Wednesday, August 5, 2009

Older Persons in Lebanon

Lebanon is a country of contradictions. In fact, ask anyone from the city of Beirut to describe it, and they will tell you with pride that on a few days every year, you can go skiing and swimming in the same day. Mountains surround the Mediterranean along the coast, creating a dramatic contrast that provides a tangible manifestation of the various contradictions found throughout the country. Civil War plagued Beirut for 15 years, and the country (as I’m sure anyone who reads the news would recall) constantly faces moments of political unrest and upheaval. But driving down the streets, seeing people go to the beaches, shops, or nightclubs, you would never guess such a thing to be the case. A similar tension exists between the growing conservatism in many pockets of the Middle East, and the complete laissez faire, anything-goes, attitude exhibited by the younger generations.

All of this is what surprised me the most when I first took off to Lebanon to work in a refugee camp just on the outskirts of the capital city, Beirut. Sitting in the terminal of Heathrow Airport in London, waiting to board the flight to Beirut, I noticed women sitting across from me wearing the most fashionable skinniest jeans, high heels, and tank tops while right next to them sat others wearing the hijab (veil), exhibiting the modest dress of a more conservative individual. Before even setting foot in the country, I was already face to face with the contradictions that represent it.

Similar tensions can be found on the drive I take to get to the refugee camp everyday, where my project is based. Within three minutes of leaving the city, full of Range Rovers, designer boutiques and nice restaurants, you witness conditions worse than the most squalid project housing in America. Windowless buildings piled on top of one another, tangled electricity wires that don’t even work much of the time, and beat up cars that shock by the fact that they still run, provide a striking contrast for the viewer.

So, how does all of this relate to older people? As I said, Lebanon is a country of contrasts, juxtapositions between rich and poor, mountains and sea, conservatism and liberalism, and while such dichotomies can be incredible (as with the landscape) and certainly unique, they can also be detrimental. The most pronounced of the contradictions found here seems to pervade all of the others. In fact, it can be found in almost every aspect of life in this country. That is the tension between modernity and tradition, and nowhere is this tension more evident than in the status of older people. The changing family structure represents the largest social change taking place in the Middle East. People are no longer all staying in the same town. Many go abroad; many don’t get married or have child after child in order to perpetuate the family legacy. Unfortunately, these changes place a large burden on older people. In the past, it was understood that kids took care of their parents. Older people received attention and aid from their children. It was an unspoken agreement. Today, while the agreement has been largely broken, it remains unspoken.

My grandmother lives in an apartment by herself, as all of her children live abroad either in Europe or the United States. An 80 year-old who can still drive on the deadly chaotic streets of Beirut, she represents an exceptional case. However, even she has difficulties. She has to navigate life in an incredibly busy city with no one to help her both with the menial everyday tasks and more importantly, with enforcing her individual rights. If she is having difficulty with her landlord, something I have witnessed more than once. He tries to intimidate her and there is not much she can do about it because she is unaware of her rights. If she needs to travel a long distance, she has to find a driver. However, she does not trust just anyone. Afraid that a random driver would take advantage of her age or her frailty, she only wants a driver she already knows and can vouch for. This proves a problem because the only person who fits this description is also an octogenarian who is unable to work all day everyday. So my grandmother cannot always get where she needs to be. In these instances and others like them, I have noticed that there are no social provisions or serious legal ramifications to serve as a safety net for elder rights abuse, and the traditional safety provided by family no longer exists for so many people like my grandmother.

She has four sisters, three older and one younger, who also face similar problems in their everyday life It has been very enlightening, though sometimes disheartening, to spend time with them. An older sister clearly suffers from some sort of memory loss. She does not recognize me, although we have been acquainted for some time. She gets confused, and thinks I am my mother, until she is reminded who I am with a laugh by one of her sisters, only to forget again moments later. Every time she forgets anything, one of her sisters will act as though she is just being silly, and subtly point out the mistake or recollection, as though she is simply one of those absent-minded people who has just misplaced her keys. After seeing this process occur over and over again, I realized that they were all in denial. No one was acknowledging that she has a more serious, graver problem. When I asked my grandmother about this, she brushed off my concerns, saying her sister was just “tired.” In the Middle East, particularly among older and more traditional generations, the word “tired” is a euphemism for everything from the common cold to lung cancer. One does not talk about illnesses and everyone who is suffering from one is just “tired.” I constantly find myself wanting to scream, “Really? Then why can’t you cure it with a double espresso??” Mental health issues are particularly stigmatized in this society, but with modern medicine available, even as treatments for dementia or Alzheimer’s, older people need to be made aware of their options This can only happen if they are willing to talk about it.

It is not just mental health issues that older people do not want to acknowledge. They also, more than anyone else, fail to openly recognize the social changes occurring all around them. This denial creates an interesting socioeconomic breakdown of issues facing older people here. From what I have witnessed, the city of Beirut is where the most changes are happening. However, many of the older people here have money and the physical means of accessing better health care and aid should they need it, even thought family/social support does not exist to a large extent for them. On the other hand, people of lower socioeconomic backgrounds tend to gravitate more toward tradition. While they are worse off physically, living in difficult conditions (particularly in the camp where access to health care and even facilities such as elevators and wheelchairs that help vulnerable populations are virtually nonexistent) the family structure remains intact. People there receive attention and help from within their social networks.

In other words, older people in the city, like my grandmother, suffer more from problems related to the changing family structure. Although their quality of life at large may be much higher, they are not necessarily happier or better off in terms of social integration than older people in the camp. This, for me, is an interesting paradox. With economic and social progress come changes that benefit many. However, older people are not necessarily gaining from these changes. In fact, in some cases, as a group, they are losing. As I said, Lebanon is a country of contradictions, and unfortunately, though we’d like to pretend that a double latte could cure everything, the reality is just not that simple.

By Marya Hannun, for Global Action on Aging


  1. I liked this article a lot. . .but please tell us more about what you are doing in Lebanon. What are the stories that you are reading to the children; what do the children have to eat each day; what are their dreams--both nocturnal and daytime?

    Please answer these questions. I want to know more. Shirley Summers

  2. Hi! Thanks for your comment. We basically teach the children a lot about self respect, respect for each other, and positive forms of self expression. In other words, we work with them on how to channel their violence and anger at their situation and with their peers. We do this through art expression. If they have an emotion, we want them to learn how to express this through a creative outlet such as painting or charcoal drawing. One thing we did was make them draw campaign ads as if they were running for election - what would they change?
    It is difficult because they are not as innocent and idealistic as your average ten year old, so you have to approach them differently. They have been through more hardship, so they don´t necessarily feel as though they have the whole world open to them and that they can indulge a lot of optimism. Part of our work is addressing that and helping them to think about the future positively, but it is hard because they really do not have a lot of opportunity for change.
    I will be happy to write a piece focusing more about my experiences, when I am back in the States, so please stay tuned, and if you have any more specific questions, I would be happy to answer them. -Marya

  3. Although your area is Lebanon, I want to tell you about the situation of my mother in Mexico as it has a bearing on many elderly and their family structure. This is an international problem because so many of us have emigrated leaving our loved ones in the hands of our relatives. We send money to support our loved ones but many, like me, find out that the relatives have stolen the money sent to them and their savings taking advantage of a defenseless old person. It is impossible to prosecute these criminals legally due to the lack of laws regarding the elderly and the distance. So they walk away unscathed. For this, I had started a blog as a cautionary tale and as a forum to share ideas, experiences and feelings.

    I hope you can write about this problem since it affects people everywhere.

  4. great post, thanks!