I was delighted to attend the 13th OECD Rural Conference in Cavan, Ireland last September to speak at a plenary session on young people as leaders in our rural communities.
A few weeks beforehand we were briefed on what the aims of the session were and given some guidance on what kinds of things we should try to get across to our audience. We were told to be confident, bold, and to try and get a key message out to a room full of policymakers and stakeholders. Some pressure came with such a great opportunity to speak up and get the views of myself and other young people heard on the issues facing our local areas and what policymakers – some of them sat in the room – needed to do better on.
I remember first seeing my picture appear on the OECD’s website where the speakers were all listed. There I was situated right next to the then Taoiseach Micheál Martin. I could not quite believe it at first, and honestly felt a bit of imposter syndrome creep in. Who was I, a young student from a far-off island and why should anyone listen to me at this event next to top academics and policymakers from Europe and beyond? I knew, however, that my place at the table was just as important as theirs. I’ve lived my whole life in the islands, I am passionate about the Gàidhlig language and culture which is inseparable from where I am from, I have had years of experience standing up as a young person and contributing to policymaking and a range of local and national issues, and the voices of young people deserve to be heard – especially in the world we live in today.
The plenary session was exciting, engaging and elicited a fantastic response from those who sat in the room. Alana and I spoke on the key issues facing the islands, and 2 young women from Ireland spoke with passion about their rural areas as well. It was fascinating to see how much we had in common in rural Ireland and Scotland. All of us were proud of our local areas and the culture and heritage which is so strong in them, and we were passionate about the issues faced in them today.
We called on policymakers to break down the barriers preventing young people from returning and to help match their aspirations with the opportunities available. We called on policymakers to directly empower communities, to bring them around the table, and to especially involve young people directly, who are vital in ensuring the continued prosperity of our rural communities, emphasising that the responsibility fell on the policymakers to reach out, to listen and to act on what we need. Our key messages were that young people do want to return, we are proud of our communities, and we need action to reduce the difficulties faced when trying to return to our rural communities. We also emphasised that young people are already leaders in our communities and that policymakers should never underestimate the power of our voices.
Our discussion and the key messages that came from all of us on the panel made a big impression on those in the audience. After a long day of academics and professionals presenting their carefully planned, long-winded, meticulous and nuanced viewpoints, it was incredibly refreshing for them to hear directly from the young people from these rural communities speaking boldly and passionately from their own life experiences and what they strongly believed was the future of their communities. We had several of the attendees speak to us after the session, praising us for being so bold and outspoken which made me feel as if I had accomplished my mission of really grabbing their attention and getting our key messages across to them. That was my first international conference, and so to have that kind of reaction was unbelievable to me, given how easily the voices of young people have been disregarded in the past.
My thanks firstly go to the Scottish Rural Network for making it possible for me to attend the conference, to everyone at CoDeL who reached out and invited me to attend, and finally to the OECD for facilitating such a vitally important discussion and giving a platform to young people from rural communities to speak our truth which I think had a big impact on many of the attendees at the conference.
Living on an island, it is easy to get caught in a bubble, thinking that the issues faced by your community are isolated and completely unique. My recent trip to the Arctic Circle Assembly, hosted in Iceland, provided an opportunity to see that whilst the issues faced in my community are on a different scale compared to Arctic communities, at their core, they are very similar. I found myself attending panel discussions on the remote housing crises for young people, the importance of reviving language and tradition, and on sustainable island futures.
Island communities can offer something completely different, and in my opinion significantly more, than cities and suburbs. However, the two shouldn’t be compared and neither should be disadvantaged. I made the decision to move home after graduating, knowing that I was severely damaging my job and career prospects, especially in the Energy/Engineering field. However, since Covid, I have watched more and more opportunities open up due to home working. I think there is huge potential here (once we have started to address the housing crisis) to revive island populations and reduce the large ‘brain waste’ i.e. people not using their education, training or skills (another term I picked up at the conference).
A few things stuck out to me from the discussions, like the introduction of entrepreneurship into the local school curriculum and how intrinsically linked the housing crisis is to mental health. Starting with the former, in my opinion, Covid highlighted that our economy in the Highlands and Islands is far too reliant on the seasonal tourism industry. Whilst tourism definitely has its place here (who wouldn’t want to experience our incredible landscape?), in order to achieve sustainable communities, there really needs to be a diversification of career opportunities. These can stem from both access to home working and entrepreneurship, so why not get a jump start and teach it in schools?
On the latter point, it seems completely obvious that the housing crisis is significantly affecting young peoples’ mental health, yet it didn’t even cross my mind until it was mentioned at the conference. Having no option but to live in insufficient housing, a caravan or with your parents when half the houses are holiday homes would be difficult for anyone. Add in lack of access to mental health services and you are basically pushing young people and families out the door. I could spend days ranting about the housing situation here, but others have already done a far more eloquent job, so I’ll leave it there.
I would like to thank CoDeL for inviting me to the Arctic Circle Assembly, and the Scottish Rural Network for funding my travel and participation at the conference. I was invited through my involvement with Raasay Community Renewables who set up and run the local community owned hydro scheme. By participating in a panel on the Just Transition to Low-Carbon Economies, I got to share our story of using a community share offer to fund the majority of the project, our hopes and plans for selling the energy generated locally, and the community benefit fund that will be created with the profits. I got to meet and listen to speakers on subjects that I am very interested in, such as green hydrogen and marine renewables and their place in a low carbon future. Overall the experience was invaluable and I loved seeing what Iceland and the Arctic has to offer.
Tha CoDeL an dòchas gum bidh deagh Nollaig is Bliadhn’ Ùr aig a h-uile duine; do muinntir Uibhist, dhaibhsan a tha a’ cumail taic rinn agus cuideachd dhaibhsan a tha nas fhaide air falbh. Tha bliadhna thrang air a bhith againn fad 2022. Tha sinn air ar cumail a dol le Uist Beò agus tha sinn air molaidhean fhaighinn aig an taigh agus cuideachd air feadh an t-saoghal. Seo dealbh no dha a sheallas an obair a tha CoDeL air a dhèanamh thairis air 2022.
