The conundrum of old age and COVID-19 responses in Eswatini and Zimbabwe

Abstract

This article explores domains of challenges in guaranteeing enhanced social functioning for Southern African countries of Zimbabwe and Eswatini in the context of COVID-19. Government of Zimbabwe (GoZ) and Government of Ewatini (GoE) social protection interventions targeting COVID-impact mitigation for older persons are analysed within the context of resource constraint challenges. Social security programmes initiated by the GoE and GoZ are analysed while noting emerging milestones and gaps. Finally, pathways for the roles of social workers are proposed.

Introduction

On 11 March 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic. According to WHO, 95 percent of COVID-19 deaths in Europe are among people aged 60 years and older (Lardieri, 2020). It has also become rather clear that globally the elderly, particularly those with comorbidities, are at risk of contracting COVID-19 (Zhou et al., 2020). Furthermore, although there are elderly people who may not contract the disease, they are also likely to find themselves socially and physically isolated. This is as a result of enforced self-isolation to reduce the spread of the virus, which has become the order of the day in many countries (Landry et al., 2020). Therefore, given their vulnerability to COVID-19-related illness, poverty, isolation and neglect, older persons require social protection and other accessible supportive services in order to maintain their physical and mental health.

This situation is worsened by the fact that the economies of Eswatini and Zimbabwe are fragile and as such suffer from economic structural weaknesses and pervasive natural shocks. This creates a conundrum in guaranteeing the social protection of older persons. Furthermore, weak public health infrastructure settings, a lack of gerontological expertise at all levels of the health delivery system and limited trust in government make COVID-19 responses difficult (Lloyd-Sherlock et al., 2020).

COVID-19 has also laid bare the absence of social protection measures in Eswatini and Zimbabwe to cushion vulnerable populations, older persons included, from the social and economic impacts of this pandemic. Although this state of affairs is a result of pervasive resource constraints, it also demonstrates the need to view social protection as an investment in human capital and not as wasteful expenditure. Social protection should be prioritised in the development processes in these countries. In this regard, different constituencies providing social services must collaborate in coming up with responses to the psychosocial effects of COVID-19 (Rasool, 2020).

The elderly face challenges to accessing information and humanitarian assistance and they are also discriminated against in decisions regarding the allocation of resources (HelpAge, 2020). Despite having the highest primary needs in this crisis (COVID-19), older people have not been specifically included in a list of those ‘most affected and at-risk’, thereby limiting humanitarian support availability to them (HelpAge, 2020). Commenting on the United Nations Secretary General’s humanitarian plan and US$2.1 billion appeal to fight COVID-19, HelpAge notes the plan’s failure to deliver protection for older people at risk.

Zimbabwe COVID-19 situation analysis

The government of Zimbabwe (GoZ) only adopted a raft of measures in its response to the COVID-19 outbreak following its declaration as a national disaster on 19 March 2020. It declared a 21-day nationwide lockdown from 30 March 2020 to contain the spread of the virus (OCHA, 2020). However, the response to the COVID-19 pandemic is being implemented in an environment where the health system is weak and with a health workforce that is overburdened, with fewer health professionals per capita than most countries. Poverty in the country is pervasive and over 70 percent of the labour force is unemployed. Zimbabwe has also been experiencing intractable political and economic challenges which have impacted negatively on the quality of life of the majority of the people, the elderly included.

Nonetheless, the Treasury (GoZ) set aside resources to cover 1 million vulnerable households under a Cash Transfer Programme targeting a million beneficiaries to receive $200 per month (in Zimbabwe dollars). This cushions the vulnerable communities only to the extent of being able to buy a 10 kg bag of mealie meal (Mhlanga, 2020).

However, given Zimbabwe’s already severe climate- and recession-induced hunger crisis deepening and COVID-19 taking hold, it is going to be difficult to respond effectively to the socioeconomic impacts of this crisis. In this regard, the United Nations World Food Programme (WFP) needs US$130 million to sustain the assistance programme until August 2020, in an emergency operation to prevent millions of the country’s most vulnerable people plunging deeper into poverty and hunger (United Nations Zimbabwe, 2020).

