Standing Structures

A Review of CBOs of Elders in Tsunami-Hit Areas of

Coastal Tamil Nadu & Kerala

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This Publication is largely based on a study conducted by Dr. B. R. Dwarki, Development Consultant and former Dean, Faculty of Rural Development, Mahatma Gandhi Chithrakoot Vishwavidyalay. M. P. and Professor of Rural Sociology and Head Dept. of Sociology, Gandhigram Rural Institute, TamilNadu.

Editorial and Production Consultant : Tapan K. Ghosh

Printed by: Ad Strings Advertising Pvt. Ltd., New DelhiJanuary 2009

Published by: HelpAge Indiaunder Tsunami Extended Response Project

HelpAge India (Head Office) C-14, Qutab Institutional Area, New Delhi-110016Tel: 011-41688955, 41688956 Website: Helpageindia.org

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FOREWORD

In December 2007, Helpage India’s Tusnami Extended Response project in coastal Tamil Nadu and Kerala finally came to a close. An evaluation a few months prior to withdrawal had revealed more or less an encouraging picture of sustainability so far as the community-based structures were concerned. The relatively older structures, particularly at the grassroots level, like the ESHGs and the VECCs were quite strong and one could hope that the higher level ones federated at the village, district and beyond would gain sustenance from them. At the same time, Helpage India decided to support the now experienced PAs for one more year through a retainership arrangement to ensure that the community received necessary support for some time more at the field level. How has all this been working out ?

This report, based on a study, 8 months after closure of project, by Dr Dwaraki in August 2008, and supplemented with other field reports looks closely at the year that has passed since the exit of Helpage India from the project areas.

On the whole the findings are encouraging. At the same time, there is no doubt that the future of these CBOs will largely depend on the quality of leadership that would emerge at different levels. And that, of course, would require constant nurturing and some level of guidance.

January 2009 Avenash Datta

New Delhi Country Head

Programme & Emergencies

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CONTENTS Page Nos.

1. Looking Back 05

2. Profile of the study 07

3. Elders for Elders Movement 12

4. Ripple Effects 23

5. Looking Ahead 26

ABBREVIATIONS

AAG : Adopt-A-Granny

AVVAI : Partner Agency of HI at Nagapattinam

BWDC : Bharathi Womens Development Centre

(PA of HI at Vedaranyam)

CGCM : Cuddalore Granny Care Movement

EfEF : Elders for Elders Foundation

ESHG : Elders Self Help Group

MMU : Mobile Medical Unit

MPCCE : Multi Purpose Community Centre for the Elderly

OAP : Old Age Pension

PA : Partner Agency

QSSS : Quilon Social Service Society

(PA of HI at Kollam)

SaGP : Sponsor a Grand Parent

TEV : Tamairakulam Elders’ Village (Cuddalore)

VECC : Village Elders Care Committee

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I. LOOKING BACK

Background

While a number of agencies swung into action into the tsunami-affected areas following the unprecedented havoc of December 2004, HelpAge India (HI) was the sole agency addressing exclusively the specific needs of the elderly. Following the relief work that was the immediate need in early 2005, HelpAge India did not lose much time in bringing in transition from relief to rehabilitation through four Partner Agencies (PAs). The Elders’ Self Help Group (ESHGs) was recognized as an important entry point activity to ensure the supply of needs which was met through an organized and effective delivery system in all the target villages. The foundation for sustainable livelihood trends had been laid.

As an effort to strengthen the community role in rehabilitation, Village Elders’ Care Committees (VECCs) were constituted so that the responsibilities could start moving village-wards from the PA headquarters. The all-round positive response of the VECCs reassured HelpAge India and the PAs that the sustainability trends could be further strengthened. ESHGs got federated into VLFs (Village Level Federations) and these into DLFs (District Level Federations). Later an apex level institution was created in the EFE, which has taken over the overall management role.

Interestingly, out of about 500 NGOs that had swung into action soon after the tsunami disaster, less than half of them stayed on as the efforts entered the rehabilitation stage when the NCRs were constituted. All through HelpAge

India, along with its partner agencies, stuck to its mission in serving the elderly in the tsunami area. A survey conducted just before HI’s withdrawal from the area had shown positive results. The community structures from the village level upwards were functioning properly.

In mid 2008, after lapse of several months, it was important to know how the CBOs were doing and what signs of sustainability these structures were showing. Thus a new study was taken up in August 2008. The study team was led by Dr Dwaraki who had earlier done the assessment in October 2007 just before HI’s withdrawal. This report is substantially based on the Dr Dwaraki’s study but also has inputs from HI field staff and others mainly pertaining to developments in the last quarter of 2008.

Need for this study

The reason for this study was obvious. It had been well over 6 months after HI had withdrawn from the coastal areas of tsunami-hit Tamil Nadu and Kerala following three years of relief-cum-rehabilitation efforts. As HI had exercised due care to create traditional social security and support systems to take the ‘Elders for Elders’ movement further, it was all the more necessary for theoretical and practical reasons alike to know whether the CBOs were on the right track. Dr Dwaraki and his research team were asked to conduct a study with a simple brief: one, find out how the CBOs were performing and two, recommend areas where further guidance could improve matters.

The study drew its major data from the research team visiting a total of 16 villages –

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4 in each project area – wherein Focus Group Discussions were held with crossection of ESHGs (Elders Self Help Groups), SaGPs/AAGs (Sponsor a Grant Parent/Adopt-A-Granny) beneficiaries and VLFs (Village Level Federations). Four villages per project area were identified; these included one large village, one small village, one best performing village and one poorly performing village. The data has been supplemented by periodical reports, earlier reports by the same team and also a self

anchoring technique applied with VLFs. Data from different sources have been collated though no comparisons have been attempted. This document presents the highlights with regard to community based organizations in terms of the functioning of support structures, the strengths and weaknesses, as also opportunities. Based on the findings, the study team has been able to throw up some ideas for advocacy and change that HI could seriously consider in their work in the coming days.

