Addressing Greenland’s Healthcare Staffing Crisis

A Decolonial Look at New Hiring Policy

By amaasa olsen

There has always been a big discourse within Nunarput (Greenland) regarding the healthcare system and the many different challenges in that sector. One aspect of those challenges has been staff shortages, which Naalakkersuisut (the government of Nunarput) has tried to address in a new policy regarding the hiring process of healthcare workers outside of the Nordic region. This new policy, which was developed in 2021, has been implemented as of September 6. 2023 and is a deal between the Danish government and Naalakkersuisut (Lindstrøm, 2023). To further understand and analyse this policy it is important to give historical context that can help explain why the policy came about and what the underlying issue is. I will also interview someone who works at the hospital in Nuuk, the capital of Nunarput, to ask about their opinion on the policy and how it might look in practice.

Colonialism

This historical context and underlying issue is the colonial structure within Nunarput. Nunarput was a Danish colony from 1721 and became part of the Kingdom of Denmark as an autonomous province in 1953, which officially ended the colonial period. While Nunarput was not technically a colony anymore Denmark’s colonial practices continued as they started to push the process of ‘modernization’ and Danification on the indigenous Inuit population to new heights. This process included policies where civil servants born in Nunarput would legally only earn 85% of the salary of those born in Denmark (Birkhold, 2019), segregation between Danish-speaking and Kalaallisut-speaking students in school, and many more atrocities committed by the Danish state. One that concerns the healthcare system in Nunarput was a recent discovery of the Danish state committing genocide with doctors putting IUDs in Inuit girls and women without their consent and knowledge with accounts from the mid-1970s till the early 2000s (Murray, 2022).

Nunarput later gained home rule in 1979 and self-governance in 2009, while also taking over the responsibility of the healthcare sector from the Danish state in 1992 (Platou & Hyldal, 2022). The point of all of this context is to showcase how prevalent colonialism has been and has therefore formed the social structure and policies within Nunarput to that of a colonial one. This is especially important to keep in mind when analysing policies and how Naalakkersuisut looks at a problem.

The policy

Getting back to the policy at hand. Before the deal went through the Danish government held the authority over Naalakkersuisut in the hiring process of healthcare workers from outside the Nordic region. Another element that made the hiring process much more difficult was the requirement for the workers to speak Danish, which has been relaxed with the new deal (Lindstrøm, 2023). The problem represented by this new policy is clearly on staff shortage, particularly in key medical roles, such as doctors, nurses, and specialists. Former Naalakkersuisoq for health, Anna Wangenheim, helped out with forming the policy and spoke out on how Danish doctors would only be employed with short-term contracts and would also discriminate against the Inuit. She emphasizes that a better solution would be to educate enough Inuit (which I will get into) but that this new policy is a step forward from hiring Danish workers who usually stay a few weeks or months (Holm & Platou, 2022). With all this in mind, I ask, how do the healthcare staff shortages relate to colonialism and why is it not being addressed?

The roots of the issue

Wanting to understand this further I interviewed Seqineq (pseudonym for anonymity) who works in healthcare at the hospital in Nuuk. Seqineq explains that there is an importance on speaking Danish within the healthcare system, not only due to the Danish workers who come to work short-term but also the higher-ups working within the administrative departments who don’t speak Danish. According to Seqineq, this Danish culture within the workplace could possibly make implementing the new policy in practice quite difficult. This is also extended to the Inuit who work there as they have to learn Danish at schools within Nunarput and Denmark, whereas it is possible to live in Nunarput your whole life without speaking any Kalaallisut.

There is a similar issue with having to go through high school speaking Danish as many of the high school teachers are hired from Denmark due to a shortage of Inuit high school teachers as well. This has led to high schools in Nunarput having an incredibly high dropout rate. All of this is not accidental either but reflects the policies and social structure that was set up by Denmark, which is a difficult thing to change, especially when it is not acknowledged.

Seqineq also mentions how this leads to a colonial mindset for the Inuit as they end up having to assimilate into the Danish language and culture if they wish to get an education and be in a higher social position. For some degrees, like a medical degree, you would have to study at a Danish university. Seqineq explains how this aspect of having to speak and act Danish to do well is a huge barrier that does not get addressed as the colonial structure is set up to be hidden and normal. A way she explained this was as if we were living in a collective Stockholm syndrome, which is when victims start identifying with their capturer. This makes it very taboo to talk about colonialism and how it still strongly affects us today.

The c-word

When it comes to addressing any social problems in Nunarput it becomes nearly impossible to look for solutions without mentioning colonialism and the colonial structure we live in. Yet naalakkersuisut do not address colonialism and the colonial structure. This does not mean that they can’t make policies that address certain issues and are able to put a band-aid on them, but as long as they don’t address the roots of the issues and problematize the colonial structure no long-term solution will be addressed. Hopefully, this blog has been able to explain and contextualize the new hiring policy and how it does not address the actual roots of the problem. While the idea of colonialism and colonial structure can be difficult to explain and understand I hope it is clear and that it is able to make you think of colonial structures when policies are made within former colonies or settler colonies. Special thanks to Seqineq as well who was able to help me further understand the limitations of the policy and Inatsisartut (parliament of Nunarput).

references

Birkhold, M. H. (2019, August 22). A Brief History of the Indignities Heaped Upon Greenland. The New York Times. https://www.nytimes.com/2019/08/22/opinion/trump-greenland-denmark.html

Holm, M. M. F. & Platou, K. (2022, February 1). Wangenheim om fødestedsfadæse: Vi er tæt på et velfærdskollaps. https://knr.gl/da/nyheder/wangenheim-om-f%C3%B8destedsfad%C3%A6se-vi-er-t%C3%A6t-p%C3%A5-et-velf%C3%A6rdskollaps

Lindstrøm, M. (2023, September 6). Ny aftale skal lette regler for tilkaldt arbejdskraft i sundhedsvæsenet. SermitsiaqAG. https://sermitsiaq.ag/node/246425

Murray, A. (2022, September 30). Inuit Greenlanders demand answers over Danish birth control scandal. https://www.bbc.com/news/world-europe-63049387

Platou, K. & Hyldal, C. (2022, October 13). Naleraq: Vi har brug for hjælp fra Danmark til sundhedsområdet. https://knr.gl/da/nyheder/naleraq-vi-har-brug-hj%C3%A6lp-fra-danmark-til-sundhedsomr%C3%A5det


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