Chaplain Dana Kalnina-Zake on Latvian chaplaincy

Health Care Chaplaincy in Latvia

Latvia (one of the three Baltic States) has a population of approximately two million (2,271,000 in 2008), half of which live in the capital city of Riga. There are approximately 100 hospitals in our country, only 15 of them (the biggest hospitals) have chaplains. However major structural, legislative and economic changes in our country, like in other parts of the world, influence every field of health care.

Since 2005 there has been a professional organization for healthcare chaplaincy in Latvia – Latvijas Profesionalo veselibas aprupes kapelanu asociacija (the Association of Professional Health Care Chaplaincy - LPVAKA).

Our mission is to develop an open system for interdenominational and interfaith dialogue, which educates, trains and certifies spiritual care-givers in different health care settings. From the beginning we have also taken the initiative to educate society and especially the medical community about relevant issues regarding spiritual dimension of health care, human rights, bioethics, end-of-life and palliative care, etc., organizing local and international conferences (2005, 2006, 2007).

The legislation in Latvia now allows each health care institution to decide itself whether or not, how many and to what extent they employ spiritual care givers. Although the situation now is in transition – recently our country has begun to elaborate a National Cancer Control Programme and the chaplain is being taken into account as a full member of multidisciplinary team at least in palliative care – our Association has been invited to participate in a working group on palliative care within the framework of this programme. Also the Patient Rights Law is waiting to be enacted soon where our Association has achieved that spiritual care be included as one of the basic rights of patients, relatives and staff. Although there have been many struggles since then!

Over the past two years the Association achieved three new professions to be put into the Latvia Classificatory of Professions: Director of Spiritual Care Department, Professional Health Care Chaplain, and Associate Chaplain.

All employed chaplains are paid by hospitals. Some denominations try to support their chaplains by symbolic stipends and opportunities to receive spiritual care and pastoral support as well as to participate in international conferences and workshops. Our Association has always tried to seek additional funding through local and foreign sponsorship to realize most of its projects. Last year we achieved our Association being recognized as a charity organization – this status facilitates the involvement of sponsors and raising funds for our programmes and projects.

At this moment there are 25 hospital chaplains in Latvia, two of them have successfully completed four units of CPE in USA (Barnes-Jewish Hospital, St. Louis, USA). Members of LPVAKA are healthcare chaplains, ministers and theological students from Roman Catholic, Evangelical Lutheran, Baptist and Methodist Churches. Not all working chaplains are members of the Association. The number of the membership of the Association has been constantly changing since its foundation, mainly because of the rather high requirements the Association demands from its members. We have five different member categories – professional chaplain, associate chaplain, student, affiliate and honorary member – all of these have different requirements, rights and obligations.

Approximately two thirds of all working chaplains have completed clinical training in Latvia based on principles of CPE in USA. However, it has been less in- and ex-tensive and much shorter. One of the main issues we feel as problematic now is a lack of qualified supervision for working chaplains. We are trying to solve it through collegiate supervisions and holding monthly workshops where we do our verbatims and prepare different relevant presentations ourselves as well as we can, also inviting experts from different disciplines – nurses, physicians, psychologists, theologians, pastoral therapists, spiritual directors, etc.

The Association holds Annual Certification interviews and always invites experts from other countries to serve on the Certification Committee as we have no qualified supervisors in Latvia yet. Nevertheless we try to educate all those who have a vocation to work as chaplains in health care settings. All working chaplains - Association members, whether they are certified or not - have an obligation to fulfill the educational programme each year and gather a certain amount of points to maintain their member status.

Last year (2007) the Association of Professional Health Care Chaplaincy of Latvia organized a two-day international conference “The Quality of Life in Illness and Death – Interdisciplinary Approach”. More than 200 people participated from Christian Churches, other faith communities, hospitals, theological universities, medical universities, medical associations, state and public organizations, mass media, and others interested parties.

The Conference included such presentations and workshops as: The Negative Aspects of Pain and its Impact on the Systems of Human Organism, The Quality of Life of Paediatric Patients with Life-limiting Illnesses and their Families, The Quality of Life and Ethical Dilemmas of Adult Patients with Life-limiting Illnesses and Their Families, The Quality of Life of Carers of Severely Ill and Dying Persons, Palliative Care and Problematics of Euthanasia, The Possibilities of Alternative Therapies for Persons with Life-limiting Illnesses and Their Carers, etc.

Among the speakers there were two participants from other European countries - Dr. Sergiy Filimonov, DTh, MD, priest of the Orthodox Church of Russia, Doctor of Medicine, President of the Society for Orthodox Physicians who lectured on "The Role Spirituality and Religion Plays in Health Care, Russian Orthodox Christian Spirituality in the Context of the Health Care System of Russia”. Dr. Anne Vandenhoeck, PhD, lecturer in the Catholic University of Leuven, Faculty of Theology, Supervisor in clinical pastoral training (Leuven, Belgium) lectured on "Hope and Quality of Life for Palliative Patients."

We had also guests from USA - Sister Janet Crane, M.A., member of the School Sisters of Notre Dame, HIV/AIDS Educator with the Red Cross, the Organization of Professional Chaplains of Eastern Africa (St. Louis, Missouri, USA and Nairobi, Kenya) lectured on “Quality and Harmony of Life in Illness and Death – A Chaplain's Story” and led a workshop on the “Impact of Infectious Diseases on the Spiritual Outlook of a Person. What should be considered caring for a person with end -stage AIDS, STD and other infectious diseases”. Lisa Novak , R. N., B. S. N., Six Sigma Green Belt Certified Performance Excellence Consultant and Instructor, Fairview Health Services (Minneapolis, Minnesota, USA) led a workshop on “How to Build a High Functioning Health Care Team” where participants learned the benefits of a high functioning health care team and learned what steps to take to build a cohesive effective team.

We had also our dear friends and co-workers from Barnes-Jewish Hospital in St. Louis, Missouri, USA - Rev. Lawrence Olatunde, M.Div., BCC, Chaplain, Emergency/Trauma Services of the Barnes-Jewish Hospital, who lectured on “The Spiritual and Psycho-emotional Needs of the Patients, their Families and Staff in the Emergency /Trauma and Intensive Care Units”. We were very lucky to have the inspirator and teacher of Latvia professional health care chaplaincy and Honorary Member of our Association, Rev. Dace Skudina, D.Min., BCC, Women and Infants Chaplain of the Barnes-Jewish Hospital who lead a workshop on “The Spiritual Needs of a Dying Person. Methods of Assessment and Response for Medical Staff”.

Among our guests from Barnes-Jewish Hospital there was also Rev. Arthur M. Lucas, an ACPE Certified Supervisor and the Director of Spiritual Care Services at Barnes-Jewish Hospital (St. Louis, MO) and more – our Association's Honorary Member and dear friend, who lectured on our first Conference in 2005 and now for the second time served on Certification Committee here in Latvia.

Please visit our Web site to learn more about chaplaincy in Latvia: www.lpvaka.lv.

Do you have thoughts about advocacy you’d like to share with your colleagues? Send an e-mail to info@PlainViews.org.