Adding life to years

Bhutan joined the global community to observe the World Health Day on Saturday. The theme this year was ‘Ageing and Health’ with a slogan “Good Health adds life to years.” As Bhutan marked the day, our reporter Tenzin Rabgye travelled to some parts of the country to find out few elderly people who seem to be ageing healthy for their age.

Angay Rinzin is 82 years old. She lives in Thimphu with her husband Agay Tashi, who is about 80 years old. She broke her leg a few months ago and has a difficult time moving around. She normally sits outside her house while Agay Tashi goes to the National Memorial Chorten. This is a daily routine. Agay Tashi gets up in the morning, cooks breakfast for Angay Rinzin then heads to the chorten. They don’t have any children. They are looked after by a nephew and an adopted daughter; who pays their rent and provides them with necessities. Their neighbours also help them as well.

Agay Tashi circumambulates the Chorten for about two hours every day after breakfast. He is a simple man who seems content with his life. Many other elderly people come to the Chorten as well, most over the age of 75. All have their own stories to tell as they make innumerous rounds.

After about two hours Agay Tashi goes back home and spends the afternoon with his wife, talking with his neighbours about old times.

In the evening, Agay Tashi heads towards the Lhakang at the Thai Pavilion and spends about an hour there. I joined him on the walk. He tells me that he worked on building the Dechencholing palace. He also tells me that he worked for the Thimphu City Corporation for 27 years as a supervisor. He got one month’s pay when he retired. That is because he was a temporary staff at the city corporation. When asked Agay Tashi why he thought he was so fit he answer in his old husky voice, “I think it’s because I did not do anything to hurt anyone in the past. I also pray to Goddess Dema.”

Angay Rinzin waits as Agay gets back home. Once home Agay Tashi cooks dinner for his wife.

To find out more of such healthy elderly people, I headed to Trongsa. Tshangkha, a small village just a few kilometers away from Trongsa is where I met Agay Lotey Choza, 86. When I first visited him he was babysitting his great grandchildren, Choley and Dechen. Tshering Yanki is a friend. It was mid-afternoon by then. Agay Choza lives with one of his grandsons. He has 6 children, 9 grandchildren and 9 great grandchildren.

He served under the Second and Third Druk Gyalpos.  He has seen four of the five monarchs. Agay Choza was in armed force for several years before retiring to his village. I found Agay Choza extremely fit for his age. He was active most of the day. Little Dechen can be a handful at times. Agay Choza offers a butter lamp at the family Lhakang every afternoon. He normally prostrates but today Dechen seems to want some quality time with her great grandfather. He looks after his great grandchildren until his grandchildren come home from day’s work. Tshewang is Choley and Dechen’s mother. The family enjoys a bit of television and then its dinner time. Agay Choza watches what he eats. He says it is one of his secrets.

After dinner Agay Choza heads up to his room. By now his grandson Sonam is back home as well. Agay Choza says prayers and then goes to sleep.

Tshewang Norbu is Agay Choza’s neighbour. He grew up in the village and knows Agay Choza well. “He has lived so long because firstly, he looks after his body. He doesn’t really go to crowded places, and stays at home and prays most of the time. He doesn’t even eat things which are bad for him.”

Agay Choza’s day begins at about 5 in the morning. He sits in bed saying prayers. He was already awake when we went to see him in the morning.

Agay Choza normally washes up outside then sips a cup of tea with Kapche. He tells me that he is a happy man. He has everything he needs. “I am happy because firstly I have no illnesses, my family has no sicknesses, the situation in the country is great, and people live in peace and happiness. A major factor is His Majesty the King, the gods and a bit of luck. I have no worries and I think that’s why I’m happy,” he says.

Agay Choza says that when he was younger he used to drink. “But then I prayed, ate medicines both traditional and modern, I gave up drinking and haven’t gotten sick since, I used to get sick often when I was younger but now I don’t have any major problems.”

After breakfast he goes up to the Lhakang and offers water to the altar. He chants some prayers, lights incense and then prostrates. Agay Choza says that taking care of oneself is very important.

Agay Choza went on to explain the paintings on the walls of his Lhakang, very beautiful and meaningful paintings. I said goodbye to Agay Choza and continued on my journey. On the way we met 70 years old Agay Ngachu. He was working on the road towards the Dratshang, breaking stones, soling the road.