Basket Weaving: an elder engaged in a productive activity at the Elders Village in Cuddalore.

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II. PROFILE OF THE STUDY

HelpAge India through its office at Cuddalore, that came into existence in the wake of the tsunami disaster of December 2004, attempted several innovative ideas in its efforts to rebuild the devastated communities in the coastal regions of Tamil Nadu and Kerala. Past experience of the partner agencies (PAs) and the co-operation from some volunteers of the service villages, combined with timely innovative approaches from the PMO, had brought about visible changes in these villages in the lifestyle of the elderly as well as the village groups that were organized in the process. The study was organized around distinct objectives and methods so as to help in coming to definite conclusion and some recommendations for the future.

Study objectives and methodology

This study had four distinct objectives:

To obtain first hand empirical data 1. pertaining to selected villages in the four project areas.

To collect information on the 2. performance of the village based groups in the care of the elderly.

To identify areas of activity in which 3. HelpAge India could consider bringing about changes.

To recommend the aspects of elders care 4. on which HelpAge India could initiate advocacy.

The methodology of the present study involved mainly having Focus Group

Discussions (FGDs) with cross-sections of:

AAGs / SaGPs z

ESHGs z

VLF/DLF. z

Selection of villages, four from each PA area, was based on the following: one big village, one small village, one well performing village and one poorly performing village.

The idea behind selecting the villages in this manner was to have as much of variety of inputs as possible for interpretation. No comparison either among the villages or between the PAs was visualized. Therefore, for interpretation purposes, the entire data collated from the above methods has been organized systematically under different sub headings in the report.

The above data was planned to be supplemented by:

Secondary sources (reports from PAs/ HI zCuddalore)

Case studies z

FGDs were held with the following cross-sections of village populations considered directly relevant to elderly care:

1. Elders Self Help Groups (mixed gathering)

2. Village Level Federation (which included DLF members)

SaGP / AAG beneficiaries

It may be noted that the term ‘beneficiary’, in the background of participatory sustainable approach to elders’ care, could be regarded as

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inappropriate. Yet it has been retained in the report partly because the term is still in use in HI/PA reports and partly because the way ration distribution operations are managed; those receiving ration items under HI-assisted programmers are in still some sense ‘recipients,’ with no specifically defined roles in the decision making process.

Thus FGDs were held with three groups in each village, i.e. in four villages in each project area.

On an average each ESHG cross-section for FGD comprised of 4

men and 8 women, the actual range being 3 to 10 for men and 5-20 for women. A checklist and guidelines was prepared for the FGD in advance.

At the VLF sittings for FGD the composition – gender wise – was in contrast to that of ESHGs i.e. men out-numbering women. Also, in terms of size these groups tended to range from 4 to 16 because the composition of VLF depended on the number of ESHGs in the village. Further each VLF sitting included one or two DLF numbers as well.

Regarding SaGP/AAG sittings, the groups were rather heavily dominated by women numerically, the number ranging from 3 to 12, with the ratio of 1:3 between men and women.

Secondary data was obtained from the monthly reports of the PAs for the period from

January – July which was regarded in the study as the reference period. However, portions from the reports have been used either to substantiate or corroborate the interpretations based on primary data.

Selection of Villages

Keeping in view the most specific objective of the present study, the selection of villages tried to bring in as much a variety of factual experience from the people and their representatives as possible following HI withdrawal. Therefore below mentioned definitions were given to the PAs to identify the villages for study.

One big and one small village; z

One village rated by PA as among the best zin performance: and

One village rated as below par in zperformance.

The obvious idea behind the above purposive choice was that each village would bring out from experience somewhat different aspects of the programmes/experiment that may be unique irrespective of whether or not the study itself, with its time constraints, could trace it back to the specific aspects of socio-cultural-political situation of the community.

While the research team selected the villages with the idea of eliciting maximum input from FGDs, no effort has been attempted to make any cross comparisons either between village groups or between PAs.

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VILLAGES COVERED UNDER THE STUDY

(Abbreviations used for village for the sake of anonymity)

VILLAGE ELDERLY ESHGs

(NO.)

ESHG MEMBERS VLF

MEMBERS

M W M W M W

AL 350 960 20 2 328 0 28

AS 310 535 4 12 36 2 6

AB 570 690 15 59 137 12 18

AP 360 495 11 40 96 14 8

DLF 96 572 768 13 11

BL 460 247 14 139 75 21 7

BS 201 321 4 22 35 3 9

BB 241 441 6 40 68 4 8

BP 210 418 14 92 136 11 15

PLF 117 828 1036 22 6

CL 122 138 8 68 79 10 6

CS 19 57 2 4 28 0 6

CB 141 119 8 83 63 13 3

CP 51 29 2 17 13 3 1

PLF 78 562 728 16 12

KL 979 812 10 28 104 4 16

KS 212 223 10 - 156 - 20

KB 340 360 13 106 42 20 6

KP 693 430 9 32 12 6

PLF 108 475 1057 20 6

Note: Prefixes denote Project Areas: A: AVVAI; B: BWDC; C: CUDDALORE; K: KOLLAM. Suffixes denote Village Size: L= Large; S= Small; B= Best; P= Poor

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Some insights from the study villages

The figures from the large village (AL)

in the AVVAI operated area are noteworthy.

Despite the substantial number of elderly males

in the village, their representation in ESHGs is

next to nil. There is an urgent need to look into

this and in case more ESHGs are to be formed

in this done such villages, the urgent work of

convincing and mobilization may have to be

more among elderly men.

Also noteworthy is that in the best performing

village in the Cuddalore area (CB), men are

heavily over-represented in the VLF. There

seems to be a need in such cases to work for

motivating and training more women leaders.

