The Pako team at the Kalasatama Health and Well-being Centre specialises in health care for undocumented migrants and integration clients. Close cooperation with social welfare professionals ensures seamless and effective service.
On the first floor of the Kalasatama Health and Well-being Centre, Public Health Nurse Tadeja Munyui holds a walk-in clinic for undocumented individuals every weekday morning. At the clinic, Tadeja assesses each client's situation, checks their vaccination status, considers what kind of treatment would benefit them and refers them for the appropriate follow-up care. Social issues, such as how the client is doing in their daily life, are also discussed at the clinic.
– It's important to give the client the opportunity to talk about their situation, after which I can offer solutions, says Tadeja.
Most of the undocumented people Tadeja meets do not know whether they are entitled to healthcare in Finland. As a result, many of them wait for a long time while suffering from health and social challenges before they find the courage to seek help.
If the client's situation requires a medical assessment, Tadeja will book an appointment with Moona Merikallio, who works as a doctor with undocumented individuals. If necessary, an interpreter will also be booked.
In Moona's experience, most health problems experienced by undocumented individuals are relatively easy to resolve medically, but the background and life situation of the clients brings its own challenges when it comes to caring for them.
– Our clients often have difficult backgrounds and challenging life situations. As a doctor, you must pay particular attention to hearing what your client is saying and be patient in helping them, says Moona.
As a doctor, you must pay particular attention to hearing what your client is saying and be patient in helping them.
When it comes to navigating the service system, the situation for undocumented migrants is in many ways different from that of someone who has lived in Finland all their lives and grown up with Finnish social services. For this reason, professionals need to be able to ask many questions that are not necessary to ask as part of so-called ‘normal’ health station work.
– There are a lot of different things we need to check with clients, and we do need to instruct them on what to do after a doctor's visit, for example, says Moona.
The Pako team originated from a pilot project on refugee health care, which started in 2019 for the purpose of developing health services for refugees. After two project years, health services for integration clients were established as part of the services offered at the Kalasatama Health and Well-being Centre. At the same time, health services for undocumented individuals were started in Kalasatama. In its current form, the Pako team has been operating for five years.
We are united by the desire to approach people's situations from a broader perspective than their individual health concerns.
– In the project, we developed service processes for integration clients, such as client registration. We looked at how the health of this client group has been managed in the past and how multidisciplinary cooperation has been organised. In the end, the development work led us to create a new service model, says Valentina Oroza, a doctor who has worked with the Pako team since the project's inception.
The five-person team includes Moona, a doctor for undocumented individuals; Tadeja, a public health nurse; a public health nurse for integration clients; a nurse; and Valentina, a doctor. In addition to patient work, Pako team also provides training and consultation on health care for undocumented individuals and integration clients to professionals across all health stations in Helsinki as well as other actors, such as organisations.
– I feel that our employees' skills in meeting these client groups have increased through the work of the Pako team, which is great, says Moona.
Valentina works as a personal doctor for integration clients who need a wide range of health care and social welfare services. Most of Valentina's patients have many underlying diseases that have not been treated well. Each patient visits Valentina for a maximum of one year, during which time the aim is to get their conditions under control.
– We get a lot of done in a year. We can get long-standing hypertension or diabetes under control, for example. Sometimes even a shorter treatment period helps, says Valentina.
The idea of empowerment is very much present in my work.
Many of Valentina's patients have sought help numerous times before coming to see her. However, lack of language skills, poor digital skills or difficulties in navigating the service system have meant that, despite their best efforts, they have not received the help they need.
– Patients are often referred to me by social workers. I then take overall responsibility for their health and the care pathway is simpler for the client, too.
There is also a strong pedagogical aspect to working as a doctor for integration clients. The aim of Valentina's work is for the client to learn to cope independently.
– My aim is for my patients to understand the factors contributing to keeping their conditions under control and how they can take action to promote their own health. The idea of empowerment is very much present in my work, Valentina says.