Free-market Africa's age of disrespect: Traditional care of the elderly is declining as Western ways take their toll. Karl Maier reports from Accra

AFRICA used to be one of the world's best places to grow old. Advanced age was regarded as a blessing and the elderly revered as sacred, the crucial link between the living and the ancestors, the holders of wisdom and culture.

Expressions for the elderly in West African languages often mean 'he or she who knows' or 'he or she who has vision'. Talk of the Western practice of placing ageing relatives in nursing homes makes most Africans shudder with horror. The duty of the young is spelt out in a Ghanaian proverb: 'If your elders take care of you while cutting your teeth, you must in turn take care of them while they are losing theirs.'

But today, as with so much of African society, times are changing - and for the elderly, radically so. The growing influence of Western-style education, free- market economics and accelerated migration is putting Africa's traditional extended families under strain and people's ability to care for the elderly in jeopardy.

'During our childhood in Ghana, we stayed in the family house, so we helped the aged, we did everything for them,' said Veronica Ayisi, a 55-year-old volunteer worker for Help Age Ghana. 'But now, because of 'civilisation', all their children have travelled, some have married and gone away and there is no one there to help them.'

Because of high birth rates and short life expectancies, the elderly still constitute a small proportion of Africa's population and the vast majority of them live in the countryside. But with population growth tipped to slow and medical care improving, the percentage of old people in Africa is expected to rise rapidly in the first quarter of the 21st century. And African families and society are increasingly poorly equipped to deal with them.

Part of the blame lies with Africa's gradual integration into the world economy. Rising foreign debts and flagging economies are forcing states to impose structural adjustment programmes in an effort to please foreign creditors and to attract investment. As a result, unemployment and prices have soared.

'The salaries people are getting do not keep them going; neither themselves nor their own immediate family,' said Nana Apt, a professor of sociology at the University of Ghana and president of the African Gerontological Society. 'So that now it becomes easier for children to say 'Look, I can't help the elderly', because they themselves cannot even cope.'

Dr Apt's point was clear to see during a chat with Emmanuel Anum Tetteh, an elderly Ghanaian man whose severely swollen legs appeared to indicate that he had developed a bad case of elephantiasis. He was living with his brother and niece in central Accra, but there was not enough money to take him to hospital. 'The niece does not have enough money,' said Ms Ayisi. 'She has no permanent job, she has children and she must look after her father too. So she does not have enough money to feed them and to take him to the hospital.'

The worsening plight of the elderly can be seen in the streets of cities all across Africa. What would have been unthinkable just a decade ago has become a fact of daily life. Growing numbers of old people have become beggars or homeless derelicts, wandering around in apparent confusion at the modern buildings sprouting up and the cars and lorries whizzing by them. The skills and knowledge that once earned them respect and esteem in the traditional rural setting are no longer relevant in the cash economy.

The cultural gap between the young, educated by Western-style schools, and the elderly, linked to tradition, is widening. Even the advent of democracy is undermining traditional political systems in which the elderly played dominant roles.

Akuoko Dokwi, 70, said that when she and her twin sister, Akwele, grew up near a cemetery in Achimota, a heavily populated suburb of Accra, there were no schools, no cars or lorries and very few houses.

Akwele and Akuoko seem bewildered by the world around them. They have no relatives to look after them. Akwele's two children died in their infancy. The women still live in their father's house, which is crumbling and leaked whenever it rained until Help Age Ghana put a new roof on it. They have a few chickens, but they must be kept in the house because of thieves in the area. 'When I get up in the morning, I sweep the house, clean the chicken coop and everything,' said Akuoko. 'Our rooms are full of mosquitos and we don't even have enough money for food. If it was not for the Roman Catholic Father and our friends from church, it would be very difficult.'

Dr Apt believes that the worsening crisis of the elderly in Africa will not go away and that African governments must take action now, by using measures such as tax breaks to help families fulfil their traditional role of caring for the aged. 'The wheels have turned and there is no turning back,' she said. 'We can still support family members to look after their elderly, because people are emotionally attached; people feel guilty that they are not able to look after their elderly.'

For Ms Ayisi, it is question of getting back to basics. 'If you have children and look after them, it is a must that they have to look after you,' she said. 'Parents should bring forth two or three children and look after them properly. Then, in the future, they can look after you.'

(Photograph omitted)