First impressions of Moldovan elderly care

During the second week of MFS I’ve had the great privilege of meeting the managers of elderly care in the central district of Moldovas capital, Chisinau. In a brief summary of what we’ve talked about, one may conclude a couple of crucial matters. Here are some of the highlights:
1 Moldovan elderly care mainly covers the need of people who don’t have a family, or whose families are unable of caring for them when they reach their old age. By law, family is obliged to care for their kin, and the assessment authority – the Directia Generala Asistenta Sociala si Sanatate, the administration for social assistance and health care – will duly investigate an applicant’s possibility to obtain help from their children or spouse. Hence, in this district, numbering about 100 000 inhabitants, a mere 300 are beneficiaries from elderly care, meaning 0,3% of the population receive elderly care. In Sweden, this figure is about ten times higher.
2 Once the assessment process has considered the applicant’s right to receive social help, a formal decision stating the amount of help admitted is issued. This amount may range from one to several hours a couple of days per week, and the help is delivered by a social worker which, as a general rule, will be the same person from day to day. In other words, a beneficiary of Moldovan elderly care will normally have to get aquainted with just one single person from the care provider. A Swedish home care receiver sees on average 15 different people per week.
3 The contents of the home care is decided upon by the care receiver and their social worker for each day. In this aspect, Moldovan elderly care differs widely from the Swedish one, where care provision is formulated in a set of interventions, scheduled in a detailed plan for each home care staff’s visit. Flexibility is minimal in Swedish home care, and appears to be rather wide in Moldova.
4 Public elderly care in Moldova takes place in the beneficiarie’s home. There are no publicly funded asylums, residential care homes or other units of that kind. Only those who can pay for residential care may recieve it. Regardless of how ill the care receiver is, help will only be provided in their home. In Sweden, approximately one out of five care receiver lives in a residential care home, and those that do, have been found to have explicitly severe disabilities or health conditions, motivating their move into a residential care unit.

During the upcoming week, my hope is to meet some of the social workers who provide care, and carry out at least one formal interview.

First week in Moldova

Dr Tatiana Gribincea and Glenn Möllergren

On Monday, October 5, I met my Moldovan mentor, Dr Tatiana Gribincea. Dr Gribincea is the leader of the department for social work at her university, the Free International University of Moldova. At our first meeting Dr Gribincea was running an online lecture for a class of students in social assistance, and I was kindly offered to share my research topic with them. The topic of the lecture was social work among old people, which is also my focus. Already on the next day, October 6, Dr Gribincea invited me to meet with social assistants, social workers and beneficiaries of elderly care in a village in the northern part of Moldova, Ochiul Alb. The experience from the visit to Ochiul Alb will be refered in an upcoming post.

MFS research project: Needs assessment in Moldovan elderly care

What happens when an old person in need of social care gets in touch with society’s institutions? What is the nature of the assessment interview, where the old person expresses their needs, and the assistance officer carries out an inquiry and decides upon provision of help?

These are the questions that originated a trip to Moldova in the autumn of 2021. As the research unfolds, this blog will report on some of the impressions. This, the first chapter, will provide a summary of the background and the setting of the scene for the eight following weeks.

1 The study
This research originated in a bachelor’s thesis in 2019 (Möllergren: Ålderism i riktlinjer för äldreomsorgen, link below) where care provision in Swedish elderly care was explored through an analysis of guideline documents from the municipal level. The main finding was that care provision is influenced by ageist prejudice about old peope. It is therefore much easier to receive help covering basic needs, like food, hygiene, security and home service, than to obtain support for “non-old-related” problems connected to psychical suffering, substance abuse, violence, and sexuality. The municipal guidelines explicitly state things like “going for a walk” as examples of what old persons are expected to need society’s help with. The crucial point is the assessment interview, where the assistance officer talks the applicant into accepting a certain set of care interventions, rather than openly listening to every expression of need that the old person might communicate. A “reversed assessment” evolves, where the care provision aligned with municipal guidelines replaces the actual needs, and the applicant is convinced to apply only for the type of care that the guidlines actually state.

But is this a purely Swedish phenomena? How would the assessment interview function in a less-ageist, less-guideline-oriented society? These reflections led to the establishment of a research plan for a master’s thesis in social work. As the MFS scholarship listed Moldova among eligible countries, this country became the location of choice. While Sweden has a decades-old tradition of manual-based assessment processes, this is a novelty in Moldova. And while the general Swedish perception of “old age” is among the most negative in the world, Moldovan culture is more appreciative.
The application for an MFS scholarship was handed in. A positive decision was concluded in the spring of 2021, but the Ministry of Foreign Affairs didn’t put Moldova off the corona restricted list until July 2021, meaning the research could take place only in the autumn of 2021.

