burial expenses by the village.

  Gong could earn his own living with financial support of the village and the help of relatives and neighbors, but sometimes he felt helpless and easily descended into a state of anxiety, especially when he fell sick. The elderly of the village tried to persuade the village cadres to help hire a nurse for them, but the village had no extra money.

  But the cadres had other advice in return. In May 2005, Gong turned over his farmland to the village and moved into his "new home" at the Donggou Welfare House. Soon after he moved to enjoy the "centralized care" funded by the government, his benefit was raised to 100 yuan per month and was again raised to 150 yuan per month in July.

  Gong felt cozy in the new habitat. He indulged in a "sunset romance" with a childless widow his own age. He fell in love with Huang Lanxiang in November 2005. They married on January 8, 2006. "I took a fancy to her," Gong admits, with a hint of coyness. "She is good in character and personality. We get along so very well."

  Four other elderly couples have married in the welfare house. Their pairings enable them to take better care of each other while lightening the burden on the nursing staff. Gong likes playing card games or chess in his spare time. "It's ten thousand times better than staying at home," Gong says, and boasts he could " live to 100 years, no problem".

  The welfare house, built in 1997, is now fully occupied by 85 old people, with the oldest at 95. The number of male residents doubles that of the female. The wubao laoren aged over 60 have preference in admission.  

  "It all depends on whether they want to move in," says Fu Yuancheng, 61, the principal of the welfare house ever since 1997.  He used to be a village head as well as a township factory director. "We took in two disabled under 60 because they could not work."

 Initially, the house only had 880 square meters of bungalows with 43 beds. As a result of the three-year "Mascot Project" launched in Hubei Province in 2003, an expansion with six new cottages of 660 square meters with 42 beds was accomplished in 2005. With his eight staff and the residents, Fu has tried to develop mixed farming, making this welfare house self-sufficient in grain, vegetables, fruit, fish and pork.

  According to Wei Guoxiang, an official from the Civil Affairs Department of Hubei Province, the fending funds for rural beneficiaries of the "five guarantees" system was transferred from the central government to local governments after rural taxation reforms and the source of which became more stabilized.

  It was against this backdrop that the provincial government launched its three-year "Mascot Project" which ended in 2005, designed to benefit more rural elderly in extreme financial difficulties. As a result, more than 700 welfare houses were rebuilt and expanded, with a total of 670 million yuan invested in the project.

  Hubei now has 1,620 township-owned welfare houses with 160,000 beds. Originally, these welfare houses in rural areas only had 43,000 beds. Wei says the provincial government demanded that each small or medium-sized township is supposed to have at least one central welfare house with the number of beds restricted to a maximum of 100 for the sake of better management. Meanwhile, a large township with a population of over 100,000 is allowed up to three welfare houses.

  There are 210,000 beneficiaries of the "five guarantees," mostly elderly, of whom 160,000 have been brought into "centralized care" and 50,000 into "decentralized care." Together with the central government, the provincial government spends an additional 52 million yuan to cover the yearly total cost of approximately 200 million yuan, excluding the wages paid for 9,596 staff working in welfare houses.  

  But some welfare houses, especially those reconstructed on the basis of dilapidated old houses, are in very poor condition. Last year and this year, the provincial government successively allocated 50 million yuan to improve nursing conditions in rural welfare houses. The provincial government allocated six million yuan to purchase 400 TV sets, 800 washing machines, more than 1,400 freezers and more than 200 solar water heaters as well as more than 100 sets of exercise equipment.

Gong Shihai (right) and Huang Lanxiang (left) enjoy their meals at the dining room of the Donggou Welfare House.

 The provincial government also allowed half a mu of land to be transferred with each resident to welfare houses. "None of our welfare houses in rural areas buys vegetables at the markets,"Wei says. "They are self-sufficient in vegetables, otherwise they would be burdened with extra expenses." In the latter half of last year, the provincial government encouraged each house to raise pigs and build methane ponds, encouraging the development of a circulatory economy.

  Earlier this year, CCTV presented the love story of Gong Shihai and Huang Lanxiang and also disclosed that a total of 1,180 wubao laoren couples had married in welfare houses in Hubei Province.

  "Some of them are registered," says Wei, "but some are not and they just live together. We really have difficulties in management. As long as they stay together, they remain mentally active. When they were brought into the houses, they only wanted three meals every day, but later on, they changed their minds for good meals and something else."

  It was in 2000 that Hubei Province became an aging society, says Pu Qingping, another official from the Civil Affairs Department of Hubei Province. At present, its population aged over 60 is 6.68 million out of 60.5 million people and there are 2.13 million elderly in urban areas and 4.54 million in rural areas.    

In urban areas, a recorded 35,900 elderly can no longer work, have no income and no legal guardians, or their next of kin cannot support them. They are known as sanwu laoren in Chinese. A total of 9,100 such elderly are under "centralized care" in welfare houses.

