The following chapter will later this spring be published in Cemus publication “"Being and Acting in Times of (Un)certainty". Enjoy! : )
Balancing a regional difference.
It is late in November 2011 and I’m in the Latvian countryside, in a small community named Ergli. Ergli is in a state of winter peace. Christmas decorations still shine by their absence in the windows of the buildings and on the streets, but the snow has fallen and an absorbing peace has settled over the beautiful Latvian landscape.
My good friend Lilija is making lunch; from the basement of the Soviet-built block house we have just collected root vegetables, sour cucumbers and honey. Later in the day, we are visiting Lilija’s grandmother, who is now residing in the local retirement home of Ergli and in whose empty apartment we have stayed overnight. The apartment is a time capsule; the scents, the colors, the items – the whole interior radiates of times gone by.
The meeting with her grandma is over pretty quickly. From one of the two beds in the retirement home's small rooms, an old woman sits up and we talk for a while. She is very friendly and unobtrusive, with a clear mind and eyes peering of both joy and bated wisdom. Our conversation is overheard by another woman silently lying down in the bed next. There is not much space in the room for anything else than the two beds; a small shelf and a few photos at the bedside and a minimal chest of drawers. The room is warm and tidy. And that's all. I leave Lilija in the small room with her grandmother.
Outside the room, my thoughts travel to Sweden. Already during my first period of study, I had a side job in the elderly care system back home. And for some months I was even living in a retirement apartment awaiting renovation. When they renovated the apartment, the walls separating two apartments was removed, throughout the whole building two large studios were turned into one larger two-room apartment. The bathrooms were rebuilt; toilet seats were hoisted with elevations, and armrests were mounted. Doorposts were widened and doorsteps removed.
Finally security alarms and monitoring systems were installed in each corner of the apartments and our old folks were left alone in these clinical settings, dense with technology. This formed the minimum standard for every pensioner or old aged person in Sweden.
How does the care and treatment of our elderly differ, in Sweden and Latvia?
Is it sustainable? Can the elderly care be made sustainable?
The retirement home in Ergli is still mostly and merely just a home. There are not a lot of facilities or amenities. Well, last year they got a lift between the two floors of the home, so that the staff did not have to carry the disabled or those with limited physical mobility up and down the stairs. There are not many walkers, wheelchairs, lifts or hygiene facilities around. If any at all. The public bathroom is similar to my own private one, albeit a bit larger. It serves up to 50 old people, in different ages and levels of physical mobility.
Lilija says it's probably good for her grandmother to have a roommate. Though of course, it can be stressful at times, not to have any privacy at all.
My own conclusions are not based on research, but on strong and widespread impressions. It escapes no one living in Sweden that the care of the elderly has become big business here. Its no news that elderly care has gone from being a family matter to a social and institutional activity. And quite recently it has been turned into a profit-making activity, apparently often enough even in the hands of venture capitalists. It’s an absurd development, although it is a reflection of a general trend in our society, mirroring of where our modern lives are going despite our efforts to live in a sustainable manner.
In Latvia, this last step has not been fully taken yet. The old folk's homes in Ergli sorts directly under the municipal leadership, who in its turn falls under the provincial leadership; our Swedish counterpart to the County Council. All is ultimately funded by the state. And the Latvian national economy is still weak, even though the curves are slowly beginning to point upwards and a recovery is in sight. While this is awaited, as much as possible of the governmental resources and funds are distributed to the more producing sectors of the society, according to a more or less explicit and commonly accepted political policy. The resource consuming institutions just has to be given a lower priority. This seems to be an inevitable and commonly accepted fact across the Latvian society. And as always in the Baltic’s, there is no whining and complaining! Even the old people themselves, who are able to make their voices heard, seem to refrain from lamentation. They're used to hard times and there is commonly a humble approach to the life we are given.
In Sweden in January 2012:
Back to school my thoughts buzz around a project. The framework is given by the Cemus course Sustainable Development – Project Management and Communication. I do some research. I write a project plan. I collect my arguments and begin to pull strings. With some previous experience from a company that sells all kinds of facilitation equipment for elderly care, I decide to make contact to see if they have a something to spare, that could be used at the homes in Ergli.
