All Roads Lead to Krakow

By Larisa Damian

As half of the first year students of the Global Health programme at the University of Copenhagen are getting ready to embark upon the field trip to Poland, scheduled in May-June, everyone is anticipating the experience with a complex mix of feelings. After all, most of us are headed towards a month of novelty. What should we expect? What kind of a learning experience are we preparing for? Who are the people we are going to meet on our way? Of course, the underlying emotions are very positive, but there is also some anxiety lingering at the back of our minds. ‘Resfeber’ is a Swedish word that describes the turmoil a traveller experiences before starting a journey, when anxiety and excitement are woven together. I wish I had an English equivalent for it, because that would be exactly the word I’d have used to describe this contemplation.

For me though, going to Krakow is going back to one of the places that contributed to the person I am today. In 2009, I did an internship with the Community of Hope Foundation. This is an initiative that has developed a centre for adults with autism, and since the main goal of our trip is to get acquainted with the medical system of a middle-income Eastern European country, I thought it would be useful to share with my colleagues a positive story of  the great things that can be done, even in a system with little to no support.

Rynek Główny: the main market square. Photo by Larisa Damian

In spite of the fact that over the past decades mental health care services have improved significantly, they are poorly integrated within the health care system, and there is a shortage of mental health care professionals. Moreover, the quality of health care provision differs tremendously across the country. Autism is a very good example of how the system may fail its beneficiaries. Although nowadays there are a number of facilities that provide services for children with autism, as soon as these patients turn 18 they become invisible, as psychiatric facilities are not prepared to mitigate their needs and the social system is incapable of integrating them.

The centre I worked for was created exactly to alleviate these problems. It is called ‘The Life Farm’ and provides accommodation, work options, and therapy and rehabilitation activities for all the beneficiaries enrolled in the program. The project began as a consequence of the inability of the Polish system to deal with autistic patients once they were no longer considered children. According to the European Autism Society:

“Life Farm is a kind of village community opened to adults with Autism from Krakow and surrounding neighbourhoods. As part of the long-term project, residents and other adults with Autism will be able to engage in vocational training to prepare them for the open job market, as well as participating in trade and handcraft workshops and an organic farm. Some people also benefit from professional training and apprenticeships conducted outside the centre.”

My job at The Farm was to guide the residents during the workshops and to assist in the creation of several educational tools and programs. I also had the chance to visit a few other facilities for people suffering from other mental health problems, such as a centre for children with autism,  a psychiatric hospital, and an asylum for men with both mental and physical disabilities. In each of these situations I was faced with two of the main features of the approach to healthcare in a country like Poland. On one hand there are the difficulties that both health care providers and patients encounter as a consequence of a medical system that is continuously changing, more than 20 years after the fall of communism. On the other hand, there is the resilience that characterises these people, and their ability to find answers to questions that have never been officially asked, such as what do we do with these people who don’t fit in any of the categories our systems are ready to serve, or can we do something even though nobody’s done it before?

The Krakow Ghetto Memorial. Photo by Larisa Damian

So when you’re asking yourselves what it is going to be like, my experience says that while you’ll encounter quite a number of mind boggling problems and irregularities in health care provision, you’ll be amazed by the creativity of people and by projects such as the one I just mentioned. The Jagellonian University is located in a beautiful old building in the heart of the city, in the middle of all that Krakow is. As for Krakow itself, it’s nothing short of spectacular. Castles, rivers, hidden turquoise lakes,  legends about dragons, art cinemas, and, most strikingly, a reminder of the astounding survival skills of our species; both the old Schindler factory and the Nowa Huta district built during the communism years as a centre for heavy industries have left their prints on the collective memory of the city. And me? I am looking forward to being carried around the streets of Kazimirez once again, as the sun sets and some Klezmer music resonates outside a souvenir shop by a synagogue.

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