  "Last year, the expenditure on 33,900 such elderly was around 81.36 million yuan if it is calculated on the basis of supporting one person with 200 yuan per month," says Pu. That could be a huge financial burden for Hubei Province which has been encumbered with its 38 western poverty-ridden counties. "But the government should provide social relief in any case to guarantee the rights and interests they are supposed to enjoy."

At present, there are 111 state-run welfare houses and 149 welfare houses run by local people and subsidized by the state in urban areas. Jiang Daguo, vice-governor of Hubei Province, stresses the provincial government "will raise at least 50 million yuan each year to support the construction of urban state-run welfare houses". By the end of the 11th Five-Year Program (2006-2010), the number of beds in urban welfare houses is expected to increase from 12,000 to 24,500.

  In Beijing, the elderly are increasingly found in care institutions either state-run or run by local people and subsidized by the state. Beijing No.4 Social Welfare House, the first state-run welfare house in Beijing, was set up in 1953. Originally, the institution was called Beijing Social Asylum and took in orphans, the disabled and the elderly. This non-profit institution changed its name in 1991, only accepting urban elderly. Most of them are supported by the state because they cannot work, have no income and no legal guardians or their legal guardians are unable to support them.

  In 1992, the institution began admitting elderly people who could pay at their own expenses. It now has 200 beds open to the public and 110 working staff, but the authorized size for the institution is 135 staff. Generally, it charges each resident 900 yuan for a bed and 270 yuan for meals per month. These residents must also pay for medical expenses whenever they see doctors.  

  "The ongoing expansion will enable our institution to have 350 beds plus 150 infirmary beds by the end of 2010," says Zhang Man, director of the general office. "The hospital was specially built for those who enjoy the minimum living allowance. Our elderly people will enjoy better medical care inside the institution. All residents and their relatives have confidence in our institution. We have a long waiting list." 

  The Fragrant Hills Senior Citizens Apartments, in the western suburbs of Beijing, is a three-star care institution with 420 beds and 70 staff. The institution, run by local people and subsidized by the state, has provided nursing services for nearly 2,000 elderly in its ten years of operation.

  Liu Ronghua, the principal, says, "We have more than 100 private rooms. Some residents would rather occupy a room of 19 square meters with two beds, two tables, a wardrobe, a TV set and an emergency phone. We cannot take in any new residents and we have a long waiting list.?The oldest resident is 104. Most are over 70 and few under 60. Some old couples come to live here. About 10% of the elderly come from other parts of the country because their sons or daughters find jobs in Beijing. Some aged people come to live here at the expense of their brothers and sisters.

  "We never set an age limit in admitting elderly," Liu says. "They come and go at their own free will. Generally, we charge each person an average of 12,000 yuan per year for his or her stay to enjoy our nursing services. Last year, we received a subsidy from the municipal civil affairs bureau.?However, finding good staff is a problem, Liu says. "Even if they are professional senior care nurses and receive on-the-job training regularly, they won't stay long, leaving for other jobs.?China started to become an aging society in 1999, about five years before its population hit 1.3 billion in early 2005. At that time, its per capita GDP was between 800 and 1,000 U.S. dollars.

  Generally, the per capita GDP in developed countries had already reached 5,000 to over 10,000 U.S. dollars when they entered the aging stage. By 2020, China's per capita GDP is not expected to exceed 2,000 U.S. dollars as its aging population of 240 million would account for 16% of the expected total population.

  It is predicted that the country's total population will peak at 1.46 billion in 2030 and the number of senior citizens will hit 437 million by 2051, says Li Bengong, president of the National Committee on Aging. 

  China only has a 25-year strategic preparatory period (2007-2032) to cope with the everlasting challenges of the aging population throughout the 21st Century, Li says. No developing country has successfully dealt with this challenge to provide China with a model to follow.

  China has more than 40,000 senior care institutions with about 1.7 million beds for its population of 145 million over 60, of whom about 67% live in rural areas and about 13 million aged people over 80 are now in dire need of care, says Zhang Mingliang, director of the Social Welfare and Social Affairs Department of the Ministry of Civil Affairs.

  About one-third or half of the elderly in large cities are without support from their children or a livelihood. Moreover, many rural aged people must take care of their grandchildren left behind by parents who try to make a living in large cities.

  More elderly people are realizing they cannot expect their working children to shoulder the responsibility of supporting and taking care of them. However, the Ministry of Civil Affairs has endeavored to build up a senior care social service system based on family care, supported by community services and supplemented by institutional services.

  "Suppose that 5% of China's 145 million elderly population need to live in old folks' homes," Zhang says, "more than seven million beds will be needed, but the present number of 1.7 million beds is far from enough." Under China's 11th Five-Year Program (2006-2010), a total of three million beds will be set up--2.2 million beds in rural areas and 800,000 beds in urban areas, on which the government can focus basic care for 50% of the infirm and childless and a total of 1.8 million senior care jobs will also be created.

  "The construction of senior care institutions on a large scale is now a crying need,"Zhang says. "The government should allocate more funds to purchase senior care services and constitute favorable policies for institutions, further mobilizing social resources and supporting forces in society to take part in initiating senior care undertaking."

 
  from:CSHRS
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