The Arctic Circle Assembly is the largest annual international gathering on the Arctic, attended by more than 2000 participants from over 60 countries and held every year in the Harpa Concert Hall, Reykjavik, Iceland. The Harpa concert hall is an incredible building with maybe 15 floors (my head couldn’t cope beyond about floor 5!). It was mere foundations when Iceland experienced a colossal financial crash, so eventually when the government were able to raise funds (their currency had also crashed), they managed to build it after all. So it is very symbolic for them.
“Well over 2000 participants from almost 70 countries [are here today]. It is a formidable demonstration of the desire from so many different quarters of the planet to come together in a new dialogue, in a new form of cooperation, and to seek solutions to the challenges we face. And also in the shadows of wars and increasing geo-political tensions, it is remarkable that all of you have come here today to send the world the message, we want to continue, despite the hurdles, to achieve results for a better future.”
There were representatives from all sectors of life from the Arctic Circle, with strong representation from Scotland, the most northerly non-Arctic country present. CodeL (also promoting Uist Beò), was delighted to have presented at the assembly in the session on ‘Remote Areas: A window of opportunity’. I live in the Isle of Grimsay (Griomasaigh) in Uist in the Outer Hebrides, and there is also a Grimsey Island in Iceland, so we’re closer than at first thought in some ways!
Special thanks to Scottish Rural Network, who are not only supporting Uist Beò, but also enabled Rosie MacLeod to present her work on the new hydro power in the Isle of Raasay at a session on ‘The Just Transition to Low Carbon Economies in the Arctic and Beyond’. It was encouraging to see that indigenous peoples could be heard in a range of sessions, including this one, and I will pick up on that session in my second blog from the Assembly. However, as one person said, “we do not lack technical innovation in the Arctic, but we lack business (will, as in commitment) and political innovation”.
I presented at the session on remote areas with colleagues from the Faroe Islands and Iceland. Invited by NORA, we all presented positive examples of turnaround in the communities in which we work. Our host and facilitator,Jákup Sørensen, reported after our session:“Just a short thank you for your time at our session. I think you all can be very proud. I have never before got so much positive feedback before. Here is a message from one of our guests: ‘I felt it was the best session I attended at the entire conference – all the speakers were BRILLIANT, engaging and funny and real actionable potential came from several.’” I was overwhelmed by the positive response. On a lighter note, I was feeling a little short with our Nordic cousins!
In summary, although there are obvious challenges, it was so encouraging to realise that the impact of my work past and present is inspiring others who face rural depopulation: from linking the education curriculum with local economic opportunity and industry standard qualifications, through the ‘economic literacy workshops’ which Thomas Fisher and I developed and delivered and the demographic research we conducted on young people returning, settling or staying in Uist, and now Uist Beò. I showed statements from the usual tourism messages as well as images, of an empty beach and a roofless cottage, to a soundtrack used for promoting Scotland. I then compared it to Uist Beò, on instagram, Facebook and tik tok.
On the last day we were able to get out of the conference centre and see a little of Iceland. We visited a tomato farm – hydroponics and of course heated by geothermal energy. It produces 40% of Iceland’s tomatoes. One other farm produces another 30%, so they do not export because they still have to import.
Iceland only gained its independence in 1944. They have a population of 360,000. Fish, mainly cod, is the number one sector, followed by tourism.
Two words in common usage come from Iceland: Saga and Geyser. My only comment is the toll tourism has and will take on the environment. Our guide on the Golden Circle said there are volcanoes under one of the glaciers, and if the ice melts they will no longer be ‘capped’, so eruptions could be really damaging. At the same time I saw all the massive vehicles which enable folk to trample and cover the ice. To say nothing of the tonnes of concrete that must have gone into the path to the waterfall, which keeps folk off the grass and keeps them on the straight and narrow by the bus load, but it’s a whole load of concrete which contributes 8% of global emissions. My passion would be to diversify the economy so that tourism is not so important.
CoDeL is honoured to have received an award from the Regional Studies Association for their best blogpost in 2022: view the video here.
We are delighted that this global research network recognises the insight held by many so-called remote rural and island communities as we confront global crises, and gave the award to a small social enterprise in a ‘remote’ island in contrast to a well-established academic institution.
In the award video we look beyond our original blog post focused on responses to the pandemic to the next and bigger emergencies of climate change and biodiversity. We call on researchers and policy-makers to value the knowledge and wisdom held by so-called remote communities and indigenous peoples about living in tune with nature and community.
Enabling us to explore these links has been helped by CoDeL taking a break from much social media over the past several months. We have been able to reflect more deeply on new directions and next steps, following our intensive work with many great partners around responses to the pandemic under the heading of “Redefining Peripherality”.
While we may have had a break from CoDeL social media, we have been busy at sharing insights about redefining peripherality at many different events this year: the EU’s Rural Pact conference, the World Rural Health Conference, the European Rural Parliament, the OECD Rural Development conference and the Arctic Circle Assembly. We have been struck by how much our ideas have resonated with participants from so many different communities and contexts. And by how much radical thinking, for example around degrowth rather than growth, has been welcomed at many of these events.
We will be sharing insights from some of these events in our next blogposts, starting with the Arctic Circle Assembly where Theona Morrison linked with communities across the Arctic, including representatives of indigenous communities. We will also explore emerging insights, for example around the dangerous inadequacies of natural capital frameworks that underpin much green accounting regionally, nationally and globally.
As well as looking forward, we have also come full circle back to our original research on island population which led us to set up CoDeL in 2018. Since May we have focused much energy on supporting the development of the new digital platform, Uist Beò, delivered by a dynamic group of younger islanders. The social media (on instagram, facebook and tik tok) shows clearly just how vibrant and dynamic so-called remote communities can be, with many younger people returning, settling or staying.
These younger people are setting up dynamic businesses, running remarkable social enterprises, contributing hugely to community and culture, and to the sustainable use of resources amidst the climate emergency. We continue to be inspired by their energy, confidence and commitment within a community that may be remote to many, but is at the heart not only of Gàidhlig language and culture but also of much value-driven creativity and innovation, from practical initiatives to deep thinking.
