Rajagopal Dhar Chakraborti
with a foreword by
James T. Shon,
Adjunct Faculty,
East-West Center, Hawaii and Former Legislator, Hawaii

Price Rs.550.00 / $20.00
ISBN 81-88486-00-0
MRG Publications,
Kolkata, India

The demographic landscape of Asia has seen unprecedented changes over the past 50 years of the post-Second World War era. A rapid and spectacular transition from high to relatively low mortality and fertility is not only slowing population growth but also fundamentally changing the age composition of Asia’s populations.

All across Asia, the proportions of population aged sixty and above are rising and are projected to rise significantly in the next fifty years. At a time when the elderly policies are being remodelled in the developed countries in order to contain costs as well as to mitigate the inter-generational conflict, Asia countries have barely begun to prepare their policy documents. Given the pace of population ageing, the policy makers need to work very fast.

The current book emerges out of this need. Through a rigorous and comprehensive analyses of measurement, causes and consequences of ageing in Asia, the book identifies some of the major policy options, that may be sincerely tried to create an environment which insures the elderly against all risks, including health hazards and allow older adults to maintain as much economic independence and self-sufficiency as possible without disturbing intergenerational balance. The book lists exhaustively the policies and programmes on the aged in India and also includes the full text of the international plan of action on ageing, including the resolutions of the Madrid Conference.

The book would be a useful text and reference to the students, and researchers in gerontology, demography, sociology and economics.

Foreword

Dr. Rajagopal Dhar Chakraborti’s Ageing in Asia: An investigation into its nature and social dynamics with special reference to Japanese, Thai and India Elderly is essential reading for anyone in Asia concerned with a society’s ability to cope with the demographic tidal wave of ageing populations. From government planners, to medical and nursing school faculty, to leaders in all sectors of the community – Ageing in Asia provides an important perspective on new realities of the 21^st century.

Just as all societies are challenged by global influences on their economic, technological cultural, political and health care systems, they are also confronted with new demographic realities that reach from the cities to the villages to each and every family. Not only are there are more of us, wherever we may call home, the structures of our communities are undergoing rapid change. Future Shock is not a term confined to western urban contexts.

In many Asian nations, there will soon be just as many people over the age of eighty-five as there are under the age of five. The dramatic extension of life expectancies brings with it a plethora of chronic conditions and frailties with which the families and health care systems are ill prepared to cope. It may not be the building of new hospitals, although hospitals are important, rather, the development of community-based systems that can reach out to the isolated or homebound elderly that we need the most.

It may not be the training of surgeons, although highly skilled medical personnel are important, but the recruitment and training of health educators with the ability to effectively teach our family members about “managing” diabetes, heart disease, dementia, hearing or sight loss, and immobility that is most missing from our social and health systems.

The western models of high technology medicine may look appealing to policy makers, but to focus on the adoption of costly acute care health delivery systems is moving down a questionable road to the past. The European and American medical models, if truth were told, are unable to stem the tide of escalating costs. Gap groups and governments cannot afford to stay on this expensive treadmill. Asia may be looking to the Western model just as we in the West are beginning to recognize that wellness and prevention are not an option, they are a necessity.

Ageing in Asia is helpful in that it suggests that societies need to look carefully at what systems they choose to imitate, and which elements are most appropriate or useful.

For all of the compelling data we now have on ageing, it is still true that for many societies, and for many government policy makers, ageing is not perceived as a social crisis. It is still seen through the traditional eyes of an extended family, where multiple generations living under one roof can somehow accommodate the needs of the elderly.

Unfortunately, this picture no longer describes millions of families throughout Asia. As the cities lure the young off to jobs in the global economy, villages are left without caregivers. As the status of women provides opportunities for work, the only people left at home are the very young and the very old. It is not easy for a society or culture to admit that its social traditions can no longer meet the needs of its people. Addressing the ageing crisis must become the responsibility of every sector of the society.

Ageing in Asia is a reminder that to prosper in an interdependent and globalized society, we must confront these new realities, and find new ways to respond. It is also a recognition that all nations have insights to share as we collectively seek sensible, affordable and human approaches to ageing.

