Ageing and access in the mountains

511 T alongside incredible hardship. The terrain of the area is the cause of both. The foothills of north India are imbued with an almost overwhelming beauty. On a clear day, they are encompassed by the Himalayas on the horizon — snow-capped, distant and yet serenely present. Despite their beauty, these hills are the cause of significant disadvantage for those who live there in terms of access to health care and services. In this part of north India, houses and communities are distant from one another and lack the clustering and connections seen in larger towns and cities. Most small communities are inaccessible by road. The terrain is rugged, steep in places and rocky, with narrow, poorly formed paths that are difficult to traverse — even for the young and fit. Services are minimal in these areas, and reaching them, even when they are present, often requires long travel on foot over mountain paths. Accessibility is difficult, particularly for those who struggle with independent mobility and function, such as the aged, the ill and people with disabilities.