Look out for our blogpost on the Arctic Circle Assembly coming soon, and to the launch of the Uist Beò website in February.
Theona Morrison reports on the World Rural Health Conference in Limerick, Ireland
According to the World Health Organisation (WHO) the definition of health is:
‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’.
It is worth reflecting on those words. How often when we think about health, we visualise the GP surgery or something pertaining to the medical aspect of health care. And yet we probably instinctively recognise that our ‘health’ in the context of wellbeing is influenced by a whole range of factors, not least, our environment and the communities in which we live, work and socialise.
Approximately 600 health sector workers from across the globe attended the WONCA World Rural Health Conference held at Limerick University, Ireland in June 2022. CoDeL were the imposters! Why were we there?
The chair of the conference Dr Liam Glynn, Professor of General Practice at Limerick University and GP in a rural practice in the west of Ireland, was quoted as saying (see Liam’s blogpost here):
“The deep knowledge of individual and family health profiles that each of the community-based healthcare teams posses in relation to the population they serve and the therapeutic relationships on which these are based, are an enormous health asset in our healthcare system.”
In other words, there are a whole lot of influencing factors which impact health outcomes before we take a seat in the doctor’s surgery.
Liam’s words perhaps sum up well how health provision can work well when rooted in a community. We asked those gathered to consider what assets does the community have which contribute to wellbeing.
We found ourselves facilitating and delivering a workshop to an internationally diverse group of doctors and healthcare workers. We heard from those working with indigenous Sami communities in northern Norway bordering Russia; indigenous first nation communities in Canada and Australia; a township in South Africa; Ontario in Canada; Kenya, and much closer to home a GP working in the rural lands that straddle the Republic and North of Ireland.
When asked what positive actions they had been involved with or seen in the communities they were working, we were overwhelmingly moved by the examples of resilience and turn-around in fortunes that these communities had achieved.
Indigenous people, or at least communities which had historically been ruled by a n other, had often been perceived with a sense of powerlessness and valueless resulting in the well charted negative health outcomes that such communities suffered. This, combined with a global shift from rural to urban built on the narrative that rural often indigenous peoples needed assistance from those who ‘knew better’, has been applied across the globe against a backdrop of colonialism.
Yet, on the contrary, we heard story after story of remarkable resilience, in spite of being ‘remote’, socially and economically ‘deprived’. Something to do with what Liam had noted, ‘that deep knowledge of individual and family health profiles that each community healthcare team posses’
Strange isn’t it, that if we were to turn our attention to land, we know that according to the United Nations Environment Programme, ‘even though indigenous peoples make up just 6% of the global population, their lands shelter about 80% of the remaining biodiversity.’ This of course only includes those peoples who have indigenous status. There are those with linguistic and cultural inheritance unprotected by indigenous rites, but who also carry the knowledge of custodianship of each other and the land where they live.
We facilitated recognition of the assets communities often already have which contribute to the wellbeing of the people within those communities. We sought to present the context that health care infrastructure sits within the wider parameter of a ‘healthy community’ in its broadest but place-based sense.
Our findings have come to be framed under ‘Redefining Peripherality’, and increasingly as we present findings we also gather more lived-experience evidence across, health, economy and land. We see the paradigm really is shifting in recognition of what ‘rural’ provides for humanity.
Scotland’s Landscape Alliance (SLA) was set up in 2019 by a grouping of over 60 organisations with a common interest in raising awareness of the importance of Scotland’s landscapes to climate resilience and nature, economic performance and public health and wellbeing and, in doing this, gain public and political support for the better care of Scotland’s landscape and places to maximise future benefits.
A key message from SLA is that ‘Good landscape contributes to improved health and wellbeing, including in our poorest, most deprived areas and most vulnerable groups. The benefits of being in landscape are not limited to improvements associated with physical activity; using the outdoors improves mental wellbeing and encourages community cohesion.’
Bobby Macaulay has argued that community land ownership can contribute to better community health and wellbeing (see here).
So, I think we all instinctively know that being in what they call ‘good landscape’ is conducive to better wellbeing, if not exactly better health outcomes. After all, many of us take our ‘holidays’ in the rural beauty spots, indeed we know this only too well in places like the English Lake District, Snowdonia in Wales, the Scottish Highlands and Islands and the West ‘Wild Atlantic Way’ of Ireland. Places where in the summer time one can hardly move for the hoards of humanity that gravitate to such ‘hot spots’ to feel the benefit of ‘good landscape’.
The SLA goes on to say that ‘Greater numbers of people could benefit from landscape for health and wellbeing but cannot do so due to under-investment in design, implementation and stewardship of their local landscapes.’
“The picture that emerges from the extensive evidence of this project demonstrates peripheral communities have often shown remarkable resilience, drawing on many local assets and strengths, demonstrating significant flexibility and adaptation, generating much innovation and creativity (from technology to sustainable living) and many localised solutions. Often borne out of necessity, peripheral communities have tapped into their long history, rooted in generations of experience, of having to respond and adapt to changes and crises. They have turned what are often regarded as the challenges of peripherality to their advantage during Covid-19 as resilience factors ….”
“Peripheral areas demonstrated remarkable resilience during the pandemic and, on balance, performed relatively well during Covid-19, even though many did not have fully developed health infrastructure.”
Once again this reaffirms the impact of being in what have traditionally been considered peripheral locations, somehow ‘back in the day’, but just great for holidays. Somehow these places hold a great deal more than the tourist marketing would suggest.
Redefining Peripherality is not just in Scotland, Ireland, Nordic countries but stretches across the globe. It encompasses health, land (access, food production, ownership), also the social, environmental as well as financial economy and cultural cohesion.
We were the imposters at WONCA but collectively the narrative is changing and what we have shone a light on is not new, the resilience factors have been there for millennia, but they are gaining new recognition in the light of challenges such as Covid-19 and the climate emergency.
by Ryan Dziadowiec. Ryan is a PhD student currently based in the Isle of Grimsay whose thesis is “Dùthchas: Locating and Nourishing the Roots of Scotland’s Land Reform Revolution”. He is interested in crofting and the way people relate to land. When not at the desk he likes all things cows and going swimming in lochs.
