Conflicts: Impact on Older People

I beg to move, That this House has considered the humanitarian impact of conflicts on older people. It is a real pleasure to serve under your chairship, Mr Betts; thank you for chairing this debate for us. I have been asking for a debate on this subject for some time. The subject is close to my heart, and not merely as a matter of policy—it is a matter of conscience, human dignity and our shared responsibility for the most vulnerable in our world. I thank hon. Members for attending. It is always a pleasure to see the Minister in his place. He is always very jovial and friendly and tries to give the answers that we hope for. I want to start by referring to a constituent named Margaret. She is 83 years old and lives in the Ards peninsula, where I live in my constituency of Strangford. She still keeps a photograph on her mantelpiece of the street where she grew up, which was not in the Ards peninsula. It was in Belfast on a street that no longer exists because it was destroyed—a casualty of the troubles that we had in Northern Ireland. Margaret speaks about the cold, the fear, and the long, painful shadow of conflict. She speaks from experience because it is her story. As an 83-year-old, she can remember it very well. Across Northern Ireland are thousands upon thousands of older people who carry with them a lived memory of trauma. My family lives with the trauma of the death of my cousin Kenneth; my aunt, uncle and family were never the same. Across Northern Ireland, many thousands of families are affected by the troubles. As the title of the debate states, this is about the impact of conflicts on older people. I will refer to conflicts across the world, but the Northern Ireland one is the one that we can draw experience from and illustrate. That experience, alongside my role in addressing health policy for the Democratic Unionist Party, means I understand viscerally what conflict does to older people—maybe because I am older now myself. I am more conscious of those who are just ahead of me, which makes me very aware of their vulnerability. I think of my mother who is 94—95 next Tuesday, if God spares her. Again, I think of older people and what they have lived through. A wound does not simply wound the body, although it does that profoundly and permanently. It fractures community and destroys the very networks of care and support on which older people depend. It strips away the intrinsic dignity that every human being deserves, regardless of age, faith and nationality. My own community of the veterans of the Ulster Defence Regiment, the Royal Ulster Constabulary and the Prison Service and their families fully understand the lasting impact of trauma. Apologies—I should have thanked the Backbench Business Committee at the beginning for allowing this debate. The global picture is incredibly worrying. The scale of the crisis is mammoth. The United Nations estimates that approximately 200 million people aged 60 and over are living in fragile or conflict-affected settings. Let us take a few moments to let that number sink in: 200 million older people are living in fear, without adequate healthcare and shelter, and too often without any recognition that their needs are specific, urgent and distinct from those of younger people in the same crisis zone. I wanted this debate because I have felt for some time that we look at the wars and see the young people, the deaths and the lack of education and healthcare. But in the middle of that are people of an older generation with incredible problems. We see that with devastating clarity in Ukraine. Whenever I read the stories about Ukraine, they move me significantly. Who is left in the villages that are destroyed? Who is left among the ruins? Usually it is the older people, living in the basements. I want to focus on them for a few moments. I have stood consistently with the Ukrainian people in their hour of need, as has the House, the Minister and every hon. Member. Ukraine has the highest proportion of older people affected by conflict anywhere in the world; one in four Ukrainians is aged over 60. In eastern and southern Ukraine, near the frontline, the situation is even more acute: one in three people who need assistance is over 60 years of age. The families fled, of course, to get away from the violence, the attacks and the Russian aggression. Only 5.4% of the Ukrainian refugees who arrived in Europe were over 65 because elderly people have been left behind, either due to their choosing to remain in their homes because it is the only place they have, usually with their pets—their cats or dogs—or because of severe health conditions that make fleeing conflict zones more difficult, even though the Ukrainians always try to give such people the choice to leave. The situation has left older people facing acute challenges. Shockingly, around 50% of documented civilian deaths in Ukraine have been of people older than 60 years of age. They have faced severe disruptions to their support systems as family members, friends or carers have left. Some 90% of older people in Ukraine are unable to pay for even their basic medical needs to be met. They are probably in the conflict zones and often their medications, or the medical help