Most of the older people in the country are suffering from many basic human problems such as lack of sufficient income and employment opportunities, absolute poverty, senile diseases and absence of proper health and medical facilities, exclusion, negligence, deprivation, socio-economic insecurity, etc. Health is one of the important human rights that strengthens the persistence of human being and help them to increase basic capabilities. The breakdown of traditional family pattern, changes in traditional norms and values, innovation of modern medical facilities and increasing the rate of older people. For these changes, the older people face difficulty to meet their physiological, psychological and social needs. They are mostly vulnerable in terms of living arrangement, food consumption and possessions on wealth, participation in decision making of the family and social attitude and values. In Bangladeshi context because of traditional norms and religious and social values most of the older people are living with their offspring but at the same time it should be elicited that how easier this co-residency. Because of wide spread poverty and socio-economic change, living together is no guarantee of economic well-being of the older people. Old age brings both physical ailments and social problems. Major social problem of the old people is their adjustment to their surrounding social world in general and their immediate families in particular. Old people very often feel neglected and forgotten. This gives rise to anger, sorrows and frustration leading to tension in the family. In low-income societies, very few older people have access to any comprehensive care, and there is little or no emphasis on the importance of understanding the contextual reality of the older people’s life.
Social support for the older people mostly comes from the informal networks, often with a little support from semiformal network. The tea garden older people avoid seeking health care from a formally qualified doctor due to high costs. Familiarity and accessibility of health care providers play important roles in health-seeking behavior of older people in tea garden areas. Flexibility of health care providers in receiving payment is a crucial deciding factor of whether or not to seek treatment, ebb flow table and even the type of treatment sought. Most significantly, old age is found to be an accepted explanation of ill health and the decisions taken to seek health care are influenced by factors such as perception of severity of illness, familiarity and accessibility to health care providers, and financing of health care. In the absence of specialized knowledge in geriatric health care, multiple sources of health care, such as allopathic care, kabiraji and homeopathic care are sought by the elderly people as also reported in an earlier survey on health-seeking behaviour of adults in rural Bangladesh. It is very important to understand the health needs of the older people and so solicit their opinion in improving the existing health care and hygiene system in the country. Therefore, this study was undertaken to understand the health care and hygiene practices of older people and to gather some information about their perceive health needs using the information and over of Lackatoorah tea garden in Sylhet district.For the purposes of the study, the following operational definitions of the key terms were used. Old age is considered the closing period of human life of an individual. The Constitution of Bangladesh in its clause 15 clearly declares to introduce the Social Security Programme in 1998 for the older people who is 65 years or above for man and 62 years or above for woman. The government, through the Public Servants Ordinance, 2012, promulgated on Dec 6, 2012, increased the retirement age of the public servants to 59 years from 57 years and the freedom fighter public servant will enjoy one more year in job before going on retirement.
Therefore the inclusive criteria were to become Bangladeshi citizens living in the tea garden areas in Sylhet District and having the age of sixty years and above. The area around Sylhet is a traditional tea growing area. In the tea garden area, most of the land is hill slopes and tea garden worker and their family live in hilly place. They have no their own land for building their houses. So, they live in small and soil made houses. In this study tea garden refers to a place where disadvantage indigineous people live with poverty, poor healths and nutritions, densely, inadequate lighting, lack of safe drinking water, water logging during rains, absence of toilet facilities and non-availability of basic physical and social services. Particularly older people suffer more in tea garden areas. Health care is generally used to indicate the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. In this study health care was used to refer to the government health care services, NGO, voluntary and family health care related services etc. In this study Sylhet district was used to refer the area of Sylhet district including the all tea garden in this region. Health seeking behavior was used to refer the way of seeking health care and their attitudes about health care. Hygiene is a set of practices performed for the preservation of health. Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases. Social support was used to refer the services and allowances for older people and their health care and it was statutory and non-statutory support. The term attitude was used to refer the treatment behavior, thinking pattern and outlook of family members and community people towards older people in tea garden areas.This study was based on qualitative research method with various data collection procedures, such as interview, focus group discussion were employed to collect necessary information. Although the study was based on primary data, a number of secondary sources, such as policy documents, journal articles, academic books, official documents were used to conduct the study. In this study Lackatoorah tea garden was selected for collecting information about health care and hygiene practices of older people. This tea garden has eleven villages and all tea garden workers live in that area with their older people. The older people live in soil made small houses with their other family members.
