There is not a sound to be heard in the tiny health centre in Eranhikkal, a small town about 10km from Kozhikode city in Kerala. Some 50 men and women — all senior citizens — sit quietly in the one-room Hridaya Pain and Palliative Centre, waiting for their turn to meet the doctor. Among them is Kalyani Manapurath. She sits in the first row, dressed in spotless white clothes and nodding off every now and then. On alternate Thursdays, people above 65 are given free medical examination and medicines at the clinic as part of the Kerala government’s Vayomithram initiative. Manapurath has been waiting for long, but not because the doctor is late. She had reached the centre two hours before her scheduled check-up.

Manapurath is 101 years old, and flashes a toothless smile when she talks about her daily routine. “I’m up by 5 am and finish all the chores at home,” she says. After a brisk sweep of the courtyard, she has her bath and breakfast. Every other Thursday, she walks down to the centre from her home. “I walk everywhere. But today an autorickshaw driver dropped me here,” she adds.

The centenarian is a source of wonder in Eranhikkal — not so much because she hit a century but more for how she chooses to live her golden years. Unsurprisingly, the whole of Eranhikkal knows her, and more often than not, she is offered a free ride to her destination — which spans from the nearby to the remote.

Every year, she makes the arduous trek to the hill temple of Sabarimala. She also travels annually to the Muruga temple in Pazhani, Tamil Nadu. “I have gone to Sabarimala for 26 years without a break. When the policemen see me at the temple, they make sure I get a good view of the deity.”

Does the family take her on pilgrimages? “I take everyone along,” she says.

A widow for nearly 50 years and mother to eight, three of whom are no more, she used to help women with post-pregnancy care and newborns until a few years ago. “Most newborns in the locality have been bathed by Kalyani Amma,” pitches in Aparna P, a staff member at the centre.

“I’m mentally strong and never feel old or unwell. I want to be on my feet always. In fact, as I age, I become more confident,” she says. Her daughter has now moved in with her, but she had lived alone for years, supported by a network of family and community. Her children often urge her to move in with them, but Manapurath values her independence. She hops into a neighbour’s house to watch television, walks around the riverside neighbourhood chatting with acquaintances, grinds ingredients for her meals without using a blender and walks without footwear.

Her needs are meagre and largely taken care of by the widow pension of ₹1,200 that she gets from the government every month. The health card she clutches shows that she is in fine fettle: She has been prescribed medicines for blood pressure and flatulence, but she needs no reminder to take her medicines.

Tell her she doesn’t look 101, and she readily agrees. “Many tell me that I don’t look a day more than 80,” she grins. Manapurath wanted her 100th birthday in July last year to be a quiet affair with a visit to a temple and toffees for her elderly friends at Vayomithram. But the staff at the centre turned it into a party; it was soon followed by similar functions by the residents’ association in her neighbourhood.

Kalyani Amma, 101 not out, is a warm thought in Eranhikkal.

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But she is not an aberration in Kerala. Census 2011 pegs India’s elderly (60 and above) at 103.9 million, accounting for 8.6 per cent of the population. The percentage is considerably higher in Kerala — the elderly made up 9.79 per cent of the population in 2001 and 12.83 per cent in 2011. It is estimated that Kerala has 4.1 million people over the age of 60 — almost the entire population of Croatia.

The elderly will account for 15.63 per cent of the state’s population by 2021, and 20 per cent by 2026, Kerala’s Policy for Senior Citizens states. According to Situation of Elderly in Kerala: Evident from Kerala Ageing Survey 2013, a study by the Thiruvananthapuram-based Centre for Development Studies (CDS), Kerala’s elderly population is growing at a rate of 2.3 per cent. “The growth rate is high among the elderly aged 70 or 80 and above,” it says.

With women living longer than men across India, the majority of the elderly in Kerala are women, and many are widows. What makes Kerala stand out is the number of women nonagenarians and centenarians. The census 2011 notes that in Kerala there are twice as many women as men aged above 90 — 46,007 women against 23,713 men.

“Life expectancy is very high in Kerala. On an average, women after reaching 60 can live for 23-25 years more, while for men, it is only 17-20 years. If women touch 80, they are likely to live for another 12 years; if they reach 90, they can live for another 5-7 years,” says Irudaya Rajan, author of Situation of Elderly in Kerala: Evident from Kerala Ageing Survey 2013and professor at CDS, explaining the ageing pattern.

With their population just shy of half a lakh, it is not surprising that Kerala’s nonagenarian women along with the 3,000-odd centenarians are springing up frequently in the State’s social milieu. Kerala, according to the Social Justice Department, has the most number of old age homes in the country. At the same time, an efficient healthcare system with avenues for geriatric care, and an assortment of schemes run by the Social Justice Department for the elderly, make it a friendly state for senior citizens.

But old age is no child’s play. Many women in their 90s or 100s and more have suffered intense personal losses, not just the death of spouses but offspring as well, witnessed turbulent times and watched the passing of their way of life. Yet, many have soldiered on, abiding by their discipline, picking up new challenges and doggedly keeping pace with life. And it helps that few are bogged down by physical infirmities — largely because of a healthy diet and the robust healthcare system.

