I was invited to attend the above three day conference by Prof Hans-Joachim von Kondratowitz of Berlin in order to moderate a session on ‘Migration as Impact on Ageing Mediterranean Welfare Societies’. It was held at the Imperial Hotel (more of which later) in Sliema, a popular residential suburb of Valletta.

The conference was attended by 29 delegates, just over half of whom came from countries with a Mediterranean coastline. Not all the Mediterranean rim countries were represented but those who attended included academics from France, Italy, Israel, Greece, Lebanon, Tunisia and of course, Malta. There were several delegates from non-Mediterranean countries including Portugal, Sweden, Norway, The Netherlands, Germany, Czech Republic, Belgium, the USA and the UK. In the opening session, there was an interesting discussion on which countries do indeed represent ‘Mediterranean’ cultures. For example, Parisians rarely consider themselves ‘ Mediterranean’, but the Portuguese, who do not have a Mediterranean coast, certainly consider themselves part of the Mediterranean culture. There were other dilemmas pertinent to identifying a ‘Mediterranean culture’. The coastline spans three continents: Europe, Asia and Africa, and represents the three principal monotheistic religions of Christianity, Judaism and Islam. The region also contains a wide diversity in socio-economic status, political and welfare systems and demographic profiles. There are even greater disparities in the status of women, young and old, which impacts substantially on family responsibilities for and by the older generations.

The extremely interesting papers ranged from general topics such as household and family structure; demographic patterns and predictions; dependency in old age; employment opportunities; pension provision across the region, to more specific topics such as social relations and social networks (Israel); present and future health (Greece and Lebanon); home care arrangements and family responsibilities (Portugal); illegal/unregistered unqualified migrant care workers (Italy) and legal registered unqualified migrant carers (Israel); and migrant populations growing older in a host country (France). The conference concluded with a round table discussion with invited presentations from academics from Germany and Norway who outlined the topics, suggested gaps and where and how research might be taken forward.

Each presentation stressed the centrality of caring for older people within the family, as a duty and obligation enshrined in religious practice and the law. It was equally stressed particularly in the Islamic culture, that such obligations are taken on completely willingly out of love and respect for their elders, and an acknowledgment that the physical care was carried out by daughters-in-law, daughters and nieces. Although there was a slightly more ambivalent attitude to the ‘hands on’ aspect of family (female) responsibilities from the Roman Catholic and from the Israeli presenters (where carers were employed to look after extremely frail elderly parents), there was nevertheless a recognition that the overall management of care rests concretely within the family.

The overwhelming ‘take home’ message is that the eastern and southern shore – non-European countries of the Mediterranean are beginning to follow the demographic patterns of their northern neighbours inasmuch as they are experiencing dramatically decreasing fertility rates and increasing life expectancy. It goes without saying that there will therefore be fewer adult children to share the responsibility of care for longer living parents. As important, is the increasing rate of female employment in all these countries with the concomitant reduced availability of adult daughters/in-law to provide round the clock care for very frail and sick older people. In the southern states of Europe, particularly Italy, this gap is filled by cheap, hugely exploited and unregulated 24/7 female labour part paid for by state subsidies. These migrants are tolerated by the governments because they fulfil a vital role in caring for the ageing population. In the countries without state support for the care of older people, there is, or will be, a substantial structural lag between what is happening in society in terms of women’s choices in life, and formalised state help forthcoming for the older population. At some stage, support for elder social care must be available as well as the health and pension provision increasingly recognised as a state welfare responsibility in the region.

From a northern European social democratic welfare gerontological perspective (mine), what also unfolded was the apparent powerlessness of older men and women in choices about how or where they wished to live, especially when they were bereaved. Although as mentioned, almost all the papers stressed the importance of duty, obligation and respect to older people, none put forward the perspective of the older people themselves or for that matter, their female carers. In the round table discussion, I pointed out that the Mediterranean countries do not have the monopoly on loving, respecting and caring for their older parents, and also that nothing had been discussed about older people who had no family to care for them.

It wouldn’t be a proper report from me if I didn’t give you some of the context of the conference. The Maltese Islands are steeped in history and have standing stone and temples which predate Stonehenge and the pyramids. As an important crossroad in the Mediterranean, it has enjoyed and suffered a multitude of conquerors and governors. It had a mainly good and amicable relationship with the UK for over one and a half centuries and there are many relics of ‘British’ rule including English being widely spoken, red phone and letter boxes. One such relic is the Imperial Hotel in which the conference was held. A most impressive building of great character with a fabulous ‘reception’ area, stunning sweeping staircases either side, a lovely courtyard and swimming pool and excellent conference facilities. The accommodation was a little ‘tired’ and the cuisine left much to be desired, but the atmosphere at the conference was highly convivial and well worth the journey.