Taking good care of each other

pass the dice!
Inuit Elders and family members at an afternoon gathering with traditional games and food (Gjoa Haven, Nunavut, Canada)

Last week the Paul Schiller Foundation published the report “Gute Betreuung im Alter – Perspektiven für die Schweiz” (‘Good Care in Old Age – Perspectives for Switzerland’). It shows the need for action in health and social policy for high quality and affordable care for the ageing.

A few weeks before I noticed an article in a regional news paper about the enormous value of volunteer work in Switzerland, an estimated CHF 35 billion. “The majority of informal volunteer work in 2014 is attributable to personal help and care… Personal assistance is the main occupation of informal volunteerism within family networks” (own translation from Freiwilligen-Monitor Schweiz 2016). I considered it to be a joke Continue reading “Taking good care of each other”

Gute Betreuung im Alter

pass the dice!
Inuit Älteste und Angehörige beim Altersnachmittag mit traditionellen Spielen und Speisen (Gjoa Haven, Nunavut, Kanada)

Letzte Woche hat die Paul Schiller Stiftung den Bericht “Gute Betreuung im Alter – Perspektiven für die Schweiz” veröffentlicht. Darin geht es in erster Linie darum, den gesundheits- und sozialpolitischen Handlungsbedarf für eine qualitätsvolle und bezahlbare Betreuung im Alter aufzuzeigen.

Schon vor einigen Wochen habe ich in einer regionalen Tageszeitung gesehen, welche enormen Kosten sich verstecken in der Freiwilligenarbeit, nämlich hochgerechnete 35 Mia CHF. “So entfällt auch im Jahr 2014 der grösste Teil informeller Freiwilligenarbeit auf persönliche Hilfe- und Betreuungsleistungen… Persönliche Hilfeleistungen machen gerade im Verwandtenkreis einen wesentlichen Teil informell freiwilliger Tätigkeiten aus” (Freiwilligen-Monitor Schweiz 2016). Ein absoluter Witz Continue reading “Gute Betreuung im Alter”

Working in Aboriginal communities: What kind of health are we promoting?

DSC01493.JPGWorking in Aboriginal Communities: What Kind of Health are we Promoting?

In this paper, I will explore the paradoxes and dilemmas embedded in intercultural health care practice. It is the intent of this work to reflect on theories and practices of Western-trained health care providers, consider the implications of our practice in an intercultural environment, and accept the invitation to the visitors on Aboriginal territory by Umeek to find guidance in scholarship from the world views as handed down over generations in First Nations creation stories (Atleo, 2004) to explore an Aboriginal understanding of health and health promotion.

Othmar F. Arnold, unpublished manuscript, University of Victoria BC, 2004

Individual beings are designed to help one another in order to fulfill the requirements of wholeness, balance and harmony, interconnection, and interrelationality. Therefore, to practice vanity as a lifestyle can be destructive. (Atleo, 2004, p. 35)

In the traditional Cree language of the Whapmagoostui, there is no word that translates directly into health (Adelson, 2000). In many Aboriginal worldviews, health is a desired state of the universe (Atleo, 1997). In our North-American context, it seems that health as an abstract and isolated concept that can be discussed and analyzed in a pure scholarly manner, a standard that needs to be achieved, is a phenomenon imported by the European colonizers of the continent. In the European tradition, physical and mental health are researched and discussed at least since the ancient Greek times. Since health is mostly defined as a state of physical and mental wellbeing, and therefore linked to the absence of disease and illness, it is associated with the biomedical sciences (Anderson & Reimer Kirkham, 1999). However, only within the last century was the medical profession successful in appropriating the definition of health and therefore dominating the health care system. Continue reading “Working in Aboriginal communities: What kind of health are we promoting?”

Palliative Care as form of worship?

An unusual point of view.

careTo mention the word God in conjunction with a well defined professional discipline seems rather strange in a secularized and science-informed society. Based on my own lived experience with human beings, whom I was able to accompany in living and in dying, I would yet dare to apply such a provocative point of view for some thoughts.