Agay Nga chu is also from Tshangkha and knows Agay Choza pretty well. He is very active and has his own theory as to why old people are generally fitter. “The reason old people are generally fitter than youngsters these days is because they worked and suffered when they were young carried around stones, I think our bodies are used to it.

“These days youngsters aren’t so fit because as soon as they get out of their houses they get in their cars. The food they eat isn’t good as well. They eat snacks too much, which is not got for you. I think that’s the reason,” says Agay Nga Chu.

We travelled to Zhemgang as well.  There we met Agay Tshering Wangchuk, 87, and Angay Kuenzang Pedon, 89.  They normally spend their evenings praying. Agay sits on his bed and prays with his prayer wheel. And so does Angay Kuenzang.

They live with their daughter and youngest son. Agay and Angay do not drink and they watch their diet as well. They don’t eat pork and eggs. They both have a good appetite.  Their children provide for them and look after them. They have no worries. After dinner they head to their room, say prayers and then go to bed for the night.

Angay Kuenzang is fit and helps with the house work. Agay Tshering offers incense to the house altar and then goes to his room. Angay Kuenzang prostrates 50 times every day, something which would be hard for me to do. She is very fit and very humble as well.

In Khengkha Angay Kuenzang tells me, “I am blessed by the Ken Cho Sum and also because of my parents. Everything is in the hands of the Ken Cho Sum. Even if I get sick now and die I have nothing to regret, I am content.”

While Angay Kuenzang prostrates, Agay goes to offer Tsho at the local Lhakhang. He has travelled all over the country and has also been to Lhasa and Dorji Dhen in India several times. He used to be the personal body guard of the second King’s brother-in-law, Dasho Thinley Namgay.  Everyone in the village knows him.

“He is very fit, he can to go everywhere and do all sorts of work with ease. He doesn’t because his children don’t look after him and he doesn’t need to. He is skilled at doing everything and is a very active person,” says Chuki Wangchuk, caretaker of the Lhakhang about Agay Tshering.

He tells me that he believes that he is still fit because he had a very hard life in the past, a very physical life. He believes that it is his difficult past that has helped him live so long. “If you came here from Gelephu you would only reach in seven Nights, we used to carry everything on our backs; I think maybe that had something to with me being fit.”

What does it take to live healthy and long? According to Dr. Tashi Wangdi, a Senior Medical Specialist at the Jigme Dorji Wangchuck National Referral Hospital, there are three reasons why people live so long. “If you have long-lived parents then they say you probably already have the genes to make it past 80’s and 90’s maybe even up to one hundred. Together with the genetic factor also the lifestyle that you lead is a very important factor,” says Dr. Tashi Wangdi, “I think the lifestyle that you lead is a very important factor and secondly also the exercise factor. All these factor are very important, the genetic, the environmental as well as well as the lifestyle factors, so these three are very important factors for leading long and healthy lives.”

The Director General of Public Health, Dr. Dorji Wangchuk, says that there should be a good policy in place. “If we have in our policy to look after our healthy people in the place where they are, not dislodge them, not de-populate them, I thought that this is a very good opportunity to launch this elderly care project and the world health day today is a good launching pad for us.”

Non-communicable diseases such heart disease, stroke, cancer, diabetes and chronic lung disease are some of the main health challenges facing elderly people everywhere. Bhutan is no exception.

Dr. Nani Nair, the WHO Representative of the WHO Country Office for Bhutan says it is important not to add years to life but add life to years. “This really requires a well-articulated process which begins even before a child is born literally from the womb to the tomb. She add that old people should  be able to recognize their full potential, physically, mentally, emotionally and socially in order to be able to contribute to society, to their families in all spheres of life.

Dr. Nair also talked about the importance of including old people in the development process of the country. “Not just being able to look after themselves, as we traditionally think, but for them to be part of and contribute to very effectively social economic development, cultural affairs, civic affairs, labour and productivity in their countries. Although we maybe talking about healthy ageing in the context of health, healthy ageing is not something that can be done by the health sector alone.”

As Bhutan observes the World Health Day, one of the significant issues confronting the elderly people in Bhutan is losing the value of social support network. Urbanisation and rural-urban being the main cause of this.

The world health 2012 focuses on ageing and will strive to highlight ageing as a rapidly emerging priority that many countries need to realize and address adequately. Bhutan is no different. It is time to think about adding life to years, for each one of us.