The influx of Syrian refugees into Jordan has significantly impacted the nation as it has absorbed so many people into its cities and communities. Jordan ranks second in the world with having the highest ratio of refugees per citizens, and the government has needed to prioritize and allocate resources to address the needs of refugees and citizens alike. Much analysis has been done by Jordanian government ministries and international humanitarian agencies about the vulnerabilities of Syrian refugees along with the challenges faced by the Jordanian host communities.
Older people have been identified to be among the most at-risk categories of displaced people by the United Nations High Commissioner for Refugees (UNHCR). Despite this classification of risk, most attention has been directed to the impact of the crisis on younger generations.
Very little work has been done to ascertain and identify the experiences of older people in the Syrian refugee community as well as in the Jordanian host communities. HelpAge International Jordan undertook this project to identify the specific risks facing older people, (aged 60 and above) as a means to educate and build awareness of the unique experiences and challenges faced by older people in Jordan.
The findings of this comprehensive profile bring forth a much-needed characterization of older people in Jordan that highlights their unique challenges and what service gaps exist, when measured against their rights. This report will provide a framework upon which to develop targeted governmental and humanitarian outreach programs to better serve older Syrian refugees and older Jordanian citizens.
The study results gathered from the interviewed older people revealed:
Health risks and access to health services
Access to health care services varies depending on nationality group. Two-thirds of surveyed older Jordanians indicated they always had access to health services and medications, in contrast to only 18% of older Syrians. Notable differences in access to care were found when comparing across governorates.
Almost all surveyed older people reported having one or more chronic illnesses. Diabetes, high blood pressure and cardiovascular diseases are the most prevalent.
Regardless of nationality, older people experience increased difficulty with self-care and mobility with advancing age. However, a majority of older people under age 80 report being fully independent with self-care.
Most of the surveyed older people in this study received help, in varying degrees, from family members. Utilization of formal, paid caregivers was minimal among those interviewed. A notable proportion of surveyed older Syrian refugees and older Jordanians reported needing caregiver support but having no one available to assist them.
Psychosocial risks and protection challenges
Feelings of autonomy and being their own decision maker appeared to vary by nationality and gender. A higher proportion of older men reported feeling autonomous compared to older women. In general, older Syrian refugees felt less autonomy with decision making compared to older Jordanians.
Memory challenges are more common for older people aged 80 and older. Approximately onehalf of those younger than age 80 reported having no difficulty with memory or concentration.
In contrast, approximately one in four aged 80 and older reported having some difficulty and an additional 15% reported having a lot of difficulty with memory and concentration.
Older Syrian refugees experience a great deal of social isolation and feelings of loneliness, which can be attributed to being displaced from their home community when fleeing Syria.
Only 3% of interviewed older Syrian refugees indicated feeling they were fully active members of their community. Older Jordanians also experience isolation and loneliness. One-third of interviewed older Jordanians reported having limited interaction with community, family and friends.
Economic risks facing older people
Older Syrian refugees rely largely on humanitarian assistance as their primary source of income. Older Jordanians rely more on pensions as a source of income, but a notable 14% also rely on humanitarian assistance.
The ability to financially provide for daily needs is a challenge for older people in Jordan.
Twenty-three percent of older Syrian refugees and 14% of older Jordanians revealed not ever being able to pay for all basic living costs.
Reduction of food intake is a common response of older people to financial need. Two-thirds of older Syrians and one-half of older Jordanians reported having to limit food to financially compensate for other household needs.
Shelter risks facing older people
One in five older Syrian refugees and 10% of older Jordanians interviewed reported living in homes that were not durable for the extreme temperatures of summer or winter.
Water and Sanitation risks
Fifty-one percent of older Syrian refugees and 62% of older Jordanians interviewed had daily access to clean water. For those without regular access to water, limited finances or insufficient supply from the municipality were listed as reasons of explanation.
- Limited access to sanitation for older people in Jordan was largely attributed to poor mobility by those interviewed.
A family member of each older person was also interviewed to gather perspectives about the role of older people within family networks and in the community.
Within the family context, according to interviewed family members, some older people do maintain a high degree of authority. They are most commonly viewed to be advice givers to younger generations.
Within the community context, mixed findings emerged about the role of older people. For some family members, older people hold important roles in conflict resolution and in giving advice. However, 40% of interviewed family members reported feeling that older people had no community role. Reasons for older people being excluded from community roles included that they were perceived as being too sick, to be from a different generation, or simply had no right to be involved.
The findings of the HelpAge assessment in Jordan can be summarized into the following points.
Improved availability and accessibility of health services is needed
Mobility impairment has far reaching consequences, from community engagement to accessing services
Social isolation and loneliness are prevalent.
Family is an important support network.
Humanitarian assistance is essential for older people.
Older people limit food intake because of financial constraints.
Self-advocacy by older people needs to be promoted and nurtured.
The rights of older people need to be better communicated and understood, including through intergenerational focused work.
The following recommendations to invested stakeholders, interested in the wellbeing of older Jordanians and Syrian refugees, are being put forth in response to the findings presented in this report.
To the Government of Jordan
Continue ongoing efforts to promote the rights of older people in Jordan and to promote policies that support their rights being upheld and their positive wellbeing.
Prioritize and commit to building more government sponsored comprehensive health centers to better meet the needs of the large numbers of older people being served.
Prioritize the allocation of government resources to programs that support low income Jordanian citizens.
Efforts must be made to combat ageism and to promote positive views of older people within society.
To National and International Humanitarian Organizations
Begin to specifically incorporate older people into programs and to identify their unique needs as an important priority when developing services.
Utilize the Humanitarian Inclusion Standards (HIS) in programme development to ensure that older people have equitable access to humanitarian services, are knowledgeable of their rights and the proper channels to share their feedback.
Introduce programs that address the specific inclusion and protection risks facing older people. Integrate these with other services and programme activities.
Develop programming to combat loneliness and encourage community engagement of older people.
Develop programming that supports family caregivers, in accordance with preferences and the consent of older people about who provides support and how support can be provided.
Such programming should also highlight the two-way direction of care by also developing support for older people who are caregivers for younger members in their family network.
To the International Donor Community
- Recognise the rights of older people to humanitarian assistance and protection and ensure these rights are upheld through providing appropriate levels of funding to specifically work with older people, and ensuring all humanitarian programmes are age inclusive. Identify older people as an invaluable group and earmark funds to specifically address their needs.