2 The preparation
Initial discussions involving the mentor Linda Lill at MaU and the local Moldavian supervisor professor Tatiana Gribincea at the The Free International University of Moldova, ULIM, started out in the autumn of 2020. It was therefore possible to fast-forward the pracitalities once the scholarship was granted. In order to maximize flexibility during the research, I chose to use a car to get to Moldova. Departure date was September 29 from Malmö and the trip went through Poland and Ukraine entering Moldova in the north-west. The 1750 kilometers took four days to complete and today, October 3, I arrived in the capital of Moldova – Chisinau.

Chisinau is a city of 700 000 people, counting a number of universities as well as an array of economical, educational and political institutions. Official language is Moldovan, which is practically identical to Romanian, but broad layers of the population – especially in Chisinau – speak Russian. The territory currently known as the Republic of Moldova was under Russian and Soviet rule for the lion part of the last two centuries, and in Soviet time, russians were encouraged to relocate to Moldova. The country also has a significant Ukrainian minority as well as Roma and a number of smaller nationalities. Up until the Holocaust, it was also home to a large Jewish population, most of which was murdered by Romanian and German fascists.
After independence following the demise of the Soviet Union in 1991, Moldova has encountered a dramatic decline in living standards, resulting in migration to both Western Europe and Russia. Combined with a drastic decline in nativity, Moldova is, after 30 years of independence, a country that, to some estimates, has lost half its population while the remaining half is considerably older, compared to 1991. In other words, the present-day Moldovan state struggles with finding a way to support its increasingly larger old-age-population, with less working people around to contribute. The situation is challenging. As if this was not enough, a significant part of the contry’s territory is a de-facto independant state over which the central gouvernment exercises no control – Transnistria. It is a frozen conflict, where the Transnistrian leadership in its capital Tiraspol enjoys Russian support, meaning that Moldova is unable to win a military show-off. Lacking control over parts of its territory effectively blocks Moldova from entering the EU. In 2020/21 the Moldovan electorate, however, vote for a pro-EU, liberal leadership, throwing out the former communist gouvernment.

Since Moldova has primarily been ruled by pro-communists since 1991, it has defied the introduction of neo-liberal mechanisms that characterizes most Western states. At the same time, funding of welfare services is painfully insufficient. It therefore offers an interesting research environment for studies in social work, and the logic along which welfare services are provided – which brings us to the present moment, where this research is about to begin.

I’m looking forward to sharing findings along the way. I also welcome feedback and questions.

Glenn Möllergren, master student of social work at MaU

Om MFS / About MFS

In English below

MFS  (Minor Field Studies) är ett SIDA-finansierat stipendium på 27 000 kr för studenter som vill samla material till sin uppsats eller examensarbete  på kandidat- eller masternivå. Ett MFS ska genomföras i ett giltigt land under minst 8 sammanhängande veckor och kan utföras enskilt eller i par.

En MFS-ansökningsomgång för de som vill göra sin fältstudie under HT22 eller VT23 är öppen. Ansökningsdeadline är 11 april. Läs mer om hur du ansöker här.

About MFS

Minor Field Studies is a scholarship of 27 000 SEK financed by Sida, for students that want to collect data to their bachelor or master thesis. An MFS shall be conducted in an approved country during minimum eight continuous weeks.

An MFS application round for those that want to do a field study during autumn 2022 or spring 2023 is now open. Application deadline is 11 April. More information about how to apply is available here.

Madaraka Day, Ramadan, Serengeti wildlife and other everyday life in Kenya

Hi everyone. I’m on my second last week here in Western Kenya in Wagwe. The days for me are mostly calm and easy. However, I have during this time of two weeks experienced: a music festival in a high school (a singing and dancing competition from various schools); Madaraka Day (Kenya’s 56th year of self-rule); and Ramadan.

This picture I took during Ramadan

It was a big celebration in Narok Country during Madaraka Day, located in the South-West Kenya, the land of the Maasai. Every year Kenya celebrates the day from a different county with music and dance, speeches and other events. This time, because it took place in Narok county, people had the chance to enter the Serengeti wildlife reserve for free.