On an unbelievably sunny day in September 2021, I climbed Beinn Shlèibhe, the tallest point in Berneray. I had been living in the Outer Hebrides for just over a month at that point, and had already done my fair share of banter with friends over WhatsApp and email about my recent move ‘to the edge of the world’. Before coming to the Outer Hebrides, I had lived and worked in Skye, and before that I had spent a few years doing different jobs up and down the Highlands in mainland Scotland. I was already used to Highland living and to people asking me what it’s like to ‘live in the middle of nowhere’. But I remember that, somehow, moving to Uist felt different. It came with an apprehensive feeling of going somewhere that was very far away. Uncharted territory, at least for me.
Standing on the summit of Beinn Shlèibhe in all its 93 metres of glory on that balmy September day, I felt the rock and soil beneath my feet shifting. Earthquake-like, my pre-conceptions and apprehensions split apart and tumbled down the hill, into the sea. I found myself experiencing a paradigm shift and I knew things would never be the same again. Up there, I found myself seeing a country which doesn’t, to my knowledge, feature on any maps: Dùthaich MhicLeòid, or MacLeod Country.
The Gaelic scholar John MacInnes once said that the word dùthaich – like dùthchas, a concept I am researching – cannot be translated into English without losing its ‘emotional energy’. The Dùthaich MhicLeòid which I was looking at from Berneray is so much more than ‘MacLeod Country’. It is a richly storied mythopoetic landscape; it is made up of many miles of geologically diverse islands, each with a unique identity though all united by the Gaelic language; it is the native place of MacLeods as well as many other kindreds and clans. Dùthaich MhicLeòid is a world of its own – and in favourable conditions, a birlinn could take you across the Cuan Sgith or Minch to another island, another dùthaich (the Gaelic name for Sutherland is Dùthaich Mhic Aoidh or MacKay Country, for example). Or you could travel onwards to Ireland, Scandinavia, and continental Europe. So much for ‘the edge of the world’. After my paradigm shift, I was looking at the centre of the world. I’m not the only person to have experienced this effect, either. Sabhal Mòr Ostaig’s professor Hugh Cheape has described his own experience of ‘paradigm shift’ back in 1984 when he visited South Uist:
“Conceptual clichés of periphery and centre flipped over and slipped away. In an eurocentric and anglocentric culture, cities have been at the centre and islands at the edge. [In Gaelic], periphery or edge is iomall and it has been traditionally perceived that iomall na Gàidhealtachd was not the Outer Hebrides but places such as Dumbarton, Dunkeld, Blairgowrie and Braemar… Here, on the west coast of Uist and on the doorstep of Tobha Mòr, was the self-evident highway of the oceans leading west and an ‘Atlantic corridor’ leading north and south.”
On that sunny September day, I could imagine a MacLeod chief taking his heir up Beinn Shlèibhe and saying something akin to Mufasa’s speech to Simba in the Lion King: son, everything the light touches is part of our kingdom. Evidence of this kingdom is still etched into the dùthaich: Dunvegan Castle is just the famous tourist trap. Back in the Middle Ages, what is now a heap of stones on Pabbay was the castle of the MacLeods of Harris, where Tormod MacLeod died in 1320. Near the hostel on Berneray there is a cluster of old byres and outbuildings known as ‘MacLeod’s Gunnery’, with a plaque commemorating a Tormod MacLeod who was born here three centuries later. The dùthaich stretched as far out as St. Kilda which the MacLeods had the right to for some time; in 1549 Donald Monro wrote that MacLeod would send a man to Hiort annually at midsummer to collect the rents from the tenantry or tuatha. If the weather was fair, I can imagine no better place to watch the sun plunge into the sea in the distant north-west about 11PM on those glorious summer days.
How can we, today, benefit from standing about on hills and thinking of places like Dùthaich MhicLeòid? There is a wealth of knowledge that can be drawn out of the well of history. But we should look carefully at what we’re drawing up and see if it will nourish us. The sorts of clan chief tales told on Highland tour buses are typically still concerned with romantic notions of Jacobites in kilts in bygone days. They rarely tell of the clan chiefs as rack-renters, blackmailers, kidnappers, warmongers, thieves, or slave traders. But that is what many, if not most, of them became – particularly in the 19th century when the chiefly castles which attract so many visitors every year were (re)built. The 22nd chief of clan MacLeod, Tormod (1705–1772) was remembered by his tuatha as ‘an Droch Dhuine’ or ‘the Wicked Man’, and for good reason. There is much more nourishing knowledge to be re-gained from studying the ways of the tuatha – the tenantry – than the Droch Dhuine himself.
From the tuatha we can get a glimpse of what Dùthaich MhicLeòid was like before the demands of commercial landlords forced the wealth of this ‘periphery’ to be shipped to some distant ‘core’. From their patterns of land use – like ‘run-rig’ or the annual redistribution of arable land, the tradition of common grazings, and seasonal movement of cattle to shielings – we can infer that for most of history, they had communal rights to at least some of their people’s territory. From their proverbs – breac à linne, slat à coille ‘s fiadh à fìreach: mèirle às nach do ghabh Gàidheal riamh nàire – we can infer that they also enjoyed implicit rights to fish, game, and wood. There were no written laws stating the rights that people had to these, as well as myriad other resources edible and inedible, possibly because the rules that governed this were both obvious and sacred to the people. Estate management became increasingly systematised and written rather than oral around the same time that the peoples’ customary rights were being eroded. There is an undeniable bias in the estates’ sources towards documenting the enforcement of laws banning the taking of game or seaweed, or evictions of folk who never had a written lease before. Only from the tuatha’s reactions to these can we see what laws the people knew to be right and just for all.
