Exclusive: Inside Cambodia’s elder care strategy

“In Cambodia, we have a culture of helping each other,” says Mom Bunthan.

This culture is evident in the country’s respect for its elder citizens. Bunthan is the Undersecretary of State for the Ministry of Social Affairs, Veterans and Youth Rehabilitation and chair of the national committee on the elderly.

He faces a big challenge: increasing pressure on budgets caused by an ageing society. In 2015, there were 1.3 million elderly people in Cambodia, and by 2050 that will rise to 5 million - about 21% of the population.

With these numbers in hand, the government is now updating its 2003 policy on elderly for 2017-2030.

The aim is to ensure that the elderly have “full rights and freedom to participate in social development and to live in dignity”, Bunthan says. GovInsider caught up with Bunthan in Siem Reap, where he was hosting an ASEAN delegation on ageing, to find out how the country plans to do this.

Busting stereotypes

Jobs and income security are the biggest challenge facing Cambodian senior citizens, he believes. “The main impact of ageing population in Cambodia is that the older people are having a hard time earning [and finding] a job,” he says.

Many have to rely on their families for financial support. Even pension offered to former civil servants is not sufficient for retirement, he notes: “They still need to find a job to earn more money to support their daily living”.

There is an “institutional perception” that the elderly lack skills to compete in jobs, Bunthan believes. Businesses “do not really understand well about the ageing situation”, he adds, giving preference to younger recruits when hiring.

There is also a rise in the number of elderly becoming caregivers for their grandchildren, he says. Young couples are migrating from villages to look for jobs, leaving their parents to take care of their children.

This “stops them from going to find a job and to earn money to support their living, while they are busy taking care of the children”, he says.

Boosting job prospects

Government is trying to encourage the civil service to recruit retired officials as advisers and counsellors in areas where they have specialised skills or knowledge.

“The government has some work that older people can do even though they are retired,” says Bunthan. Cambodia also plans to expand the number of community groups to help senior citizens.

The groups are called “older people’s associations” and bring together elderly in small communities. They are run by an NGO called HelpAge, and provide training on healthcare, opportunities for work and organise social activities to keep them active.

Bunthan announced in December that the number of associations will double this year to 1,123, with one in every community and district.

Cutting across ministries

Beyond jobs, the challenges of ageing cut across nearly every area of government service delivery. The national committee chaired by Bunthan is meant to bring all of these together.

15 ministries are taking part in the review and implementation of the new ageing policy, each responsible for developing more elderly-friendly systems in their own sectors.

For example, the Ministry of Health will look at how access to healthcare can be improved for the elderly, Bunthan says. “Healthcare in Cambodia is still limited,” he acknowledges.

Meanwhile, the Ministry of Public Works and Transport will look at “how to coordinate and facilitate transportation for older people”, he says, perhaps offering free rides in cities.

The Ministry of Women’s Affairs has also been roped in. Cambodia has a particularly high ratio of elderly women who lost their husbands and children during the brutal Khmer Rouge regime. “That’s a very big issue for Cambodia to recover from,” Bunthan says.

The Government has taken a “consultative” approach to ensure that they get buy-in from all ministries. “This is one of the concerns that we are thinking of,” Bunthan says.

The ministries have been involved in the process right from the beginning with the setup of the committee, he says. Each ministry nominated an official to join the committee.

“They have also set a lot of common inputs to the national ageing policy based on their expertise sector,” he adds. There is also direct control from the top, however, with the Prime Minister serving as the president of the committee on ageing.

The final policy will have to be reviewed and endorsed by the Prime Minister.

Preparing the next generation

The government also wants to prepare younger citizens for their old age. It is encouraging them to start saving early so they can support themselves after retirement.

“The government is trying to provide a warning to younger generations to know why the need to save,” Bunthan says. It also wants to ensure that more children have skills for jobs in the future.

“The Ministry of Education and Ministry of Labour are setting up vocational training programmes to ensure the younger generation gets more knowledge,” he says. Finally, Cambodia believes that the young have to be more empathetic towards the elderly.

The government will encouraging them to volunteer their time to work with the elderly in older people’s associations. It hopes that this will provide more social support for the elderly and mentally prepare the young for their own old age.

Using tech

In the future, technology could help the elderly be more independent and active, Bunthan believes. A key area is data, he believes.

The country does not have any database on its elderly population, he says, but it is “very important and should be in place”.

The data will allow the government to identify who needs support and target specific support to them, he adds. “We would like to have this kind of a system in the future,” he says.

There should be age-friendly road signs and lights to allow elderly with poor eyesight to travel, he suggests. Mobile phones can also be made easier for elderly with poor hearing or eyesight to use.

“The phone should be more feasible for older people so that they can easily contact each other or their family,” he says.

Cambodia is still pulling itself together from the violence of the 70s, but its government and people are determined to look ahead. And this society with a strong sense of community wants to do more for its eldest citizens.

GovInsider is running a dedicated stream on Ageing Demographics at Innovation Labs World on 26 September 2017. Find out more at www.innovationlabsworld.com.

Photo by HelpAge International at the ASEAN Regional Workshop on the Promotion of Older People’s Associations, 6-8 December 2016