Underneath, is a picture of the Maasai. Not only are they known for wearing red and to be one of the world’s last great warrior cultures – but they are also incredible good a jumping!

This picture is taken from the webpage: https://www.lightworkers.com/maasai-warrior-happiness/

I can tell you how most of my regular days looks like here: I wake up around 07:00-08:00 by the rooster. You wake up with less stress and tiredness than waking up from an alarm-sounding phone (what I am used to at home). Then, I go and boil some eggs or make myself an omelette. Every morning I need to take the malaria medicine (a red pill), which is best taken with something fat – like eggs. I make some tee and if I sync my breakfast with my host family, I will share it with George (my kind and hospital contact person). Then, either I will go to the Mama Norah school before lunch to help the chefs in the kitchen to serve the pupils or stay home and write and read. After lunch if I’m in school, I might sit in the library and read, or I attend the classes. Around 15:00 – they have something called “game time”. They bring out a basketball and some footballs to play with for about an hour. For the record, the footballs are very expensive here. I reckoned this when I bought one for the school and one for a boy. In Kenyan schilling it estimates around 1500-2000 schilling, which is about 200 Swedish crowns ($20).

When attending the Kiswahili class

On the way to and home from school there is a 10-minute walk that I usually go with one of the neighbours, one is a teacher at the school. I usually meet children on the way that wants to high-five me and others that I greet on the way. Rocky, the dog from the house I am staying in, sometimes follow me too.

Yesterday (6 June), I had an interview with one of the teachers. It was really giving. I am performing the fieldwork through participant observation, where I go on about the everyday life and attend local events and meet people in the community. It seems natural to have an interview after 1-1,5 week after some observations and time to think. I write down some structured questions as a guide of what I want to discuss or ask about, but usually the conversation leads to greater insights and discussions than what I beforehand had planned. So, there is more of an ongoing storytelling from the informant and random questions I come up with when being in the moment – it feels more natural and I get more inspired “in the zone” than writing out questions beforehand.

The community in Wagwe consist of many different types of religions. Mostly, the community consist of Roho, a branch from Christianity. But there is also Hindus, Muslims and other branches of Christianity, like The Seven Day Adventist church that live together side by side in the community. I have attended the Roho Church (mostly) every Saturday as the host family are going there. They wear a white or red coat/long dresses, and women wear a scarf around their head. Someone preaches to the crowd and then suddenly, a person starts singing, and then more people are singing. First, you can hear one drum beating in fast paste that shortly accompanies by 2-3 other drums – creating a dance beat. Someone also joins with maracas, that makes one more inspired to stand up and dance. And that is what’s happening. As soon as the first drum sounds – the smallest kids start to bounce up and down and run towards the centre where the people playing the drums and maracas and the person singing stand. The sound is so loud, it feels like your heart vibrates to the sounds of it (it’s hard for me to sit completely still). Then more and more people from all ages joins the dancing in the middle.

This is how I can look like when attending the Roho church

I seem to have written a lot this time, I hope you enjoyed the reading of some of the everyday life of mine in Wagwe. I must end this by saying that tomorrow, I will be going early to Serengeti, a wildlife reserve in Maasai Mara. It will the first trip for me “outside the field work” – I look very much forward to it. Apparently, there is low season now, because the wildebeests are over the border in Tanzania. They usually arrive to Kenya in July and departs in November. It is said that during a period of three days, more than 1 million (!) wildebeests migrates over the river to Kenya  – which is why many people come to visit the reserve at the Great Rift Park. However, I’ve been told that because of climate change, the herd will arrive earlier than usual to Kenya – which is why I might be able to view it. I will write a post after this trip, and of course put up some picture for you to see!

This is how the wildbeests migration in Serengeti can look like (pictures used from safari sites)

I also want to thank those that contributed to the foundrasing about two weeks ago to the school. I have been talking with the teachers and people in the CBO who got very happy about this – and so together we will see how we can get the best use of it – I will not forget to update about this.

Until next time – take care! /Isabelle

Sista veckan och sista inlägget

Hooola a todos y todas,

Nu har vi haft vår sista helg tillsammans här i Cali och Rolanda är påväg norrut för att resa runt i Colombia och Brasilien medan jag, Malin, stannar ett par veckor till här i Cali. Uppsatsen ska presenteras i augusti och är därför inte helt klar, fattas lite finslip på diskussion och korrekturläsa. Men det sparar vi till juli när vi båda är hemma i Sverige igen. Det var dags för en paus nu efter två månaders intervjuande, läsande och skrivande på tre olika språk.