Going by the figures on the table, in the large

Commitment personified at Cuddalore Village

Mr. P is in the late fifties with three children. Having witnessed his mother’s death

due to cancer, Mr. P jumped into the service mode, especially for elderly. Even when

the interviewer requested him for a brief sitting, he was actually to proceed on his

bicycle to meet some relative waiting for him to go to hospital. His commitment is almost

unparalleled. A look on his face combining wisdom and humility, the study team had

the opportunity of observing Mr. P. conducting DLF (of which he is the chief) meeting

with aplomb so meticulous that it would be hard to believe that he had not completed

even school graduation! The clarity, conviction, firmness of speech – mincing no

words – and his articulating ability guided Mr. P with ease in convincing his member

colleagues at the meeting (numbering about 20, fairly equally balanced genderwise).

Mr. P looked patience personified at the meeting. His firmness of speech was mixed

with appealing tones; even his rebuke (when necessary) was firm but not unkind.

village in Kollam (KL), quite like in the case of

the counterpart in AVVAI area, men are heavily

under represented in ESHGs and thereby in

VLF, too. More efforts are needed here to bring

in more men into the movement.

Much more surprising than the revelation

above is the case of the small village in Kollam

(KS) in which inspite of the fact that the elderly

population is somewhat evenly distributed

gender- wise, there is not a single male member

involved in the ESHG movement! And among

the sixteen dependent elderly receiving ration

items there are 3 men!

Notably in the best performing village, the

dominance of men is evident despite the fact

that the elderly population is fairly balanced

gender-wise.

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The above comments only drive home the point that there are aspects to ponder over even beneath the apparently successful outlook of ESHGs, as there is still scope to improve the movement.

The above case from cuddalore (see box P.10) highlights the kind of leaders needed at the base of the movement to ensure its sustainability.

This is something that will require further thought.

In one FGD with a VLF, there was a case of demand for the savings of a deceased ESHG member by a first degree kin. It was interesting to observe the discussion on this subject. The VLF seems to have already taken a decision to release the savings in such cases along with 1 percent interest.

A Multi purpose Community Centre serves as a day centre for elders and a night shelter for destitutes

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III. ELDERS FOR ELDERS MOVEMENT

The formation for ESHGs theoretically represents that the community and the elderly alike have come to recognize the value of mutual trust and respect. Further, the logical impact of co-operation on the productive ability has also been realized.

The most solid example of the ‘able elderly’ getting into productive livelihood mode is the milk dairy of one VLF studied where owners of 43 cows in ESHG groups pool the milk for local sales. It is not the amount in terms of litres or money earned that matters. What is remarkable is the determination and self confidence of the elderly that the venture represents. The same group has now presented a ‘business plan’1 through the DLF to EfEF running into a turnover of five figures.

In the present study about a third of VLF groups considered the proposition of increasing the ESHGs with the intention of raising more revenue to feed additional members among the dependent elderly.

1 (AVVAI claims that they had prepared and guided the people (VLF) to create their business plans.)

Becoming a member of an ESHG seems to have made the elderly more vocal and even more articulate. The manner, composure and the conviction with which many elderly members were communicating in the FGD sittings, this researcher, who has had along years of such interaction with SHGs of younger age groups, could not for a few moments believe that the respondents here were the elderly!

Even among the dependent elderly met with during the FGDs with SaGP / AAG recipients, the mutual recognition of the struggle that their leaders are going through in providing ration items could be seen in the present study. Seventy five percent of the groups expressed that they were now getting less items and also less quantity than last year, but were quick to add that it was so because on the one hand there was price rise and on the other hand there is no direct help as before. But as such the respondents have not progressed with respect to dependency.

The accountability of the self-sustaining representative group like VLF is further substantiated as almost all the participating SaGP/AAGs in FGDs confidently responded that there were no undeserving elderly people receiving ration items.

In 2007, when a detailed study of the functioning of VECCs was carried out, VLFs were getting deeply entrenched in the design of financial sustainability for elders’ care within social support structures.2 At that time an observation had been made of the possible

2 At the time of the 2007 study, VECCs were functioning full-steam and the idea of VLF was in its nascent stages, although the HI vision itself was clear.

An elder takes up candle making at TEV, Cuddalore.

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confusion in the minds of people in general and elders in particular about the role definitions and even power-sharing issues.

In 2008, by the time of the present study, VECCs had started functioning almost like sub committees of VLFs. Now VLFs have continually grown in strength, through DLFs to culminate in the EfE Foundation, the last of which will be discussed later.

Livelihood Programmes:

Elderly people – especially those who remain non-productive resulting in rejection by family, find the final answer in coming together. What they could not even have dreamt of as individuals, as a group they are able to experience—the real thrill of earning some money themselves.

In this sense, the very formation of ESHGs has helped elders rediscover themselves. Over the years since 2004-05 they have grown from strength to strength and have been able to change the mindset of initially reluctant bank officials to finally accept ESHGs as ‘bankable’.

As for HelpAge India, in providing livelihood opportunities to the elderly population, the departure in the classification of elderly3 was, in a way, a watershed in so far as organizing the elders was concerned. To recapitulate, the difference in the definition is in the table given below:

3 Traditional and social support and security structures in the care of the elderly-Aug 2007.

Classical HI-Definition (PMO)Young – old: 55-60 yrs of age Working ElderlyMiddle – old: 60-65 yrs of age Assisted ElderlyOld – Old: 65 and above Dependent Elderly

It can be easily construed that the HI definition is based on ‘ability’ where as the classical one is based purely ‘on age’.

There is the need to project the achievements of the elderly within the community through mass media methods to build up the self confidence and dignity of elders.

Under the livelihood plans, HelpAge India through its partner agencies sanctions varied amounts of revolving funds depending on the level of the grading of ESHGs under the government approved grading formats. The ESHGs are also assisted in securing loans through established credit institutions to individuals and groups, as finalized by the groups under the guided supervision by PA field staff.

