Address by the Minister of Health M Tshabalala-Msimang at the International Day for Older Persons, Ugu District, KwaZulu-Natal

As a mother and a grandmother, I am proud to share this day with all the special older persons in KwaZulu-Natal. You are all special because in spite of the many hardships you suffer and the great family burden you carry, you still show us wisdom and strength in being the pillars of our often troubled communities. The Department of Health has an obligation to keep you healthy and ensure that you receive all forms of support.

The theme for this year's International Day for Older Persons is 'Addressing the Challenges and Opportunities of Ageing: Empowering Older Persons.' As a country, South Africa is committed to strive towards empowering older persons so that they can face their many challenges with greater ease and success. This year's event is evidence of our firm commitment as the Office of the Premier, the Department of Social Development and the Department of Health to work together to strive jointly toward empowering you.

Our country is committed to implementing the International Strategy on Ageing as it recognised that you, as older persons are custodians of our traditions, our heritage and our past as well as mirrors of our future. The International Strategy on Ageing has three priorities:

* older persons and development
* advancing health and well-being into old age
* creating a supportive and an enabling environment.

The Department of Health, together with other government departments, recognises the need to implement strategies that are in line with these three priorities and that will address the challenges of ageing while empowering the older person. South Africa has been selected by the World Health Organisation (WHO) to participate in a ground-breaking household Study on Global Ageing and Adult Health (Sage), the first of its kind to be conducted in this country. South Africa is one of six countries that are taking part in this survey. The study will provide governments in developing countries with comparable data most-needed for effective health-policy planning.

It is estimated that by the year 2025, the global population of people over 50 will have exceeded the numbers of persons younger than 15 years. Today, about two thirds of all older people are living in the developing world, by 2025, it will be 75%. This demographic change has several implications for public health and when these conditions do occur in older people, primary health services must provide accessible, integrated and regular care.

The goals of Sage are to promote a better understanding of the effects of ageing on well-being, to examine the health status of individuals aged 50+ years and changes, trends and patterns that occur over time, and to improve the capacity of researchers to analyse the effects of social, economic, healthcare and policy changes on current and future health.

The National Health Act (No 61 of 2003), policies, strategies and structures will ensure that the Department of Health meets the health needs of our older persons. We are aware that older persons experience specific health problems and that their specific needs are related to the fact that many persons are poor and have difficulty accessing services. Health workers receive and are trained on the use of guidelines for conditions affecting older persons that have been developed and implemented in healthcare facilities. Some examples that are applicable to older persons are the management of hypertension, diabetes, overweight and obesity, stroke, osteoporosis, arthritis and prevention of chronic diseases of lifestyle. We also provide screening for different conditions such as refractive errors of the eyes and different cancers. In addition we are also focus on foot health, active ageing and prevention of falls.

Any older person that meets the criteria outlined in the policy document will also qualify and therefore not pay for any health services at hospital level including, when you are being treated at hospital, when you need specialised care and if you require assistive devices. Many persons, especially those who are 60 years and older become needlessly blind as a result of cataract. The Vision 2020 Prevention of Blindness Programme in line with the World Health Organisation Vision 2020 Programme, identified cataract surgery as one of the most cost-effective interventions to reduce avoidable blindness.

A Public Private Partnership exists between the Department of Health and the Bureau for the Prevention of Blindness, which renders cataract surgery in rural areas in the country on behalf of the department. The total cataract operations performed since 1997, when the programme started, is more than 260 000. Some of the other programmes available for older persons are dental care, cancer prevention and screening and food supplement for chronically ill patients who are malnourished. The process of establishing support groups for older persons with chronic conditions in the communities is in place.

While it once seemed that health problems are inevitable in older age, the department firmly believes that many diseases can, in fact, be controlled or, even prevented. Thus, although we strive to empower our clinics and community health centres to promote health and prevent or manage diseases of older persons, we also emphasise the enormous need for older persons to adopt healthy lifestyles.

Some ways in which our older people can reap health benefits are to improve their diet and nutrition, maintain an appropriate weight, stop smoking, use alcohol and medicine wisely and do regular physical activity and exercise. The promotion of healthy lifestyles is one of the key priorities of the department for the next five years. The benefits of the healthy lifestyle programme are also intended to show value on the quality of lives of older persons. Therefore, the promotion of active ageing is important for older persons.

The adoption of healthy lifestyles and actively participating in one's own care are important. Thus, there is no better way to celebrate today by promoting active ageing, which will advance health and well-being into old age. One of the myths of ageing is that it is too late to adopt such lifestyles in the later years. On the contrary, engaging in appropriate activity, healthy eating, not smoking and using alcohol and medication wisely in older age can prevent diseases and improve your quality of life.

The department however acknowledges that while older persons may want to engage in healthier lifestyles, they experience many challenges. Perhaps at present are the many difficulties you face as a result of the impact of families being infected and affected by HIV and AIDS. You need to be supported, given information and capacity during the time of great burden while you take care of sick children, experience grief at the time of their death and take care of grandchildren who are orphaned in the process.

Additionally, the healthy lifestyles of many older persons continue to be compromised by the ongoing unacceptable physical, psychological and sexual abuse they experience. The Department of Health is represented on the Human Rights Commission and is thus closely involved in the monitoring of the abuse of the elderly. The government and community at large have a moral obligation to jointly protect the rights of older persons. When healthcare is needed older persons have equal access to free primary healthcare packages of services at clinics, home based care as well as palliative care.

Government strives to have the necessary policies and structures in place to create an appropriate environment for our older persons, which will enable us to reach the goals identified in the United Nations Principles for Older Persons. These principles are independence, participation, care, self-fulfilment and dignity. We undertake to help you access all health services that government is making available to you. Our institutions should be 'age friendly.' For instance, we should ensure that we maintain sufficient stock of medicine for chronic illnesses affecting older persons. There is no reason for our older persons to come to a health facility more than once to collect their medicine when the clinics are out of stock.

We strive to have quality health services available that is affordable for the country. Our provinces are working hard to deliver cost effective health services, including special needs of our older persons. The department has systems in place to measure the provinces' performance of their Health Programme for Older Persons. The Eastern Cape province was the best performing province during 2006/07 and will receive the floating trophy. Congratulations on this achievement!

A final word to all our older persons:

* we are here to celebrate and acknowledge your contribution and effort towards a better South Africa for all of us
* we thank you for being the source of knowledge and values, also for a rich heritage of survival skills you bring to us
* we thank you for your unselfish giving of yourself to the country
* we recognise your contribution that you are making to the sustenance of families and communities, especially in the face of the HIV and AIDS pandemic.

Your adult children return home to seek care when AIDS has ravaged them to a point of helplessness. We thank you for caring for your grandchildren and others less fortunate than yourselves. Let all South Africans assist our older persons to be safe and live free of abuse and violence; and oppose discrimination against older persons in all areas of life.

To all older persons in South Africa, we salute you!

Issued by: Department of Health
1 October 2007