Older People's Treatment In Bolivia: A Cultural Perspective

Bolivia is one of the poorest countries in Latin America, and more than 63% of its elderly population lives in poverty. Elderly poverty in Bolivia involves issues such as food insecurity, limited livelihood options, abandonment by family members migrating to urban areas, and discriminatory policies. However, Bolivia ranks higher than many Eastern European countries in terms of the well-being of its senior citizens, largely due to its universal pension scheme, Renta Dignidad, introduced in 2008. This non-contributory old-age pension has helped close coverage gaps and achieve universal coverage, and it has contributed to a reduction in poverty, increased household income, and improved education access for children.

Senior citizens in Bolivia benefit from a guaranteed pension

Bolivia is one of the poorest countries in Latin America, with about 37% of its population living in poverty in 2019. The country's elderly population is growing rapidly, and over 63% of them live in poverty. In 2002, 53% of those aged 65 and over faced a high incidence of poverty. In response, the Bolivian government introduced the Renta Dignidad, or Dignity Pension programme (RDP), in 2008.

RDP is a universal benefit for all residents aged 60 and above, providing a minimum level of universal income security to all Bolivians. It is administered by the Authority for the Monitoring and Control of Pensions, which manages payments through 1,100 payment centres across the country. The programme is financed by taxes on hydrocarbon production and profits from capitalized enterprises, forming a part of the newly established Dignity Pension Fund.

The monthly payments under the RDP are USD 28 for all resident citizens aged 60 and older. For those already receiving contributory or solidarity pensions, the RDP provides a payment of USD 21. This expansion ensures greater assistance to those in need while maintaining everyone's right to a universal pension. The RDP also includes financial assistance for funerals, incentivizing families to report the death of recipients.

The RDP has successfully reached almost 100% of its target beneficiaries, with 97% of eligible residents receiving the benefit in 2010. It has contributed to a 14% reduction in poverty across eligible households and increased household income and consumption rates. Child labour is significantly less prevalent in households receiving these pension benefits, with school enrolment rates being 8% higher than in households without the RDP.

The introduction of the RDP has allowed Bolivia to close coverage gaps and achieve universal coverage, ensuring that the oldest and most vulnerable population is taken care of. It has also helped formalize the rural economy, as the registration campaign has allowed people in rural areas to obtain personal identification documents, which are crucial for receiving benefits.

Elderly poverty in Bolivia

Bolivia is one of the poorest countries in Latin America and has a high poverty rate, with about 37% of the population living in poverty in 2019. Elderly poverty is an even more pressing issue, with more than 63% of elderly people in Bolivia living in poverty. The elderly population in Bolivia is also growing rapidly. Elderly poverty in Bolivia involves challenging circumstances such as food insecurity, limited livelihood options, abandonment by family members who move to urban areas, and discriminatory policies.

The emigration of younger generations has significant consequences for older people in Bolivia. Research has been conducted to understand how the parents of migrants cope with the absence of their children and the impact of migration on the older population in terms of gender, ethnicity, and class. International migration by younger people can affect the economic and social well-being of those left behind.

Despite the high levels of poverty, Bolivia ranks above many Eastern European countries in terms of the well-being of senior citizens. The Bolivian government has taken direct action to address poverty and income inequality, implementing the National Economic and Social Development Plan 2016-2020. Economic growth has played a crucial role in poverty reduction, with Bolivia's GDP growing by 80% from 2000 to 2014. Wage increases have also contributed to poverty reduction, with the real minimum wage increasing by 122% from 2000 to 2015.

To tackle elderly poverty specifically, Latin American countries, including Bolivia, have introduced and raised pension schemes. Bolivia implemented the non-contributory old-age universal pension Renta Dignidad in 2008. This pension scheme has been highly successful, reducing poverty by 14% across eligible households and increasing household income and consumption rates. Renta Dignidad has also contributed to reducing child labor and increasing school enrollment rates. Additionally, the program has helped formalize the rural economy and reduce elderly poverty in rural areas, where poverty is more extreme and a higher proportion of older people are undocumented.

