Dr. Marianne Hedlund and Dr. Bodil Landstad
◦ Department of Health Sciences, Mid Sweden University ◦ Faculty of Health Science, Nord-Trøndelag University College
◦ Can be broadly summarized as health-promoting processes in relation to organizations/workplaces and the people who are sick or who are at risk of being marginalized in relation to employment or activity.
◦ Faculty of Health Science, Nord-Trøndelag University College ◦ Department of Social Work and Health Science, Norwegian University Of Science And Technology
◦ Research the concept of disability as a political and bureaucratic construct, other types of disability research focusing on power perspectives, participation, democracy and social categorization, process of labelling disability and disability discourses.
Disabilities: insights from across fields and around the world Edited by: Catherine A. Marshall, Elizabeth Kendall, Martha E. Banks and Reva Mariah S. Gover Praeger, 2009.
Selected for the list of Outstanding Academic Titles, 2009
Norwegian policy‟s overarching goal is to ensure services available for all groups of service users, across geographic, language and cultural boundaries. Aims to develop services that are professionally and organizationally appropriate to the Sámi minority‟s unique cultural, language, and settlement practices Integrated national services, not special services Public health and welfare system – ◦ Principles of Equality ◦ Principle of Universalism Source: Norwegian Government, White Paper No. 25, Ministry of Health and Social Care Services, 1997. 5
the indigenous people of the
Norway: 68 000 (70%) Sweden: 20 000 Finland: 10 000 Russia: 2 000
lFinno-Urgic Language 1. Syd-, 2. Ume-, 3. Pite-, 4. Lule-, 5. Nord-, 6. Skolt-, 7. Enare-, 8. Kildin- and 9. Tersamiska.
Arctic population Nomadic lifestyle Traditional homes, clothing and shoes for outdoor living in cold environment Facing rapid change last 30 years Socio-cultural transitions occurring
A process of reintegration back onto the land of their ancestors Increased ethnic revival and pride in cultural heritage
◦ Years of discrimination, assimilation and colonization policy (Norwegianisation policy) ◦ Actively resist being assigned a subordinated position in society and in so doing, articulate the need to redefine their status.
Multiple identities (Calhoun,1994)
Traditional and modern transition Not “beside” society, but “within” Minority – Majority expectations
To contribute to knowledge and engagement with indigenous‟ people's worldviews ◦ Study what characterizes the interactions between health and welfare professionals and the Sàmi users of health and welfare services. ◦ Study in what ways integrity is ensured during encounters between local health and welfare professionals and users of Sámi origin. Patterns leading to the development of cultural sensitivity and/or cultural competence? Search for the situation for women and health, particularly compared to men.
◦ 8 Sámi in different age brackets (25 - 70 years) ◦ 7 health and welfare professionals - communities having Sámi population for many years (South Sámi area) - Doctors (GPs), nurses, midwives, etc.
3 Key informants
◦ priest, administration officer, academic
Researchers and informants shared local knowledge – used in the empirical analyses
All women ◦ General: mental stress and depression due to culture commuting
Informants with chronic diseases or longlasting disabilities ◦ ◦ ◦ ◦ ◦ ◦
Mothers Daughters Higher education (younger) Lower education (older) Some where reindeer husbandry, others not Living in rural areas, small communities
One informant with severe disabilities, performed reindeer husbandry together with her husband Needs: ◦ ◦ ◦ ◦
Technical Equipment Accessable surroundings Homecare and assistance 2 places Summer house AND Winter house
◦ Struggeling life and helpers ◦ Wanting to re-career
The language ◦ Sámi - different dialects ◦ Norwegian language the dominate
Vulnerable when acute and seriously sick ◦ Seen to have a mental problem or „delirium‟ speaking Sámi at the hospital ◦ Native language comes first when sick or less conscious Elderly women in need of institutional care are particularly vulnerable
Sámis approach health and welfare professionals of Norwegian origin with caution Sámis typically suppress their emotions in interactions with Norwegians
Private experiences are not typically shared with “outsiders” “Silence” mean protest or anger, not agreement Particularly health weakness and female experiences such as a miscarriage, etc
Making the system and providers more culturally sensitive Health and welfare providers need to recognize the history of colonization and the Sámi struggle for equal status Recognition of difference and cultural diversity Recognize and pay attention to positions of powerlessness and marginalization “within” the Sámi population – like women with disabilities Practicing critical reflection – reflect on “action” of help and how it is received from the “needing” person
A need for more knowledge about Sámi women and health, sickness and disabilities. Working title: Frameworks for understanding the concept of health among Sámi women with disabilities: A systematic review.