Five days a week, 40 senior citizens come to the Harmony Center to eat, browse and socialize in warmth and safety. (photo: Molly Corso)
Through Caritas Georgia, pensioners have access to doctors, social workers, medicines, clothing, heating fuel and food. (photo: Molly Corso)
For Nona Iashvili, even making tea is a daunting task. With her hands maneuvering her walker, every step taken by the 77-year-old must be carefully choreographed: one hand on the kettle, one to balance; switch hands to turn on the small electric hot plate; switch hands to get the cup.
Mobility is not her only challenge. Her apartment in downtown Tbilisi has neither running hot water nor heat. She shares a bathroom with her neighbors in the common yard. The former music teacher lives alone, on the brink of abject poverty.
But at the Harmony Center in Tbilisi, Ms. Iashvili does not have to worry about how she will make tea or stay warm. Here, she can sit, relax and talk with friends. “Here, it is warm,” she says, settling down in a comfortable chair near the piano in the center’s television room.
“Here, by any definition, things are good.”
Ms. Iashvili is one of 37 senior citizens who spend their weekdays at the Harmony Center, an institution of Caritas Georgia, the social service agency of the Catholic community in Georgia. Since opening its doors seven years ago, the center has provided shower facilities, basic medical care, physical therapy, concerts and a score of other activities for seniors in need.
They come in the morning and stay until early evening. They may cross the courtyard and eat lunch at the dining hall, and return for tea and sandwiches or cookies while they watch television, talk with friends, sew or read.
A native of Poland, Sister Monica of the Sisters of St. Elizabeth is on hand to perform checkups and to ensure everyone is current on their medicine. The center organizes weekly events, such as lectures and musical performances, and a doctor visits once a week to address ailments or other concerns.
Most of those pensioners who utilize the center live alone and below the poverty line. Harmony, Ms. Iashvili says, provides them with a place to spend the day in warmth and comfort.
Along with Caritas Georgia’s health clinic and home care program, the Harmony Center is a small source of solace for seniors in the former Soviet republic who grapple with a state pension — 150 Georgian lari (roughly $86) monthly — that cannot keep up with the cost increases for such necessities as medicine, food and heat.
Olya Gardava, a pensioner who regularly comes to the center, says she spent 70 lari — nearly half of her retirement income — just to keep a single electric heater running. The cost, she says, makes it simply too expensive to stay warm at home. Likewise, the uptick in the cost of medication means even the treatment of the most basic of colds can deny the pensioner enough food to eat.
Gaioz Kubaneishvili, Caritas Georgia’s social and medical program manager, says that despite new government programs to provide seniors with health care benefits and vouchers for electricity in the winter, old age is becoming more difficult in Georgia.
“We don’t have good statistics, but according to our observations, there are people for whom food insecurity is very high,” he says, noting that pensioners also receive less food aid from international agencies than they did just five years ago.
In the aftermath of Georgia’s 2008 war with Russia, international aid helped pick up the pieces, providing resources to help the most vulnerable, such as the old and the sick. Today, global priorities have shifted and with it, international aid. Georgia’s problems, however, remain unsolved.
Until a few years ago, Caritas Georgia provided food to housebound pensioners, delivering prepared meals door to door. However, as financing for health care and other immediate needs grew tighter, the program had to be cut.
Today, Caritas Georgia helps over 800 people with its soup kitchen, health clinic, home care program and the Harmony Center. But, says the Rev. Krzysztof Kowal, the director of Caritas Georgia, the demand is much, much greater.
“The demand is ten times more. If you could accept 10,000 people and feed them,” he says, “there would still be more demand.”
These overwhelming needs exist because Georgia remains very poor. Nearly 43 percent of the nation’s population lives below the official poverty line. Those unable to work, such as the elderly or disabled, are especially vulnerable. While the current government has put a priority on strengthening a social safety net — unveiling new, state-subsidized insurance initiatives following the privatization of health care in the last decade — its programs stop short of providing a stable quality of life for seniors, especially those who live alone. They still lack the means to buy medication, heat their homes and, in some cases, eat.
Canceling the clinic’s food program is significant, Mr. Kubaneishvili explains, because the clinic’s entire clientele — walk-ins and the housebound alike — struggles with food security.
Determining exactly how many seniors remain in need of help remains “the big question,” says Mr. Kubaneishvili.
“Unfortunately, there is no reliable source of information because the government’s department of statistics does not have any information.”
