Rayomand Coins

Aging, gracefully

When on a visit to Surat eight years ago to attend a West Zone B meeting of The Federation of the Parsi Zoroastrian Anjumans of India (FPZAI), we witnessed a couple busy making preparations at the Tamna ni Dharamshala meeting venue. While conversing, the lady contrasted life in Bombay and abroad with that in Surat and pointed out how in their Nanpura neighborhood or mohalla if someone was unwell, others would visit at different times of day, bring across meals, offer comfort and companionship. They looked after their own. Would the same happen in Bombay or elsewhere? she queried. Most likely not, was the answer. 
Could the model of the caring mohalla be replicated elsewhere? Would that prototype permit the elderly to remain in their present environment? In an urban setting where neighbors are mostly strangers and may opt to keep to themselves, one may not be able to create a mohalla setting. But the thought of a closely knit community overseeing each other’s wellbeing is appealing. Communes provided such an environment but few exist today, and not in the cities. For the elderly, quick access to healthcare is imperative. 
The effects of an aging population are being felt all over the world. As the demand for healthcare workers grows, the supply becomes scarce and expensive. Governments may divert a portion of their funds and expertise for the care of the elderly but in India, state healthcare facilities are lacking. In the last Indian budget less than two percent was allocated for health as versus the World Health Organization’s specification of six percent. (In the USA it is 18%.) 
The average age at death for 2022 for Bombay Parsis was 81 years (see "Bombay: The Telling Figures for 2022,” pg 188). Among the deceased were four centenarians and 192 nonagenarians (those in their 90s) So what can a small, aging, diminishing and closed community do when confronted with long life expectancies and very few young members? 
"We estimated there is a current population of 14,500 Zarathushti seniors (those 60 and above) among 47,000” in India, write researchers Nawaz Merchant and Dr Dolly Dastoor in their paper, "Aging Across the Zarathushti World.” The 12th World Zoroastrian Congress held in July 2022 in New York devoted a session to the subject, the learnings from which are highlighted in their paper. 
The study found that seniors in the West and Pacific areas are "well supported by families and neighbors, with sufficient resources and medical attention. In many countries, Zoroastrian associations have formed support groups for seniors and offer local activities.” A recurring theme and worry in many communities, the two found, was loneliness, the desire to meet younger family members more often and being exploited by unscrupulous elements.
US based Merchant has a master’s degree in health policy and worked in the pharmaceutical industry for over 20 years. Dastoor has a doctorate in clinical psychology and retired as clinical administrative chief of the Program in Dementia with Psychiatric Co-morbidity at Douglas Hospital; she also chairs the education committee at McGill University Research Centre for Studies in Aging. Theirs is the first such attempted review of aging in the international Zoroastrian community and the duo is to be congratulated for their pioneering effort. Six years ago the Tata Institute of Social  Sciences had published an in-depth study on the Indian Parsis, including the elderly. 
As the problems of aging are universal, one can always learn from solutions found elsewhere. Countries such as England, Canada, Australia and New Zealand extend free medical services to their citizens/residents; others may offer services at a discounted rate or through affordable insurance schemes. In many countries such as India people have to manage with their own limited financial resources.
The Parsis have been fortunate that their ancestors founded hospitals offering medical assistance free or at subsidized rates to those of limited means. But as the Parsi population in India dwindles, so does the number of patients. Hospitals require a critical mass of patients to survive. Those whose doors are open to other communities continue to thrive. Those that do not, or find their efforts to do so thwarted, are unable to afford the latest diagnostic equipment and the people to operate them. Their existing facilities remain underutilized, half or more of their beds lie empty, many of the wards are closed.
Centers for the elderly exist in Bombay, Navsari, Surat and elsewhere. Infirmaries are also there. All are a boon for those who are unable to live by themselves or with their families. But how long can the community continue to fund these institutions? What about the thousands who live in their own homes?
Community organizations could discuss the issues and search for common ground to agree on. But who would take the lead in such a venture? The Bombay Parsi Punchayet is too preoccupied managing their properties, institutions and funds. The FPZAI meets erratically with many of the major anjumans outside of Bombay and Gujarat being conspicuous by their absence. The solution therefore lies in other less structured groupings that have a keen interest in the community’s well-being. In Bombay, and elsewhere, baug associations, hospitals, or senior citizen centers, or youth groups may be the ideal organizations to tackle the issue. 
Parsi colonies are the closest entities to mohallas and communes. Colony organizations are presently involved with their occupants’ well-being. Who but one’s neighbors, building residents and baug companions can best tend to the elderly, the differently abled, the lonely and the financially disadvantaged? Parsis living in the neighborhoods of a baug should also be able to avail of the facilities.
In places like Calcutta where Parsis are more scattered, they have volunteers for the seniors to organize outings, visits to the fire temple, etc.
Issues of aging can be mitigated with thought and compassion. We have a vested interest in seeing to the needs of the elderly. Nearly all of us will join their ranks one day, if we haven’t done so already. On the occasion of Jamshedi Navroz why not prepare for the inevitable? Steps taken today will bode for a better tomorrow. Forewarned is forearmed. 

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My mother passed away in Karachi on 8 March 2023 at the age of 108.I am so grateful for the facilities at Parsi General Hospital, albeit we paid 'through our nose' Rs 67,000/- alone was the room rent and her personal attendants/nurse costed another Rs 60,000 and of course meds and pampers etc were also in 5-digit. BUT the facility was there and we felt comfortable knowing she was safe and cared for. Also the visitors kept her in good cheer which in our 3rd floor flat would not have been there.

On her passing away, the shezdegah facility with all concerned well tuned about what to provide and perform, made us so comfortable and confident. The charaam dinner too what just a few discussions on WhatsApp with our own club Karachi Parsi Institute and all was done.

My Muslim boss who had visited my mother at Parsi General remarked that he never expected such airy/clean/cheerful place for elderly. It is then I realised we have soooo much to be thankful for and play our role in giving back
- Sunnu Golwalla
- 15-Mar-2023


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