In today’s utterly commodified world, governments struggle to see the wealth of this ‘periphery’. They see low population density resulting in little tax revenue to be made. They see a land in constant need of importing everything: government money, human food, animal feed, medicine, fuel, electricity (pinging back up north via the National Grid at a hefty premium, despite most of it being generated in ‘the north’ from renewable sources), and even people to tackle demographic decline. But wealth comes under many guises and this ‘periphery’ has done its fair share of export: kelp ash, rent money, cattle, marble, diatomite, slate, gravel, and – most importantly – people. Dùthaich MhicLeòid may not have vast reserves of oil or old growth forest ripe for exploitation by the forces of international capital, but it has immeasurable stores of cultural wealth that those in government are reluctant to recognise. The words of Màiri Mhòr nan Òran, renown Gaelic bard, come to mind:
Cuimhnichibh gur sluagh sibh / Is cumaibh suas ur còir
Tha beairteas fo na cruachan / far an d’fhuair sibh àrach òg…
Remember that you are a people / and stand up for your rights;
wealth lies beneath those mountains / where you spent your early life…
The recently-published bilingual anthology of poetry and prose by Alasdair MacIlleBhàin, maim-slè, feels like a journey across the Isle of Mull. Reading it, I felt like a wallflower listening in to conversations Alasdair was having with the folk of his native island. Alasdair’s sensitive relaying of Mull seanchas or local lore peeled back the bracken and Sitka spruce which covers much of the island’s native settlements from before the Clearances and crofting, revealing the riches beneath. Through his research, he often comes across names – like Loch Leamhain or Bròlas – which are seldom used today, not unlike Dùthaich MhicLeòid. Most pertinently, Alasdair MacIlleBhàin’s book explores the connection between tìr is teanga – land and language – and èiginn na gnàth-chànain agus èiginn na gnàth-shìde – the Gaelic crisis and the climate crisis.
There is much in the Gaelic language that can help us find new ways of using old knowledge to help us cope with a changing climate. There is also much in the Hebridean demeanor that can help us cope with the modern-day crisis of compassion. The crises are interlinked and need a holistic approach; but to see the issues we’ve always deemed as ‘peripheral’ flipped around to form the ‘core’ of the matter requires a paradigm shift – and these are rarely comfortable.
To come full circle, I want to share a song, Thèid mi le’m Dheòin, here performed by Alasdair MacIlleBhàin and Niteworks. The song was composed by the 17th century bard extraordinaire, Màiri nighean Alasdair Ruaidh. It was likely composed when the bard had been temporarily exiled to Mull for praising Tormod MacLeod of Berneray – yes, the one from the commemorative plaque mentioned earlier. Sailing back north, she sang, Thèid mi le’m dheòindo Dhùthaich MhicLeòid – willingly I shall go to MacLeod country. Hearing Màiri nighean Alasdair Ruaidh’s words today, nearly four centuries later, accompanied by synths and a pulsing bass, re-draws the shape of Màiri’s dùthaich, and re-positions us today at the centre of her world. A real place that pulses with life, whose pulse can teach an outsider like me how to find my bearings within.
Thomas Fisher reports from the EU’s Rural Pact Conference in Brussels
So often rural areas lament their depopulation, but seem unable to do anything about it. We know from CoDeL research in Uist, across the Scottish islands (see the many casestudies in www.islandsrevival.org), and across the Northern Periphery and Arctic (e.g. in Atlantic Canada and the Faroe Islands) (see here, here and here) that the over-arching narrative that all so-called ‘remote’ areas suffer from depopulation is not the case. There are plenty of areas where younger people with new perspectives and aspirations are returning, settling or staying, where the local population is stable or growing, and where these trends accelerated during the pandemic.
However, there is no denying the depopulation in some areas in almost all countries, including in central Spain. The Region of Castilla-La Mancha is just a little larger than Scotland, but with a population of only two million. Over a quarter of the region’s municipalities have less than 100 residents, over two thirds of municipalities less than 1000 inhabitants.
But as I discovered at the EU Rural Pact Conference in Brussels last week, the region is not sitting idle at all. It has introduced a pioneering Law on Economic, Social and Tax Measures against Depopulation which came into force in June 2021.
The law aims to overcome the traditional agri-centred approach for rural development. It is based on the assumption that the cohesion of rural territories affected by depopulation requires interaction among diverse activities and sectors (tourism, trade, industry, green, digital, silver and social economy, etc.). This exercise stems from a 360º analysis of the problems affecting rural areas and incorporates cross-cutting measures to be implemented by all departments of the regional government. Specifically, it promotes actions aimed at guaranteeing equal access to basic services: education, health and social services. It also places special emphasis on ‘connecting’ rural areas, both digitally and through new transport alternatives. Finally, it supports and encourages the development of economic activity, with specific incentives for the different areas, taking into account their degree of depopulation.
European Network for Rural Development casestudy (here)
Measures for municipalities that have a population density of less than 12.5 inhabitants/km2 (two thirds of the total), as well as additional municipalities at risk of depopulation, include:
1) a guaranteed access to public services:
opening rural schools with a minimum of 4 students
a contract Programme (“Contrato Programa“) that funds higher education for young people who decide to study out of their hometown while their family continues living in the municipality, and if the young student comes back or goes to another sparsely populated area when concluding their studies
access to health emergency services in less than 30 minutes.
boosting homecare services for the elderly and access to residential resources at a distance of less than 40 km
introducing demand-sensitive transport
2) Investment incentives for businesses, including:
public aid of up to 40% more than in other areas of the region, for companies and self-employed workers who decide to establish themselves in sparsely populated areas
a €10 million fund to provide financial support for business projects in sparsely populated areas or areas at risk of depopulation
a Talent Recruitment Programme with incentives to return to work in rural areas.
3) a plan to guarantee access to optic fibre and 5G in all towns in the region. By 2023 there will be optic fibre in every municipality. There is also aid for delivering optic fibre to industrial sites and business areas, most of them in depopulated areas, and a social voucher on connectivity (“Bono Social de Conectividad”) to guarantee internet access to 5,600 vulnerable families at risk of digital exclusion.
4) tax incentives, e.g. deduction of up to 25% on personal income tax for residents in areas of extreme depopulation, a 15 % income tax relief for the purchase or renovation of a home, and a reduction of more than 50% in taxation on capital transfers and legal acts for acquiring a primary residence in these areas, or business premises.