“We know the number of people who applied to the social services agency and they are people who are registered as living under the poverty level, but it does not cover the whole population.”
In many cases, he says, those who need care most desperately are housebound and cannot get to the ministry’s office to register. “When we learn about such people, our social worker helps them to register. This is one of our functions. But it is difficult to identify such people.”
Since they are largely out of the public eye, Mr. Kubaneishvili notes, it is easy to forget about them.
“Maybe it is the reason why they are so neglected. Because they do not go out, they cannot speak in demonstrations, they cannot go to the ministry of health. It is only our voice and the voices of our colleagues from other organizations who speak for them.”
Father Krzysztof Kowal is one such voice speaking out for seniors and lobbying for a better system of care.
If given enough space, Father Kowal says, the soup kitchen could easily feed more people. With enough financing, the Harmony Center could become a proper retirement home — a safe place where seniors who have no one to care for them could live their remaining years in dignity.
“We have one limitation: space,” says the priest. Nona Iashvili, for example, had to wait for a place at the day center; it can only take a maximum of 40 clients. But Father Kowal is not deterred. The needs are great and the goals, he says, lofty: “to create a home for senior citizens who are living alone.” The key, the Polish-born priest says, is first to “secure the initiatives one has, and only after that go after new ones.”
The projects he has found the means to maintain — especially the home care program — are changing the way people care for the elderly. Caritas Georgia is already providing training for new nurses, and has received some financial assistance from the Tbilisi mayor’s office to continue their home care initiative.
One of the first examples of home care nursing in the country, Caritas Georgia’s team of nurses works in several cities and towns around Georgia, providing medical care to people who are too sick or disabled to make it to a local clinic.
At the Harmony Center, the program is having an equally impressive impact. It is changing the way the senior citizens think about themselves.
For Georgia, a society with a long, cherished tradition of multigenerational households that take care of their own from cradle to grave, the idea of a senior citizen with no money and no family used to be unthinkable. As part of the Soviet Union, Georgians were insulated by a state-run system of health care: doctors were plentiful and medicine was cheap. The question of who would take care of grandma or grandpa in their old age was never an issue.
Today, however, with widespread poverty pushing families apart — many emigrate to Russia, or abroad — it is becoming more common.
Tsiala Gogodze, 74, used to arrange tours and official visits for dignitaries when Georgia was part of the Soviet Union. With a smattering of English to flavor her fluent Russian and Georgian, Ms. Gogodze laments the loneliness that gnawed at the seniors before they found the center and each other.
“You know what is horrible? No one needs people like us, not our relations, not anyone,” she says. “That is horrible.”
Family is a crucial part of Georgian culture, and the expectation that one’s family will always be there runs deep in the national psyche. Without family to look after them, or visit with them, many of the seniors who now visit the center had no one to talk with them or even care about them.
For Ivlita Kokaidze, a veteran of World War II who will turn 92 in 2014, the center has become a home away from home, a place where she can seek “relief” from the grief of losing her daughter four years ago.
“If I didn’t come here, I would go insane,” she says. “I come here, even just to read magazines, and that relieves my sadness.”
Nona Iashvili notes that the warm atmosphere and caring staff at the Harmony Center can make it hard to go back home.
“The workers here are so warm and nice; people don’t want to leave in the evening. Some even say if you brought a bed here, we would stay and sleep,” she says.
“I can’t say anything but thank you.”
Nana Natsvalishvili, the project manager at the Harmony Center, says before the center opened, seniors who went to Caritas Georgia’s soup kitchen for lunch would linger as long as possible because they enjoyed the companionship.
“When they came here, they got to know each other. They found friends in one another, created relationships. If someone falls sick, his or her friend will pick up lunch and take it to them. This means a lot.”
Ms. Natsvalishvili and her team at the Harmony Center work to provide the seniors with attention and entertainment — occasional day trips out of town, a weekly movie in the winter, special guests and even birthday parties.
Tsiala Gogodze enjoys the parties, but being acknowledged is a joy unto itself.
“We are very happy, very satisfied,” she says. “We have birthday parties, we receive presents — but most importantly, we congratulate each other. We are all alone, and it is very pleasant when someone celebrates with you.
“The most important thing is not the party; the most important thing is that someone remembers us.”
The writing of Tbilisi-based photojournalist Molly Corso has appeared in EurasiaNet.org.