When you don’t have good information, you begin to make your own ideas based on prejudices. But when it concerns migrants, this is really dangerous,” says Prof Esperazna Diaz, director of the Pandemic Centre at the University of Bergen. The Norwegian researcher was interviewed by CZRUG interns Natalia Supińska and Kinga Urbańska.

Could you tell us where does your interest in migration come from?

It’s a very good question. I was working as a GP, a General practitioner, for many years in Bergen. Then I realized I noticed that I had a lot of patients from another countries. If it was only people from Spain and Latin America, I could have understood that because I speak Spanish. That could be easy. But there were also people from Congo, China and everywhere. So I got curious. I had already done my PhD in something else, so I knew how to do research, but I thought “hmm, is this only me?”. My first research question was do other GP’s with migration background have a lot of migrants in their list? Then I started being curious and now it’s like, I don’t know, 20 years of research, but it was the question came from my practice as a GP.

You leaded the project “Health ambassadors”. Why was this project important??

Well, when you don’t have good information, you begin to make your own ideas based on prejudices. But, in case of of migrants, this is really dangerous because we have a lot of stereotypes and ideas on how the others do things, what they do and what they don’t do. You begin to have a lot of discrimination and thoughts that are not correct. So the only way to counteract that is to give proper information that is acquired in a good methodological way, right? Of course, you have never the completely truth, but at least not come we say “okay, this is not that we think that they think so, but we have asked the migrants and this is how people answer”. That is the reason why it’s important to do research in the field of migration because otherwise when you don’t have data, you have prejudices, preconceived ideas, stigma.

What was your role in this project?

I was a leader of it, the principal investigator. I started the project and phoned everybody.

Could you tell us what Health Ambassadors project was exactly about?

It was a try to put together key persons in the communities of migrants. People that are important and known in all groups. There is always one person that everybody knows, and everybody relates to that person. That person gives the other people necessary information so they could spread information to their communities. But it was also about asking them what the problems are so that the municipality and the doctors could give the right answers.

To start from this personal level that you talked about during the lecture?

Yeah. And communication. The other projects, what they have done, is like what I just did with you. You come to a room and I teach and that’s it. But in that way, I don’t listen what are their problems. So there were smaller groups and a dialogue.

And what are the conclusions from this project? Was it successful or you wanted to achieve more?

I think it was successful. There were people who got correct information. There were people who chose after getting the information that they wanted to get vaccinated. Then municipality was more flexible to get people to get vaccinated without appointments. They could just go, for instance. So it worked. It was not perfect, but it worked, and I think it has been a very good start to have this dialogue about the issues that we have now to keep the dialogue for other things. Because there are many other things in health issues that must be understood.

What would you want to achieve with the project that is currently being implemented in Tricity with Dr Elżbieta Czapka as the leader?

I have worked with dr Elżbieta Czapka for many years. We have known each other for, I don’t know, at least 10 years. So we have done many projects together before that.

During the ongoing project, we would like to get information so that we could inform policymakers and inform health providers. Then we could make the necessary changes, the interventions to improve the situation. Because if you think, for instance, that people are not following the recommendations because they don’t understand, Yyou provide papers with translations, but if the problem is not only understanding, but they don’t trust you, it doesn’t help. So you have to know what the problem is to do what you need to improve the situation.

How did Norway cope during pandemic? What restrictions were imposed on society?

Norway coped quite well. We had very few deaths and relatively few people with infection. Well, everybody has had the infection, but hospitals kept working all the time. It was not horrible. There are many reasons for that. The population in Norway is not very big and there’s a lot of space. So, it was relatively easy to keep distance. Also, people usually do, what they are asked to do. So that the distances were kept. Don’t get out, when you are sick and all these things that were everywhere like that you could not have more like 5 people in the house. Most people did what they were told to, but we never had, for instance, lockdown, because in Norway everybody could go for a walk in the mountains. The mountains are just here. If I go out from my house, I just walk in the mountains. So in that way, it was easier. And then the last thing which was important is that people who could not go to work or if they got sick, they all get money from the state. So, there was nobody that had to go out to get money for food.

So, can we say that Norway didn’t need the lockdown because people just trust authorities and obey the rules? And if authorities say don’t go because there is pandemic, they just obey it. In Poland we had many issues with it.

Well, it was more complex than that. I mean, that was part of the reason as you’re saying. This trust. It was also the social welfare that people didn’t have to go out to get food. It’s easier to do what you are told, if they pay you. So, it was a welfare. We don’t have a lot of people in the country. It’s a big country and the health system works very well. It’s public universal.

That was the last question. Thank you very much for your time and answers.

Thank you very much.

Esperanza Diaz is a medical doctor educated in Spain (1995) and a specialist in general medicine in Norway since 2003. In addition to her positions as head of the Pandemic Center since 2020 and professor at the Department of Global Public Health and Primary Care at UiB, she also works as a senior researcher (20 %) at Western Norway University of Applied Sciences. Diaz has researched migrant health since 2008, written over 150 peer-reviewed articles on the subject and published the book Migrant Health: A Primary Care Perspective. Esperanza Diaz has extensive experience in collaborating across faculties, institutions and groups in the population. Diaz has developed and led the Pandemic Center since 2020. The Pandemic center is administratively anchored at IGS but is an interdisciplinary center with representatives from all seven faculties at UiB.

Working across disciplines and with non-academic environments, as well as the inclusion of social inequality in health in a pandemic perspective, have been keywords in Diaz’s research in recent years. In 2023, she leads the NFR-funded project Integration for health (in Norwegian), which follows the project Changes in health and health needs among Syrian refugees on their way to Norway (in Norwegian). She is also involved as a partner in other NFR projects such as EQUALPART – Western Norway University of Applied Sciences) and from 2024 will also be a partner in the EU-financed the UniHealth project.

Diaz has taught several topics related to general medicine, including clinical consultation, ENT in general practice, pregnancy control in general practice, clinical meetings with patients from other cultures, narrative medicine, and unfortunate events, as part of the position at UiB. In recent years, she has mainly taught migration and health and pandemic-related topics. In both subjects, she has developed her own PhD/subject courses (Migration and Health | Universitetet i Bergen (uib.no) and Learning from the COVID-19 pandemic: an interdisciplinary approach | Universitetet i Bergen (uib.no)) Speaker at several courses for medical students, nursing students and doctors in Spain and Norway since 1999.