5) rural proofing as a compulsory measure in the law to identify and assess the impacts on rural areas of new regulations, plans or programmes – through ’demographic impact reports’ – and define measures to correct potential imbalances.
6) a Regional Strategy against Depopulation, designed for a period of 10 years, with 210 concrete actions. These include measures to develop cultural resources and activities, and access to these in villages. The overall strategy mobilises EUR 3 322 million from regional, national and EU funds.
This “comprehensive, multi-sectoral and integrated” approach, enshrined in law, is striking, and other regions such as the neighbouring region of Extremadura are taking up similar actions. Will other countries follow with the same political will and allocation of resources?
For the presentation at the Rural Pact Conference, on Castilla-La Mancha’s Law on Economic, Social and Tax Measures against Depopulation, see here. For a casestudy on the law see here, including analysis of the critical role of pre-zoning (different responses to different starting situations, based on a detailed zoning exercise that classifies rural territories in clusters of areas, not just in terms of population, but with similar levels of socio-economic development and quality of public services), the integrated approach to rural development, the strong political leadership and coordination of actors with a long-term vision.
“Open world begins with place, not with simple piety of place, but with knowledge (informed, sentient, intelligent) of place. Thoroughly known, every place is open. From the smallest rivulet, via a network of rivers, one arrives at the ocean. A little geology allows one to know that not all the stones on the local beach are necessarily of local origin, that glaciers may have brought them in from elsewhere. Likewise, from a layer of local rock one can move across nation and continents. An informed look at the sky will see mot only wind-driven cloud, but the tracks of migratory birds. To all of which must be added the movements of population and language.”
Kenneth White, The Wanderer and His Charts, 2004
“How many individuals, cultures, and histories are behind every seed sown? This vastness is important, for it is inseparable from the seeds. They must go together. They should all be on the seed packet, or handed to us by the last person to grow the plants who should know the names of these individuals, cultures, and histories. The people just by growing these plants are participating in all of this. They are doing a hell of a lot to keep the world alive. But do they know what they need to know to be actually keeping the seeds of culture alive along with the seeds that represent them?”
Martín Prechtel, The Unlikely Peace at Cuchumaquic, 2012
I’m a seed collector. Grains tend to be my thing. I see them as a vital component to envisioning a healthier farming system than the dominant one of industrialised monoculture we have today. Today fewer and fewer varieties of cereal are available to us, and those that are don’t tend to be fit for the healthier system we may wish to create. Over the past few years, I’ve written to a number of gene banks around the world requesting seed samples of different “accessions” of cereals. I’m then sent are little packets generally containing 5g of each different type of grain. I’ve received a great many seeds from places as varied as Georgia, France, Afghanistan, Ethiopia, Armenia, Switzerland, Azerbaijan, Iran, Germany, Morocco, Belgium, Tajikistan, and Spain.
Learning from seeds
These grains had all been deposited and maintained in centralised gene banks, often over a number of decades. In a sense, despite having originally come from very specific places, which you can often trace back to, they are often many generations removed from the parts of the world they developed and were originally from.
The purpose of me collecting all of these different seeds, is not to grow them out as a museum of the world’s grains with individual lines kept separate. What I’m doing with them is attempting to work out which seeds thrive on this farm, which happens to be in the Scottish Highlands. Far from everything grows and works well here, but a surprising amount shows great signs of potential. What I aim to do with this, is select all the seeds that look as though they have interesting characteristics and are able to express them well in this particular part of the world and then grow them all together in the field. Over a process of time these mixtures will develop into a more coherent “population”. Eventually these populations will be perfectly suited and adapted to this specific farm’s unique characteristics, challenges and conditions. Eventually this mixture of seed will become a “landrace” which can be defined as something that has “developed over time, through adaptation to its natural and cultural environment”. They will “belong” to this place.
Another angle of the seed work that I do is to track down and grow the last remaining landraces which have been grown, saved and passed on in an unbroken line for an unknown number of generations here in the north of Scotland. In today’s world, the fact that these still exist at all is very special. Seen by most modern farming standards, these landraces of small oats and bere barley, could be dismissed as agronomically unviable genetic throwbacks that can have no part to play in farming today. Keeping them going on marginal lands in the Western Hebridean Islands and the Northern archipelagos of Orkney and Shetland, is all fine and well, but these have no place in “modern” farming or agriculture. We can’t expect to “feed the world” with these. There may be some truth in this but, these were the crops that sustained the people who lived in this very marginal part of the world for hundreds if not thousands of years. Most of the terrain in the Highlands and Islands is not prime arable land, but yet these grains thrived in these conditions and supported high numbers of very active people. These are not inferior foods but forgotten foods, and we need to reimagine how to use them.
When I have these different seeds in my hands, I often think about all the history and culture that is embedded into them both from all different parts of the world. I don’t see these two different approaches to collecting grains as being in any way mutually exclusive. I am in no way held back from preserving and reimagining uses for the local landraces just because I’m also bringing in grains from all manners of different places and cultures. After these grains all get a chance to settle into being grown on this farm, they will hopefully complement each other to make a more beautiful, resilient and relevant arable system to the one we are currently working with or ones that have existed in the past.
Recently though, I’ve realised that I have missed a number of tricks with the seeds I collect from gene banks. In many ways, seeds are embodiments of the cultures from which they have come from. The two are intertwined. By losing track of or not giving due attention to where these seeds have come from and what meaning they have to these cultures, I’m guilty of colonial appropriation and an extractive attitude. These seeds belong to certain cultures and by being grown out by me in a different context, they have been decoupled and severed from their links to the customs and cultural traditions that go with them. These seeds have become displaced from these cultures and have been scattered across the world. If I wish to integrate them into my practice, they deserve to be repaired with some cultural context about where they have come from. If I wish to use them, I have a responsibility to attempt to understand, at least on a basic level, the stories and cultures that come with them.
“The historic role of capitalism itself is to destroy history, to sever any link with the past and to orientate all effort and imagination to what is about to occur.”
