Caring for the most vulnerable in pandemic times

Galina Zakradze turned 102 this year. Each of her birthdays is a true celebration for the staff and residents of the municipal home for elderly people in the small town of Samtredia in western Georgia. But in 2020, as the COVID-19 pandemic swept Georgia, it assumed particular significance. Zakradze, like most of her fellow residents in the home, fell ill with COVID-19 and had to be hospitalized. Happily, she survived and has returned to brighten the Samtredia facility with her tenacious good humour.

The Samtredia municipal care home is located in a disused customs house far from the centre of town. In such modest surroundings, providing proper care was already difficult in normal times. In the words of Father Shio, who is tasked by the municipality to run the home, the challenge is not simply to provide food and shelter but to ensure that homeless older people enjoy safety, comfort and, above all, dignity.

With the onset of the COVID-19 pandemic, which poses the highest health risks to elderly people, this challenge became almost overwhelming. By December 2020 all 19 residents had become infected with COVID-19, 15 had had to be hospitalized and five had died. Many of the home’s care-givers also fell sick. But the Samtredia facility has continued to function and provide a high level of care for its residents.

In repurposing programme resources to support the response to COVID-19 in Georgia, it was risks like these that mobilized UNDP to focus on elderly persons.

Photos: Vladimir Valishvili/UNDP

According to data from the Social Service Agency, Georgia’s population includes 772,300 people registered as pensioners. Of this total, more than 41,000 pensioners live alone in extreme poverty — and 85 percent of this number are women.

For this population, the need for professional care is vast, but NGOs estimate that they can cover only around 15 percent of demand. Tbilisi is the only city in Georgia where home care is partly covered by municipal service providers, but even there, only 1,200 out of 20,000 people are eligible for support.

“Georgian society shows immense respect for its elderly members, who customarily live in multi-generational households with children and grandchildren. But older persons who lack support from relatives often find themselves penniless and alone. In pandemic conditions, this can translate into mortal danger, so this is one area where UNDP has focused its support,” said UNDP Head Louisa Vinton.

Photo: Leli Blagonravova/UNDP

A first point of action for UNDP were municipal shelters for the elderly and homeless.

In Rustavi, Samtredia and Tbilisi, such shelters house some 200 people. Here UNDP made multiple deliveries of protective gear, sanitary supplies and medical equipment to help prevent infection, and also provided kitchen and household appliances and furniture to improve living conditions more generally.

Supplies provided to the Rustavi shelter included both life-saving equipment like oxygen generators and tools oriented to give the 45 residents a source of outdoor activity and a sense of purpose, such as a cultivator that will be used to tend the facility’s garden and vineyard. Age is no barrier here: among those keen to benefit is Margarita Gandzeli, an 84-year-old who has lived at the facility since 2018.

Photo source: Georgian Red Cross Society

A second focus for UNDP action was the large number of elderly persons living independently but alone.

Not only did the pandemic create extreme new health risks for this group; it also cut them off from many sources of outside support, as restrictions on travel and social contacts exacerbated isolation.

Here UNDP joined forces with the Georgia Red Cross Society to provide more than 5,000 vulnerable persons with home care services, information and counselling through a network of more than 600 caregivers and volunteers. As part of a broader pandemic-driven shift from in-person to digital services, UNDP helped to establish an online learning platform and mobile application for home-care providers. This will help home-care staff and volunteers manage their workload during the crisis and beyond.

One such volunteer is Romeo Malazonia, who is looking after Meri Zakaria, an 82-year-old resident of Zugdidi in western Georgia. Malazonia pays Zakaria regular visits, bringing her food and medicines, keeping her company and helping with everyday tasks. Zakaria also receives professional counselling, which helps her to cope better with the psychological effects of isolation and immobility.

A third focus area for UNDP were elderly people living in “collective centres” for internally displaced persons (IDPs).

Of Georgia’s 286,000 registered IDPs, some 40,000 still live in 411 of these facilities — mainly Soviet-era hotels and factories with crumbling infrastructure and substandard sanitation. Many residents are elderly people who have lived in the centres since the armed conflicts of the early 1990s.

One such centre is located in a gutted sanatorium in the village of Surami in Shida Kartli region. Gulnazi Abashidze, 85, has lived here in since fleeing Abkhazia in 1993. She finds it hard to imagine how COVID-19 could make her situation worse since she already has trouble keeping warm and buying food.

“I have no living relatives and my only income is a state pension of about USD 80 per month,” says Abashidze.

Working with its partner NGO, the Charity Humanitarian Center Abkhazeti, UNDP has focused its support on the 100 collective centres where conditions are worst and the need for help is greatest. Sanitary supplies and food packages have been distributed while UNDP seeks opportunities to organize longer-term solutions for the most vulnerable IDPs. In addition, UNDP has helped to organize home care services for elderly IDPs and referred those in particular need to state and non-state service providers.

UNDP was able to provide this diversified response to the COVID-19 pandemic thanks to the flexibility and agility of its partners and donors. Funding for initiatives to support at-risk elderly persons came from UNDP resources, projects supported by Denmark and the UK, and UN rapid response funds.

“The challenges posed by the pandemic are not new ones. But COVID-19 has brought them into sharper focus and shown us why finding solutions is so urgent. That is why all of UNDP’s efforts are aimed not only at addressing immediate humanitarian needs but looking beyond the pandemic to find longer-term solutions to ensure that the elderly can lead full and dignified lives,” said UNDP’s Vinton.