Eine deutsche Fassung des Eintrags gibt es hier zu lesen: Palliative Care als Gottes Dienst?

Palliative Care is a young, but nowadays recognized medical specialty that prides itself for working inter-disciplinary and for putting people’s comprehensive needs at the core of its practice. Why do these aspects have to be highlighted so much? Is it not absolutely self-evident to the average person and the affected? Would it be possible to conclude from this emphasis that the other medical specialties were too special to work inter-disciplinay? Continue reading “Palliative Care as form of worship?”

Palliative Care als Gottes Dienst?

Ein ungewöhnlicher Blickwinkel.

careIn einer säkularisierten und wissenschafts-orientierten Gesellschaft scheint es eher ungewohnt, im Zusammenhang mit einer gut definierten Fachdisziplin, das Wort Gott in den Mund zu nehmen. Aus meiner Erfahrung mit Menschen, die ich im Leben und im Sterben begleiten durfte, möchte ich es trotzdem wagen, einen solch provokativen Blickwinkel als Ausgangspunkt für einige Gedanken zu nutzen.

An English version of the article can be read here: Palliative Care as form of worship?

Palliative Care ist eine junge, heute anerkannte medizinische Spezialität, die sich rühmt fach-übergreifend zu arbeiten und die umfassenden Bedürfnisse des Patienten in den Mittelpunkt zu stellen. Warum denn müssen diese Aspekte, die einem einfachen und betroffenen Menschen doch völlig selbstverständlich erscheinen, so hervor gehoben werden? Continue reading “Palliative Care als Gottes Dienst?”

Is perpetual direct democracy good for your health?

A friend of mine, Ion Delsol, operates a website – pasifik.ca – to support a vision of perpetual direct democracy. One of the experimental features is a section called “Now Polling” that is used to assess the will of the people on an ongoing basis. It is Ion’s firm belief that democracy should happen more often than on election day every four years. To read about Ion’s vision, visit this link: Perpetual Direct Democracy (available in Spanish as well).

I was recently asked by Ion to share my views and experiences of the health care system in British Columbia and Canada. The discussion started with a critique of the current health care system. It continued to consider more fundamental factors than bigger and better machines and shorter wait times: Social determinants of health. Income equality, social justice, and political empowerment will make people healthier.

Ion taped and edited the conversation and it will be broadcast on the community cable channel in British Columbia. The interview is also available online on pasifik.ca and YouTube:

Determinants of Health – Part 1

Determinants of Health – Part 2

Determinants of Health – Part 3

Determinants of Health – Part 4

Nursing with indigenous communities: The question of membership

Membership and belonging are important factors for well-being on an individual level. It is a topic that resonates strongly with me for a long time. In 2004/05, I have written an article on community membership and belonging from a nursing perspective with a particular focus on cross-cultural practice in indigenous communities. It was never published, but might be of interest to some.

Nursing practice with Aboriginal communities: An exploration of the question of membership.

Othmar F. Arnold, RN, MN,


For most nurses working with Aboriginal people, such a posting is a professional challenge. Nurses do not hold any formal membership in the cultural and ethnically diverse communities they serve. The importance is placed on competent and efficient delivery of needed services for populations that are known for significant health disparities and marginalization. Drawing from Nuu-chah-nulth origin stories, it appears to be important for the realization of Aboriginal health, healing, and well being that health professionals acquire community membership. The difference between the two world views poses an ethical dilemma, possibly constituting a form of cultural imperialism. Nursing science based approaches for bridging the intercultural gap are explored.

Health Centre, Carmacks, Yukon, serving the Village of Carmacks and the Little Salmon/Carmacks First Nation


Membership from an Indigenous Perspective

Membership from a Discussion among Community Nurse Practitioners

Membership from a nursing theory perspective

Ethical questions

Recommendations for action at micro, meso, and macro level
Continue reading “Nursing with indigenous communities: The question of membership”