The researchers were selected those villages purposely because Lackatoorah tea garden was near to researchers resident and had proper knowledge about the study area. The primary population of the study was comprised the aggregate number of older people living in Lackatoorah tea garden area of Sylhet District who belong to the age of sixty and above. The total older population of the above eleven villages were 108 and among them 67 female and 41 male person. Purposive sampling procedure was used to access the data necessary to address the research objectives. A number of 20 samples were purposively selected and collected information from each of them. In addition two focus group were formed with eight participants in each group. The methods/techniques of data collection were semi-structured interview schedule and focus group discussion . Apart from primary sources of data secondary source was used in order to understand the present situation of older people in slum areas.Validity in research is concerned with the accuracy and truthfulness of scientific findings. In this study, it was demonstrated what actually exists and a valid instrument or measure actually measured and what it was supposed to measure. Reliability is concerned with the consistency stability and repeatability of the informant’s accounts as well as the investigators’ ability to collect and record information accurately. In this study the consistently of the same results over repeated testing periods was checked. During study period, hydroponic grow table the researcher using the same or comparable methods obtained the same or comparable results every time and used the methods on the same or comparable subjects. The researcher developed consistent responses or habit. The researcher collected information from the respondents through in-depth interview and focus group discussion and observed their present health conditions personally. Whenever needed, responses were cross-checked with the respondents over telephone. In case of content analysis, principle of authenticity and subjectivity was maintained. So data were credible and reliable as possible.Qualitative analysis of data requires an interpretive approach concerned with understanding the meaning which people attach to phenomena within their social world. The recorded interviews and focus group discussions were transcribed in full and the accuracy was checked against the original recording and noted by the researcher. The transcripts were analyzed using thematic analysis, derived deductively from the research questions and inductively from meanings or actual phrases used by the participants. The trustworthiness of the data analysis process was enhanced by the researcher.
Triangulation of data was ensured by comparing focus group discussions and interviews data for identifying consistency and contradictions and eventually inconsistencies were examined and interpreted. In contrast, semi-structured interviews provided a great deal of information concerning personal issues. Interview and focus group discussion participants talked about their health and hygiene status, hospital experiences and the issues of general wellbeing. They were confident to talk about family matters including personal experiences of care, evaluation of self, and attitude towards diseases, treatment and future planning.When we talk about ethics in social research we are addressing those issues that concern the behavior of social researchers and the consequences that their research brings to the people they study. As such ethical issues have the potential to impact at every stage of the research process and within any research project. This is particularly important issue in qualitative research where there is significant potential for misleading people to be genuinely interested, using contacts to gain confidential information, betraying confidences, and consequentiality. Participation in the study was voluntary and relied on the ethical principal of consent. At the start of interview and focus group discussion, the study purpose and nature were explained. Although the written consent was not taken from the respondent but verbal consent was taken from them. Since the most of the participants were illiterate in Bengali and English; their presence at the interview or focus group was taken to be consent. It was further explained that while the anonymity of individual participants were preserved that their verbatim may be published, although action was taken to prevent them being identified.The demographic information of the population living in the studied area is important to understand the health care and hygiene practices characteristics of older people in the tea garden area. From the study it was seen the average age of respondents in tea garden areas in Sylhet District was 70.25. In the tea garden areas most of the older people live with their son’s and daughter family. It was revealed that the thirty six percent respondents live in joint family with their sons and sixty four percent of respondents live single family with one son or daughter. Education is the backbone of the nations. Education is considered as an important factor of the socioeconomic characteristics of the household. It reveals from the collected information that only fifteen percent respondents completed primary schooling and other dropped out due to poverty of their parents and lack of educational facilities in the tea garden areas. Most of the older people are unemployed and they spend their time in home. Although a few numbers of older people work in tea garden but their income is very law. Twenty three percent respondents earn one thousand taka per month through picking tea leaf and planting in the garden. Older people in tea garden areas suffer various diseases, so, for their treatment and livelihood they need money. Their expenditure is high in respect of their income. It is seen that monthly expenditures of the respondents are three to four thousand taka and eighty five percent respondents depend on their offspring for daily food and medicine. Bangladesh is a multi-religious country. Mainly four types of religious people live in this country but in the tea garden they are indigenous and mainly belong to sanatan/hindu religion. Marital Status of the respondents was shown that thirty three percent of the respondents are widow and widower. The high proportion of widowhood among the older women and who live with their son or daughter’s family.