PROJECT
Impact of AIDS, Poverty, and Social Upheaval on the Elderly: The Case of Cambodia

Cambodia experienced civil strife, political violence, severe food shortages, and lack of medical care during the rule of the Khmer Rouge in the 1970s. Many who died as a result were adult children or spouses of today’s older-aged population. The post–Khmer Rouge period was characterized by severe social dislocation and continuing conflict resulting in further losses of children and spouses. These have eroded the base of core family support in a country where formal channels of assistance are virtually absent.

More recently, Cambodia has been experiencing the worst AIDS epidemic in Asia, resulting in the infection and death of adult sons and daughters of the current elderly population. This project collects and analyzes data from persons aged 60 and over in Cambodia on their current social, economic, and health status to assess the impact of the political turmoil of the last few decades on their support structures, health, and economic well-being; to examine the impact of the AIDS epidemic on their well-being; and to assess their knowledge and attitudes related to AIDS.

A representative sample survey of 1,273 persons aged 60 and older was conducted during April–October 2004 in an area covering over half of Cambodia’s population and including Phnom Penh. The questionnaire was designed to gather information on the standard issues regarding elderly economic, social, and physical well-being that recent surveys in the region focus on as well as aspects of the situation that relate specifically to Cambodia. The latter included questions on the impact of the Khmer Rouge era and its aftermath on the lives of the current elderly generation, including the availability of support from family members; questions directed toward older persons who experienced the death of an adult child during the last five years, including several questions that could serve as a verbal autopsy to determine whether the child died of AIDS; and questions on the awareness and knowledge of older persons regarding AIDS, especially as related to caregiving to HIV-infected persons.

This is the first systematic representative survey of the situation of older persons in Cambodia with special attention given to assessing both the longer-term impacts of conflict and violence and the effects of the illness and death of adult children on the well-being of older adults. To date, there have been virtually no studies of links between conflict and violence and elderly well-being a generation later and only a very few studies of the impact of the AIDS epidemic on older parents.

There are both practical and theoretical benefits to be had by bringing together these areas of interest. Older adults constitute a key group of persons for whom the legacy of widespread violence and conflict a generation earlier can have dire consequences today. This is particularly so in contexts where physical decline associated with aging is accelerated by poverty and a lack of effective health care systems and where old age translates into increased dependency on adult children and kin for care and material support. Older-aged parents in such settings are also particularly vulnerable to adverse consequences from providing care to and losing adult children to AIDS or other causes.

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Location

Cambodia

Duration

2004–2006

Population Council researcher

Zachary Zimmer

Non-Council collaborators

Kiry Sovan Kim, Sina Puch (Royal University of Phnom Penh)

John Knodel (University of Michigan)

Donors

The William and Flora Hewlett Foundation

The Andrew W. Mellon Foundation

National Institute on Aging

Population Council

UNFPA Cambodia

US National Institutes of Health

Publications/Resources on this project

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See Also

• Cambodia

• Social Science

• Aging

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