Meeting and expanding our understanding of homeless and underprivileged people

We chose to participate in this seminar with a desire to obtain inspiration and knowledge that we could use at our work as future nurses. Homelessness has been a topic that unfortunately has received little attention, both in the nursing program and community. At Lovisenberg, students have been able to theming this topic through a two week project, Oslo by night. This project has given the students a closer relationship with the weakest in society.

Before the trip to Finland, we have had great expectations of an enjoyable seminar where we could discuss the matter and to compare what the conditions were in the Nordic countries. Considering that the seminar would include nursing students and master students from all the Nordic countries, we thought that it would be exciting to exchange ideas, thoughts, experiences, knowledge and competencies.

Our experience of the seminar has in summary been positive. We have been welcomed by the staff and been provided with good information about the program of the course. We have gained a good impression that the seminar has been structured and well planned. The props, like school building, auditoriums, lighting, library and cafeteria has worked well in relation to the use of resources and feeling of comfort and relaxation during the seminar. Thursday night was the first day of the seminar where we were pleasantly greeted with live band and a warm dinner. Towards the end of the evening, the students participated in a game where they could become familiar with each other. We were to present our names and country we came from. The game created a pleasant and fun atmosphere, but we wish that it was taken into account of other forms of games or more time to set aside for us to get to know each other. We felt that the social parts were happening outside the seminar and through the students' own initiative. Unfortunately we did not get any good tips for sightseeing, adventure or culinary experiences from one of the Diak student during the first day. She told us that Helsinki had limited offers for the tourism. As an experience for the next seminar, we hope that the organizers can take into account that the ability to joint activities the first two days of the seminar is very important for the establishment of openness and close cooperation among students.

When it comes to the lectures, we felt that some of them were unnecessary for the program, for example about Diaconal, which is a very familiar theme in all of the diaconal schools that participated. Some of the lectures were in forms of statistics, which was a bit overwhelming. We also found some of the use of English language challenging as in terms of different dialects and communicative skills. During our sessions with the master students, we found it challenging to discuss the topics related to research articles. The short form of reasons for this included a lack of English knowledge and understanding. Many of the students couldn't provide a summary or opinions regarding their topics, which made the discussions more complicated.

Looking back at this course, we found two of the topics quite interesting. The first one was the visit from Global Clinic. The second one was the visit to Helsinki housing unit for people with mental health issues and drug related problems.

Who´s responsibility? Global Health Clinic.

Before we went to the seminar in Finland, the participants were given the opportunity to choose between different study tours. We decided to join the study tour named "Global Health Clinic", because we thought it would be interesting to learn about the health care provided to paperless residents and immigrants in Finland. Unfortunately, it did not cross our minds that it would be difficult to visit this particular place because of the matters of security for the clients of the clinic. Since the clinic had a secret address, the communication leader of the clinic held a presentation at DIAK instead. Although we were disappointed that we could not visit the clinic, we received a lot of interesting information about the paperless residents' possibilities for getting health treatment and practicalities concerning the clinic.

One of the points that were made during the presenting and that we think is worth highlighting is the fact that the clinic is based on volunteers and private funding. As for today, there is only one employee who gets a salary from working at the clinic, so the rest of the personnel are as mentioned volunteering. Based on the diaconal values that we have been learned and reflected about during the seminar, working as a volunteer and helping other underprivileged people is highly relevant. There were different types of ethical dilemmas regarding this kind of health clinics in Finland and the situation of the paperless residents. One of the dilemmas that made an impression on us and that we though were absurd, was that the government were not engaging in the health situation of paperless immigrants and neither cooperated with the health clinic for paperless immigrants. In practice this could have a negatively impact on the clients in different ways. One example is clients who are in need of more advanced health care than the health clinic can provide to their clients. Since the government is not collaborating or supporting the clinic, it is more difficult to refer patients when in need of more advanced and suitable health care, to more resourceful hospitals like university hospitals. Moreover there are several legislations that define when people, regardless of their background, can receive "emergency care" without being discriminated. In practice this meant that if the patients´ health condition were not "bad" enough to fit the legislations criteria, they would not get the medical treatment that they needed until their condition got bad enough to fit the criteria. The woman presenting this facts, underlined that this system were inhumane and also very little cost-effective. Their clinic was trying to ease the paperless immigrant´s difficult situation, but expressed that this were not a long-term solution as the situation were today. The workers of the clinic think that the government should take responsibility for the health condition of paperless immigrants and change the existing legislations regarding this topic. As the situation is today, the workers of the clinic though that the government are neglecting their responsibilities concerning this vulnerable group. The workers at the clinic is also being challenged concerning the morally and juristically responsibilities they have through their professions, because they are being forced to priorities their services due to financial reasons. The economic resources limit them in a matter that affects their possibilities to sponsor medication and long-term treatment to the clients who needs this. The financial barriers also lead to short opening hours, and as for today the clinic are only open for two hours once a week. We think that this is too little when thinking about the number of paperless immigrants that exist in Helsinki.

In comparison to Oslo where their clinic is led by the Church City Mission and Red Cross, the clinic in Helsinki seemed to be have more difficulties providing the needed health care. The clinic in Oslo seems to inhabit more resources to proceed their health work. One example of this is that the health clinic in Oslo is open for eight hours a week, compared to two hours in the health clinic in Helsinki.

Housing Units for people with mental health issues and drug related problems

On Monday we went to the Housing Units for people with mental health issues and drug related problems. Most of the residents are originally homeless, coming from the street. The average age for people staying there is 45-55 years, but they also have residents under 20 and up to 65. Different professionals work at the unit, such as practical nurses, social workers, occupational therapists and regular nurses. The residents pay rent to stay in the apartments, and the stay is temporary. Some of the residents have stayed for three years, others for a shorter amount of time. An individual plan is made for each person, containing different treatment activities the person is supposed to attend during the stay and unique goals. The main goal is to help the person get back on his/her feet, supporting them and prepare them for the outside world, often with follow-up from the community. For this, different kinds of activities are offered at the unit, both therapeutic and social. The treatment activities includes discussion groups, individual therapy with a personal contact (social worker or nurse) and art therapy, and the social arrangements includes cooking classes, gardening, bingo, movie nights etc. They also have the freedom to go out to work, buy groceries, go to doctor's appointments, attend AA-meetings, collect money from social services and so on. We were told that some of the residents found exercising therapeutical and were therefore encouraged to do this. Also, when guided around the area with one of the employees, two residents welcomed us into their apartments. Me and my fellow students thought this was a very nice gesture, as we were a quite large group (approximately 12) and also from different countries speaking unfamiliar languages. With the employee translating for us, the two residents told us they were very satisfied with their lives at the unit, that they appreciated the freedom given, the activities offered and the facilities and appearance of the apartments. We asked one of them what his plans was for the future, and he replied that he has been living out on the streets for many years, and that his main goal was to keep a roof over his head. He would be satisfied if this could be managed. This was quite touching to hear. He didn't dream of a life filled with an overflow of money and expensive things, he would be grateful if he had a place to stay. It was also interesting to see how they live at the unit, that they have a lot of freedom and mainly decides for themselves what to do - with some restrictions of course. For example, they are free to do drugs in their apartments, as long as they keep behaved and peaceful. We appreciated that we actually went to the unit, instead of them coming to DIAK. It left us with a lot of impressions and thoughts, which we students have reflected on afterwards.

Who are we?

We are Susanne, Vy and Valentina (age: 24, 28 and 21), nursing students from Norway. We are in our final year of the bachelor degree in nursing at Lovisenberg Diaconal University College.