BMJ No 7115 Volume 315
News Saturday 25 October 1997
Speaking out for the aging population
Julia Tavares de Alvarez, the Dominican Republic's ambassador to the United Nations, tells Janice Hopkins Tanne how she earned the nickname "ambassador on aging"
| The first thing you notice about Julia Alvarez is her enthusiasm, then her fluff of snowy white hair and bright red suit. The next things you notice are her intelligence, persistence, and willingness to speak out.
Last week, for example, she told Kofi Annan, the United Nation's secretary general, to put his own house in order on issues of aging. In June he had called for a "rejuvenation" of the UN workforce - whose average age is 49, which he said was "far too high." The UN's mandatory retirement age is 60 or 62, depending on when an employee was hired. "Nowhere in the UN charter does it say people have to retire at 60," she said. "Strangely enough, the political posts - secretary general, undersecretary generals, assistant secretary generals, and heads of agencies - do not have a mandatory retirement age," she told a non-governmental organisation's committee meeting on aging. |  |
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| Julia Alvarez is fighting against age discrimination |
Julia Alvarez, now 71, has led a bicultural, bilingual, binational life. She went to boarding school in New York and graduated in 1948 from the Connecticut College for Women with a degree in psychology and sociology. Soon after, she married Dr Eduardo Alvarez, a surgeon, and had two daughters. They moved back to the Dominican Republic and had two more daughters. Life became dangerous under the Trujillo dictatorship, and after 10 years in Santo Domingo the family hurriedly returned to New York. Dr Alvarez established a practice in a Spanish speaking neighbourhood in Brooklyn, and when the girls started school, Julia Alvarez managed her husband's group practice of 15 doctors. Managing the practice "wasn't challenging" but what she liked was attending medical meetings with her husband on a subject that interested them both - geriatrics.
"I saw the problems of the Hispanic elderly in New York City. There are more than a million Dominicans in the city. Many immigrated as adults. They worked to support their families and had no time for school to learn English. As they got older, they were isolated and invisible. They didn't know their rights and they felt that accepting subsidised housing or meals on wheels was taking a handout."
In 1978 her brother, foreign minister of the Dominican Republic, had problems finding bilingual staff for the nation's UN mission. He asked her to help. "One day a week turned into five days," she says, and she was appointed ambassador and alternate permanent representative of the Dominican Republic Mission to the United Nations. She insisted on a nominal salary of $1 a year and decided to focus on the problems of elderly people, in particular elderly women. She earned the nickname "ambassador on aging," and after years of lobbying she managed in 1992 to establish a UN "international day of older persons." Another achievement is the first "international year of older persons," planned for 1999.
Whether it is called the age crisis, the demographic timebomb, or her phrase, the "agequake," by 2025, 12% of the world's population will be over 60, and 70% of them will live in developing countries. Ambassador Alvarez says: "In developed countries, the next generation, the baby boomers, will be different. They're mostly professionals, and most women work. If they retire at 65, they have 20 more years. They'll have a second career, start a business at home, work on a flexitime schedule, or go back to school. Computers are ideal for them. Marvellous! You're connected to the world. You get on to the internet. You're empowered."
But in developing countries computers are prohibitively expensive and electricity and telephone services unreliable. "In my country, social security doesn't exist. The most pressing problem for elders in the Third World is avoiding death by starvation. We can't follow the model of developed countries."
Ambassador Alvarez envisages a model of interdependence that helps both the elderly people and the community. She and her husband began a personal effort, starting the Center on Aging in the Dominican Republic, donating their house, and involving the Sisters of the Sorrowful Mother, a religious order that runs about 20 hospitals in the United States. "We started with the poorest of the poor, a rural area near the border with Haiti." Many young adults had left for jobs in the city or the United States, leaving their children with elderly relatives. The children received no kindergarten or preschool education, dropped out of school after a few years, or lagged behind. Her "interdependent" solution was to hire retired teachers who were living in poverty and train them to teach skills to preschool children - for example, elementary hygiene such as washing their hands and brushing their teeth. The children were provided with breakfast and offered some basic medical care, such as rehydration therapy for diarrhoea. "We started with 12 teachers and 200 children; now we're up to 1000 children. Four years from now we'll do an evaluation. Their school performance will tell us how successful we are."
With the help of Unicef, about 50 centres have been set up in the country to provide oral rehydration therapy for diarrhoea, a common problem. With a $10000 (£6250) grant, the project has also set up a revolving loan fund that lends small amounts to help older people to start small businesses. The first loan went to 10 women who wanted to buy pregnant cows, sell the calves, and start a cheese making business.
In the worldwide trend of declining birth rates and nuclear families "communities are replacing the role of the extended family," Ambassador Alvarez says. "The UN charter calls for respect for human rights and for fundamental freedoms for all without distinctions as to race, sex, language, or religion. Notice it says nothing about age." For the UN's 50th anniversary, she would like to see a reaffirmation of the Declaration of Human Rights that condemns age discrimination and recognises the interdependence of people of all ages.
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