Under vår sista helg, med besök från Sverige, gjorde vi en roadtrip till Cristo Rey, en utkiksplats i Cali, och Kilometro 18 som är ett svalt område i bergen dit man åker när det är allt för varmt i staden och man är sugen på något som liknar svenskt höst-rugg och varm choklad med ost i. Det fortsätter förvåna oss att Colombia varierar sååå mycket i temperatur, kultur och landskap bara efter en halvtimmes körning. Vi dansade även lite salsa, promenerade i stan och åt god mat.

Roadtrip med fina vänner, från Sverige och Colombia

Detta blir sista inlägget från vår resa och vi hoppas vi inspirerat fler till att ta chansen att söka MFS och resa till ett land du intresserar dig för och skriv om något kul, spännande, orättvist, sorgligt eller whatever. Det har varit utmanande vid flera tillfällen, meeen så otroligt lärorikt och helt klart värt det.

Här tillsammans med Damaris, vår tolk och nu nära vän

 

Un abrazo graaaande!

Malin y Rolanda

 

New home

Phnom Penh from our private boat tour

Time passes quickly… like always when having fun. So, with the interviews done and over two months passed, my return back to Sweden is approaching. And I don’t feel ready. Living here for just a while  really makes one see new perspectives of things, like always when travelling. If you haven’t been travelling away for longer trip – just do it. Even when feeling the most lost or culturally shocked it makes you appreciate life and respecting other cultures. Being in a development country and researching on such a sensitive topic like politics (which should not be a sensitive topic) makes me so grateful for all the freedoms back home that we just take for granted. Don’t take it for granted! Especially with the political climate in Europe that to some extent is shifting towards closed borders and scepticism against people with different backgrounds and the current political system – a system that is so great comparing to how it could have been!

 

On a night out with my Cambodian friends

But being here also offers tolerance and patience – for example in traffic. There is no point even trying to get rushed, instead I just look out the tuktuk and admiring the views or curiously glance at people in their everyday life which is so different to what I’d see back home. At the same time it is not too different. People are still people, trying to make a living and appreciating life sipping frozen cocktails from shotglasses on an outdoor bar in 32 degrees heat. At this bar we got to meet some locals too, the nicest people who kept on buying us snacks, such as different fruits we’d never tried before while discussing the Chinese investments of the country. I have also met two other cambodians, laughing at my rules of playing pool and showing me how it’s really done. These two sisters that I’ll definately miss when going back.

With the thesis submitted earlier than planned I went out to the island Koh Rong Sanloem for some vacation before going back home to defend my thesis. Right now I am stuck in Sihanoukville, a town that has horribly changed within the past few years to Chinese construction work. Hopefully time will pass quickly with a coffe and a book in hand.

M’pai Bay – Koh Rong Sanloem

Tomorrow I’m flying home to Sweden, back to reality with cold weather and shy people. I am so looking forward to seeing all my friends and family and clean streets though!

Partir, c’est mourir un peu.

(To leave is to die a little)

Good morning from a chilly airport in Brussels,

Yesterday was the day, I left Ghana. It was still impossible for me to believe, somehow it still hasn’t really hit me. Except for the sadness, and already missing soo much.

A funny thing happened though since I had been thinking about extending my stay, it turned out that I had overstayed my VISA! I almost had a heart attack when the people at immigration said I had overstayed my VISA, and that it was a very very serious offense and that I would get a penalty! Somehow I had thought I had a 3 months VISA automatically when entering Ghana, did not even check the stamp when I arrived, where they had written 60 days… After being taken into an office at the airport to a very angry woman, she said I would have to pay a fine. Again, heart attack because now I thought okay if I’m not getting arrested or something crazy like that – at least this fine is going to be HUGE. Haha, nope. 80 Ghanaian cedis, which is about 145 SEK. I wanted to laugh, but it was not the moment. I was still scared too, so I was already almost crying. But the lady warmed up, we talked about nice things with Ghana and I was good to go! So a suggestion from me, check your stamp at arrival haha!

Anyways, the week has been hectic. I had 3 interviews, all insanely interesting and helpful! I still can’t believe all the amazing people I have met during my time in Ghana. So many people fighting for human rights, and children’s rights, it gives me hope for the future.

