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Immigrant Healthcare Assistants in Norwegian Elderly Care: Roles and Experiences in the Land of Equality

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Immigrant Healthcare Assistants in Norwegian Elderly Care: Roles and Experiences in the Land of Equality Immigrant Healthcare Assistants in Norwegian Elderly Care: Roles and Experiences in the Land of Equality Vyda Mamley Hervie Dissertation for the degree of philosophiae doctor (PhD) Department of Social Work and Social Policy Faculty of Social Sciences OsloMet – Oslo Metropolitan University Spring 2019 CC-BY-SA OsloMet – storbyuniversitetet OsloMet Avhandling 2019 nr 5 ISSN 2535-471X ISBN 978-82-8364-148-6 OsloMet – storbyuniversitetet Universitetsbiblioteket Skriftserien St. Olavs plass 4, 0130 Oslo, Telefon (47) 64 84 90 00 Postadresse: Postboks 4, St. Olavs plass 0130 Oslo Trykket hos Byråservice Trykket på Scandia 2000 white, 80 gram på materiesider/200 gram på coveret Immigrant Healthcare Assistants in Norwegian Elderly Care: Roles and Experiences in the Land of Equality. Vyda Mamley Hervie Dedication Dedicated to my lovely daughter Ingeborg, without whom this dissertation would have not been completed. Thanks for the inspiration and providing mamma with the writing space with the hope that one day, mamma will be like Doctor McStuffins. I hope that when you grow up and pick this dissertation off of the shelves, you will still carry that big heart-warming smile and be proud of mamma, even though you will better understand what this kind of ‘doctor’ means. Love you, Nerkie. Acknowledgements In writing about the experiences of immigrant healthcare assistants, I too had experiences. However, unlike the experiences of participants, which are related to reminiscences in elderly care, my own experiences remind me of my attempt at climbing Lurfjelltind, the 1284 meters- tall mountain in Bodø. Though embarked upon with determination, my encounter with loose rocks and steep stretches of the mountain left me frustrated and with an urge to give up. However, with words of encouragement and unfailing hope, I found myself at the top of the summit with a fantastic view and feeling of fulfilment. One person who understood my doubts and fears before the start of this mountain climbing experience, yet still motivated me to try was my Norwegian ‘mother’: Liv Johansen. And when returned home with the incredible feeling of fulfilment, she said to me, ‘Men du klarte det Vyda!’ (i.e. ‘You made it, Vyda!’). Liv gave me all the credit without realizing that her encouragement was a major part of my achievement climbing that mountain. Similarly, there have been many people who have walked closely with me during the past three years, throughout this PhD project. These people have supported me, placed opportunities before me and motivated me to open useful doors that I felt were impossible to open. Nevertheless, only my name appears on the cover of this dissertation. I offer my utmost reverence to my all-sufficient God, who renewed me with strength and solace in those quiet moments when the human understanding was not possible. I would particularly like to thank my first supervisor, Professor Marie Louise Seeberg (who I call ‘Prof’). Prof, had it not been for your motivation, patience, wisdom and practical support, I might have drowned in what seemed like an endless storm at sea. You always understood, taught me to be a better researcher and had confidence in me throughout the dissertation. Beyond just your academic sense of duty to supervise a student, you taught and reminded me about important aspects of life—the key being that wise and genuine people are truly humble. They do not show people how powerful they are but rather; they share the responsibility of supporting others to know how capable they are or can be. Indeed, one of my goals in life was to cross the finish line in this PhD journey. However, when critical moments made this goal uncertain, you always cheered me on, saying things like ‘Come on Vyda, it’s all up there in your head, you only need to bring it out and write it as you have just explained to me!’ just to motivate me. Thanks for the interesting and long-lasting chats, which made me enjoy the process of doing a PhD. For these reasons and many more, I remain truly grateful and indeed, if I become half the person and supervisor that Marie Louise Seeberg is, this will be on the list of my greatest achievements in life. I would also like to thank my second supervisor, Associate Professor and Head of Studies, Lise Cecilie Kleppe, for her positive appreciation, reflective criticism and valuable suggestions towards the latter part of this dissertation. Under your guidance, I was inclined to widen my study from other critical perspectives. With Lise, I learnt that it is not only about writing but also, as she will say, ‘You need to watch out for the “so what” questions’. Lise’s ‘so what’ questions, insights, respect for my ideas and myself as a human being, and her own personal zeal to make the PhD process stress-free inspired