Through promoting formation of ESHGs and encouraging income generating activities by ESHGs, it has been possible to bring a new

Rope making activity at TEV

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look to the elderly people within a community so much so that there has come about a sea change in the way in which the family as well as community members by and large look at the elderly now—with a little more dignity. The core idea is: as the ESHGs become stronger, destitution among the elderly should reduce significantly.4

The increased community value attached to ESHGs is understandable by the mere fact that the PAs have taken much less time this year for the process of formation of ESHGs and two ESHGs were formed purely through the efforts of VLF. Whereas the former represents the impact of earlier experience for the PAs and the elderly alike, the latter is a good indicator of the value the people in general and the elders in particular attach to the very idea of coming together with dignity.

The livelihood programmes promoted by HI were multi-pronged. Although the most badly hit by tsunami were the fisherfolk in the coastal areas of Tamil Nadu and Kerala among others, and the media strongly projected the tsunami as a sudden curse on the fishermen communities, HI did not lose sight of the reality that there were agricultural communities deeply affected too in the coastal regions. The gravest problem that stared the communities in the face was that of soil erosion resulting in a high degree of salinity of the soil. The HI efforts to assist these communities to get back to their feet, were on five distinct fronts:

For agricultural communities : 1. (desalination followed by fertilization of soil, hybrid varieties etc.), animal husbandry support

4 Referred to in the report of August 2007 report (Footprints in Coastal India).

For fishermen communities: provision 2. / repair of boats, nets and other related equipments.

Alternative livelihood sources: training 3. and material support for both.

Support to artisans, handicraftsmen.4.

Ration items to the dependent elders.5.

In particular, the departure HI made in classifying the elderly on the basis of ‘ability’rather than on the basis of ‘age’ has had such a telling effect on the mindset not only of the elderly themselves but on the villagers in general that the villagers would often cajole the elderly to remain active and productive! And as for the elderly men and women who became part of the working brigades, they tended to forget their age!

The most solid example of the livelihood trends that got built up among the elderly is

that of Kameshwaram ESHGs of Vedaranyam5 which having successfully operated a co-operative milk dairy for about a year, have had the confidence of presenting a ‘business plan’ to EfEF running into lakhs.6 This was something beyond their imagination less than three years ago!

5 Incidentally this was one of the villages in the study.6 From the Consolidated Report from Helpage India,

Cuddalore, (part of PPT material).

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Sustained Protection

As said before, DLFs, and subsequently EfE Foundation, were the most obvious logical extensions of the idea of VLF at the district level and beyond.

It was realized during the present study, that VLFs today have become strong levers and hinges around which ESHGs on the one hand and DLF on the other hand are able to revolve

A Self-Assessment by VLFs

¥

¥

¥

Before Help Age India After HelpAge After VECC take over

Intervention India Intervention

freely facilitated by the movement of funds both ways. Thanks to the VLFs and DLFs, the elderly members who contribute in terms of tens are able to hear and talk in terms of thousands, lakhs and even beyond. ‘Business Plans’ being prepared and submitted – although only 6 VLFs have done so till date at the time of study i.e. August 2008 – represent the pragmatic and futuristic view that has developed in the minds of the elderly, leaving the moaning and groaning of ageing idle far behind!

All said and done, however, even group effort in a positive and productive direction is led by a handful of entrepreneurially oriented people with the bulk falling behind them.

Self Perception of the VLFs

A self anchoring technique7 was used by the study team to understand how the VLFs perceived themselves in terms of their performance.

The self anchoring technique which had been adopted by the same researchers for studying VECCs in 2007 had requested the participants

7 See August 2007 Report cited earlier, for details on the technique.

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to identify on a 10-rung ladder the relative shift in the condition of the elderly in the village resulting from HI intervention. The result was that the groups had indicated an upward shift by 4 rungs i.e. from 3rd rung to the 7th rung as a result of HI intervention. In the present study, VLFs were asked in the FGD sittings to rate their own performance in this regard after December 2007, i.e. following the withdrawal by HelpAge India. Nearly 75 percent (11 out of 16) VLFs put the level all the way up at 10! What is more interesting and noteworthy is that 3 of them further expressed that even if the ladder had been shown with 12 rungs, they would have still put it on top! Such was their self-confidence and pride in what they had been able to achieve in the last 7-8 months’ time.

Most VLF groups, however, recalled the strength of the financial conduit structure–ESHGs towards EfEF through VLF & DLF and back—that the HI left behind at the grass-roots level at the end of 2007 as a major prop for this achievement. Nearly a third of VLFs claimed that the village leaders took it as a challenge that the level is not to be allowed to slide down. However, two VLF groups who picture no change in the level, while still expressing pride in having maintained the status quo were pragmatic enough to concede that but for HI financial support which was left behind in December 2007, the level might have gone down at least by one rung. Among other factors accounting for the achievement are the commitment and conviction prevailing among the members as well as the co-operation extended by the villagers. Whereas one VLF was at an extreme in declaring that the staff absence was “not felt at all”, another VLF (all women) was rather at the other extreme as

it said that the ration receivers were not even informed of the HI withdrawal till date lest they felt disillusioned and distressed about future prospects of receiving food items! (More than a dozen SaGPs / AAGs who were present at the FGD agreed with this statement!) In a sense, the use of this technique and what it has brought about could be considered the cornerstone of the present study.

During the study period – data collection visits to villages – the study team, by coincidence, had two welcome opportunities: One, DLF meetings in two villages following the agenda, second, the election of new representatives of VLF to become part of the newly created EfEF structure. The first occasion was an opportunity to observe the meticulousness of the DLF chief in conducting the meeting. These village groups really seem to mean strict business – they do not have much time to waste in the meetings talking or debating. This DLF chief, in this case seemed exceptional as he declared he would remain honest and upright in mentioning his displeasure about laxity in maintaining records by VLFs although, he confessed, he had been asked by one VLF chief not to mention the same at the DLF meeting.

