Staff Shortages Impact Mothers’ Safety, Midwives Say

The vast majority of midwives in Iceland say mothers’ safety has been put at risk due to staff shortages. Almost one-third of midwives have considered leaving the profession altogether within the last two years. Too much strain, staff shortages, and dissatisfaction with how the shortening of the work week has impacted shift work are all named as key reasons.

The data is from a recent survey by BHM which was commissioned by Icelandic Association of Midwives last month. According to the survey, 85% of midwives say the safety of mothers has been put at risk at some point in the past six months due to staff shortages, and 48% of them say that such incidents happen more often than before.

More strain on shift workers

When asked to consider the last six months, 85% of midwives say they have encountered situations where staffing was not sufficient to ensure minimum safety requirements for patients. This percentage is lower among midwives who work daytime hours (72%) and higher among those who work shifts (93%). Notably, 39% of shift workers stated they have often encountered such situations within the past six months.

Dissatisfaction with impacts of “shortened” work week

Three-quarters of midwives stated that the level of strain they experience on the job is “high” or “very high,” and 70% say that strain has increased over time. These figures are higher among shift workers than daytime workers.

When asked how their working conditions had changed with the shortening of the working week, 54% of midwives working shifts in the public healthcare system believe that working conditions have worsened as a result, while only 30% believe that working conditions have improved. There is great satisfaction with the shortened work week among midwives in daytime work, while dissatisfaction among shift workers is mainly related to a system that financially incentivises them to take more evening and night shifts, as well as the negative effect on work flexibility.

Staff shortages and strain have been an issue across Iceland’s healthcare system for years, including among nurses and in emergency care.

Mumps Diagnosed in Reykjavík Area

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A case of mumps was diagnosed in Iceland’s capital area in early February. Now, a second person connected to the first case has also been diagnosed with the illness. Mumps is a viral respiratory infection that has been quite rare in Iceland since 1989, though a few outbreaks have occurred since then.

Those who were exposed to the positive mumps cases have been informed by health authorities, according to a notice from the Directorate of Health. Those who were exposed and are unvaccinated were advised to stay away from others to reduce the risk of infection. The gestation period for mumps is about three weeks, so it is possible that other cases will emerge in Iceland.

Vaccination is the most effective protection against mumps and has been routine in Iceland since 1989. Since 2000, a few outbreaks have occurred, mainly in people born between 1985-1987. Older cohorts are generally considered immune due to frequent outbreaks prior to 1984.

Rates of measles rising in Europe

A case of measles was diagnosed in Iceland recently as well, in an adult traveller who had recently arrived from abroad. Chief Epidemiologist Guðrún Aspelund stated that measles infections are on the rise in Europe, which increases the likelihood of an outbreak in Iceland.

First Measles Case in Iceland in Five Years

Landspítali national hospital

An adult traveller visiting Iceland was diagnosed with measles on February 2, Iceland’s first case of the highly infection illness in five years. The man is in isolation at the National Hospital and all those at risk of exposure to the illness have been contacted by authorities.

A serious illness

Measles are a highly infectious, serious illness, characterised by red flecks that spread across the skin. The death rate of measles infection is 1-3 per 1,000 cases. Once infected, it usually takes 10-12 days for symptoms to appear.

While those who have been vaccinated against measles are very unlikely to get infected, participation in measles vaccination in Iceland has been falling in recent years. According to the newest review by the Directorate of Health, participation has dropped from around 93-95% down to around 90%, which is too low to maintain herd immunity.

“We would really like to see higher [participation] in order to better prevent the spread of infection through society, but participation needs to be quite good to ensure that,” Chief Epidemiologist Guðrún Aspelund told RÚV. She added that measles infections are on the rise in Europe, which increases the likelihood of an outbreak in Iceland.

Eradicated in the 90s in Iceland

Measles were eradicated in Iceland in the 1990s, and were not diagnosed again until 2014. Since that date, all measles cases diagnosed in Iceland have originated abroad. “It’s not circulating here in Iceland and we want to prevent it from spreading and leading to group outbreaks or more cases here,” Guðrún stated.

Children in Iceland typically receive two measles vaccinations, which Guðrún says provide protection for life.

Updated Sex Ed Curriculum for Secondary Students in Iceland

Iceland’s Association for Sexual Health has published new educational material for sex ed in secondary schools. The material takes into account the major societal changes that have taken place in recent years, the association’s chairperson told RÚV.

The material consists of a new teaching manual for secondary school teachers, titled Youth Sexual Health and Wellbeing. The manual is a product of collaboration with a broad range of organisations, including the National Queer Association of Iceland (Samtökin ’78) the feminist disability movement Tabú and Trans Iceland. Secondary school teachers were also involved in the development of the material.

Self-esteem and sexual health

The manual’s 13 lessons cover a wide range of topics, from self-esteem and body image to emotions, porn literacy, healthy relationships, STI prevention, and pregnancy. The lesson plans use interactive teaching methods that actively involve students in the learning process.

Updated teaching material

Sóley Bender, the chairperson of Iceland’s Association for Sexual Health, told RÚV she hopes some teachers will start testing the material this autumn. The sex ed curriculum was last updated in 2011 and there have been many societal changes since that time.

“We know for example that just the Metoo movement and the whole discussion that took place after it regarding abuse. That is something that needs to be discussed.” Sóley adds that it is also necessary to take diversity into account in the curriculum and integrate it into teaching materials.

The manual is publicly available on the association’s website.

Less Participation in Childhood Vaccinations in Iceland

Participation in childhood vaccinations in Iceland has not recovered since the downturn that occurred during the pandemic, RÚV reports. There is still a shortage of vaccines due to production problems.