me to do more. Lise, thanks for being the part of my consciousness that silently reminded me that spending moments at the beach to relax the mind is equally important. Without hesitation, I would like to thank my PhD leader, Amy Østertun Geirdal, for providing good leadership and a positive working environment for the PhD programme. I could not imagine having a better leader and mentor for my PhD study. My sincere thanks also goes to Anne Thorsen and Tore Vogt for their administrative support. I extend special thanks to my colleagues, and members of the Migration Group at NOVA for the stimulating discussions and moments of fun. I also thank my friends at the Senter for kvinne- og kjønnsforskning (KVINNFORSK) at UiT, who provided me with an opportunity to join their team as a guest researcher. In particular, I am grateful to Professor Ann Therese Lotherington and Lise Nordbrønd for giving me access to research facilities and resources, especially on gender. To the Heimberg family (Linn Marie, Lasse, Johannes and Amelia), for continually providing a space for active fun with the kids. It has been a fantastic opportunity to be part of your lovely and kind family particularly, when a good break was needed amidst deadlines. Special profound gratitude goes to Helena Roos and Frode Rinnan for your unfailing support and inspiration. I would also like to thank my ‘family’ in Bodø for supporting me in general and especially throughout the process of writing this dissertation. A very special appreciation goes out to Veronika Johansen and Anders Fiva for the myriad ways in which you actively supported and practically stood by me in the most challenging moments. To my enthusiastic ‘blå mamma and pappa’, Liv and Willy Johansen, for checking up on me, to see how I was progressing. I enjoyed your shouts of joy whenever you heard that significant progress had been made, even though it was likely that you did not grasp how much more progress needed to be made to complete this dissertation. To Nicholas, Jemima, Andreas and Khetura: thanks for the lovely company during each trip to Bodø. In talking about trips, I now take my acknowledgements on a trip to Ghana, the land in which my energy resides—that is, to my biological family. To my mother, Mercy Lartekai Ayin, who remains my perpetual life-coach and cheerleader. Thanks for your selfless love, sacrifice and dedication to support every decision that shapes my life for the best. You gave up many things to be there for me. Thanks for always being around and giving me a shoulder to lean on through thick and thin. Your unflinching support and belief in me made the completion of this dissertation possible. I bow to your contribution, devoted prayers and motherly love. I am also grateful to my siblings, Daniel-Dominic, Priscilla and Vivian, and my nephews and nieces, Yvonne, Yvette, Kelvin, Aba Nhyira, Daniella, Paa Kow and Melvin, who have provided me with various forms of support along the way. And to my ever-encouraging, positive and interesting friends: Lizzy, Denise, Ruby, Joan, Kezia, Kojo and Oboshie and Kwame Anim-Boamah, a million thanks for your moral and emotional support and especially to aunty Emma Laryea who silently motivated me to complete this journey by consistently asking about my submission date. Finally, to all the participants in this study, a very big thank-you for sharing your experiences with me. Now I can tell the experiences of immigrant healthcare assistants in Norwegian elderly care, with fascinating details to make this a crucial step in getting additional insights and knowledge out there. Abstract This dissertation draws attention to ‘unskilled’ immigrant health care assistants in Norwegian elderly care. Their everyday experiences and reflections on their role in the workplace are explored through an ethnographic approach. Fieldwork was conducted in institutional settings as well as in the private homes of elderly people. The study focuses on practices as they unfold at the intersection of two policy fields: healthcare policies aimed at meeting the needs of elderly people, and integration policies aimed at incorporating immigrants into the labour market. The analysis draws on theoretical approaches to work and occupation (Abbott 1998; Hughes 1971, 1994), complexity theory (Heylighen et al. 2007, Kernick 2002) and intersectionality (Collins 1998, Crenshaw 1991). Concepts of dirt (Douglas 1966) and dirty work (Hughes 1956, Dahle 2018, and others) enable an in-depth analysis of participants’ narrated experiences. The analysis of participants’ experiences brings out the following key themes: the experience of cultural dilemmas at work, limited career mobility, experiences of being disregarded, structural discrimination, and the need for adequate training. Participants’ reflections on their experiences are influenced by what they see as a corresponding lack of recognition of the elderly in society, and particularly by a political discourse where older people at the receiving end of care services are attributed a low value.
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