that they need, cannot get to them. Some 43% of older people in Ukraine have at least one disability. I know, from my position as health spokesperson for my party, that when someone gets to a certain age, they do not just have one thing wrong with them but half a dozen things. Complex needs are incredibly common among many elderly people. That makes evacuations and displacement even more challenging. There are barriers of mobility, digital exclusion and bureaucratic complexity that become insurmountable for an 80-year-old person who has lost just about everything they ever had, including their family. I speak as one who has spent considerable time examining the collapse of health systems under the pressure of conflict. I want to underline this point with some force: older people have healthcare needs that are complex, chronic and ongoing. They need orthopaedic care. Many old people will struggle to get about at all; being in a warzone, under attack, makes that even more difficult. They also need cardiac monitoring and management of long-term conditions, such as diabetes—I am a recipient of management for that—and respiratory disease, hypertension and dementia. Those are not luxuries; they are the basic requirements of survival. When a conflict destroys a hospital, a medical centre or a GP surgery; when it displaces a medical team; or when it cuts off a supply chain of medicines, it is the older people who suffer first and most. Long-term conditions are worsened by food insecurity, income insecurity, and the pressures of displacement and living in conflict situations. There are no shops and only the smallest means of cooking—it may be only a wee Calor gas thing, or even only a wood fire. The waiting lists that I have seen grow to crisis point here in Northern Ireland even in peacetime are as nothing compared with what older people face when the infrastructure of healthcare is obliterated by war. Let us look at some of the harrowing theatres of war across the world. In Lebanon, older people face compounding risks from the escalation of hostilities, rising displacement, economic collapse and pressure on a weakened health system. A 2025 HelpAge assessment of 670 older women and men across five regions of Lebanon found that they were frequently excluded from assistance and recovery planning because they are at an age, they are probably still in the danger zones and little or no effort is made to help them. Some 61% received no humanitarian aid after the conflict and 39% reported being completely left out of the response, even during active hostilities. Only 12% of those who received aid said that it met their needs. Many have been unwilling or unable to leave their homes despite evacuation orders, while those who have fled found shelters that were poorly equipped for mobility, care and dignity, all three of which are so important. Lebanon illustrates a wider failure. Aid might be provided, but if it is not designed around older people’s access needs, including their outreach, transport support, continuity of medication, assistive devices, home-based care and mental health support, it will not reach those most at risk. Who is at the back of the queue? It is the elderly. Sudan is the second place that I will focus on. Today in business questions, Sudan was asked about; there was also a question about South Sudan in the questions about NATO, which the Secretary of State for Defence replied to earlier. I secured a Westminster Hall debate on Sudan—four weeks ago today, I think—in which I highlighted the issues in the country. What is happening there is absolutely tragic. Since fighting erupted in April 2023, Sudan has seen repeated waves of displacement. Over 20 million people need health assistance and around 1 million of them are older people. Civilians face worsening conflict in the Kordofan region and risk escalating violence, confinement and starvation. UN figures provide an evidential base, showing that older men and women each make up about 4% of the population living in displacement camps, while around 3% live in refugee camps in neighbouring countries. Older people remain one of the least supported groups in Sudan. Human rights monitors report that they are often left out of aid programmes, especially in remote areas. It is a massive task to get aid to remote areas; I understand that. But some consideration must be given to it. At the end of my speech, I will set out some ideas, which I hope the Minister will give me some encouragement about. Due to limited mobility, many older people struggle to flee explosions or attacks. I am 71. I cannot run a marathon any more; I could probably walk it, but I could not run it. Older people who are on mobility aids cannot walk or run at any speed whatever, so they cannot get away from the destruction coming their way. Older people also face high rates of depression and post-traumatic stress. As we get older—maybe you and I both recognise this particular trait, Mr Betts—things may worry us more than they did when we were younger. I say that in jest, but the fact is that older people sometimes dwell on things longer than they should.

Order. The hon. Member should not take my views for granted in this sort of debate—he can speak for himself, I am sure.

