Book Rt!v~ws 103
on what Jomtein (1990) identifies as the real literacy.
Despite some inconsistencies and a lack of uniformity which, in a report such as this,
is not necessarily a weakness, the Conference does succeed in shedding light on ILY9O;and
the problematic of literacy in the next decade, putting them in the limelight. TI1e report
contains a wealth of information and insights, and is highly recommended for "those
interested in development, education and literacy in the Third World"
Reviewed byR E Carmen. Centre for Adult and Higher Education, University of Manchester,
Manchester, United Kingdom.
Reference
Jomtien (1990) '''Framework for Action' for the Nineties" in Bask Education, 8.
Ageing in Developing Countries, Ken Tout, Oxford University Press and HelpAge
International, Oxford, 1989 (xvi and 334 pp, £30, ISBN 0 198272790 hbk, 0 19827276
6pbk).
Doctoral dissertations rarely succeed in being transposed to readable and informative books.
This one manages, though I have some qualifications to make. Its success and its limitations
arise from the same cause, the unusual conditions under which the author completed his
work. Ken Tout worked fulltime for the UK-based NGO, HelpAge International, and
specialised on projects in South America for seven years.
The first six chapters of his work set the scene. The introductory chapter contains
defmitions of ageing, and points out how the extended family network ofsupport for elderly
is disintegrating; then the author discusses demographic data on the greying of populations;
analyses the impact of socioeconomic factors (rural decline, lack of social security,
migration, "ageism", malnutrition); reviews some surveys of the elderly in South America,
Africa, Western Pacific, Malta, and the Caribbean; looks at a selection of individual case
studies and themes focusing on those elderly who live in destitution, in isolation and in poor
health; and outlines the available information on existing social services (pensions, health
care, institutional social services) in different parts of the Third World.
The remaining five chapters discuss policies and projects for enhancing the lives of
elderly in developing countries. Experimental projects that provide income generation,
substitute support, andemphasise integration into alocaIcommunity are discussed: a bakery
run by elderly, specialising in delicacies of yesteryear; a laundry run on behalf of old
peoples' homes but open to the public; a fast-food outlet; weaving project; farms and
cooperatives. Tout also includes acomprehensive analysis of problems and mistakes in pilot
care projects for the elderly, but with relevance to other development projects - culturally
inappropriate project design, dishonesty, staff shortages, the difficulty of targeting the really
needy. The author then proposes a typology of three model programmes, at district,
metropolitan and national levels, and in a separate chapter concentrates on national
strategies on ageing.
104 BooIcRevie_
Toutemphasises the importance of proposing and implementing strategies commensurate
with the economic abilities of the country, and his comments have particular relevance for
Zimbabweans who are witnessing the introduction of a new national pension scheme.
European and American pension schemes will no longer be able to be supported in the next
decade, buthe asks "how does a third world govemmentcommencesuch a scheme?" (p246).
Inspite of adverse recommendations from the ILO and others, it seems that Zimbabwe will
follow the path that so many others now regret, that of introducing a scheme which will be
an increasing burden on the nation, but which benefits only a small, already privileged
employed class. Other aspects of national strategies discussed by Tout are the transformation
of attitudes to the elderly, the promotion of smal1scale and cottage industries, appropriate
housing and health care services, family support, community action, the involvement of the
elderly themselves in programmes, and the impact of international aid upon national ageing
strategies. In this field international financial aid fromNGOs is much more significant than,
say, UN assistance: NGOs gave more in one year to African countries than was pledged for
five years by govermnents to the UN Trust Fund on Ageing. Tout also discusses the various
conferences held on ageing in Third World countries, including Dakar, Nairobi and Harare,
and concludes that their resolutions leave no excuse for a lack of initiative but do underline
how much needs to be done. In a further chapter on special groups Tout singles out the
elderly refugee, the older women and what he calls "grandmothers and AIDS" as deserving
of preferentialtreatmenL The book ends with a call to society to restore to the elderly the
prestige, independence, mobility and challenge which so-called civilised attitudes have
destroyed.
