Ending neglect of older people in the response to humanitarian emergencies.

Abstract

At the heart of humanitarian action are the principles of humanity and impartiality. All people have equal value and dignity; the exclusion of an individual or a group on the grounds of nationality, religion, or politics is contrary to the humanitarian ethos [1]. We suggest that neglect on the grounds of age should be added to this list. But first, what do we mean by “older”? Variation in life expectancy between countries makes it difficult to agree upon the age at which someone becomes old. The United Nations (UN) definition is 60 years and older, but in developing countries, where most humanitarian crises occur, 50 years is an appropriate cut-off and the one we use in this article [2]. Emergency aid has failed to address the needs of older people in emergencies [3]. High death rates among older populations in crises are common, partly due to their inherent vulnerability and partly due to services that inadequately deal with their needs often because these are not well identified or understood [3]–[6]. For example, an assessment by Medecins Sans Frontieres (MSF) of how it met the needs of older people in emergencies in Haiti and South Sudan showed that after initial registration of individuals at health clinics, disaggregated data beyond the under-5 and over-5 year age groups were not collated [7]. Issues with mobility and vision that increase in prevalence with age can mean that older people are more at risk in crises and are less able to access care and support [8],[9]. Vulnerable groups such as older people are therefore likely to bear a disproportionate share of health problems [10]. Thus, specific interventions are often necessary to prevent these groups from suffering disproportionately. Here we describe the neglect of older people's health and nutrition needs by humanitarian agencies, donors, and international bodies. Our aim is to stimulate thinking and action on how older people are treated in humanitarian emergencies.