Access to health care in remote communities in northern Finland


Living in northern Finland one is used to relatively advanced infrastructure compared to other regions in the Arctic, which easily makes one to forget how far north and how remote one lives. But there is the important aspect of the word relatively! We usually get quickly used and adapted to the place where we live. Along with the adaptation goes the change of perception of numerous normative measures, such as distance or maybe time. However, there are times when it becomes more obvious where one lives, and which reminds us again on the relativity of our perceptions.

Living in Enontekiö, the municipality in the very northwest of Finland, I generally get the feeling of having a very sound and functional infrastructure surrounding me. Sure, my Internet connection is not as fast as I was used to it when I lived in Vienna where I studied. Nonetheless, it is obviously fast enough to maintain the HuSArctic website, as well as to stream videos – which I just heavily did when joyfully following some of the exciting games of the icehockey world championship that was won by another Arctic state: Canada. It was also during that time that I needed to see a dentist, as unfortunately one of my teeth broke. Shouldn't be a big deal, I thought, as there is a dentist's ordination in Hetta, the biggest village of Enontekiö, in which almost half of the municipality's population is living. The village hosts a few shops as well as the 'terveysasema' – the health station. However, when I called to get an appointment to have my tooth fixed, the person on the other end of the line had an unpleasant surprise for me: There was no dentist working in the village for almost two more weeks, so they offered me to make an appointment in Muonio, which is the next bigger village about 80 km from Hetta. But also there I had to wait a few more days to get an appointment, as only in the following week (I called on a Thursday morning) a dentist was available. Fortunately I didn't experience much pain, so waiting for a few days wasn't a big problem for me. And looking at my ever growing belly, eating a little bit less for a few days also didn't seem to become a crucial factor of survival. Anyhow, after the weekend I went south to Muonio and got my tooth fixed. After that incident I checked back on the website of terveysasema in Hetta to gather some other information and found out that if you want to make a regular appointment for the dentist, you should do so at least six (!) months in advance; for a medical practitioner you should do so two weeks in advance. Of course, in urgent cases it would be possible to get an appointment immediately; that is, if a doctor is present. Pretty much at the same time when I needed a dentist, also one of the cats who we share our apartment with got sick and needed medical attention. To his luck, the vet was available immediately and he did not have to travel to another village or wait for days. Still, this experience once again reminded me that northern communities in Finland – despite their relatively advanced state of infrastructure – are different to southern or more urban areas.

 

Like myself, also our room mate Herr Schrödinger has completely recovered (photo credit: Heidi Nousiainen).

 

Talking about the story above, also a friend of mine told about a similar experienc for basically a minor incident: After getting a deep cut in the hand, she needed to see a doctor to check if some nerves got damaged, and of course to get the wound properly treated and stitched. Her bad luck was that she injured herself on a Sunday afternoon, and the place of the accident was: Hetta. In the terveysasema there was no doctor present, so she was sent as well to the health center in Muonio. However, after arrival it quickly became clear that also the health center there wasn't properly prepared for treating her injury on a Sunday afternoon, which is why she got send to Kittilä, which is about 150 km from Hetta. Fortunately, there a doctor could see her and treat her injury. But, as she continued to tell me, traveling these distances for medical care is not unusual. As a mother of two children she already twice had to go to the next hospital to give birth; and the closest hospital (where you also need to go with severe injuries or for carrying out surgeries) is in Rovaniemi, some 300 km from Hetta, or 440 km from Kilpisjärvi, the northernmost village in Enontekiö. In Hetta there is an ambulance car permanently stationed. For emergency cases this car is standing by in order to drive their clients to the closest suitable facility. In case of giving birth it means, that before finally arriving at the hospital you will have an at least four hours car ride ahead of you, or in winter, or with bad road conditions, the ride could even take significantly longer. Another young woman from Enontekiö who is going to become a mother later this year, told me that she is not willing to take any risks, but instead wants to look for a room or a hotel from about a week before the birth should take place.

Access to health care is of course an important aspect of human security, and its absence may be a stress factor for some. More than once I have heard from travelers or tourists that they wouldn't feel secure to live so far away from a hospital, or that they would be concerned about the distance to the next hospital when going for a hike into the forest or into the tundra in northern Finland, which on the other hand is the regular work place for many local residents, such as reindeer herders. Since we get used to the environment and the infrastructure in the place we grow up or decide to live in, we may not necessarily perceive infrastructural gaps as immediate threats. Yet, lack of health infrastructure does pose certain challenges and risks to the concerned communities.

 

  • Health station building
  • cat sitting outside on the window sill
  • cat fighting a stuffed animal

Last modified: 

Saturday, May 30, 2015 - 15:21

Tags: