On the surface Chiang Mai appears to be a wonderful place to retire. But as Sawang Kaewkantha, Executive Director of the Foundation for Older Person Development pointed out, there is another side to the coin. Beneath the sabai life, the tropical weather, and all the pleasantries that make Chiang Mai attractive to retirees are a number of issues that make the city a challenging place to live out the autumn of life.
Among these issues include environmental factors, sidewalks littered with obstructions, a virtually nonexistent number of public restrooms and a challenging healthcare system.
Recognising that Chiang Mai can be a less than perfect place to live for elderly people, especially elderly expatriates, the Ministry of Social Development and Social Securities recently held their first of a series of three seminars aimed at addressing the root of the problems and coming up with viable solutions to assist the elderly expatriate community. The first seminar, which was held at the Empress hotel, is hopefully the first step in a mission to make Chiang Mai a more comfortable place for elderly expatriates to live.
The other two seminars will take place in the coming weeks. One will look at how businesses and the healthcare system can change to accommodate the large elderly and disadvantaged community while the other will focus primarily on what the Thai government can do to help the aging community.
The first meeting brought together many different sectors and nationalities, including a large group of Japanese nationals, representatives from various consulates, multiple persons from elderly-focused care facilities and the aforementioned Sawang who spoke about the need to empower our elderly and promote their basic rights. Members of the Thai government were also in attendance, including the head of the Minister of Social Development and Human Security, Mayuree Yoktree.
Allowing people from many different backgrounds to air their opinions was one of the main goals of the seminar. As Mayuree explained, “the more we work together the better, the more we can change.”
While the seminars primarily function as a forum for the elderly expat community to voice concerns and get access to information, all issues discussed and solutions derived from the meeting will be adapted to alleviate problems faced by elderly Thailand nationals as well.
The first problem discussed was that of the annually atrocious air quality. Much talk was focused on the “burning” months when breathing-related issues are most rampant, forcing some of the seminar’s participants to seek hospital treatment, or if able, to simply leave the city altogether. Running the risk of sounding like a broken record, many of the event organisers agreed that keeping pressure on government officials would likely be the only way to get the issue addressed.
This issue does not just hurt the elderly community, but all of Chiang Mai’s residents and visitors.
While the city has many attractive and interesting sites to see, getting to them can be problematic, especially for elderly persons and people in wheelchairs. Uneven and often riddled with hidden steps and other impediments, the sidewalks around the city are difficult for anyone to navigate no matter your age, let alone those with disabilities or infirmities.
Understanding that it is a large job to fix all the city’s pavements, the one thing that the seminar participants asked authorities to address first was the number of safe zebra crossings. Crossing the street is a dangerous affair even if doing it at a designated zebra crossing.
According to a 2012 report on crime and safety in Chiang Mai, pedestrians should “not expect drivers to grant them the right of way, even in marked crosswalks.” This is quite startling advice as it acknowledges the fact that many motorists ignore simple traffic laws such as stopping at crossings and red lights. While vehicles may not always stop, adding in more zebra crossings would hopefully add a more visual reminder to motorists and eventually change the habits of bad drivers, especially in highly visited areas like the old city and along the moat.
Where’s the Loo?
Another issue which was brought up was the dearth of public toilets, let alone any which cater to the elderly or handicapped. The lack of public facilities means that many have taken to planning their routes around toilets available at coffee shops or department stores just in case of a sudden bathroom emergency. While a few public parks and buildings do have public restrooms many have yet to modernise and still have only squat toilets, making the already few restrooms completely unusable for most elderly persons.
Adding in more elderly-friendly restrooms would be a simple fix. Encouraging temples, tourist attractions and other venues to switch out at least a few of the squat toilets for the Western style ones would not only help elderly persons but the younger populations as well. According to a report published by the Department of Health in 2013, squat toilets can lead to arthritis. In fact, the report claims that up to six million elderly Thais suffer from arthritis as a result. This led to the deputy ministry making a promise to replace all public squat toilets in Thailand by 2016. However, considering there are virtually no public toilets in Chiang Mai, this isn’t going to help much.
Chiang Mai is marketed as one of the top destinations for medical tourism, thanks to the large number of hospitals, both public and private. While this may sound like a good thing for the elderly population, in truth, because expats are unable to enter the government’s healthcare programme and must therefore visit only private medical institutes, the cost can be quite steep for even the most basic check-up, let alone any medical emergencies of a more serious nature.
A language barrier can be difficult no matter the situation, but when it comes to your health it can be overwhelmingly stressful.
The more we work together the better, the more we can change.
The lack of English speaking healthcare personnel and signs has caused many difficulties for the many attendees. Improving language skills of doctors and nurses along with adding more directional signs in English would allow expats more of a choice between public and private facilities. Similarly, distributing more information about an English speaking emergency health line would help the elderly expat community feel safer knowing there was a number to call in case of a fall or serious illness.
The tourist police is supposed to be the best number to call in an emergency but many attendees voiced their skepticism of this organisation. One of the organisers of the event and government employee suggested everyone call the number 1133 (the number for directory enquiries) as the most likely to be of help in emergencies. None of the expats had ever tried to use this number so Mayuree decided to find out herself whether the line would be of use. After a brief discussion on the phone in English she concluded that yes, using 1133 would connect you with an English speaking person who could help with many different issues, including questions on health and emergency.
Having proper healthcare is one of the biggest problems the elderly community faces. Because many of them have been living abroad for many years they no longer can receive insurance from their home country, leaving them in a costly limbo.
Expat retirees are also forbidden from holding jobs or even volunteering, and if you get caught you may face jail time or be deported. Some groups, like Lanna Care Net, have found ingenious ways to bypass this ruling. Rather than using the word volunteer, they call it “friends helping friends.”
While many, including members of the Thai government, have called the elderly expat community a “brain bank,” because of archaic and irrelevant laws, they cannot share that wealth of knowledge and contribute to the community. Not only are we losing out on such talent, knowledge and energy, but the elderly themselves would benefit from staying active and involved. Hopefully, with the help of these seminars and later discussions with the government, changes will be made.
Many elderly experience bouts of depression and loneliness in their later years. This is especially common for people who do not have some form of activity to fill their days. A study conducted by the University of California San Francisco concluded that the elderly demographic has the highest number of people who suffer from loneliness. The same study showed that lonely seniors are more likely to see their health decline faster which ultimately leads to earlier death. Having someone to talk to and do things with is an even bigger challenge when living far away from family members.
It’s a no-brainer, social interaction and a feeling of contribution is beneficial to one’s health. Whether this is working, or volunteering, people need something to do, but too many restrictions on retirees leave many of them sitting at home alone. Creating more volunteer opportunities and allowing expats to actually partake in those opportunities would not only help the elderly community be happier and healthier but would also help spread the knowledge that they possess: a true win-win for both the elderly community and the younger population.
Increasing the awareness of what the elderly population needs will only help the city in the long run. Chiang Mai markets themselves as a prime location for elderly expats, but if changes are not made they may soon lose their spot as a retiree haven.
The goal of the three seminars is to discuss the issues that plague the local and expat elderly populations in the hopes of informing the business and government sectors. Hopefully, these discussions will eventually lead to real, positive changes for not only the elderly but for the entire city.
The next Elderly Expat Seminar for Northern Thailand will be held July 3rd at the Empress Hotel.
For questions, please contact seminar organiser Jack at firstname.lastname@example.org or consult the Foundation for Older Person Development website at: http://fopdev.or.th/en/.