I speak for myself, but I think you are not too far off my years, Mr Betts, although I know that I am older than you. In Sudan, the health sector has been destroyed and medicines are in short supply. Even those with manageable health conditions are at grave risk. In parts of Darfur, dozens of older people are among those who have died of hunger in recent months, after armed groups blocked food deliveries. Who cannot get to the aid centres or food centres, because of their disabilities or their particular needs? Older people. Why is that allowed to happen? It is because older people are invisible in the data. We often come back to data when it comes to debates—especially health debates, but perhaps debates on anything—because data collection and analysis fail to capture the realities of older people’s lives, with data collection often stopping before people are 60. If someone is over 60, their time in this world, according to those who collect data, is limited. Where older people’s data is included in data collection, they are often lumped together as a single group—those over 60—but that obscures diversity and hinders effective policy making. Evidence shows that age inclusion specialists can change humanitarian assistance by improving assessments, data collection, training and programme design. To give just one example, the data collection tools used by HelpAge Ethiopia showed that there were six times more older people in one region of Tigray than had been previously thought. The data had not been there before so the number of older people had been unknown. In Venezuela, age inclusion specialists supported humanitarian actors through adjusted food basket guidance to better meet nutritional needs. They use the data for the betterment of services. Unfortunately, there has been a double earthquake in Venezuela and many people are missing—the country is dealing with some incredible problems. A 2025 systematic review found that the barriers to age-inclusive healthcare include inaccessible health services, shortage of medication and equipment, limited geriatric expertise, age discrimination, low mobility and dependence on others—more often than not, elderly people do depend on others. Funding reform is desperately needed. A 2025 analysis by HelpAge found that older people are rarely named in humanitarian funding databases. How can we deliver enough aid, medication, food and support to elderly people if we do not know how many there are? In funding databases, only 6.5% of descriptions and 0.1% of project titles mention older people. I must raise the question—you would expect me to, Mr Betts, because I always do—of freedom of religion or belief. It is intrinsic to this debate in ways that are not always acknowledged. In many conflict zones, such as in Myanmar, Nigeria, Syria and Ethiopia, older people are targeted not merely because they are in the wrong place at the wrong time, but because they are the custodians of their communities’ faith and culture. The hon. Member for York Central (Rachael Maskell) and I share this concern, and I look forward to her contribution. As custodians, older people hold the memory of worship, tradition and identity. They are the heartbeat of the congregation and the lifeblood of the community, and they are targeted because of that. They are driven from their homes because of their faith and denied the right to practice a faith that has sustained them across a lifetime. That is not simply a humanitarian failure; it is a moral outrage. Does the Minister agree that the protection of older people in conflict zones must explicitly include the protection of their right to freedom of religion or belief? I know the Minister’s answer to that, but perhaps we could have it on the record in Hansard. I do not want to be churlish about the progress that has been made in international humanitarian law. There are frameworks and conventions, as well as the “Sphere Handbook” and the Inter-Agency Standing Committee’s work on inclusion, but let me be direct in a respectful way. The gap between the frameworks that exist on paper and the reality experienced by an 80-year-old woman sheltering in a basement in Kharkiv or a 75-year-old pastor driven from his church in Kaduna state in Nigeria is vast and unconscionable. I have a number of questions for the Minister—seven, to be precise. We need to make humanitarian aid age-inclusive by default. Will the Minister commit to requiring UK-funded programmes to explicitly and systemically identify and reach older people, including those living alone, those with disabilities and chronic illness, and those unable to travel to distribution points? To protect older people’s health, care and wellbeing, will the Foreign, Commonwealth and Development Office prioritise continuity of medication, accessible health services, assistive devices, safe evacuation, accessible shelters, home-based care, if possible, and mental health support in active conflicts? Will the Government support universal social pensions, inclusive cash assistance and shock-responsive systems that enable older people to meet their own priorities with dignity? That will ensure age-inclusive access to cash and social protection. Will the Department include older women in protection and its responses? Pre-existing patterns of discrimination are exacerbated during conflict, and extreme levels of violence against women and girls are a recurring theme. Older women are particularly at risk due to their age, gender, disability, caring responsibilities, widowhood or financial dependence. The UK international strategic framework on women and girls fails to consider how older women are affected, but there must be a focus on older women in particular. Will the Government ensure that its implementation includes explicit reference to older women’s humanitarian protection and safeguarding, and programmes to tackle gender-based violence through a life course approach? Russian army personnel have carried out horrendous sexual attacks on girls as young as eight and women as old as 80. We need to protect women of all ages. We must count older people properly. Will the Minister require age, sex and disability to be included in disaggregated data, including specific age cohorts over 60? The age of 60 is where it seems to stop. If someone is over 60, we do not know about them for the purposes of all humanitarian assistance that the UK Government provide or support. We must recognise older people as rights holders. Will the UK support the creation of a UN convention on the rights of older persons to recognise the agency and contributions of older people and to facilitate their participation in humanitarian planning, peace building and monitoring, and local decision making? Last, there must be engagement with devolved Administrations. Will the Minister engage directly with the relevant Ministers in the devolved Administrations of Scotland, Wales and Northern Ireland, where we have hard-won knowledge of what conflict does to older people across generations, so that the lived experience of communities like mine can inform and enrich our international humanitarian policy? I opened my speech with Margaret, so I will close it with Margaret. She once told me something that I cannot forget—that the worst thing about conflict is not the noise of it but the silence that comes after, when the world moves on and forgets that you are still carrying all that pain, memory and trauma. The older people of Ukraine, Sudan, Lebanon, the Sahel and every conflict zone across the world are still carrying that. The United Kingdom of Great Britain and Northern Ireland—these great four nations together as one—has both the capacity and the moral duty to ensure that they are not forgotten. I commend this debate to the House. I thank Members for turning up, and I look forward to their contributions, particularly those of the shadow Minister, the hon. Member for Fylde (Mr Snowden), and the Minister. I look forward to engagement with the Minister and to ensuring that older people in conflict are not forgotten about. There are ways of doing it better; let us start now.

