Cross-border care: Finnish healthcare staff play vital role in Sweden’s Norrbotten region

Doctors, nurses and many other healthcare workers who live in Finland have an exemption from quarantine when they return home after shifts in Sweden.

File picture of Dr. Kjell Melander at Kalix Hospital, Norrbotten Sweden

Every day dozens of Finnish healthcare workers cross over the northern border into Sweden, and at the end of their shifts return home again to self-isolation.

They’re part of a small number of international travelers who don’t need to go into mandatory quarantine when they arrive in Finland, as their roles are vital to keep the Norrbotten hospital system functioning during the coronavirus pandemic.

“They’re important for us and we can’t operate without them” says Anna-Stina Nordmark Nilsson, the Regional Director of Healthcare in Norrbotten.

“If the Finns can’t come into our region then we must close healthcare facilities” she says.

There’s five hospitals and 20 health centres scattered across the sparsely populated 26,000 square kilometers of Norrbotten, and most of the Finns work in the eastern part of the region.

Around 90 Norrbotten healthcare staff live on the Finnish side of the border, among them four ambulance nurses; six midwives; five general practitioners; a physiotherapist; a medical secretary; ten specialist doctors; four dentists;, a psychotherapist;, 48 nurses and six nursing assistants.

In Haparanda Health Centre alone, adjacent to Tornio, 100% of the GPs and 60% of the nurses are based in Finland.

There’s also many more Finns working in elderly care in Norrbotten, outwith the Swedish public healthcare system.

File picture of Kalix Hospital, Norrbotten / Credit: Anders Alm, Norrbotten Regional Healthcare

Commuting from Tornio to Kalix

Cardiologist Kjell Melander commutes 40 minutes – and a one-hour time difference – from his home in Tornio to Kalix Hospital over the border.

Brought up in Sweden to Swedish-speaking Finnish parents who emigrated there in the 1960s, Dr Melander has lived in northern Finland now for almost 30 years.

“Coronavirus has affected us more in the way we are preparing for the big wave to come, and that’s the problem right now. We have locked down a lot of things here, and have changed the way we are working” Melander explains.

There’s an epidemic ward at Kalix Hospital, and while they do currently have patients with Covid-19, anyone who falls seriously ill would be sent to Luleå, 170 kilometers away.

“Every time we have a patient with a fever, and we can’t say this is obviously something else, we have to take care of these patients as if they were infected with the virus, and it makes everything very complicated” Dr Melander tells News Now Finland.

Kjell Melander also agrees there would be some serious problems if Finland-based staff couldn’t cross the border. Nurses he says, will do a few night shifts in a row, then take some days off.

“They have done it for many years and if they don’t come then it’s going to be very hard to keep the ward open without making very big changes, and move around persons from other parts of the hospital organisation. We have been very anxious about this” he adds.

File picture of Tornio-Haparanda border crossing / Credit: Google Maps

Crossing the border 

With border restrictions in place for travelers arriving in Finland, the journey to and from work has become more complex.

Finnish staff leaving hospitals at the end of their shifts in Norrbotten must fill in paperwork when the arrive at the Finnish border to explain where they’re coming from and where they are living.

In addition, they have to sign a statement to say they won’t be going to any places where they could potentially infect someone else with coronavirus. It’s a halfway house between voluntary self-isolation and enforced quarantine for other people who cross the border into Finland during the lockdown.

“When we go back over the border it’s a quarantine-like situation. We should go from the border right to our home. Sit there. And wait for the next day and go back to work” explains Dr Melander.

“We are not allowed to walk around. We can go to pharmacy and the shop if necessary, but it’s not recommended” he says.

“We have a right to move back and forth but in Finland we have to be in quarantine-like conditions and not travel around.”