Children’s participation in general vaccinations in 2022 was lower than in previous years, according to a new report from the Chief Epidemiologist. Increased strain on healthcare centres and a shortage of vaccines have impacted the situation and the healthcare system has not been able to make up for the vaccinations missed during the pandemic. The number of unvaccinated foreign citizens may be skewing the data and is being looked at more closely.

The Icelandic Medicines Agency (Lyfjastofnun) reports that the Boostrix Polio vaccine, which has been unavailable in Iceland for some time, has arrived in the country and goes on sale on September 13. Shortages of other routine vaccines for children have also been reported. While pharmaceutical wholesalers are responsible for stockpiling medicines in Iceland, various factors can cause temporary shortages of vaccines and other medicines.

Systematic vaccination has largely eliminated many diseases that regularly lead to death within the population. Continued vaccination is crucial for herd immunity to develop and diseases to be kept under control. Statistics from other countries show that when routine vaccination is relaxed, outbreaks of diseases such as measles, diphtheria, and polio have occurred.

Municipalities in Iceland Raise School Lunch Fees

iceland education

School lunches and after-school activities will cost parents in Iceland more this year than last, RÚV reports. The country’s eight largest municipalities are all raising the fees for these services, though mostly in line with price level increases. The CEO of national parents’ association Home and School expressed concern about the changes, which he says will leave some parents with no choice but to cancel their food subscriptions or withdraw their children from after-school programming.

Despite being encouraged to keep their fee hikes to a minimum, all of the country’s largest municipalities have raised fees for school meals, after-school activities, and afternoon snacks. The fees also vary greatly between municipalities, with the highest and lowest fees for school lunches showing a difference of 71%. As last year, parents in Seltjarnarnes pay the highest fees for elementary school services and those with children in Mosfellsbær pay the lowest fees.

Public health issue

Arnar Ævarsson, CEO of Home and School, a national parents’ association, says the price hikes will have the greatest impact on those who are less fortunate, disabled, or immigrants, and those who have the smallest social support networks. The consequence can be very serious, and Arnar points out that stress, anxiety, and guilt that parents or guardians might feel over not being able to provide their children with the same things other children receive also impact the children themselves.

Arnar says there’s a need to change the rhetoric around school meals and discuss them as a public health issue rather than a service. “In the long term, there is a risk that poor nutrition will later affect the health of individuals. Then this is a cost that comes down elsewhere in the system,” Arnar stated. School meals are also a social equaliser when all children can partake in them, he added.

Insecticide – With a Buzz

nicotine pouches in iceland

According to data from the Directorate of Health, 34.2% of Icelanders between the ages of 18 and 69 smoked cigarettes on a daily basis in 1989. In 2022, 23 years later, that percentage had shrunk to an impressive 6.3%. This decline is not, however, so straightforward as it may appear, for the introduction of new […]

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In Focus: Opioid Crisis

opioid crisis iceland

In April of this year, National Broadcaster RÚV reported that social media had “been abuzz with rumours” concerning the inordinate number of drug-related deaths in 2023 in Iceland. Some of those rumours claimed that 15 people had died from addiction-related problems over the preceding two weeks; others that there had been 35 addiction-related deaths since […]

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Three Deaths in Swimming Pools in Three Months

A woman in her late forties died in Lágafellslaug swimming pool in the town of Mosfellsbær yesterday, RÚV reports. It was the second death in a capital area pool within one week: a woman in her 80s died in Kópavogslaug swimming pool last Friday. In addition to these two cases, a man was found dead in a hot tub in Breiðholtslaug in Reykjavík last December. A swimming safety expert says it should not be possible for deaths like these to occur in capital area swimming pools.

Paramedics were called to Lágafellslaug pool in the capital area municipality of Mosfellsbær yesterday when a woman was found unconscious. The woman was taken to the hospital where she was pronounced dead. Detective Superintendent Margeir Sveinsson says the case is under investigation, as other cases of deaths that occur in swimming pools.

Police continue to investigate the death that occurred in Breiðholtslaug pool last December. The victim was in his 70s and physically disabled, and he had likely been unconscious for around three minutes before he was discovered by another patron. Hafþór B. Guðmundsson, a former lecturer in sports science at the University of Iceland and an expert in swimming safety, was interviewed by RÚV last December following the death in Breiðholtslaug. He called for action on safety issues in Icelandic swimming pools.

Annual Limit on Capital-Area Pollution Already Exceeded

Pollution in the capital area has exceeded the health-protection limit 19 times so far this year, which is more than the permissible number for an entire year, RÚV reports. The law authorises restricting car traffic on days when the limit is exceeded, but such measures have yet to be implemented.

Legal authorisation yet to be translated into regulation

The Environment Agency of Iceland’s air quality metres continually measure the air quality in the city and publishes results every hour. At 6 PM yesterday, the pollution exceeded health protection limits for the nineteenth time in 2023, RÚV reports. According to the regulations of the Ministry of the Environment, the limit can only be exceeded eighteen times a year.

There are no precedents for such high levels of pollution in recent years, according to Svava S. Steinarsdóttir, a health representative at the Reykjavík City Public Health Authority.

“We haven’t seen such high numbers until the last few years,” Svava told RÚV.

The increase goes hand in hand with the increase in car traffic, powered by petrol and diesel. The weather also has its say: calm or little wind combined with the recent day’s frost means that nitrogen dioxide (NO2) hovers over the city for longer periods.

Svava stated that exceeding health-protection limits was serious, given that these limits were set to protect citizens. “We may need to consider encouraging people to use more ecological means of transport.”

Municipalities are authorised by law to restrict traffic on days when pollution is high. However, that authorisation has not yet been translated into regulation.

Svava added that the Environment Agency of Iceland has mentioned radical measures, such as traffic restrictions, in its contingency plans. So far, the agency´s only option is to encourage people to reduce emissions from private cars and studded tires.