The study team at the election meetings of DLF observed that there was unanimous acceptance of the latest direction of EfEF—that the members would be so selected that there is equal gender representation i.e. one woman and one man. Further, the DLF chief pointed out that both being women was acceptable but not both being men! The impact of the gender sensitization programmes organized by HI for the VLF members was clearly visible.

A trend of constructive, pragmatic and positive thinking by the people’s representatives

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at the DLF could be witnessed when a suggestion came up and was discussed on the theme of healthcare with 3 to 4 VLFs coming together to set-up a common facility for use by the elderly in particular and the villagers in general.

The efforts of ESHGs, however laudable, would have remained confined within the boundaries of the communities unless some effort was made to take them beyond these domains. The answer lay in the concept of federation. Thus the ESHGs got initially federated at the community level (VLFs : Village Level Federations). The obvious extension of VLF was to form the District Level Federations (DLFs). Built on the economic strength of the component ESHGs, VLFs / DLFs would take the progressive, protective and productive efforts beyond the boundaries of the village, linking themselves in the process with the economic and financial structures lying in the wider world.8

TEV and MPCCEs

The home for the elderly at Cuddalore–Tamaraikkulam (literally “Pond of Lotuses”) – and its PA level counterpart called Multi Purpose Community Centre for the Elderly (MPCCE) are both dream concepts of HelpAge India. They both theoretically and practically create living situations wherein three classified levels of elderly based on “ability” come together under one roof.

The proposed composition for residents at TEV is quite sound i.e. 50+30+20: Able + Assisted + Dependent elderly. This sound logic of distribution could possibly be extended even to the occupancy in a single dormitory for 2+1+1

8 One of the PAs claimed that in their VLF meetings, often a suggestion came up from VLF that they should work for creating a Contingency Fund to support the dependent elders.

for a close living together. The locale of TEV is unquestionably picturesque. With the exquisitely designed buildings with lawns and gardens and a pond, the ambience is so inviting. For the residents, earlier used to neglect and isolation, the campus is a haven more than a home. It is important also to see that where possible residents at the TEV retain their organic links with their village and family. There have been cases where after a few months, family members have come to take back the elder/s from TEV; hopefully these are permanent reconciliations as these instances have involved a bold decision on the part of the sons or daughters in the face of social embarrassment.

The paid workers at TEV must therefore be encouraged to remain alert, imaginative and innovative. TEV is to be regarded not only as a solution to the dependent but neglected elderly but as the starting point of a novel and noble experiment of giving back self respect and confidence to the once despairing elderly.

The TEV has in recent months become a hub of social and cultural activity. Some vocational activities are doing well. All religious festivals like Christmas, Deepawali, Eid and Pongal are

Tamaraikulam Elders’ Village at Cuddalore (or TEV)

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celebrated. The managers of TEV bring out an online newsletter which lists out the events of the month and has become an important networking activity. The institution attracts visitors from across India and even abroad. Charities and NGOs, educational institutions and corporates apart from State government agencies have participated in various programmes at the Village quite often as sponsors. TEV has recently attracted support from a number of organizations. The TEV also houses the head office of EfE Foundation.

MPCCE

All that has been said about TEV holds good for MPCCE. In this effort of rebuilding organic linkage for elders, MPCCE has a distinct advantage in the sense that it is located in the middle of rural communities in different PA areas. Unfortunately, MPCCEs, during this study period, were yet to take off in the real sense of the term. From what the study team researcher could gather on this issue from the FGDs with VLFs, the people who are supposed

AnecdotesOne elderly man (resident of TEV) who zhappened to travel along with a researcher in the vehicle to Nagapattinam revealed that he was visiting his grand-children, a boy and a girl of his son, who has disowned him. Can this intergenerational link be used as a bridge to rebuild the family connections for the elderly?

Another elderly man (another resident of TEV) zwho also travelled in the vehicle was going to visit his son, who was against the father joining TEV. The old man said that he still decided to move to TEV because he did not like his daughter-in-law! The question is, who in the whole situation needs counseling and on what?

An interesting idea propped up in an FGD with a zVLF group. Why not put up a board in a prominent place in the village which would read: “so many (number) sons are there in this village who do not care for their aged parents/father/mothers. And watch for the reaction of these sons to the board (after all they know who are these sons in the village)!

Elders enjoy a T.V. programme at a community Centre

to use the facility have not, perhaps, been a part of decision-making process at any stage till the completion of the building. Or perhaps the villagers are so used to dealing with “unipurpose facilities” that they do not quite understand the implication of a multi purpose facility?

In the last quarter of 2008, however, MPCCEs in some areas have taken off, as per reports from the field. In Vederanyam and Cuddalore, the centres have started functioning;

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the destitute elderly in Kameshwaran village of Vedaranyam stay at the facility at night. In Mottandithoppu of the Vederanyam, they use it as a place for meeting and gathering and for the destitutes it has become a much needed shelter.

Retainership Arrangement

The retainership arrangement that HI instituted for the PAs in 2008 (i.e. for a year after exit) seems to have achieved less than what was visualized. Summarily, the CBOs have done well and the grass-roots personnel, PA/HI alike, seem to have remained more relaxed than could have been allowed. Perhaps there has been a perfunctory approach by the field staff partly due to the possible interpretation that the “support” would end soon and partly because the hands were new.

The arrangement was expected to achieve CBO level strengthening of the process of sustainability though the extended period. The to-and-fro correspondence between PAs and HI/CRC perhaps remained at the “bureaucratic minimum” level!