John Berger, Landscapes: John Berger on Art, 2016
Understanding our own histories
If we zoom out for a moment, we can see that, in many ways, we humans are facing very similar situations to these seeds. There is a dominant and ever encroaching capitalist monoculture which many believe is not giving us an option of a safe and healthy future. A great many of us today, like these genebank seeds, find ourselves scattered, displaced, cut off from our ancestral roots and without a sense of truly belonging to a place. If we do belong to an indigenous culture that, against all the odds, has managed to retain a sense of distinctiveness and autonomy, just like the landraces, they are looked upon by the rest of society as hangers-on from a by-gone day without any relevance to the modern world. Possibly we also feel that there is a tension and conflict between these two situations and, in a way, these can be seen as opposite ends of a spectrum.
Just as we need to create coherent new ways in which these seeds from all over the world belong to new places in a deeper way, we need to collectively learn how to feel sense of belonging to place in a deep way.
One common thread I see reoccurring through a great many indigenous cultures I’ve looked into is reverence for and veneration of ancestors. This is apparent in many different parts of the world and different cultures. Maybe it’s a case of seeing ourselves as a part within a continuum. We can hear values such as “borrowing the land from future generations”, sentiments which have an inherent idea of ‘sustainability’. But as well as that, knowing who your ancestors are and knowing their history give you a greater sense of who you are.
According to Amílcar Cabral, the great anti-colonialist, cultural autonomy and liberation is based on “the inalienable right of every people to have their own history; and the aim of national liberation is to regain this right (which has been) usurped by imperialism”. We need to understand our history. Our collective history and our own family histories. This is going to involve a lot of work. It’s going to be scary and daunting. Sometimes it may involve significant grief and/or shame. But we need to know our history and this needs to be an honest view of history, warts and all. In Scotland, we are prone to buying into a narrative of being the historical victim, editing out our very significant roles in various imperial and colonial projects. We are choosing to remember a half history. Scots-Jamaican councillor Graham Campbell refers to this as “organised forgetting“. Our historic past needs to be known to give us an idea of where we are and who we are in the historical present.
Many folks will find that various lines of their ancestry can be traced to specific cultures and places, some of which may be very different to where they are situated today and call home. This process may involve an investigation into these specific cultures and places. Beginning to get a fuller understanding of who we are and where we have come from can give you a sense of positioning and orientation to move through the world with. Start to learn about these places’ unique histories and cultures: their stories and songs, their festivals and celebrations, their foods and foodways, and the spiritualities and rituals traditions of these places. All these different things can begin to give you a grounding in where you have come from individually. If you find that much of your ancestry points to the place you find yourself still in, do exactly the same, start digging a little to uncover and understand what this particular place’s history and culture is.
“We can think of place-making as something that happens through movement: significance, memories and relationships are created by patterns of walking, approaching, branching away, visiting, gathering.”
Michael Given, Attending to place and time, 2020
Understanding “this place”
To feel that you “belong to a place” is to have a deep and thorough knowledge of that specific place. Starting to “belong” could be seen as being much less about belonging to an existing culture, but instead being deeply connected to a certain place through a thorough understanding of it: of that specific place’s terrains, weather patterns, flora, fauna, fungi, as well as an understanding of this place’s place name’s, stories and folklore, and histories from what has come before. It’s about knowledge of specifics. Specifics to that place. This knowledge needs to be accumulated, over time, through observation and interaction with that place, but can also be informed by knowing about what has come before in this place. There might well be a minority language that is still spoken in here, which, if learnt, can offer a lens through which to gain deeper and richer understandings of the human observations and interactions which have already taken place here. To start to belong to a certain place will involve gaining a thorough knowledge of and reverence for it.
Archaeologist Michael Given uses the term “conviviality” to describe an ongoing conversation and interactive, working relationship with a place’s natural rhythms, seasonal changes, ecological processes and the movement of other species through it. “Seasonality demands a close awareness of, response to, and negotiation with the changing attributes and affordances of plants, weather, soil, water, animals and of course, those other animals called humans. This attentiveness enables a recognition of interdependence.”
It’s important to say here, that the knowledge and learning required here is not just intellectual, but just as much sensory and bodily. It involves physically moving through spaces, smelling different seasons, feeling the cold, or the heat, or the dampness or the wind, tasting your way through it. Movement and seasonality are in fact key to gaining this understanding. As Given says:
“for humans, mobility is the key to navigating and negotiating these complex rhythms and patterns. It acts as a bridge between different areas, opportunities and meaningful places. It is mobility that enables the circulation of practice, social connection, meaning and interaction with the environment, thus generating families and communities with a sense of cohesion and meaning.”
To know and understand spaces we belong to, we must constantly move through them and interact with them. We must learn to understand their unique rhythms of how they change with the seasons, the tides, winds.
So where to begin? If coming at it from somewhat of a standing start this will seem daunting. Are there any practical, structured ways that you can begin to go about this? Luckily, an ever increasingly popular activity – foraging – is something that can offer ways to begin this process in a way that is both very practical and structured. It is also an activity that is accessible to anyone, anywhere. There are foraging groups emerging everywhere and a great deal of resources available specific to most places. In The Forager Handbook (2009), professional forager Miles Irving writes that “gathering wild food in our own locality creates a rich and ongoing relationship with the land. When we start digging around for this forgotten knowledge, we are getting into the ground of our heritage. Our ancestors knew the places where they lived: every inch of land, every kind of plant, every sign of life. They made use of everything. They were intimately involved with their surroundings, immersed in the ebb and flow of the seasons. Their attention was anchored to the here and now as they watched with anticipation the gradual emergence of shoots and stems, flowers and fruits, waiting patiently for the time to gather and make used of them. Signs indicating the presence of plants, animals, birds, and fish consumed their consciousness. With senses sharpened to the immediacy of instinct they discerned the presence of every animate or inanimate object. In doing so they were themselves powerfully present.”
Foraging offers a powerful and practical structure through which to practice this movement and attentiveness to place and through this begin to understand its own particular natural rhythms and seasonality. This understanding of place could be the first step needed to begin to belong to it.
