In Gambia, a youthful country grapples with how to care for its elders

Beneath a cashew tree on a busy road in the Gambian capital, Aziz Newlands is people-watching. 

Today, like most mornings, the 70-year-old has laid out a thin plastic tarp here and settled in, greeting familiar passersby and waving to strangers, hoping to spark a conversation. If no one stops to chat, he fills the silence with news shows on his small battery-powered radio. 

The days are long and languid. But life wasn’t always like this. For most of his adult life, Mr. Newlands spent his days working as a construction worker and wood carver. His evenings were punctuated by boisterous family dinners with his wife and eight children. 

But now he is a widower, and his children have moved away to start their own families. He lives with a nephew, but during the day the house is empty. So one day he began coming out to this street corner, looking for human connection. 

“I’m very lonely,” he says.

Mr. Newlands isn’t the only one. Africa is the world’s youngest continent, with an average age of 19, and 70% of the population under 30. But like everywhere in the world, people here are also living longer. By 2050, the number of older Africans – defined as anyone over 65 – will triple. This is a significant demographic shift that will outpace other regions. 

Although older people are revered in many African societies, advocates say their tangible needs – from accessibility in public spaces to healthcare to community support – are often little considered by their governments. 

It is “a bit of a challenge to find a space in policy discussions for people to realize that it’s not just about the youth,” says Sola Mahoney, acting director of the Ageing with a Smile Initiative, an NGO advocating for the rights of Gambia’s 56,000 people over 65. But it is essential, he says, in part because the country’s young people will one day be old, and they “will be the beneficiary or the victim of whatever policies are in place.”

Unprepared

The crowded streets of Banjul illustrate the profound challenges of caring for Africa’s aging population. Drivers honk in disapproval at seemingly never-ending traffic, police officers forcefully blow their whistles at pedestrians who cross the road too slowly, and minibus operators hurry people in and out of their vehicles, shouting their destinations above the din of traffic. 

There are no sidewalks or railings anywhere in sight, no stop lights that help people cross the street, and no ramps leading into shops. According to Mr. Mahoney, there is also little patience for people who can’t keep up with the brisk pace of street life. 

For him, the city’s infrastructure – or lack thereof – is the most visible evidence of its lack of investment in older people.

But there are other indicators as well. Take healthcare. Like nearly all African countries, Gambia doesn’t have a national system of long-term care facilities for older people. And its medical schools don’t offer specific training in geriatric medicine. In fact, only a handful of African countries do, including South Africa, Senegal, Tunisia, and Egypt. 

“People [in Africa] are living longer because there’s less child mortality and less maternal mortality,” says Jane Buchanan, senior advocacy advisor at HelpAge, a global advocacy group for older people. Medical advances like vaccines have also helped the continent’s citizens live longer, she says. “But health systems have not prepared for the demographic change.”

A new protocol 

That is part of the reason why advocates across the continent are pushing their lawmakers to ratify the African Union’s Protocol on the Rights of Older Persons. The document is a legally binding agreement that a country will protect older people from discrimination and ensure they have access to jobs, healthcare, and social support. Once the protocol is ratified by a member country, citizens can use the AU’s legal system to sue their government.

In Gambia, the National Assembly ratified the protocol June 25. Mr. Mahoney says that is crucial to moving the needle on the treatment of aging people in the country. 

For advocates for older people, “change[s] the nature of the conversation with policymakers,” he says. 

What’s more, Gambia is the 14th country to ratify the protocol. That is significant because once 15 countries have signed on, the protocol becomes a binding treaty – meaning it applies to every AU country, even if they haven’t signed it themselves. 

For Mr. Mahoney, the stakes of this fight are partly personal. In the late 2000s, his 90-year-old father suffered a fall that eventually led to a hip replacement. 

“That experience awakened in me a certain awareness to older persons’ issues,” he says. Not long after, he began volunteering with organizations working with older people. Now he is the interim leader of Ageing with a Smile, which pushes to make public spaces and healthcare more accessible to older people, and provide them with social support to fight loneliness and depression. 

For now, though, many older Gambians must still find ways to care for themselves. As a call to prayer fills the air, Mr. Newlands rises from his spot under the cashew tree and walks toward a nearby mosque. He does this five times a day, an undertaking that is part religious obligation, part social outlet. On his way back, if he still feels lonely, he takes a long walk before returning to his favorite corner. 

Today, returning from the mosque, Mr. Newlands looks over at a group of girls playing with a ball just down the street. Watching their loose-limbed game, he thinks of his younger brother who suffered a paralyzing injury a few years ago

 “Praise be to God,” he says in Arabic. “I have my health, that is a blessing.”