A dedicated group of aid workers and volunteers deliver food, essential products, and compassion to elderly people in need.
It’s late October. The sun is out in Tirana, but in Korca, the southeastern Albanian city famous for its stone roads and culinary delicacies, you can already feel the cold around the corner. Its elderly residents know this better than anyone, as they start to make calculations within their tiny pensions to cover wood and heating.
Residents like Joana, Niko, and Dallendyshe, who I meet outside a restaurant among a group of elderly people. They are here to celebrate a birthday. They don’t know each other and live in different neighborhoods, but they are all part of Community Safety Net – a program created and implemented by Dorcas Albania, established in 1992 as the local branch of the Dutch Christian development organization Dorcas. The program supports elderly people who live alone or are in financial need. In all, 355 people in Korca and the surrounding region, from 58 to 90 years old, get assistance with medication, food, and social activities.
One popular group activity is celebrating birthdays, says Viola Cekani, program coordinator at Dorcas Albania. “Because material aid and medicines are not sufficient for them – they need to feel they are alive, that somebody cares about them.”
Dallendyshe, today’s birthday lady, is a widow who lives alone and is struggling financially, Cekani explains. “Yesterday we surprised her with the pupils of the school nearby who prepared birthday postcards and flowers for her. Today we are celebrating here with some of the elderly people in the group.”
Dallendyshe stands at the head of the table, dressed in black. She responds politely to the well-wishes, but her expression is grim. “Last time I celebrated my birthday was 30 years ago, when my husband was alive,” she whispers. “God bless the Dorcas girls and boys, especially Gezim, the driver, for the help they give me. With my pension of 8,000 lek [around $74], it is very difficult to survive. I have to pay the rent, water, electricity. At least I have a secure supply of food. And this year I also have the wood donated by Dorcas. God brought me these good people.”
Slowly, everyone starts to open up about their life stories. Some of them live alone as widows or widowers.. Jani has lost not only his wife, but three children. Now he has to care for his nephews, who are orphans. Niko, a widower who used to be a tapestry maker, has lived alone since his daughters married and left. “The most difficult part of the day is the afternoon,” he says. “It’s unbearable.”
For Joana, life is especially difficult. Married at 15, she left her remote village to move to Korca with her husband, an alcoholic. She has six children, but nobody is here with her. One of her sons is in prison in Greece for drug offenses. “My son does not talk to me, he blames me for his situation,” she says, her eyes filled with tears. Joana is nostalgic about the times before the unrest and social disruption of the 1990s following the collapse of the totalitarian regime. “We were poor even then, but there was love. Now nobody cares for you. My neighbors just say hello and nothing more.”
Her breathing grows quicker and she pulls out an inhaler to help with her asthma. “I didn’t think my life would be like this when I grew old. My mother died when I was six months old, and I decided I would have six children, each with two children of their own, and my table would be filled with people and joy. Instead, I am here living alone, in a rented apartment, and I am afraid to die alone, at night, when the door is closed. But I have Dorcas, at least. They will not let me [die alone].”
Adjusting Assistance to Fit Changing Needs
The Community Safety Net grew out of a sponsorship program for elderly people that started in the mid-2000s. Donors in the Netherlands sent a fixed amount of money for one year to support an old person in Albania living alone and without financial means, enough for a package of flour, oil, rice, pasta, sugar, and cheese worth 2,000 lek, delivered every two months to the beneficiaries. The number of beneficiaries grew from 45 people initially to 355 today.
Besides the food packages, Dorcas also helps with other basic needs. The organization maintains a small fund for medicines, and lately, wood. In the case of Aksinja, an orphan raised in state children’s homes, Dorcas paid off her overdue water bills. Aksinja is single and now lives in a tiny apartment she shares with two other people and her four cats.
“I had no water for eight years, because I had no money to pay for it, only the state benefits of 2,000 lek,” she says. “Dorcas paid the debt for me and now I have water in my apartment. They also gave me the stove and wood for winter, some guys from Holland came to help me bring the wood inside.”
Aksinja is a force of nature. She still rides a bicycle at the age of 63, although her last checkup, organized by Dorcas on World Diabetes Day, revealed some problems. She is also an active participant in the group activities such as visits to museums.
In 2017, the sponsorship approach changed. In order to make it more sustainable, Dorcas asked the staff in Albania to raise funds for the program. “The first year they gave us a budget for 12 months, the second year for 11 months, the third for 10 months,” with the costs for the remaining two months meant to be covered through fundraising, explains Ilia Dishnica, director of Dorcas Albania.
This is how the Blue Bucket initiative was born – a campaign to collect aid from the community in the form of food or cash, which was then distributed in distinctive blue buckets, each containing food worth some 2,000 lek. “It was a good start,” Dishnica says, but when fuel prices rose as a result of Russia’s invasion of Ukraine, “prices jumped, and with the same amount of money we now only get a half-full bucket.”
