Health module in Master Programme in Indigenous Studies

1. Introduction lecture

The lecture will give a historically overview over the health status of the Sami people, but also of recent epidemiological research. The students will be introduced to the organization of the Norwegian health care system with its different levels and to the development, planning and construction of a Sami health care service through the last three decades. A specific focus will be put on the ideas, aims and functioning of the Sami health care institutions but also on cultural sensitive health services for other indigenous peoples.

Teaching: Siv Kvernmo; Dr. Med., Child psychiatrist, Head of Child and Adolescent Psychiatric Outpatient Clinic, University Hospital of North Norway, Tromsř, Norway


2. Culture, health and ethnomedicine

In these lectures we will explore the subject of culture, health and illness. We will discuss various dimensions of ethnomedicine such as sickness etiology, healing and social control. The lectures will be based on medical anthropology. Medical anthropology is about how people in different cultures and social groups explain the causes of illness, the types of treatment they believe in, and to whom they turn if they do get ill.

Teaching: Valeria Marton, Research-fellow, Center for Sami Healthresearch,


3. Stigma and living conditions for the Sami people in the north of Norway

In this lecture we will first study the consept of stigma and living
conditions for the Sami people living in the north of Norway. We will compare
data from the Sami population in this area with the Norwegian population, and
study how stigma affect living conditions and health. Data from
the health and living-condition research, SAMINOR will be used.

Teaching: Ketil Lennart Hansen, Research fellow, Center for Sami Health Research



4. Users perspective in the health service for Sámi patients

The University Hospital of Northern Norway has a Sámi department with two employees. Our work is to interpret between Sámi speaking patients and medical and nursing staff, translate information, inform about the Sámi department in seminars etc. and to make sure that the Sámi language is visible at the hospital. Almost all the signs at the hospital are in both sámi and norwegian. The most important work that we do is to interpret when it’s needed. Even if the patient understands and speaks norwegian, it is important to understand that being able to speak your own mothertounge is crucial for the communication between the patient and the medical staff. The risk of misunderstandings is minor and it feels more confident for the patient. For many people it is a shock coming to the hospital, and the patient is probably anxious about her/his own medical condition. It is important to be met as a person, not as some diagnosis. Research into treatment-satisfaction shows that the quality of contact with the medical and nursing staff is one of the determinants of both patient satisfaction as well as patients’ reception of adequate information about their treatment and condition. Using the language that you know best, makes you feel respected, understood and being able to express yourself without always having to look for the correct words. Under Norwegian law you have the right to use sámi in public institutions, and it is also a human right.

Teaching: Lill Tove Fredriksen works as a consultant and interpreter at the University Hospital of Northern Norway. She has a post-graduate degree in Sámi literature.


5. “Sámi patients – to see, to understand, to help”

Based on personal experiences as a nurse in cancer care.

The Cancer Department at the University Hospital of North Norway are working with seriously ill patients, including Sami patients, coming from the whole North region. It can be difficult to recognise the Sami patients because they look like anybody else and most of them speak Norwegian when needed. The “difference” appears when reaching the patients’ inner feelings as expressions of pain, fear or death. The way they are speaking, or not speaking, about their own situation, as living with a deadly disease, can be ignored or misunderstood if the staff don’t have knowledge of cultural differences. The ability to care for and help the seriously ill patients can depend on cultural knowledge.

Teaching: Inger Dagsvold is a nurse, specially educated in cancer care. She works at as a consultant at the Norwegian Cancer Union. She is now doing a Master of Health Science at the University of Tromsř.



6. Mental health among Sami adolescents

The lecture will focuses on mental health issues such as anxiety, depression, suicidal behavior and substance use/abuse among indigenous adolescents residing in Arctic, with a special focus on Sami adolescents in North Norway. Both inter ethnic (indigenous versus non-indigenous) and intra ethnic differences in prevalence rates of mental health problems are presented. Risk- and protective factors related to suicidal behavior and substance use will be discussed. The relationship between mental health issues to cultural factors will also be discussed.

Teaching: Anna Rita Spein; Research fellow, Center for Sami Health Research
M.D., Psychiatric Outpatient Clinic for Sami Youth
Anne C. Silviken; Research fellow, Center for Sami Health Research
Psychologist, Psychiatric Outpatient Clinic for Sami Youth



7. Indigenous people and somatic health

The Sámi (formerly called Lapps) are the indigenous people in the artic part of Scandinavia. Little systematic knowledge is available about their somatic health due to few specific studies. The main question is whether there are differences between the ethnical groups in Northern Norway, and what do we know about the incidence and prevalence of the diseases.
Ethnic definitions of Sámi are difficult, because identity is not always fixed or easily determined. Are they homogenous or heterogeneous groups? Ethnic self-identification can be complex and multilayer. While many individuals identify with a single ethnic category, others identify themselves as bi ethnical or multi ethnical, affirming their connection to more than one group. Self-identification can also evolve over time. There are other category which individuals can assigned on like skin colour, country of origin, ancestry and language or dialect spoken.
There has never been accomplished a specific health screening study among the Sámi population. The studies that are carried out are mainly based on cardiovascular screening program that covered the total population of Finnmark. The question based on ethnicity was either grandparent’s language or familial history.
Most of the knowledge about Sámi somatic health is from these studies what the first lesson will describe.
The second lesson will describe the recently finished study named the “Health study in communities with Sámi and Norwegian population”, methods and some preliminary results.

Teaching: Tove Nystad, Phd student/ Paediatrician, Centre for Sámi Health Research, Department of Community Medicine, Tromsř
Title of the Phd project: “Prevalence of abdominal pain in adolescents in Northern Norway, and whether there are ethnic differences.”
Ann Ragnhild Broderstad, MD, Research fellow, Medical Faculty, Center for Sami Health Research, Institute of Community Medicine, Tromsř. Title of the PhD project: Serum iron and prevalence of heamochromatosis in two populations in Northern Norway




8. Traditional Saami medicine

The saami people have developed their own traditional medicine during several thousands of years. The saami traditional medicine has clear connections with Siberian religion; shamanism. A brief historical overview on shamanism and the cultural transition to Christianity will be given introductorily as a background for understanding explanation of disease in saami culture. Subsequently, traditional types of treatment will be reviewed, such as “reading” (healing), laying on of hands, stoppage of bleeding and saami herbal medicine.

Teaching: Aina Ravna, Post. doc., Department of Pharmacology, Institute of Medical Biology, Faculty of Medicine, University of Tromsř



9. Guest lecture