Zambia's elderly population are faced with a double jeopardy: they are either shunned by communities as witchcraft practitioners or, with little or no understanding of the disease, are burdened with caring for HIV/AIDS orphans, says a non-governmental organisation concerned with their wellbeing.

"Our elderly people are facing a very big problem in Zambia; it is either they are abandoned by the community and their relatives on allegations of practising witchcraft, or they are forced to look after their grandchildren, whose parents die of AIDS without leaving anything for these old people, who become [surrogate] parents," Rosemary Sichimba, president of the Senior Citizens Association of Zambia, told IRIN.

About one in five Zambians, or 1.6 million of the 10 million population, are infected with HIV/AIDS, many in the productive age group of 18 to 45. According to the government's Central Statistical Office, about 500,000 people are aged 65 years or older, but independent analysts claim this is a conservative estimate, as it is difficult to ascertain the actual number of elderly people living in rural areas.

"We might have up to 800,000 old people in Zambia, but we are afraid such a number may soon be reduced by HIV/AIDS because the elderly are not taught any specialised skills or given protective clothes to help prevent them from contracting HIV as caregivers and traditional birth attendants," said Sichimba, whose organisation fights for the upliftment of the elderly.

"Since old people are often very caring, they do not even bother to avoid coming into contact with the blood of the [HIV/AIDS] infected, which is sad, because if such a person is infected, falls sick and goes to the hospital, she won't be tested for HIV. The doctor will assume she is not sexually active and just say, 'it is old age'," she said.

The senior citizens organisation is calling on the government to introduce more elderly-friendly voluntary counselling and testing [VCT] services, which are generally youth orientated and administered by the young, who often shun the aged. Contrary to popular perception, "some of our colleagues are still sexually active", Sichimba commented.

Burdened by loss

Modester Kalonde, 79, who lives in the capital, Lusaka, cares for her 8-month-old grandchild, who began displaying illnesses associated with HIV/AIDS at four months old.

"I now have to be at home all the time, or most of the time. I cannot go to church, attend funerals or even visit my friends because I have to be with her [the daughter] and also look after her child, who is my grandchild - I only go out briefly when some Good Samaritans visit us," Kalonde told IRIN. The Evangelical Lutheran Good Samaritan Society provides shelter and supportive services to older persons and others in need.

"I don't know what to do, because my other two children are still in the village [outside of Lusaka]; I just came to visit. At the clinic, the doctor told me to take her [daughter] for injections every day, but I have no money because she has spent everything she had on buying medicine and food."

Despite being a signatory to several international conventions on the elderly - including the 2002 Madrid International Plan of Action on Ageing, which calls on governments to recognise the rights of older people - Zambia has no legislated policies for the aged.

Community development minister Catherine Namugala said government was in the process of formulating a policy on the aged that would outline key intervention measures, including a policy on HIV/AIDS and the elderly.

"We are doing everything possible to ensure that the policy comes into effect by December this year [2007] or early next year, so that we can be properly guided as a nation in dealing with issues affecting the aged. At the moment, we are just offering support under our Social Welfare Department to a number of institutions taking care of the vulnerable citizens, most of whom are the elderly," she told IRIN.

No retirement for most

The retirement age in Zambia is set at 55 years, and the average monthly pension for a retired public servant is about US$10, but it only applies to people who have worked in the formal sector. About 400,000 people are employed in the formal sector, both public and private.

Rental for a three-bedroom house in Lusaka's medium-cost residential accommodation ranges from $180 to $300 a month, with many landlords demanding a deposit of between three and six months' rent. There is no pension arrangement for people who have not worked in the formal economy.

Government has introduced a free medical scheme for people aged 65 years and older, but Andrea Masiye, 70, a practising lawyer, dismissed this because "only consultation is free in essence; there are no drugs and we are all told to buy our own medicines after prescription".

"Many of us are forced to work for a lifetime because there is no policy to take care of the aged. Otherwise, we would all have to end up in hospices after being abandoned by communities, and this is what has led to the overcrowding of hospices because government simply can't take care of its own senior citizens," Masiye said.

Judith Bozek, a sister-in-charge at Cheshire Divine Providence, a faith-based institution looking after orphans and elderly homeless people in Lusaka, told IRIN: "We are overwhelmed by the high numbers of people coming here.

"Most old people here have either lost all their relatives to HIV/AIDS or have been abandoned by the communities. There is a need to restore the dignity of the old people by empowering them with some reasonable income, so that even when looking after their infected relatives they will not strain so much," she said.

"Other countries have the universal cash transfer policy, which entitles the elderly to some disposable income, and I think the same should be done in Zambia to end these problems that the elderly are facing."