The privatization of the elderly care in Sweden has quite naturally resulted in the fact that care providing companies are seeking rational solutions along with care facilitation equipment that really provides an effect. A large number of companies are producing and selling care facilitation equipment to all different nursing homes and elderly care units. Their managements have become strong business partners who often buy large quantities of equipment. The supplying companies naturally want to stay ahead of their competitors with new, modern products. This results in new manufacturing and updating of equipment which is offered to the new market entrants. Walkers and wheelchairs should often enough be of the latest model of the year! Market forces reign!
This also seems to lead to a relatively large amount of equipment being replaced long before its technical life-span has been reached. And the surpluses, the phased-out equipment, is often returned to the re-sellers storages awaiting disposal and, at best, waste sorting and part recycling.
How about in Latvia, then?
From this development there is not yet much to be seen.
And in Ergli, the staff of the old folk's home has turned an old desk chair to a jerry chair, or a hygiene chair, as it would be referred to here in Sweden, by some inventive carpentry. In Latvia the resources are still managed in a completely different way – a much more sustainable way.
But in order to address a lack of equipment and the current need that has emerged – how about if I managed to persuade some Swedish companies to donate some of their surplus to Latvia?
A temporary transfer of resources and excess production, while awaiting the same assumed development in Latvia? A transfer that would balance a regional difference of available resources?
Sounds like an idea to me. Certainly the transport would produce CO2 emissions, but in the relative sense, in very limited amounts. Especially in relation to what destruction along with new production of these high-tech materials would generate. In an equation of this kind it evidently becomes an environmental win-win situation, where people find use for the equipment until its technical life-span is reached, instead of a far too early breaking it apart, to a cost our environment has to pay by new production and the emissions generated by premature destruction. Would someone do the math on this, it would appear that our global environment would be better off .
But then again, it's just about common sense. Isn’t it? And about the old folk’s in Ergli.
So is the project idea really worth the efforts?
Already my first tries give unexpectedly positive results. The willingness to help often enough proves so big that I almost get moved. I get an external partner in my former contact at a company that sells the devices. In their storage there are already a large number of different facilitation aids that has been lying there, waiting for someone to come and buy them. But by some time passing, the more likely alternative points to destruction, as everyone seems to want the newest models!
With the well meaning hearts of the company’s management, the stretch to a decision is short; it’s – come and get it!
In addition, the company has a broad network of suppliers. The message is suddenly spreading in the market community, and also several re-sellers find non-utilized materials at their own disposal. Now the message is spreading even to customers and clients, such as municipalities and private care providers.
The snowball is rolling!
On March the 20th, 28 hospital beds from the retirement home of Hagaborg in Norrköping, are dismantled and dispatched with destination to Ergli! Beds that have not even reached half of their technical life-span are provided, each with three motors for position adjustments and with mattresses and lateral support.
Several companies follow and start to donate: I receive crutches, walkers, ergonomic pads, pressure relieving dressings and over 60 air cell pressure wound preventing mattresses along with some electrical pumps for maintaining their air pressure. Another company donated sheets, duvet covers and pillow cases – about one hundred of each! I receive a mobile floor lift, an investment worth 15 000 SEK! A well known shipping company part-funds the transportations. And already, the total value of the donated equipment is approaching a quarter of a million SEK!
A new problem arises: the framework of this project within Cemus' course is suddenly not big enough to accommodate the project! This project can be developed to any length!
But with results achieved, we address the retirement home in Ergli, leaving the equipment to them with nothing more than the words: please accept our gifts!
It came as a surprise to me that the will to help can be awakened by such fairly moderate efforts. It shows that there is good in us. And we always have the potential to act upon it.
Thank you fellow donors and project partners! It is a privilege to be able to help your fellow.
Note: Gaida Marija Vekmane, Lilijas grandmother, who unknowingly initiated this project by our meeting, passed away on December 30, 2011, 88 years old.
I dedicate this project to her.