It is a pleasure to serve under your chairship, Mr Betts. I congratulate the hon. Member for Strangford (Jim Shannon) on securing this debate. I also wish his mother a very happy birthday for next Tuesday. In many areas of deep conflict, the population rarely reaches our definition of older people. In Gaza, life expectancy has plummeted from 73 years to just 40.5 years. In Sudan, life expectancy is 66 years, and in Nigeria and Chad, it is 55 years. Compare those numbers with the UK life expectancy of 81.3 years or the life expectancy in Japan of 84.7 years. It is a privilege that our nation is safe, secure and conflict-free. Those figures show that conflict shortens lives by decades through poor access to healthcare and pharmaceuticals; disability, disruption and displacement; prevalence of disease and hastened frailty; and an environment of climate change, floods and famine. Gender-based violence scars the lives of its survivors. I am so proud that our Foreign Secretary has rightly placed tackling the prevalence of the use of gender-based violence as a weapon of war at the heart of her work. Access to healthcare, an issue that I particularly look at in my work in the House, is significantly reduced, with the targeting of health facilities and health professionals now central in many conflicts. We have seen that in Gaza and in Sudan. Health professionals working there run these risks in the work that they do and because they are targeted by weapons. That breaks the rules of just wars, but these wars, of course, are never just. We have also seen the shrinking capacity of healthcare against the increased demand, whether from the wounds of war or the poor mental health sustained from the sharp rise of sexual violence against women. As a result, the ability to access healthcare is reduced, and that, of course, will always impact older people the most. Often in war, we look at the wounds and we understand why, but it is the chronic conditions—the cancers, the diabetes and other illnesses—that often get forgotten; it is the drugs not getting through, the treatments not available, the clinicians simply diverted to acute care. Our hearts beat when we know that a child has been rescued or a life has been saved, but although the life of an older person is of equal value, often the resources are not there to save or sustain that life. As the hon. Member for Strangford said, it is often the elderly who stay behind in conflict zones because they cannot move—they cannot be displaced, and they stay in those areas. We have seen that in Ukraine and in many other areas. Our research shows that moving an elderly person has other impacts; it can cause much confusion and have a real impact on mental wellbeing. We need to take on board why so many older people die in conflict; it is because they are in the direct firing line, or because the facilities and infrastructure that keep them going are removed. This is not just about healthcare. It is about social care and the social infrastructure when family is no longer available to provide support. State provision can be disrupted, and pensions no longer available. Food supplies are diverted into emergency and humanitarian aid. It is so important that we put older people at the front of all agendas. I say that as chair of the all-party parliamentary group for ageing and older people; I take this matter very seriously. Now, with severe cuts to international aid, a humanitarian response is more challenging. I urge the Government to return to 0.7% as a matter of urgency and to provide leadership once again, to ensure that we can provide aid. Not everyone will be able to receive that, but we should provide it to as many people as possible. Older lives matter, too. When infrastructure breaks down, resilience plummets and that is particularly stark among older people. The Government must be mindful of that when appraising their priorities. Without financial resilience, even the basics become barriers, especially for women in conflict zones. Aid must ensure provision of food, care, medicines and support. It needs to be a lifeline. This is not just about the physical impact of destitution and the health consequences. The psychological trauma must be recognised, too. Elders play such a pivotal role in communities and families. If their resilience is broken, so is that of their societies. In many societies to this day, women are at particular risk of violence and abuse, including sexual violence. It has been a taboo subject, not least among the older generation, yet it is so traumatic. Last Ukraine day, an event was held in my constituency where I heard from a Ukrainian woman and saw a film about the sexual violence being perpetrated against women in Ukraine, and the horrors and the scars that it has left them with. They did not speak, because of the shame it brought them and the trauma that they were going through, but, when they started to share their stories, it brought healing between them. Without the proper support and psychological care wrapped around individuals, that healing does not come. That is why I am so proud that our Foreign Secretary has recognised that and has put resources into it, particularly in the Sudan region. We need to make sure that women there access the support.