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KV Sarada Amma, a 93-year-old great-grandmother, is the sporty kind. Her opponents may be schoolchildren, but she does not let that blunt her spirit of competition as she prepares for a round of carom. The coins are in her safe custody and she arranges them ceremoniously on the board. Play begins. The coins dart and slide from her fingertips with precision and, before long, she has won the game hands down. “Chopping vegetables help with the reflex of the fingers,” she says. Sarada Amma is also a committed cricket fan. The Cricket World Cup was a source of great excitement, but she was not allowed to stay up and watch the late-night matches. “She had to be in bed then. But the first thing she wanted to know in the morning was the result,” says her daughter, KV Jayasree. The nonagenarian had been confident that India would win the cup. “I like Dhoni, though Kohli is not bad,” says the staunch Sunil Gavaskar fan.

Her life at home in Cherukkunnu, a suburb in Kannur district, is one of intense discipline. The day starts early and follows a pattern that includes a cold water bath irrespective of the weather, a visit to the neighbouring Someshwari Temple and a vegetarian diet. She spends most of her day reading spiritual books. A stack of books, neatly covered and labelled, is placed on a teapoy in the living room.

“I read a bit from each book. That keeps my mind clear and negative thoughts at bay. If I’m low, I pick up a book and I’m all right within minutes,” she says. Sarada Amma did not finish school. A widow for over 15 years, she shares the ancestral house with her youngest daughter. “I can live and adapt anywhere. I’m not fussy, that’s the secret,” she adds.

The cricket fan has itchy feet too and is never the one to back out of travel plans. When the Kannur International Airport was opened recently, she and her two daughters hired a cab and had a look at the airport. It seemed “wrong” not to go see it, even if it was from the outside. Weddings in the family mean she is often travelling — to Malaysia and Mumbai, Chennai and Visakhapatnam. A recent flight to Visakhapatnam had been particularly circuitous. But as the airplane touched down in Hyderabad for yet another stopover, Sarada Amma had no quibbles. “I had been to the city decades ago. My husband once worked for the gold mines of Hyderabad.”

Arya Antharjanam, 90, too, never misses the chance to hit the road. Her travel itinerary in recent years has been hectic with trips to meet family in Abu Dhabi, Bahrain and New Delhi. When she is at home in Amballur in Thrissur district, she is happy with short trips to the City Centre Mall. She was there recently, browsing around with her son, and ably supported by her walking stick.

Raised in a family with Left leanings, she imbibed those beliefs — and continues to abide by them. She had penned a poem decades ago when her sister married PS Namboodiri, who later became a Left legislator, wishing them a life of revolutionary action. She recently recited the long poem, without slipping up on a single word, on her 90th birthday.

“I liked poetry and wrote some earlier. My sister was getting married to a trade union leader. Amballur had a lot of factory workers and politics was a subject of discussion at home,” recalls Antharjanam. Married at 19 to a schoolmaster, she stayed home and raised four children but remained interested in politics. “In the 1950s, when Communist leaders of Kerala were on the run, we had given them refuge at home,” she remembers.

Into her tenth decade, she remains as much a fan of poets Vallathol Narayana Menon and Ulloor S Parameswara Iyer as she was in her youth, and continues to read. Her daughter KS Girija recalls spotting a book on Che Guevara in her mother’s collection.

Widowed at 48, and having faced personal setbacks, Antharjanam is still stoic. “She is positive and strong, and is not bogged down by fear or anxiety,” Girija says. Sewing, a skill she and her husband learned decades ago, continues to be an engagement even after surgery for cataract. “We keep all the small stitching chores for her. She goes through them meticulously,” adds Girija. An osteoporotic knee does not interfere with her daily life; she easily slips into a cross-legged position on the floor, much to the surprise of her doctors and the envy of those years younger. And the last time she stayed afew days at a hospital was 54 years ago, when she gave birth to her youngest son.

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Kerala boasts an efficient healthcare system, and its backbone are the 700-odd primary health centres at the grassroots. Doctor’s consultations for the elderly are free of cost at these health centres as well as other government hospitals. The State reaches out to its elderly through multiple initiatives helmed by the Department of Social Justice. Vayomithram provides free medical check-ups, Vayomadhuram gives them glucometers and the Mandasaham scheme, dentures free of cost for elderly in the BPL category. The Department has programmes that help with daycare facilities for the aged.

Many nonagenarians highlight their disciplined eating habits. While some stick to a vegetarian diet, the seniors stress that they are small eaters.

Rajan of CDS also attributes longevity to physical discipline and rigorous physical activity. Today’s nonagenarians, he points out, were the children of the 1920s, when the times were hard. “They have survived in those conditions. Also what kept them physically active was that they lived in times when there were very few machines to aid us,” Rajan adds.