It is disconcerting, however, that the GoZ will not increase its cushion pay-outs of $200 per family due to inadequate resources, to provide more cover for workers, traders and distressed families owing to disruptions caused by COVID-19 (Mhlanga, 2020). Furthermore, the National Social Security Authority (NSSA) is reported to be encouraging pensioners to utilise alternative means to access their pensions, such as mobile money and bank cards, due to the lockdown brought about by COVID-19 (Business Times Newspaper, 2020). In the same vein, the Treasury has employed an algorithm when targeting the vulnerable for benefitting from the $200 monthly safety net. The algorithm encompasses mobile money transactions. However, the problem is that in some Zimbabwean rural settings, the elderly lack knowledge of cell phones or mobile money transfer usage.

Eswatini

Eswatini is a lower-middle-income country, with a population of 1.1 million. It is ranked 138th of 189 countries in the 2019 Human Development Index (World Bank, 2020). The proportion of people living in poverty remains very high, with 58.9 percent of the rural population living below the national poverty line (less than US$1.9 a day); 20 percent of the population are considered extremely poor. Furthermore, Eswatini is considered to be one of the countries with the highest rate of HIV prevalence in the world as 26 percent of the adult population are infected (World Food Programme, 2019).

On 17 March 2020, the government of Eswatini (GoE) declared a state of emergency to contain the disease and delay the spread of infection. To help individuals and businesses cope with COVID-19 consequences, the government put in place several measures including a budgetary allocation towards fighting the pandemic. Development partners and donors, including the United States’ President’s Emergency Plan for HIV/AIDS Relief (PEPFAR), United Nations agencies, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria, have also committed funds to support the COVID-19 response amounting to approximately US$2.9 million (World Bank, 2020). Additionally, the government recruited several health personnel including 8 doctors, 145 nurses, environmental health specialists, paramedics and orderlies. A total of 1007 nurses from all levels, 147 medical doctors and over 3000 rural health motivators have been trained on COVID-19 (Eswatini Prime Minister’s Office, 2020).

Furthermore, the Department of Social Welfare (DSW), in partnership with other key stakeholders, provides social welfare services addressing vulnerability and poverty. The Old Age Grant (OAG) is the flagship programme aimed at cushioning the elderly aged 60 years and above. With 69,697 beneficiaries and monthly transfers of E400 (US$20) per beneficiary, OAG is by far Eswatini’s biggest social cash transfer programme (UNICEF Eswatini Country Office, 2018). The GoE also set aside an estimated budget of about E5 (under US$1) million for a 48-bed Retirement Home for Elderly Persons construction at Mankayane for the 2019–2020 fiscal year (Deputy Prime Minister’s Office Eswatini, 2019). The retirement home will also mitigate the impacts of the COVID-19 pandemic given that the elderly without anyone to look after them will be taken of in residential care. In addition, the GoE also resolved that electronic payments be used for the payment of grants for the elderly in collaboration with the Eswatini Post and Telecommunication Corporation, MTN Eswatini and Eswatini Mobile (Eswatini Prime Minister’s Office, 2020). This was also in recognition of the need to protect elderly recipients of the grant (old age pension) from being exposed to COVID-19. The previous arrangement was that beneficiaries of the old age grant gathered in large numbers at payment points, which currently would expose them to the COVID-19 virus.

Conclusion

Eswatini and Zimbabwe, in common with other developing countries, face a number of challenges in responding to COVID-19-induced social problems. Existing social protection measures in these countries were not designed for contingencies such as COVID-19 and are therefore inadequate in responding to this pandemic. Although cash transfers have also been instituted in both countries (Eswatini and Zimbabwe) to cushion vulnerable populations, including the elderly, they cannot be expected to meet their needs for food, health care and housing, among other needs, as the amounts are very small. Furthermore, the responses are not well coordinated, leading to fragmentation and piecemeal and ad hoc interventions.