Performance by the field staff, perhaps, remained limited to scrutiny of book-keeping. The CBO leaders are still not fully conversant and comfortable with the book entries work. Even the number of registers they have to maintain, the simplicity of accounting in terms of details as well as numbers, have not changed much.

Palliative Care

The palliative care programmers introduced only in the headquarters district of Cuddalore, running into its fifth month has been doing a fantastic job on three counts: First, it has brought

cheer to those passing through uncomfortable evenings of their lives; second it has aroused spirit of voluntary service among the young and old alike, even the children; and third, it has caught the eyes of the bureaucracy that has pitched in its own might through allotting an entire ward!

Concerns, anxiety and expectations expressed by almost all SaGPs/ AAGs in the other PA areas about health care are in stark contrast to the attention palliative care is offering in addition to MMU to their counterparts in Cuddalore villages.

Looking back at the retainership contract signed with PAs in retrospect, it would have been a wiser idea to include some efforts in this direction, however rudimentary, as a part of the contract. As a matter of fact, it would have been ideal to have included efforts in this direction – even if coupled with MMU service some six months before the planned withdrawal by HI in December 2007.

However, it is about time that those under retainership arrangement are asked to initiate steps in this direction in any small manner possible like bringing together the youth to appraise them of the role that they can play in elderly care.

Elders for Elders Foundation (EfEF)

Elders for Elders Foundation, the apex structure, was the logical culmination of the mutual help approach of the ESHG movement; with ESHG leading on to VLF and then on to DLF, something like EfEF was bound to happen. Interestingly, in the partners’ meet following the presentations by the independent Evaluation Mission (in 2006) an animated discussion took

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place on the concept of an institution beyond the DLF level. One concept that emerged then through the discussion, but remained at the nascent level, was that of an MFI–a micro finance institution – that could take DLF to the State level and even beyond.

Since it came into existence the EfEF has been steadfast in proving its mettle. It is a registered trust with two representatives from each DLF (actually three DLFs and one DLF, two PAs being in the same district of Nagapattinam) coming together as the founder trustees. Besides the eight of them, the trust also has three experts from different but very relevant fields as nominated members.

Is MFI a shelved concept is a moot question to ask at a time EfEF has come to stay. Yet, all said and done, EfEF seems mainly to focus only on the monetary issues involved. According to the study findings, in order to keep the social responsibility dimension afloat, there may be a need to strengthen the EfEF structure through nominating or co-opting experts from professions like micro-finance management and gerontology, for example (there are already nominated members to cover livelihood and gender besides the legal profession).

General Body meeting taking place at TEV after elections to executive body of EfEF.

During the study, one of the PA heads chose not to respond to the question related to creating MFI besides the EfEF. Between the other two, one was positive about creating an MFI, whereas the other felt that EfEF could be strengthened and its capacity built up instead of having a duplication.

EfEE Elections

The election for the General body and the Executive Body of the Elders for Elders Foundation was conducted on par with the process of the parliamentary elections in India from August 20 to 28, 2008. General body consists of two representatives from each Village Level Federations, ie 104 members from 52 villages. With regard to the Executive Body each project location will represent two persons elected by the members of the general body of the respective project location.

Candidates campaigned using all means; hired taxies, canvassing over phone,and meeting the voters at their houses. Before the elections, the Managing Trustee announced the dates of election. A code of conduct was prepared and circulated to the members of the village Level Federations. Election process was divided into

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two phases, election for the general body and Executive body. Both the elections had one week gap. Election officers were appointed for the election. Ballot papers were used where there was no unanimous decision by the members. In Vedaranyam, secret ballot was used to elect the representatives of Executive Body.

Interestingly, while parliamentarians are fighting for the 33 percent reservation for women in the general elections of India, all the members of the Foundation agreed to have 50 percent reservation for the women. Presently, in the general body majority of them are women. At the Executive Body, 50 percent are women.

Current Financial Strength of the Elders’ Movement

The 409 ESHGs together have made a total savings of more than 6 million rupees as of August 2008. Add to that, a seed capital of over rupees 11.5 million and a share capital of over 17 million. To prove that they are “bankable”, the ESHGs at various PA locations have been able to procure from different banks9, a total of close to 9 million rupees!

The 52 VLFs together have in their kitty a share capital of close to 10 million rupees. Under this umbrella arrangement a total of 751 elderly destitute are getting the support of ration items.

The above financial figures, which remained unimaginable through the post-tsunami days/months, today look staggering and, for the elders, who were simply languishing as non entities less

9 PA reports refer to suggestions in VLF meetings that we should seek the additional percentage offer to Senior Citizens for FDs in the case of ESHGs also.

than 4 years ago, the figures are simply mind-boggling and too big to be believed as real!

VECCs, as long as they functioned independently without much of limitations to autonomy, i.e. before VLFs got structured, did a good job. For one thing, the structure of VECC was quite representative of the village and thus VECC decisions carried sufficient weight with the community. Further, they were able to convince those getting excluded from list of ration benefits, at least for the time being. The impact of VECCs was positive on two fronts; first, the finalization of list of names for receiving ration items using the exclusion-inclusion principle (most of the time, however, exclusion was applied thus bringing the pressure on ration distribution down to manageable levels); second, accountability and transparency in ration distribution.

As the current study was being conducted, VECCs functioned as sub-committees under the broader canvas of VLFs wherein, they operated almost as ombudsmen emphasizing on the social responsibility dimension in the functioning of VLF/DLF that are by and large, financial structures.

When the ESHG movement was initiated in the aftermath of the tsunami catastrophe in 2005, not only the elderly themselves, but the HI-PMO staff or even their staunchest supporters would not have imagined that it would result in the current scenario of financial strength and self confidence on the part of CBOs.