It is unfortunate, but perhaps inevitable, that much of this work is descriptive and
derivative, for where the author charts his way through unknown waters he seems confident,
insightful and relevanL For example, the fact that Ken Tout's study almost exclusively
records NGO involvement in situations of need in the Third World means that we hear too
little of indigenous and successful ageing. Programmes are proposed in response to the
needs of elderly in difficult socioeconomic conditions, but we do not hear of the methods
of adaptation and innovation by which communities at local and national level have
achieved success in dealing with problems of ageing. Such methods need investigation:
methods of support found in traditional cultures that can be adapted to modern society,
methods of enhancing support from the extended family where it exists, factors of success
in support networks that substitute for the extended family, and so on.
A second shortcoming to this work is that the discussion on the role of the elderly in an
AIDS-devastated economy and society is limited to four pages, in the section entitled
"grandmothers and AIDS". I would have thought the demographic, economic and social
crises affecting the Third World, and particularly African societies, merit a much more
thorough lreatmenL Tout does compare the visible effects of AIDS on a population with the
more insidious effects of its greying, arguing that the latter effect needs to be given greater
attention (P114), but it would also have been helpful to examine in greater depth the serious
and insidious effects of one upon the other.
Book Revkws 105
My third hesitation about the book concerns its concentration on South American
examples, sometimes to the neglect of Africa. For example, the Dakar Conference, Africa's
first, and to date only, meeting on gerontology and ageing, is mentioned in one page.
Nevertheless, in spite of these limitations, I found this study very valuable because it is
a pioneering work in a field that has until now had little by way of comprehensive analyses.
It summarises in a readable way much of the work already done, and addresses the main
issues, charting the way forwardforThird World elderly to live in dignity and independence,
an ideal which many societies embrace but do little to realise.
Reviewed by Joe Hampson SJ, Jesuit Provincial, Harare, Zimbabwe.
Group Work with the Emotionally Disabled, Baruch Levine (ed), Haworth Press,
London 1990 (133pp, US$22,95 hbk, ISBN 0 86656 9944 hbk).
(Simultaneously published as Social Work with Groups, Vol 13,No 1).
This book is one of the volumes in the series "Social Work with Groups". The collection
of papers in this volume covers a number of theoretical and practical issues of groupwork
in psychiatric and clinical settings and is a useful resource for workers in this field.
Part I by Levine deals with the history, problems and issues of groupwork. Part IT
comprises a short paper by Konopka who stresses that, despite the burgeoning of group
treatment for various clinical groups, therapy groups are not necessarily therapeutic.
Part illcontains a number of papers describing the formation and running of therapeutic
groups for a variety of clinical populations in a number of different settings. Bond and de
Graaf-Kaser present a typology of group approaches, such as unstructured approaches in
sheltered settings, structured approaches in sheltered settings, including education, skills
training, etc; experimental 'in vivo' formats whichcan be implemented inrehabilitation, and
drop-in centres. The comprehensive list of references following this paper should prove
most helpful to anyone wishing to select and run a therapy group.
Sheldon Rose's paper on the group treatment of agoraphobia, using the traditional
approach of 'in vivo' exposure, covers the steps to be followed in the building, maintenance
and treatment of such a group.
A thought provoking and innovative approach to the group treatment of children is set
out in Scharness' paper. Two types of participants are dealt with. Firstly, there is group
treatment oflatency age children from families disrupted by separation and divorce. The
aim of treatment is to reduce confusion regarding family composition and to help these
children deal more constructively with the roles they are allocated in their families. A
combination of intrapsychic and family therapy is used with the genogram being the main
medium of instruction and intervention. The second type of group discussed by Schamess
comprises teenage mothers and their toddlers and young children under the age of six years.
The children interact with one another under the guidance of a trained worker while the
mothers are given psychoeducation on child development with more constructive mother/
child relationships being promoted.