The Malayali woman’s indomitable spirit — and ability to laugh — may have added to her longevity, too. Ellikutty Kurian, 95, laughs when she talks about her daily routine, and how she became part of a business when she was well into her 80s. The resident of Thodupuzha in Idukki district began managing a betel shop next to her son’s grocery store a decade ago.

“I come here every day after church by around 7.30 am, and stay till 6 pm,” says the sprightly Kurian, breaking into laughter every now and then. The engagement appears natural to Kurian, who doesn’t want to be a bored, stay-at-home older citizen. “My help is not needed at home. I would get fed up just eating and sleeping,” she says. The shop is her nucleus, the place where she meets people and interacts with the community. A widow for over 30 years, the mother of seven surfaced on social media recently when she went to cast her vote. “I have never missed a vote,” she says.

The lives of these women have been dictated by quiet struggles. Early widowhood often pushed them to be in charge of families, and they did so with little money. “Many have been widows for 30 or 40 years. They have survived the loss of their spouse, siblings, friends and even that of their children. It makes them mentally strong,” says Rajan. The professor, a specialist in the economics of ageing, also draws attention to Kerala’s current health problems — mostly lifestyle diseases. The elderly are not greatly affected by such diseases. “It is the problem of the current generation, one that may be applicable to their children, but spares the earlier generations.”

Rajan also points out that many elderly women prefer to be independent. Their children, some in their 60s or even 70s, live apart. And that, perhaps, also helps the elderly live the lives they want to embrace. “Children often hamper their independence by restricting their movement. They want to be as independent as possible,” says Rajan.

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Age also gives them a sense of independence. Societal disapproval is not something that troubles them, and many are doing precisely what they want to, overcoming apprehension or embarrassment.

When Karthiyayani Amma sings ABCD, it is in a firm and clear voice. The 97-year-old from Alappuzha is the poster girl for education of the elderly, having cleared the literacy mission’s Std III equivalent examination last year with a score of 98 out of 100. She received the certificate from chief minister Pinarayi Vijayan. “The CM casually asked her if she wanted anything. She responded with, ‘I want a computer’,” says Sathi K, the mission’s field official. A computer was soon brought to her home by the state’s education minister, who inaugurated it by making her write her name in English.

When Sathi was conducting a survey on possible candidates for the literacy mission in 2017, Karthiyayani Amma expressed her desire to join the programme. “I saw small children studying and thought why not me,” says Karthiyayani Amma.

“These are women who did not have the opportunity to study. Subsequently, it became a wish they had set aside,” says PS Sreekala, director, State Literacy Mission. Not having the chance to learn did not mean they abandoned the desire to study, she adds. “They allowed their age-old wish to come true when they got an opportunity.” The mission conducts classes at home for the very old. The curriculum breaks conventional norms and is based on an exchange of ideas, experiences and skills. “We only need to teach them letters; they are rich in life experiences,” Sreekala adds.

Karthiyayani Amma says she wants to finish Std X and try for a job. “People might take her statement lightly, but she is not bothered,” says Sreekala. Instead, she has become an example in her neighbourhood and elsewhere, inspiring many to study. “It takes women the luxury of advanced age to discover their independence and the strength to overcome obstacles,” Sreekala reasons.

The nonagenarian is a diligent student who sits in her room and studies when the others watch television. The student now has her hands full, having enrolled for the next level. The curriculum is tougher with courses in English, Malayalam, mathematics and environment studies. “Malayalam I can manage, I may find English a little tough to crack,” Karthiyayani Amma says.

The 97-year-old student doesn’t need glasses. “She doesn’t wear slippers, goes walking everywhere and eats only vegetarian food,” Sathi adds. Her diet consists largely of green leafy vegetables. “I always find her either collecting firewood, sweeping the yard or peeling onions,” says Sathi, who is all geared up to help her clear her Std IV examination.

Far away from Alappuzha, in Vatakara near Kozhikode, Karthiyayani Amma has a kindred spirit in 91-year-old Mythili V. Because the nonagenarian would never sit still, the family thought that literacy would be a good distraction for her. Mythili proved to be a fastidious student, says field official Jisha N. “Studying became a full-time occupation for her. I would give the books. Sometimes, she would get her doubts cleared from her daughter-in-law,” she adds. Mythili passed the Std III equivalent examination last year and was invited to Thiruvananthapuram to receive the certificate. Her daughters-in-law accompanied her on the trip. “She was very keen to go. The certificate was given by the minister for education,” says daughter-in-law Priya Manikandan.

Mythili, Priya points out, has become an inspiration for other elderly people in their coastal community. “Now everyone wants to study.” The nonagenarian, who now has more to study having graduated to the next level, is miffed that the daughter-in-law doesn’t devote enough time to her academic questions. “She is always busy in the kitchen. But I want to study. Whether I can continue or not is in god’s hands,” Mythili says.

As Kerala witnesses a plucky generation of nonagenarian and centenarian women, Rajan warns that the trend will carry on only for the next few decades. “The number of women over 90 will rise. The trend will continue for the next 20-30 years, and will drop subsequently. This is a golden period for the state.”