Taking care of their own

KARASJOK, NORWAY — When Norway’s indigenous Sami go to the hospital, Sami nurses take their blood pressure and Sami doctors listen to their heartbeats.

Forty years ago there weren’t any Sami doctors. Now, Norway’s Sami Medical Association counts 50 members.

Government-sponsored affirmative-action programs sped the change, by helping Sami get into Norway’s competitive medical schools. Each year, two spots are reserved for Sami at the medical schools in Bergen and Tromsø.

Also bringing about the boom in Sami medical professionals were Sami activists, who in the 1960s and 1970s urged indigenous youths to become doctors.

“It was a political act,” said Dr. Knut Johnsen about his decision to go into medicine.

In the late 1960s, Johnsen, whose mother tongue is Sami, left his small village on the Finnish border to study in Bergen. After graduating, he and his wife, Siv Kvernmo, also a doctor, chose to practice in Karasjok, the growing capital of Norway’s Sami territory.

In Karasjok, population 2,900, there are now 13 Sami doctors: four general practitioners, six specialists, an audiologist, a resident and a medical researcher.

Most nurses in Karasjok are also Sami, or have Sami spouses.

When Sami medical professionals first came to Karasjok, locals, who’d always been treated by non-Sami Norwegians, viewed them with skepticism.

“There was a lot of suspicion of the Sami medical personnel. Some used to come to me because they thought I was Norwegian,” Kvernmo said.

Sami elders, however, were grateful to find medical professionals who could speak their language and understand their culture.

Grateful, too, were unilingual Sami from small villages, who had often resisted consulting non-Sami doctors, instead turning to healers who read passages from the Bible in an attempt to cure ailments.

For years Sami were plagued by poor health care. As a result, Kvernmo said, when Sami sought medical help they were hospitalized more frequently and suffered more complications than other Norwegians.

In Kvernmo’s opinion, Sami are best served by Sami doctors, who understand what Sami say and how they say it. For example, the Sami language has few words to express emotions, so patients often talk about mental distress in terms of physical pain.

Sami doctors have also become role models to youth, and, according to Kvernmo, they’ve done a lot for “ethnic self-esteem.”

Though Karasjok now has a 20-bed hospital, its doctors don’t perform complicated surgeries or deliveries. Pregnant women thus must travel to Hammerfest, 200 kilometres north, to give birth.

Sami health care has other shortcomings. Outside the heart of Sami territory, interpretation services are disorganized or unavailable. Bilingual Sami patients must often translate for elderly or young patients who don’t speak Norwegian.

Sami in and around Karaskjok are still sicker than Norwegians, although Kvernmo said there’s been “a big improvement” in the past 20 years.

But few statistics have been gathered on Sami, because Norwegian data doesn’t provide separate information on the country’s indigenous population.

In January the Centre for Sami Health Research opened in Karasjok, with three full-time staff and researchers, including Kvernmo.

The team plans to examine Sami health issues and statistics throughout Norway. Director Ragnild Vassvik Kalstad said a survey of Sami health and living conditions will be carried out to develop more culturally sensitive health services for the Sami population.