The Independent

 

Loneliness, the Modern Curse
By Dr Syed Amir
Bethesda, MD

In one of his early poems, Ek Arzoo, (Bang-e-Dara), Allama Iqbal had sought and longed for a state of absolute solitude where he could be by himself, surrounded by raw natural beauty, flowing streams, and cool mountains. It represented to him the highest state of contentment. However, in modern times, involuntary loneliness has become a curse, afflicting millions of people around the world. Of course, Allama Iqbal was dreaming of a different kind of solitude, peaceful and blissful, that would take him away from the trials and tribulations of everyday life.

Stories of sad, lonely people bereft of family and friends abound in the media these days. In an issue of the Washington Post, writer Emily Rauhala narrated the case of an 85-year-old Chinese man, Han Zicheng, who, living by himself, was extremely lonesome. In desperation, he took out an advertisement in a national newspaper seeking a family willing to adopt him. He described himself as a “lonely old man in his eighties, strong-bodied, who can shop, cook and take care of myself.” He had children, but they were all away in far off places and ostensibly not too interested in him. His greatest fear was dying in bed, alone, forlorn and forsaken, his body ultimately to be discovered and identified through his decaying bones. Zicheng’s worst fears, however, were not realized, as he died peacefully in a hospital bed, attended by the medical personnel.

The story of the lonely Chinese man was so surreal that it went viral, sparking world-wide interest. It spotlighted the problem of loneliness among growing elderly population.

In China, the problem is especially acute because of the nearly four-decade-old one-child policy rigorously enforced by the Chinese government in the past, but recently rescinded. Traditionally, for millennia elderly parents and grandparents were taken care of by their children. The Government policy led to a drastic reduction in the family size, creating nuclear families and upending the traditional family structure. In many cases, nobody is left to care for the aging parents.

While China has received much attention, the issue is not exclusive to that country. If anything, the situation is worse in Japan where the elderly population is growing at the world’s fastest rate. According to statistics cited by Anna Fifield in a Washington Post article, a quarter of Japan’s population is over 45, which is likely to climb to 40 percent by the year 2050. In some cases, the death of elderly persons living alone in Japanese cities currently goes unnoticed for months. Eventually, the putrid smell of the rotting body alerts neighbors that something is amiss.

As a sad byproduct, businesses specializing in picking up decaying bodies and cleaning up the detritus are flourishing. It is estimated that about 30,000 Japanese die alone, often unmourned and undiscovered for months. In common with the Chinese, the root of the problems resides in the breakdown of age-old family traditions and societal structures.
Europeans are not immune to social isolation problems. In Britain, according to a 2017 report published by Jo Cox Commission, “More than nine million people in the country, about 14 percent of the population, are often or always feel lonely.” The problem has become so severe that the government of Prime Minister Teresa May earlier this year appointed a dedicated minister to address the menace of loneliness.

In South Asia, in rural areas, the large family structures have remained mostly intact. Yet, the situation is different in large metropolises, where it is not uncommon for old people to be living by themselves. The children move away to the Gulf countries, Europe or North America, in pursuit of better career opportunities. They visit aging parents only infrequently. The problems become urgent when they no longer are able to take care of themselves and need medical or nursing care. High-quality nursing homes in Pakistan are a rarity, as it is taboo to transfer close relations to a nursing home, even though, in most cases, they can provide much better medical and nursing care than is possible at home.

In America, the problem is not the lack of nursing homes, it is the cost. They are so expensive that few can afford them. However, while providing adequate care and comfort, they don’t necessarily provide an escape from a feeling of isolation and loneliness. In some respects, their situation is no better than those living at home. According to a report in the New York Times, one-third of Americans older than 65 and half of those older than 85 live alone, in many cases having no one to connect to or talk to, leading to anxiety, depression and even suicide.

Social isolation is not only emotionally hard, it has serious health implications as well. In a study cited by the New York Times and conducted by the University of California, that followed more than 1,600 people who were on the average 71-years-old, found that more than 23 percent who were lonely died within six years, as compared to only 14 percent who were not lonely. The Time Magazine quoted the former US Surgeon General Vivek Murthy, characterizing loneliness as a “growing health epidemic” and emphasizing that social isolation is “associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day.” The article cites findings that isolation significantly increases the risk of both heart disease and stroke. Besides its ill-effect on physical health, social isolation also has adverse effect on memory, cognitive and analytical faculties. It may predispose us to dementia and Alzheimer’s disease.

How can the problem of loneliness be addressed? It is not feasible today to return to the joint family system or old-fashioned societal structures of yore. Nevertheless, some solutions have been tried with varying levels of success. In Britain, housing has been made intergenerational in which retired people and young working couples are housed together, providing a milieu conducive to frequent interactions. Although the concept is unfamiliar in Pakistan, in some countries new housing developments are designed for retired people only that offer a variety of opportunities for social interactions among people with common interests and problems.

The question of why social interactions are so vital for our happiness and wellbeing has intrigued social anthropologists for a long time. It is likely that the need for these interactions is rooted in prehistoric times, when our early human ancestors lived in caves, roamed the plains in search of food and fuel and needed help from other humans for survival, protection from predatory creatures and violent natural forces. We still need help from our fellow beings, even though our adversaries may be different.

(Dr Syed Amir is a former Assistant Professor, Harvard Medical School, and a health science administrator, US National Institutes of Health)