Is Malaysia ready to meet needs of ageing population?
Malaysia’s transition to ageing nation status is just seven years away in 2030 when 15.3 percent of its population are expected to be aged 60 and above. Has the government already embarked on plans and strategies that will enable its senior citizens to lead a more active, healthy and productive life? This is the first of a two-part article on how prepared the nation is to face the challenges of dealing with an ageing population.
HULU SELANGOR - Aminah Harun had been waiting at the government clinic in Batang Kali here for nearly four hours and there was no indication of when her turn would finally come to see the doctor.
The 63-year-old mother-of-two has been suffering from diabetes for 10 years and was at the clinic for her follow-up check-up. She was there along with dozens of other elderly patients who were forced to wait in a tent erected outside the clinic as the air-conditioned waiting room inside was already packed with patients.
The rather small clinic, located in a shophouse on the main road, has been facing congestion since the closure of the other government health facility in Ulu Yam in February this year for renovation works. "I came early but still have to wait... I’m already feeling dizzy. Sometimes I lose my patience having to wait like this,” said Aminah, who lives in Taman Genting Permai here which is about six kilometres from the clinic.
Commenting on the accessibility to government healthcare facilities for senior citizens residing in the surrounding areas, she told Bernama there are elderly people with chronic ailments who have discontinued their treatments due to the long waiting hours.
"Even coming to this clinic here is a problem for us as we have to travel on a busy road full of speeding heavy vehicles. Even those elderly people with motorcycles dare not ride on this road. We can take a bus but have to wait for it for one to two hours. Luckily for me, my son sent me to the clinic,” she said, hoping that the government clinic in Ulu Yam would reopen soon.
"I’m feeling so tired and if the current situation prolongs, I’m afraid I may lose the motivation to see the doctor (for follow-up visits).” AGEING DISTRICT As a matter of fact, the issue of convenience in accessing healthcare services is not the only point of contention for senior citizens here. Issues pertaining to public transportation and other facilities also exist in Hulu Selangor, rendering it not exactly senior-friendly even though it is among the eight districts in this country categorised as ageing districts by the Department of Statistics Malaysia (DOSM).
According to the Current Population Estimates, Administrative Districts report released by DOSM on Aug 29, eight districts were categorised as ageing districts because more than seven percent of their populations are aged 65 and above this year. The other seven are Johor Bahru in Johor, Kota Bharu and Kuala Krai in Kelantan, Seberang Perai Utara and Barat Daya in Penang and Kota Kinabalu (Sabah) and Miri (Sarawak).
The report also stated that Lubok Antu, Sarawak has the highest elderly population (65 years and above) at 14.4 percent, followed by Sri Aman, Sarawak (12.8 percent) and Song, Sarawak (11.9 percent).
The United Nations has defined three categories of ageing: an ageing society, an aged society and a super-aged society, which refer to a population aged 65 years and above reaching seven percent, 14 percent and 20 percent respectively.
In Hulu Selangor district, for example, there are no special lanes for senior citizens in crowded public areas such as bus stations. Fixtures and fittings to aid elderly users are also lacking in public toilets. Not only that, disputes revolving around their accessibility and ability to obtain services appropriate to their needs still abound.
Former head of the Federal Village Development Committee (JKKP) at Kampung Gesir here Abd Razak Baki, 69, acknowledged Hulu Selangor is ill-prepared for its ageing population status.
He said Hulu Selangor has three state constituencies, namely Hulu Bernam, where Kg Gesir is located; Kuala Kubu Bharu; and Batang Kali but despite their sizeable elderly populations, they have few facilities that are senior-friendly.
"Here, if you don’t have your own car, it’s difficult for you to move around. This is because most of our children are working elsewhere,” he said, adding they also hoped to have their own dialysis centre as many senior citizens in Hulu Bernam are dialysis patients and have to go to Kuala Kubu Bharu or Tanjung Malim to receive treatment.
Located in the northern part of Selangor, Hulu Selangor shares a border with the districts of Sabak Bernam and Kuala Selangor in the west and Gombak in the south and has a population of 243,029, based on the 2020 Malaysian census data.
Hulu Selangor is categorised as densely populated as it has a population density of 139 people per square kilometre. In view of this, former head of JKKP Kampung Kalong Tengah in Batang Kali Bahari Baharom sees a need to establish activity centres for the elderly.
"In the Batang Kali constituency, there is no activity centre for senior citizens. We know how important it is to practice a healthy lifestyle because our doctors are always reminding us to exercise or take part in leisure activities.
"By having an activity centre where we can have health-related programmes and talks, we can expose the local community to healthy lifestyles. It will also prevent them from getting bored or depressed as they are alone at home and their children are out at work,” he said.
Retired teacher Mohd Noor Osman, 64, who resides in Batang Kali, meanwhile, said he goes to a private clinic for treatment when he falls ill as he "can’t wait for hours to see a doctor” at the government clinic in his area.
The father-of-four has kidney disease and goes to Hospital Selayang for treatment once every three months.
"How wonderful it would be if the government could build a hospital on par with Hospital Selayang here (Batang Kali). For us, Hospital Kuala Kubu Bharu is the nearest but it’s old and there are not many specialists there,” he said.
He also sees a need for the authorities to intensify efforts to reach out to the elderly to inform them of the benefits and schemes offered by the government to senior citizens and other needy groups.
"There are many such schemes but they don’t know how to access the benefits. If possible, officers, members of Parliament and state assemblymen must engage with the elderly population to inform them of the benefits,” he said.
Meanwhile, head of the Laboratory of Social Gerontology at the Malaysian Research Institute on Ageing (MyAgeing) at Universiti Putra Malaysia Dr Mohammad Mujaheed Hassan said Malaysia has yet to be ready to enter the ageing nation phase.
Malaysia, he added, is still lagging behind in terms of infrastructure facilities to cater to the needs of people in various age groups including senior citizens.
"In order to be ready for this (ageing nation) phase, various measures have to be put in place with the main focus being the well-being of the elderly population. "These measures include increasing investments in the development of healthcare infrastructure for the elderly. This will involve constructing hospitals, clinics and aged care facilities that are equipped to provide specialised care for older adults. The infrastructure must not only be concentrated in urban areas but also extended to rural areas to ensure equitable access to healthcare services,” he said.
The investments must also take into consideration making improvements to existing healthcare facilities, including providing ramps for wheelchairs and other geriatric patient-friendly amenities.
It has been reported that Malaysia’s ageing population is growing at a faster rate compared to 30 years ago and DOSM expects Malaysia to attain ageing nation status earlier than predicted. (Earlier, DOSM had said that Malaysia is expected to be an ageing nation by 2030 when 15.3 percent of the population are aged 60 years and above.) Chief Statistician Datuk Seri Dr Mohd Uzir Mahidin was quoted as saying that based on the nation’s crude birth rate and crude death rate, there was an average of 14.4 live births and 5.1 deaths per 1,000 population in 2020, with a ratio of 2.8 births for every death.
Ten years ago, there was an average of 17.2 live births and 4.6 deaths per 1,000 population, with a ratio of 3.7 births for each death, he said.
"The decline in the ratio is having an impact on the structure of Malaysia’s population. It’s causing Malaysia to transition to ageing nation status earlier than previously projected,” he said. - BERNAMA