All the ESHGs in the project areas put together, present the following picture:

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Total No. of. ESHGs : 409 (With an average membership of 1070 men • and / or women)

Total No. of members : (6519)•

Total amount of savings : Over Rs. 6.2 million •

Total amount of seed money : Over Rs.11.5 million•

Total amount of share capital : Over Rs.17 million•

All this has come about in just around three year’s time! This is no mean achievement. So much so, the bank officials in the project areas who were very cautious about the idea of

linking with ESHGs and were quite reluctant to entertain them as financial propositions, have of late pitched in with a support to the tune of 9 million rupees.

By day, the multi-purpose Centres work as a distribution point for essential rations to the destitute elderly

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IV. RIPPLE EFFECTS

more revenue to broaden the fund base. In fact, a handful of VLFs under the FGD in this study also spoke of the plans to start more ESHGs to widen the fund base.

For the beneficiaries under SaGP/AAGs, however, the change of guard does not seem to have had much of an impact. They continue to be basically “non thinking dependents” so much so many of them are not even aware as to how many like them in their own village are receiving ration items. The air of expectancy also continues more or less unabated. Further efforts are needed to organize them into a group to pool the problems and possible solutions.

Emerging Leadership

The most notable aspect of the post HI withdrawal situation is the emergence of grassroots level leaders who have presented a picture of commitment and confidence. Further many of these leaders – men or women – have come to be accepted and respected by the community, by and large, for what they

The study team could observe certain ripple effects of the HI effort related to the elderly, and especially the handing over of responsibility to the people. This may been seen on two fronts: the people’s representatives who have undertaken the responsibilities of carrying forward the good work of HI, and the beneficiaries of the programmes themselves. As for the leaders who took up the responsibilities, some of them have certainly become more and more dedicated as they get in to deeper issues that they had not visualized to begin with. By the same token, some of these leaders seem to have lost their initial enthusiasm after facing some challenging situations.

Likewise, among the beneficiaries also, there have come about two distinct kinds of people: those who are more contented than before (especially SaGPs/ AAGs) after having come to know the village groups have been distributing rations even after withdrawal by HI; at the other extreme there are beneficiaries who seem to grow more and more dependent and hope for more.

A highly positive effect after the withdrawal has been on two fronts: first, the move by VLFs to have volunteers compensated through remuneration by VLF itself; second, the move successfully carried out by a VLF in forming two new ESHGs in order to raise

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are doing. With passage of time, community members from other quarters like the youth for example, have also been caught up with the demands of the situation and have jumped in with their own contributions.

It may be assumed that the tsunami catastrophe perhaps somewhat strengthened the dependency attitude among the communities in general and the devastated families/ individuals in particular. From that perspective, HI’s efforts to make the affected communities self-reliant is even more laudable.

Lessons learnt from tsunami relief/rehabilitation experience

Given below are the highlights of lessons learnt as documented by the study team following the field survey in August 2008.

ESHGs are as functional as SHGs, and are zas effective.

Structures created to ensure fund flow both zways are essentially well in place. Fine tuning is needed: in book-keeping, dealing with defaulters, etc.

The structure beyond DLF needs zstrengthening through increased professionalism to improve fund raising ability.

Retainership contract (one PA Head felt they zcould have managed the amount without HI financing). Personnel under retainership did not, function any differently compared to earlier field staff (no fresh effort to promote sustainability initiatives).

Specific efforts needed to involve more zpeople like youth in social support systems.

We have a long way to go in achieving zelders’ care as a family / community/ social responsibility.

Incidentally, the two best performing zvillages in the study – one in Cuddalore and the other in Kollam – are led by two able and committed leaders.

Even elsewhere, as was confirmed by the zresearch team, rural Tamil Nadu has had women SHGs functioning creditably. There should be nothing wrong in promoting women towards higher echelons of leadership and have men, including the husbands, play supportive roles.

Known as having brought about the best zcoverage of the elderly under ESHG movement among the project areas, even Cuddalore is yet to cross 50 percent coverage. One strategy is to use the successful ESHGs/VLFs to leverage the constitution of more ESHGs in the neighborhood.

The dependent elders in the same village zneed to be organized as a group. Besides facilitating pooling of problems and solutions, this may lead to a better use of MPCCEs.

In a substantial number of FGD sittings zamong ESHG members, they expressed an inclination to welcome HI or any such agency pitching in with financial aid for the care of the dependent elderly like earlier times. Perhaps, very likely the social responsibility dimension in the ESHG-VLF-DLF-EfEF structure may be in danger of getting diluted especially as the VECCs became defunct.

Mutual help among elders has come to stay z

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as a movement. The ultimate answer seems to lie in working constantly through CBOs to strengthen traditional social support structures for elderly care.

Under representation as well as over zrepresentation of men in ESHGs, and in particular in the VLFs should be a cause for concern. This could represent underlying attitudes that could have an impact on the movement at large in the future.

For sure, the most notable after effect of HI withdrawal has been that people’s representatives have managed a rather smooth transfer in caring for the dependent elderly. What may be interesting to ascertain is whether they have done so based on the commitment that the community should care for their elderly or out of an underlying anxiety that they might be held responsible in future if they do not continue the support.

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One unsolicited opportunity in this context is that of youth power available in villages abundantly, especially the groups calling themselves ‘Narpani Mandrams’ (except in Cuddalore area, thanks to the programme of Palliative Care, the above statement can be generalized). An assumption that can safely be made is that, if the beneficiaries of SaGP/AAG could be organized as one group village-wise certain avenues may become open: like common kitchen that could provide an opportunity for any other destitute women of younger age to find remunerative work (in terms of food) while reducing the expenditure on food preparation.

Another possibility would be to organize the women involved in sale of fish for imparting training in the preparation of fish related food products. And for marketing of the products they could be linked with the youth groups.

At the same time it would be necessary to be prepared for the next of kin of the dead elders as they (the kin) discover the rather attractive amounts lying the account of he late ESHG member!