But like I mentioned, I feel very sad and empty right now. I feel like I have left a piece of my heart in Ghana. The food, the people, the music, the weather, the city, the traffic, the languages – yeah you get it. I could go on forever. It has been so different from Sweden, it has forced me out of my comfort zone sooo many times. More times than I thought I was ready for even, but here I am, so grateful and proud of my experience in Ghana. It has been lifechanging honestly, and has brought back some light in my life that I have been missing for a long time.

My last thought goes to all the amazing friends I have had the opportunity to meet and spend my 9 weeks with. They truly are some amazing people, they are what I will miss the most. You all know who you are.

Medaase.

En sista hälsning från mig i Mauritius

Så har mina åtta veckor gått, jag åker hem ikväll. Det har varit en fantastisk upplevelse och jag är så tacksam för att jag har fått denna möjlighet. Med facit i hand känner jag mig nöjd med mitt fältarbete, jag har fått alla de intervjuer som jag ville ha och lite till och har fått kontakter med myndigheter och människor som jag kan vända mig till ifall jag behöver något ytterligare. Så nu återstår “bara” att färdigställa uppsatsen 🙂

Det är väl på sin plats att sammanfatta mina upplevelser här och det tänker jag göra genom två listor. Den första listan beskriver alla saker som jag kommer att sakna när jag lämnar Mauritius och den andra listan alla saker som jag har lärt mig eller tar med mig från denna erfarenhet.

Jag kommer att sakna:

Min härliga extra-familj som jag har fått här. Vilket mottagande jag fick, så mycket hjälp och stöd jag har fått och så många skratt de har gett mig.

Vädret. Alltid varmt, nästan alltid sol. Även om det tog ett tag att vänja sig…

Maten. Alla härliga smaker, färger, dofter. En blandning av så många olika kulturer och traditioner. Blandning av så många smaker: sött och starkt och salt och surt på samma gång. Kreol influerat av kinesiskt, indiskt influerat av afrikanskt. Chili och curry och saffran…

De otroligt vänliga, öppna människorna som börjar prata med en helt spontant, på gatan på bussen eller var som helst. Generösa och hjälpsamma samtidigt som alla tycks visa stor respekt för alla.

Naturen med de sagolika stränderna, palmerna och de alltid närvarande bergen. Grönska mitt i det turkosa vattnet. Och mina söta fladdermöss på min terrass.

Jag tar med mig från Mauritius, förutom ett rikt material till min uppsats:

Nya vänner och kontakter. Så många trevliga och intressanta möten med olika kulturer. Så många intressanta idéer och syn på livets stora och små frågor.

En insikt om att i vissa lägen fungerar inte den svenska försiktiga mentaliteten. Vill man få något uträttat här ska man helt enkelt gå dit och knacka på dörren. Kan vara ett intressant experiment att göra det hemma 🙂

Min solbränna… (trots solfaktor 50)

Som du säker förstår skriver jag detta inlägg med lite vemod samtidigt som jag verkligen ser fram emot att komma hem. Ibland har det varit tufft här, både fysiskt och mentalt, men de positiva minnena överväger helt klart och sammantaget har det varit en väldigt fin upplevelse. Jag hoppas verkligen att få komma tillbaka en dag…

Over and out.

Analysen, la salsita och ett volontäruppdrag!

Hola amigos!
Jag och Malin har pratat en del om möjligheten vi har fått genom MFS. Det är genom MFS stipendium som vi har kunnat träffa alla organisationer och få höra om allas personliga historier, samt att få upptäcka Colombia. De vännerna och kontakterna vi har fått är tack vare MFS stipendium och det kommer vi alltid vara tacksamma för.
De sista veckorna närmar sig sin slut och det som står kvar är – analys delen. Genom att vi har börjat skriva vår analys, har vi upptäckt nya dimensioner, tankar och teman inom intervjuer…Det är som att se insamlad data från en annan vinkel…

Under tiden vi inte skriver, vilket är kvällstimmar, så lagar vi en del mat och bakar och bjuder människor att få smaka på olika, svenska specialiteter. Vi har också haft chans att utföra några dagsutflykter i djungel, samt att dansa salsa som aldrig slutar spelas på radio eller gatorna. Innan vi anlände till Cali, hade vi inte ens aning att det är så mycket salsa här runt omkring.

Under tiden vi skriver vår uppsats och tränar lite salsa, har vi också hunnit att bidra med vår engelska kunskaper. Jag och Malin har fått uppdrag att lära ut grundskolebarn – engelska. Det har känts meningsfullt att kombinera skrivandet, med ett volontäruppdrag.
Ta hand om er och vi hörs:)))