Dorcas launched a Blue Bucket campaign two years ago in the northern city of Tropoja, where it has been running agriculture, tourism, and youth projects since 2001, and has hopes to start a Community Safety Net there as well.
Volunteers are still delivering the blue buckets. At Dorcas, they believe that after 30 years of foreign support, it is fair that the community itself should invest to support elderly people. But their needs are bigger than the organization’s budget can cover. They need heating, for example, which in Korca is a real problem – better without bread than without heat, locals are known to say – and Dorcas can only help in exceptional cases. That’s why the organization insists they need stronger intervention from the city.
The director of social services for the Municipality of Korca, Mariana Jorgji, maintains that elderly people are being supported, within the limits of the city’s human resources and budget. For example, every day 200 elderly people use four day centers opened by Dorcas and now managed by the county, the upper level of local government in Albania. Free tea, coffee, and newspapers are on offer, along with basic medical checks such as blood pressure readings, and occasional birthday celebrations or excursions.
Pensioners can also benefit from a card entitling them to free public transportation and tickets to sports events, a 50 percent discount on theater tickets, and 20 to 50 percent discounts at some businesses. Some services or medical checkups are also offered free of charge. Around 800 pensioners were using the card in 2022.
Aksinja is not one of them. She doesn’t know about the pensioner card or use public transport, and doesn’t go to the nearest day center because it is far from her apartment.
Reaching Out to Rural Seniors
Elderly people living outside the city limits cannot use the card either. While city dwellers can rely on public services to some extent, in the villages the structures of social cohesion are even weaker. Poverty is widespread, and community awareness about the needs of lonely people is extremely low.
Korca County’s 220,000 residents live in six municipalities. But three of the five outside the main Korca municipality, however, provide no services to the elderly, according to an analysis of social services at local level by the United Nations Development Program. A policy study carried out by the International Labor Organization in 2021 gave additional support to this gloomy picture, estimating that, of about 100,000 elderly people in need of long-term care across Albania, only 1.6 percent receive social care services. Although the Korca region came top in this ranking, providing social services to 4.2 percent of its elderly residents, this underscores that elderly people in other parts of the country are even worse served.
The ILO study also highlights that seniors living alone in rural and remote areas – an estimated 46 percent of the population aged 65 or over – are especially vulnerable. “They do not live with family members to take care of them, nor do they have access to formal long-term care services, either residential care, home care or community services. The elderly in rural areas also face disadvantages in pensions, access to health care and other social protection programmes,” the study says.
This is why Dorcas focuses its aid on villages and remote areas, home to two-thirds of the beneficiaries of its Community Safety Net program. “We are trying to mobilize communities by establishing contact with those living near elderly people, calling on their humanity and civic duty, but it is very difficult,” Dishnica says.
A former teacher, Dishnica says that children used to be taught about civic behavior in school: “Today, teachers are indifferent … During these 30 years [since the fall of the communist regime], we have raised a generation of individualists. This should change.” Dorcas seeks to address this by giving talks about the program in schools and encouraging young people to help with fundraising campaigns or birthday celebrations.
One young volunteer is proof that the emphasis on education has paid off. “I must have been around 10 years old when I first came here to the Dorcas courtyard to play with my friends,” Elis Nakolecisays. “Later, in school, I recall they came to talk about helping elderly people. Today I am 19 and I am a volunteer with Dorcas’s Blue Bucket campaign,” he says. “I do believe that everything returns – what your parents or grandparents have done for you, you should do for them. One hour in your life may be nothing to you, but for the grannies, it is everything. It is life.”
Another principle of the Community Safety Net is “active aging” – offering elderly people activities that revive their potential. “We see them as assets, not only as people in need,” explains Cekani.
One senior lady paints the doors of restaurants for Christmas and decorates Christmas tree ornaments. She also sells items she has knitted. An elderly dressmaker produced bags that were then embroidered by the daughter of another senior citizen and offered for sale. “We have created a social farm on the outskirts of the city which is run by elderly people,” Cekani says, noting that Aksinja, for one, gladly helps harvest the crop and plant trees. “But these cases are very few, as the majority of the beneficiaries are sick and in survival mood.”
The program also has good relationships with local vocational training centers. They sometimes hire Dorcas’s “grannies” as trainers for their courses, Cekani adds.
Those Who Leave and Those Left Behind
The overall aging of the population, and the exodus of those of working age, is becoming a problem for Albania. The latest figures from the national Institute of Statistics indicate that the median age has risen in the last two decades from 33.2 years to 38.2 years, while the total population has fallen steadily since 1990, to 2.8 million – a loss of almost 15 percent according to UN estimates. Demographers attribute much of the population loss to the emigration of people of reproductive age. In 2021, the population fell by a worrying 1.3 percent. Emigration not only sucks away human resources needed to maintain the economy but weakens the pension system as well.