Standing up for Rights

The conviction and determination with which many VLFs have been forging ahead on the issue of old age pension (OAP) – with plans of meeting collectors en masse, rallies and satyagraha – is quite an asset in the situation.

The opposite of old age pension issue, otherwise, that came up openly in at least three FGD sittings with VLFs is that many potential applicants seem averse to going in for OAP.

Their fear is that if they accept OAP they may lose the ration cards and other facilities offered by the government. Unless this is sorted out, the VLFs cannot hope for lessening their burden of ration using OAP as an alternative.

Perhaps, the most emergent issue on hand in elderly care is that of OAP. The Government rule that disallows (on paper) the grant of OAP to a senior citizen who has a living earning son being readily followed by the authorities ignoring on the one hand, the ground realities and on the other hand the application of their own discretionary powers.

Concerted efforts must be initiated with respect to OAP to see that the official does not as a rule take a desk based decision without a visit to assess the ground realities of the applicants.

Further, it is more likely that OAP elderly are in a greater dependency and would need attention, especially with regard to health care. VLFs may have to be alert about this aspect and not simply ignore these pensioners once they start on OAP.

To strengthen the right based approach of elders, the organized elderly demand real and meaningful inclusion of them in the mainstream of the society. In this regard a Memorandum was prepared and to do advocacy and lobbying the EFE foundation organized the “Vridh Rath”- a journey in a special train which passed through Andhra Pradesh, Maharashtra, Madhya Pradesh and Uttar Pradesh, before reaching New Delhi. The journey boosted the mutual faith and cooperation among the members of the federation, strengthened the commitment of

V. LOOKING AHEAD

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the NGOs, sensitized the media and attracted attention of influence the policy makers. The journey can be seen as a step towards building a strong movement of aged persons to fulfill their physical and emotional needs, equal rights, decent livelihood, care and support and at last peaceful and dignified living.

The total number of elders who took the trip was 786, the eldest being 85 years old! The participants came from all the four project areas and the gender breakup was balanced.

Towards the close of 2008, the Elders’ for

Elders Foundation, after having championed the cause of elders with Indian parliamentarians riding a special train to Delhi, went on to provide for the first time, disaster relief to hundreds of severely affected elders as a result of cyclone Nisha in November 2008 which flooded several

villages in coastal Tamil Nadu destroying property and lives. This relief work was taken up using own EfE funds! Elders for Elders Foundation through Project Level Federation of Vedaranyam distributed 5 Kgs of rice to the needy families of the elderly of Siruthalaikadu and Sakkarampettai villages of Vedaranyam. Before distribution, the Project Level Federation conducted a need assessment with the members of the Village Level Federations. Though all 14 villages were affected, PLF preferred to render its service immediately. In both these villages hundreds were rendered homeless by incessant rains in the district, as cyclone Nisha that had crossed near Karaikal left behind a trail of destruction. Siruuthalaikadu and Sakkarampettai villages are remote villages of the Vedaranyam project area. Some 870 kgs of rice was distributed to 174 families including the destitute elderly.

Elders getting ready for the “Vridh Yatra” to New Delhi

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Highlights of the Memorandum

A National Commission for the Aged is set up to 1.

safeguard the interests, rights and entitlements

of Aged in India.

Older people are recognized as a specific 2.

vulnerable group under national human rights and

humanitarian law.

Equal access to gainful employment for Aged, 3.

able and willing to work, must be ensured. Banks

should come forward with at least short term micro

credit schemes for elderly, treating Elders Self

Help Group on par with others Self Help Groups.

Health policies should incorporate provisions for financially and physically accessible health care 4.

services to meet the needs of the Aged. Health insurance schemes for the elderly, a geriatric

ward and separate outpatient counters, queues and timings at hospitals must be provided for

their equal access to health care.

Abuse, violence and crime against older persons must be recognized at all levels and responded 5.

to. Each district must have a legal counseling centre for the elderly.

Procedures for old age pensions approval and disbursement must be simplified with enhanced 6.

administrative efficiency and eliminate corruption.

Aged are recognized among the most vulnerable and directly included in rescue, relief and 7.

recovery operations in all emergency circumstances / natural disasters.

Any implementation of government programmes should take note of the lack of access to 8.

services/benefits faced by older people. There should be special programmes for the Aged at

panchayat level.

Multipurpose identity cards must be provided to the elderly and concessions given to them in 9.

the state transport buses.

Government must commit extending ‘Right to Development’ to older people by giving specific 10.

focus to the elderly in any of the national policies and programmes designed to combat

poverty.

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The current role of EfEF is definitely larger than actually expected at the end of the tsunami project. In retrospect, it seems that the idea of federating the groups into their village and district level federations seems to have worked since the ethos is continuing. Perhaps in 3-5 years time, one would see that EfEF has Chapters – a southern Chapter (already in existence) plus others in geographical regions

The Story of Amsavalli Amma

Bhopal to Chennai after discharge from

hospital, and could not make it to Delhi.

She died 6 days later and has become

an inspiration to many, both young and

old, committed to the cause of the elderly.

like Central India, Eastern India (Bihar) etc. There needs to be a lot of input into this but the experiences gained will stand future efforts in good stead. Elders for Elders Foundation as a movement is, hopefully here to stay with the community ready to take on responsibility for the elders on a long term basis. All in all it does seem that the structures left behind are standing tall.

A doctor checks Amma’s condition

This is the story of an extremely

courageous 80-year old woman who was

so keen to be a part of the delegation to

Delhi that she was prepared to defy death!

Though she was refused permission to

travel by train on such a long journey due

to serious illness, she somehow slipped

in but had to be detrained at Bhopal and

hospitalized. Running high fever, BP and

with all the symptoms of renal failure,

she was asked why she had taken such

a risk? Her answer was that her death in

Delhi would create some media sensation

and perhaps help the cause of the elders!

Amsavalli Amma had to return from

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