Thursday, July 7, 2016
Thailand - Aging Isaan blazes a trail for Thailand
BAAN DONG BANG, Thailand -- For the past three years, Boonterm Chaila has puttered around on his improvised three-wheel motorcycle spreading two messages across five provinces in Thailand's rice-growing northeast region. One is that smaller paddy plots are better. The other promotes crop diversification. Both messages are aimed at villagers like Boonterm himself, a graying, weather-beaten 69-year-old former farmer, who wanted to help others who continue to till the soil well into old age.
Boonterm, who runs a community organization promoting healthy living and local wisdom, sees his communications efforts as part of a grassroots strategy to help Thailand's rural population cope better with farming problems that become harder to resolve with age.
"Farmers will not stop because of age, so we need to come up with a way of working that is suitable for older people," he explained over fresh mangoes in Baan Dong Bang, his village in Thailand's northeastern province of Khon Kaen. This view has struck a chord among the area's aging farmers, many of whom rely on their plots for staple foods. "What else could I do?," asked Supin Janthattoom, an 81-year-old fellow villager who only retired from cultivating rice when he was 79.
Baan Dong Bang has the highest proportion of over 60s of any village in Khon Kaen: 110 residents out of 149 families. But many other villages across the province resemble old-age communities, with elderly people standing at the doors to their homes, walking slowly along the roads or seated in salas, the Thai-style pavilions at the center of most villages. Few young people are to be seen.
For Thai policymakers, this is a worrying picture. Khon Kaen and nearby Nakhon Ratchasima have become gray terrain much faster than most other provinces. But the rest of the country is catching up: 10 million Thais are 60 years old or more, accounting for 15% of the population, and the proportion is forecast to grow to 20% by 2020. That will make Thailand one of the fastest aging societies in Southeast Asia.
"In 2025 Thailand will be hit with a tsunami of challenges to care for the elderly," said Montree Prasertrungruang, a rural population expert at Khon Kaen University, summing up a crisis that has crept up silently but is now causing anxiety among policymakers. It took 115 years for the proportion of over 60s in France's populatoin to grow from 7% to 14%, but Thailand is undergoing a similar change in a period of just 20 years, Montree told the Nikkei Asian Review. "The Thai state is unprepared to handle these numbers," he said.
Khon Kaen city, the capital of the province, illustrates one result: a rapid spike in public health budgets for the elderly. Across the province, the cost of support for elderly urban residents rose from 60 million baht ($1.71 million) in 2012 to 90 million baht in 2016, according to official records. But Khon Kaen municipality's health expenses for the elderly rose even more quickly -- from 1 million baht in 2012 to 2 million baht this year. Somporn Chaiayuth, director of the municipality's public health division, attributes this to "many more health problems among the elderly and a rise in their numbers."
Out in the provinces, the country's impressive network of public health centers is feeling the pressure from this graying population bulge. Treatment for senior citizens under the government-subsidized universal health care program for chronic diseases, diabetes, hypertension, high blood pressure and eye problems is on the rise. One center that covers 13 villages has 8,000 registered residents and regularly sees 944 elderly patients. The caregivers grumble that they are understaffed. "We don't have the expert doctors to deal with elderly patients," a registered nurse complained. "The situation is getting worse."
A spate of recent official announcements conveys the magnitude of the social crisis that policymakers are now waking up to. The ruling military regime approved an additional 600 million Thai baht in early April to supplement healthcare costs for the elderly. The country's 1,000 municipalities are to get the lion's share. Yet, this midyear injection into public health spending exceeds the 500 million baht that the National Health Security Office had originally set aside this year for home-based care of 100,000 elderly patients.
In addition, there is a growing clamor for direct payments to the elderly. One urban activist group is urging Prime Minister Prayuth Chan-ocha, head of the military backed government, to allocate 2,500 baht per month for each elderly citizen as a state-supported pension. Currently, Thais who reach 60 are entitled to a 600 baht government payment monthly, growing to 1,000 baht a month with advancing age.
The debate over pensions has exposed a worrying feature of personal finance and savings in the country. According to officials at the National Economic and Social Development Board, a government think tank, an estimated 65% of elderly Thais lack retirement savings. The government has begun to implement a program for the elderly, "but this is late and will take time," said Porametee Vimonsiri, secretary-general of the NESDB. The issue underscores the daunting task facing Thailand -- a developing country that is getting old before it gets rich, and lacks the resources available to developed countries such as Japan and Germany that are dealing with similar demographic problems.
Analysts are also warning that Thailand risks an economic downturn as farming communities are transformed into gray zones, with particular concerns emerging about the plight facing households led by elderly people in rural areas. The agricultural sector employs 33% of the 36 million labor force, with the average age of the farmer now a ripe 52 years; many work into their mid-70s.
There are two major explanations for the rapid depopulation of farming areas. One is Thailand's low fertility rate, which at 1.4 children per woman is well below the rate needed to sustain current population numbers. The second is the allure of wages in less hostile environments in Thailand's manufacturing, industrial and service businesses, which has generated a population drift to urban areas. Bangkok taxis are a testament to the draw of the cities: Farmer's sons from Isaan, as the northeastern rice-growing plateau is known, are the drivers most likely to be found behind the wheels of the capital's fluorescent colored cabs.
Attempts to reverse these trends are unlikely to succeed: "Thailand's demographic dividend [a period of rapid growth in the productive workforce] peaked in 2010, and Thailand has been going downhill the past six years," said a foreign researcher at an international financial services company, who asked not to be named. On present trends, Thailand's workforce is expected to shrink by 10% over the 30 years from 2010 to 2040, which could reduce the country's rate of economic growth.
Meanwhile, Khon Kaen's pioneering role in grappling with these new concerns has made it an essential pit stop for officials from other cities. Bureaucrats from Phuket, the resort island in southern Thailand, were among those who came on a recent study tour. They left with colorful brochures describing the municipality's blueprint for its three types of ageing residents -- those who still go out, those who stay at home, and those who are bed-ridden.