Reflections from Gothenburg

I arrived in Gothenburg on Tuesday; in contrast to Stockholm, where I had been lucky to catch some lovely September sunshine, I was met by grey skies and wet weather. It felt like home! With three days of interviewing ahead of me, though, the weather was a good excuse to spend time settling into my accommodation (a flat in the suburb of Majorna) and do some reading up on the organisations I’d be meeting. My interviewees in Gothenburg spanned three organisations: the state-funded Refugee Health Clinic; an NGO, the Rosengrenska Foundation; and a GP clinic in Hjällbo. All of my interviews were arranged with the help of retired GP, Dr Kristian Svenberg. Kristian now works at the Refugee Health Clinic; formerly, he was a GP at the Hjällbo Vårdcentral (Health Centre) for 20 years.

My first meetings of the week were at the Refugee Health Clinic which Gothenburg offers specialised therapy and treatment for trauma caused by the effects of war and torture. I learnt from Dr Eva Theunis, a GP at the clinic, that the clinic achieves this through a multidisciplinary approach: the clinic brings together a team of psychologists, physiotherapists, counsellors, and GPs. Like the Transcultural Centre I visited in Stockholm, the clinic also provides a health communication programme to increase patients’ ‘health literacy’, covering themes such as diet, dental health, sleeping problems, and sexual health. The clinic is also trying to raise awareness of refugees’ and asylum seekers’ health needs and rights amongst doctors in ‘mainstream’ services, through education such as talks and lectures.

I was interested to find out more about the role the voluntary sector plays in supporting migrants’ health needs in Gothenburg. The Rosengrenska Foundation was established in 1998 by a small group of health professionals, including Anne Sjögren who I had the opportunity to interview along with Dr Kjell Reichenberg, a psychotherapist. Staffed by volunteers, Rosengrenska provides healthcare to undocumented, or papperslösa, migrants in Gothenburg: those that are most likely to encounter problems in accessing primary healthcare. Rosengrenska provide a weekly clinic, situated in a church, providing treatment for physical and mental health problems. Rosengrenska have successfully campaigned to improve undocumented migrants’ access to health. Since 2013, undocumented migrants in Sweden have been entitled to ‘care that cannot wait’: a subjective classification, open to doctors’ interpretation. All the interviewees I spoke to in Gothenburg noted the continuing challenges that undocumented migrants face in accessing primary healthcare; it feels like it will be a long time before Rosengrenska will be able to achieve its aim of ‘abolishing itself’ due to it no longer being needed.

My last meeting of the week was at a GP clinic in Hjällbo, a district to the north east of the city. Here, I interviewed a GP, Dr Emma Dahlgren-Mensah, about her experience of providing primary healthcare to Hjällbo’s diverse population. Like the Trauma and Crisis Clinic, the Hjällbo Health Centre is characterised by a diverse team of professions, all working under one roof, including physiotherapists, GPs, a dietician, a diabetes nurse, a lung disease nurse, and a paediatric nurse. The centre also works proactively with other agencies, such as employment and social services. Like the staff I had met in the Refugee Health Clinic and Rosengrenska, it was clear that staff at the Hjällbo Health Centre were passionate about their work with refugees, asylum seekers, and undocumented migrants. For Emma, part of the appeal was the opportunity to work ‘internationally’ from a clinic in Sweden; she told me she has a map of the word in her consulting room with a new pin added for every patient she treats that has migrated to the country from elsewhere.

Looking to the future, many I spoke to in Gothenburg were worried about the impact that the election results would have on their work and the patients they serve; in particular, the Swedish Democrats achieving their highest ever share of the votes, albeit fewer than had been predicted earlier in the summer. The Refugee Health Clinic described having received threatening letters from objectors to their work, whilst interviewees from across the services I visited commented on the levels of stress and anxiety being experienced by their patients, especially the papperslösa, due to the social and political climate. But it is clear that, within Gothenburg, there exists a community of enthusiastic health professionals committed to reducing health inequalities, whatever shape the new Swedish government takes whenever it is formed…



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