Dr. James T.SHON,
Former Legislator, Hawaii,
Health Consultant and Adjunct Faculty,
East-West Center, Hawaii
162 Forest Ridge Way
Honolulu, Hi 96822
USA.

May, 17, 2002

Table of Contents

List of Tables
List of Figures

Foreword by Dr James T. Shon
Preface
Acknowledgements

Chapter One -     Population Ageing : The Global Scenario
Chapter Two -    Population Ageing : The Causes Behind
Chapter Three -   Population Ageing : Problems of Measurement
Chapter Four -    Population Ageing : Major Effects
Chapter Five -    Population Ageing : The Social and Economic Status of the Aged
Chapter Six -      Population Ageing : The Policy Options

Select Bibliography

Appendix One :    Glossary of Demographic and Economic Terms
Appendix Two :    Policies and Programmes on the Aged in India
Appendix Three :   International Plan of Action on Ageing
Appendix Four :    Ordinance on Elderly Population in Vietnam
Appendix Five :    Suggestions for better Elderly Life

Abbreviations used
Map of Asia

Acknowledgements

My interest in the field of population ageing dates back to the early 1980’s when some of us at St. Xavier’ College, Calcutta thought about promoting a home for the aged. While a proper Home is yet to take shape, the emotional and intellectual stimulation received from the leader of the project, Dr. Dipak K. Chatterjee sustained my interest on the aged till this date. I am happy that this general and emotional concern for the subject could be transformed into a serious academic project. I acknowledge with all gratitude to Dr Chatterjee and his Tapoban for the entire initial interest and motivation. I must admit that the Jesuit Fathers at St.Xavier’s College, Calcutta where I spent virtually my whole youth first as a student and then as a teacher, moulded my academic interests with social concerns.

A research of this scope can not be undertaken without the efforts of many people. My teachers, colleagues, friends and other co-workers in the research areas have provided valuable guidance and assistance at various stages of the research. It is impossible to recognise all of them individually, but I want to thank my teacher, Professor Tim Dyson of London School of Economics for all the kind research advice during my Visiting Fellowship at London School of Economics last year. My other teacher, Professor Ashish K Bannerjee, the current Vice Chancellor of Calcutta University helped me considerably at some stage of the research. His suggestions in locating problems relating to the measurement of population ageing were quite useful.

The research inputs of my classmate at LSE, Ms. Jane Falkingham who is also a Reader at LSE were very useful. Very special thanks must be given to Dr. Emily Grundy of London School of Hygiene and Tropical Medicine who spent considerable time with me interacting on various aspects of the research. The discussions with Professor Eileen Crimmins of University of South California, Dr. Yasuhiko Saito of Nihon University, Japan and Professor Eldon Wegner of University of Hawaii – Manoa provided new insights into my research and deserve special attention. Dr Jim Shon, a political analyst and a former Health Minister of Hawaii, introduced me to some of the intricate issues of population ageing which I might have ignored if I had not interacted with him over a month at Honolulu. I am extremely thankful to Dr Shon for writing the foreword for the book.

I am much obliged to my senior and respected colleagues, Professor Asish K. Roy and Professor Jayant Kumar Ray, for all they have done for me during the research. Expert on Asian affairs, they patiently educated me, provided hours of advice as I proceeded with the research. Professor Budhadev Chaudhuri, Dr Swapna Bhattacharjee (Chakraborti), and Dr. (Mrs.) Gita Roy also joined them in many occasions to boost me up in the research. My friend from the London days, Professor Suranjan Das, now the Pro-Vice Chancellor for Academic affairs, Calcutta University always came forward whenever I needed any assistance from him. I gratefully acknowledge his support.

I also take this chance to acknowledge the role of my mentor and brother, Mr. P. G. Dhar Chakraborti, a senior IAS officer with the Government of India in the making of this research. A brilliant academician himself, he managed time to lend his intellectual and other supports for the research leading to this book. My other brother Mr. Subodhgopal Dhar Chakraborti and also the Head Master of my school, lent similar supports to ensure that I work on the project uninterruptedly.