The United Nations Population Fund (UNFPA) has been warning of the consequences of an aging population since 2017, when the last demographic and health survey was carried out. “We saw the aging trend rising over that period, because fertility rates dropped beyond demographic resilience,” says Elsona Agolli, program manager at UNFPA Albania, referring to the ability of populations to resist and recover from structural changes. For Albania, this threshold is 2.1 children per family; the figure now is 1.3 children.
Agolli also notes that the over-65 population has nearly doubled in just a few years and now makes up 15.5 percent of the total population, largely due to emigration of people aged 15 to 49.
“We lost momentum then, but we are optimistic that we can still remedy it,” she says.
In 2022, Korca Countyhad the lowest birth rate and highest death rate in Albania. Beyond figures, the absence of young people is very noticeable. “My friend just left for Italy,” says Artenida Skenderas, one of the Dorcas volunteers. “She studied sociology at university, but now she works as a shop assistant. Salaries are very low here, pensions worse.”
People have been emigrating from Korca for the past century, mainly to the United States, Canada, and Greece. Elda Zavalani, a pharmacist, left for Canada in 2000. She returned five years later because her elderly parents were alone. “There are entire neighborhoods with only old people,” she says. “But unlike developed countries, we don’t have a protection system for them. True, their children can support them with money from abroad, but you don’t find people here to serve them, so they can feel somebody is caring for them.” She cooperates closely with the Community Safety Net program, donating free medicine and giving advice by phone.
Help for the Lonely
The national government is increasingly aware of the urgency of helping the elderly, Agolli believes, even though there is no single government body or department dedicated to this task. This is also reflected at local government level, where one manager is responsible for economic aid, disability payments, helping children and victims of domestic abuse, and everything else that falls under the rubric of social protection.
National authorities do have a long-term plan to improve services for the elderly – the 2020–2024 National Aging Plan, approved in 2019 and implemented with assistance from UNFPA. Among the plan’s objectives are halving poverty among over-65s and providing full health and social service coverage for seniors who need them. It foresees building 10 more residential centers for the elderly, 50,000 visits by home care providers, and other measures to build the capacities of local governments to serve the elderly population. With the plan entering its final two years, there is no analysis of what has been achieved. But ILO’s study cautions that “even if all the planned outcomes are achieved, significant gaps may still persist.”
This year, UNFPA started working with 17 municipalities – Korca not among them – to improve their provision of services for the elderly. The approach is similar to that adopted by Dorcas: inter-generational cohesion and helping seniors stay active. The UN agency’s strategy includes proposals like incentivizing older people to take care of children, or outsourcing elderly services to nongovernmental organizations, who will train volunteers to meet specific needs.
Gezim Tushi, a sociologist with extensive experience at the State Social Service, stresses the need to expand the state’s elderly care programs. Among the solutions he suggests are more day centers, piloting home-delivered services to remote areas and training more people to implement the services.
Another advocate for active aging, Mira Pirdeni, head of the Albanian Society for All Ages, says that poverty stemming from inadequate pensions, discrimination, and lack of accessible services is at the root of the difficulties elderly people experience.
“Examples have shown that with the right combination of political will, innovation, and community involvement, poverty is something that can be overcome,” Pirdeni says. She insists that local governments should prioritize the elderly in their budgets, because “there is an emerging need to offer new mechanisms for them beyond the family, along the model of ‘age-friendly cities’ that promote interaction and understanding between generations.”
Providing assistance with everyday tasks such as preparing meals or going to the doctor can be the first step towards addressing the significant problem of loneliness among elderly people, according to a study by UNFPA in Eastern Europe and Central Asia.
Its survey in six countries and territories in the region found “no association between levels of emotional support and loneliness,” which can pose as high a mortality risk to older people as smoking or obesity, UNFPA says. “This suggests that, in this population, the provision of basic day-to-day support for older people would be most effective in addressing loneliness.”
These experts are basically suggesting what Dorcas is doing. The organization aims to expand its model further to northern Albania, but insists that municipalities must be involved, as their human resources are limited. “An NGO cannot ensure sustainability of its services,” Cekani says.
Providing regular support means people. With 14 volunteers and four staff, Dorcas can carry out up to two visits per month to the 355 people it currently serves, but support is needed every day and for many more. Its waiting list is long and includes people with pressing needs. Another problem is the lack of accurate and updated statistics about the number of elderly people living alone in Albania.
The organization is calling for more cooperation not only with local government, but also religious institutions, schools, pharmacists, nurses, doctors, and communities at large to build wider safety nets and give every older person the life they deserve.
As pharmacist EldaZavalani says, “Often, what we can do is what we should do.”
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Valbona Sulce is a journalist and researcher based in Tirana.