Impact of migration on the older generation

Bolivia is a country of emigration, with a large number of its citizens living abroad. The neighbouring countries of Argentina, Brazil, and Peru have been the most common destinations for Bolivian migrants, but many can also be found in the USA, Spain, and Italy. The main reasons for migration are the search for better economic opportunities and access to education and healthcare.

The impact of migration on those who remain in Bolivia is significant, particularly for the older generation. The 'left behind' experience economic and social consequences, which vary depending on gender, ethnicity, and class. The absence of younger family members can result in food insecurity, limited livelihood options, and abandonment, as seen in the growing number of elderly people living in poverty in Bolivia.

The Bolivian government has implemented policies to address elderly poverty, such as the introduction of the universal pension, Renta Dignidad, in 2008. This non-contributory pension has successfully reduced poverty rates, increased household income, and improved consumption rates among eligible households. Renta Dignidad is financed by taxes on oil and gas production and state-owned company dividends, costing about 1% of Bolivia's GDP.

The COVID-19 pandemic has further highlighted the vulnerable situation of migrant communities in Bolivia, who often face significant barriers in accessing essential healthcare and social protection services. The pandemic is expected to have profound social and economic consequences, with large segments of the population at risk of slipping into poverty and food insecurity.

The internal migration patterns within Bolivia are also notable, with a significant rural-to-urban migration flow. This has resulted in the depopulation of rural areas, particularly with the migration of working-age men and young people, leaving women and the elderly behind to assume larger workloads in agricultural activities.

Discrimination against older people

Bolivia is one of the poorest countries in Latin America, and elderly poverty is a pressing issue. More than 63% of older people in Bolivia live in poverty, facing circumstances such as food insecurity, limited livelihood options, and abandonment by family members who migrate to urban areas. This poverty is further exacerbated by discriminatory policies and a lack of social protection programs, contributing to their marginalization.

Migration is another factor that impacts the elderly who are left behind by their emigrating children. Research projects, such as the one led by Dr. Tanja Bastia, aim to understand the consequences of migration on older individuals in terms of gender, ethnicity, and class. The absence of adult children can affect the well-being of older people, leaving them without traditional sources of support and care.

Cultural norms and stereotypes about ageing also contribute to age-based discrimination. Older people may be viewed as a burden or less capable, leading to their exclusion and limited opportunities. Additionally, Bolivia's history of patriarchy and the objectification of women have particularly affected older women, who face multiple layers of discrimination due to their age and gender.

To address these issues, Bolivia has implemented initiatives such as the universal pension scheme, Renta Dignidad, which has helped reduce poverty and increase household income for eligible older adults. Additionally, campaigns like the "Children for Equality" initiative seek to challenge gender stereotypes and promote equality for all, including older individuals.

While progress has been made, ongoing efforts are needed to tackle age-based discrimination in Bolivia effectively. This includes continuing to address poverty, promoting social inclusion, and challenging cultural norms that devalue older individuals. By recognizing the rights and contributions of older people, Bolivia can create a more inclusive and equitable society for all its citizens.

Healthcare for older people

The SUS is not a form of insurance but a medical services program. It is funded in part by international organisations such as the World Bank. The system aims to improve access to specialised medical services in distant communities, using new technology, including mobile phones and teleclinics.

The Pan American Health Organization (PAHO) has also developed a "Regional Strategy for Chronic Disease Prevention and Control", which includes directives for robust information technology for data collection and analysis, and calls for health system adaptations for differences in culture, health behaviours, languages, and delivery models. This strategy specifically addresses the management and integration of non-communicable diseases (NCDs) into primary care.

Bolivia has also established the Universal Maternal and Child Health Insurance plan (SUMI) and Health Insurance for Older People (SSPAM), which are designed to address disparities in maternal, child, and elderly care.

Despite these improvements, issues remain. For example, only a small fraction of the population has access to comprehensive health and social services, and safety net programs are exceedingly rare. Furthermore, over 80% of Bolivians are part of the informal economy, meaning no benefits, insurance, or contributions to social security or pensions. As a result, the majority of Bolivians must pay out of pocket for healthcare or go without.

In addition, Bolivia's health indicators are among the lowest in the Western Hemisphere, with high rates of malnutrition and child mortality. The country also struggles with proper sanitation and medical services in rural areas, leaving many vulnerable to diseases such as malaria and Chagas disease.

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