Our youngest sibling Mr. Bijoygopal Dhar Chakraborti was ever ready at Saudi Arabia to send whatever I wanted at various stages of the writing of the book. My sisters Joystana and Devaki cheered me up at all points of personal tragedies, which visited me rather mercilessly. They were joined by my mother who despite being sick and bedridden, never failed to console me with the right words and food. I am thankful to Mr. Udayan Bhattacharya and his team , who selflessly took all the painstaking efforts in making the research output into a finished product.

I would like to thank the authorities of the Calcutta University and the Department of South & Southeast Asian Studies, for providing me with all the valuable logistical support to carry out the research on ageing.

I take this opportunity to thank the Asian Scholarship Foundation, Bangkok for awarding me the Asia Fellowship and funding my trip to Thailand. The fellowship and the invitation to Thailand provided me the opportunities to secure some data, which I did not have before. I am thankful to Dr Lourdes G Salvador, the Executive Director, and Asian Scholarship Foundation for all the support I received from her.

I am thankful to The Wellcome Trust International for funding my trip to UK and to the USAID and the East-West Center for sponsoring my visit to the USA, both for ageing researches. I must admit that without these visits my researches would have been far from complete. The faculty and staff of various research institutes, and libraries assisted me with wide variety of academic and logistic supports. I do not venture to list all of them but some of them without whose support this research project would not have been successful, are listed below:

 ·   Alexandre (Mr) Sidorenko, Chief, UN Programme on Ageing

 ·    Andrus Gerontology Center, University of South California, Los Angeles, USA

 ·   Asian Scholarship Foundation, Bangkok

 ·    Center for Communication Programs, Johns Hopkins University, Baltimore,

 ·    Centre for Development Studies, Trivandrum, India.

 ·    China National Committee on Ageing, Beijing, China.

 ·    College of Population Studies, Chulalongkorn University, Thailand

 ·    Demographic Institute, Faculty of Economics, University of Indonesia, Indonesia

 ·    DESA, Population Division, United Nations, New York.

 ·    East –West Center, Hawaii,

 ·    Elderly Policy and Development, Ministry of Health, Singapore

 ·    Gokhale Institute of Politics and Economics, Pune, India

 ·    Indian Institute of Population Sciences, Mumbai

 ·    Institute for Population and Social research, Mahidol University, Thailand

 ·    Institute of Population and Development and Development , Nankai University, China

 ·    Institute of Population Research, Peking University, Beijing, China

 ·    Institute of Sociology, Hanoi, Vietnam

 ·    International Institute for Population Sciences, Mumbai, India.

 ·    Japan Aging Research Center, Tokyo,

 ·    Labor and Population Program, Rand, Santa Monica, CA, USA,

 ·    London School of Economics, London

 ·    London School of Hygiene and Tropical Medicine, London

 ·    National Council of Applied Economic Research, New Delhi, India.

 ·    Population and Development Section, PRUDD, ESCAP, Bangkok

 ·    Population Council, New York.

 ·    Population Institute, University of the Philippines, Quezon City, Philippines

 ·    Population Reference Bureau, Washington DC, USA

 ·    St .Xavier’s College, Calcutta

 ·    The British Library, London

 ·    The Wellcome Trust, London,

 ·    United Nations Population Fund, New York.

I share with all whatever credit, but certainly none of the discredits that may still exist in the research and in the book.

Finally, there is one person, my late father Krishnagopal Dhar Chakraborti upon whom the success of all these efforts is known. I take this opportunity to appreciate the contribution he had in making of me. An original thinker and a selfless man, he devoted his whole life to breed us with best possible upbringing and values. An ardent follower of Swami Vivekananda, he would always remind me,

“ lay down your comforts, your pleasures, your names, fame or position, nay even your lives, and make a bridge of human chains over which millions will cross this ocean of life. Do not care under what banner you march. Do not care what be your colour- green, blue or red—but mix all the colours up and produce that intense glow of white, the colour of love. Ours is to work.”

I do not dare say that I could follow what he wanted me to do but he left a deep impression into my thought process. He would have been the happiest to see the birth of this book. My only consolation is that I could dedicate this book to him and to my mother.