The elderly in Kuwait.

Abstract

What is remarkable about Kuwait is not that it is the richest country per capita in the world (Switzerland is second), but that it has chosen to return to its people, in the form of social benefits, a large portion of the enormous wealth produced by the discovery of oil. Beginning in the 1960s, the government gradually established for its citizens one of the most complete state welfare systems ever implemented anywhere in the world. Going beyond its own borders, Kuwait is also among the largest per capita contributors to development and welfare programs in developing nations. Oil provides revenue for three major benefits: free medical care (cradle-to-grave), education (nearly 16.5 per cent of the national budget goes into education and health programs), and last, social security. Social security was established in 1976. Before its legislation, elderly persons were supported financially by their children, a practice typical of Middle Eastern countries, where today the extended family is still very much in existence. Even with social security, family members continue to support their elderly parents if there is a need, and often one or more children live with their parents. The social security scheme is based on the establishment of three funds—old age, disability, and sickness and death—covering all those working in the public, private, and oil sectors. An insured person is entitled to a pension at the age of 65 if his period of contribution was 15 years, and he may continue to practice his profession. He may also request payment of his monthly pension before he reaches 65 provided the period of contribution was 20 years. In that case his pension is reduced by 5 per cent if his age is below 45 years and 2 per cent if it is between 42 and 52 years. If there is no income, the Ministry of Social Affairs provides the person with 61 Dinar (U.S. $220.00 per month). A man and wife are given 61 Dinar for the man and 40 Dinar (U.S. $145.00) for the woman. As the family system in Kuwait is still very much intact, few elderly persons live in an institutionalized setting. Those who do live in a nursing home—and there is only one in Kuwait City—are there because they have no family or because their situations are such that their families are unable to care for them. Established in 1955, Sulaibikhat Center offers facilities for the elderly, disabled, and mentally retarded. The elderly receive medical care, rehabilitation, and physiotherapy. There are presently 168 patients over age 50 in the old age center; the average age of residents is 75 years. They occupy three floors, and many are bedridden. All elderly persons at the home suffer from the diseases of old age, the most common being arthritis and rheumatism because of the high humidity in Kuwait. Adult education has been a top priority of the government, Kuwait providing the best comprehensive education in the Middle East. Today illiteracy is almost exclusively limited to the most senior of the adult population. This is because of a law that compels persons in the 14–40 age group (men) and 14–35 age group (women) to attend schools for literacy. Nationwide centers (in 1975 there were 125) offer adults the opportunity to learn to read and write. Two years of literacy courses are required. All classes are free of charge and are paid for by the government. Kuwait is known to have the best medical facilities in the Middle East. Al-Sabah Hospital offers the most up-to-date medical equipment available anywhere; the rehabilitation department provides the finest equipment for its handicapped. First opened in 1962, the hospital has three main buildings, which contain a total of more than 700 beds. There are seven operating rooms and two annexes, an x-ray department, a radiotherapy division for cancer patients, and laboratories. There is also a lecture hall, which seats 750 persons. The hospital even has a helicopter pad for bringing patients from desert regions for treatment. In keeping with its reputation as one of the best hospitals in the Persian Gulf, Al-Sabah is the first to implement a program for the development of a gerontology department. The plan in part is to have a geriatric institute that would provide a ward in each hospital in Kuwait with rehabilitation and recreation services. This would mean 50 per cent medical care and 50 per cent rehabilitation treatment. The plan for the future would include one physiotherapist for each ward; presently there is one physiotherapist for each two wards. Another plan for the future is to have mobile rehabilitation units for home visiting. Personnel would teach families how to care for their elderly and check the homes to see that facilities such as home furnishings and appliances, are adequate for the elderly. The more immediate plan for Al-Sabah Hospital is to develop the rehabilitation department to allow the disabled to take a more active role. Presently in the department of physiotherapy very few elderly people receive rehabilitation treatment. Dr. Zam-rawy, Director of the Physiotherapy Department, cites three reasons for this: (1) elderly persons who are already bedridden come to the hospital too late for treatment; (2) available hospital beds are lacking; (3) trained staff are lacking. At present there are many elderly persons who suffer from arthritis and are receiving only 15 to 20 minutes a day of physiotherapy. This is due in part to lack of cooperation and consultation by the staff. The hospital itself was not constructed to aid the therapy patient who has a need for elevator lifts to provide accessibility to other floors. For physiotherapy to be successful it is important that the patient be allowed to move around to see different surroundings in the hospital. At this time many elderly patients spend most of the day in bed. This will change in the future when reconstruction of the hospital takes place. Besides a need for medical personnel (physicians and gynecologists), there is also a need for social programs providing activities for the elderly. Families and relatives should also be included in giving services to the elderly. In Kuwait there are three ministries for the elderly: the Ministry of Health, the Ministry of Social Affairs, and the Ministry of Education. These three ministries work independently of each other. They need to unite in work to improve the situation of the elderly. The funds are there; what is needed is a common goal. The author thanks Mr. Yasin, Undersecretary of the Ministry of Social Affairs and Labour, Mr. Salih Al Othman, Director of Adult Education, Ministry of Education, and Dr. Zamrawy, Director, Physiotherapy Departent, Al-Sabah Hospital, for their generous cooperation in arranging on-site visits and providing information about the care of the elderly. GERONTOLOGY CONFERENCE August 22–26, 1983 “Aging and Technological Advances” Sponsored by NATO Special Programme Panel on Human Factors at University of Southern California Contact: Dr. James Birren Executive Director, Andrus Gerontology Center University of Southern California MC-0191 Los Angeles, CA 90089-0191 (213) 743-6060