“To restore any place, we must also begin to re-story it, to make it the lesson of our legends, festivals, and seasonal rites. Story is the way we encode deep-seated values within our culture. Ritual is the way we enact them. We must ritually plant the cottonwood and willow poles in winter in order to share the sounds of the vermillion flycatcher during the rites of spring. By replenishing the land with our stories, we let the wild voices around us guide the restoration we do. The stories will outlast us.”
Gary Paul Nabhan, Cultures of Habitat, 1997
Of course, awareness and understanding of seasonal rhythms is not something that is restricted to gathering wild foods. The farming calendar is made up of tasks that are performed at certain times of year and often happen on certain dates. There are set times of year when tasks are performed, which are in response to the natural opportunities and limitations of the seasonal changes. Planting cereals will happen at particular times of years either in the Autumn after harvest or in the Spring; Lambing and calving will, generally speaking, happen early in the year; the shearing or clipping of the sheep fleece will happen in the summer; livestock sales tend to be towards the end of the year once the growing season has fattened up the animals; pruning and planting of trees will happen early in the year before the sap starts rising up into the trees. The farming year is very much shaped by seasonality.
Historically in Highland Scotland, these seasonal shifts and their associated agricultural tasks were often marked by specific festivals, customs and rituals. The two most significant seasonal of these were Beltane (1st May) and Samhain (31st October). These were this region’s marker points to signify the beginning and the end of the growth season. As F. Marion McNeill writes in The Silver Bough: Vol. III (1961): “whilst Beltane celebrated the renewal of vegetation, Samhuinn solemnised its decay”. By Beltane, all the cereal should have been sown in the low lying and more fertile glens (in-bye) and the livestock would be herded up into the upland hills (out-bye) to spend the long, summer months up in the shielings or summer pastures. By Samhain all the crops should be harvested and the livestock would have returned back down the hills to spend the winter low in-bye.
The other two major festivals were Imbolc (1st February) and Lughnasa (1st August), which both were centred around the seasonality of milk and grains: Imbolc signified the beginning of the lambing and with it the year’s return of milk. Anecdotally I have also heard that Imbolc was the traditional date that the grain from the previous year’s harvest had finished “curing” and was ready for grinding. Lughnasa marked the beginning of the year’s grain harvest but also was the marker for when the sheep milk would begin to dry up for the year. All of these festivals would involve all manners of elaborate rituals and rites. For the most part these agricultural rituals are no longer celebrated.
To many modern people “ritual” is an uncomfortable and somewhat alien word. It’s not the type of thing we are accustomed to thinking or talking about, much less practicing. Even the mention of it can put us on edge and immediately bring to mind images from films like “The Wicker Man”. This needs to be kept in the back of our minds, but at the same time we need to recognise that even in modern, secular society rituals are things we still, often practice. This can be day to day things such as making the bed, drinking coffee or tea in the morning, laying the table and eating together, opening and shutting the curtains, etc. It can also be things we do on specific calendar dates. For instance, my own year might involve: guising (trick or treating) and bobbing for apples on Halloween; bonfires, fireworks and burning effigies on Guy Fawkes Night; hanging wreaths and decorating evergreen trees in the run up to Christmas; staying up late and seeing in the bells on Hogmanay; first footing on New Year’s Day; candlelit dinners on Valentine’s Day; eating pancakes on Shrove Tuesday; practical jokes on the morning of April Fool’s day; and painted and chocolate Eggs at Easter. Rituals are still being practiced and carried out and remain important to us, whether we think about them as rituals or not. These are all things that need to happen at specific times in a year to retain any semblance of meaning that might be left in them. If they stray from these dates, they make less sense to us.
But yet, despite still being observed in today’s modern, largely secular society, much of the meaning these rituals are supposed to hold is no longer there. Do many of us still know why we eat pancakes on Shrove Tuesday or hang wreaths around Christmas? Do many of us care? This loss of meaning should not go unnoticed, as without this sense of meaning these processes seem neutered. Do most of us really feel that burning an effigy of Guy Fawkes is necessary today? Probably not. But the process of this ritual is something that still draws us together to participate in. Interestingly, in the town of Lewes in the South East of England, this ritual has regained its potency, by updating the effigy from that of Guy Fawkes to a caricature of a leading political “villain” from that year. This simple change has made it an event that draws folks from all over the country to come take part in. It’s been re-given meaning.
Just like the ritual festivals of Beltane and Samhain in Highland society, in traditional societies across the world, we find similar ritual festivals built into their particular calendars, which reflect the seasonal and agricultural changes of these places. The timing of these seasonal changes are things that we have no real control over nor can be deviated from in any significant way.
On the other hand, the specific traditions, rituals, customs and festivals that are used to mark these seasonal points need not be set in stone at all. Whilst there may be existing cultural traditions and practices, these can be melded and meshed with traditions and customs from elsewhere or invented afresh. There is opportunity here to create new culture together in an inclusive way, informed and inspired by ancestral traditions of anywhere in the world, but made specific to this place.
In The Future of Ritual: Writings on Culture and Performance (1993), theatre writer Richard Schechner points out:
“human ritual, too, might be said to short-circuit thinking, providing ready-made answers to deal with crisis. Individual and collective anxieties are relieved by rituals whose qualities of repetition, rhythmicity, exaggeration, condensation, and simplification stimulate the brain into releasing endorphins directly into the bloodstream yielding ritual’s second benefit, a relief from pain, a surfeit of pleasure.”
The possibilities implied here are exciting. As mentioned earlier, in uncovering our own personal and collective histories, we are going to be faced with dealing a potentially overwhelming amount of trauma. Some of us will need to have ways to deal with ancestral grief; some of us will need to have ways to deal with ancestral shame; many of us will have to deal with both.
These traumas are incredibly complex and deep and we need ways to process them. In so many ways, we need to work out how to do this collectively, as well as individually, so we can heal, reconcile and understand each other. Perhaps creating new rituals could be one way to do this. The poet Kenneth White writes that the great work needed of us at this time “is to integrate aspects of many cultures into a new coherence”. Ritual could be a means through which to imagine new cultures, to understand belonging and to discover shared values. This can happen both individually and collectively as communities, dwelling in these specific places.
“By the time a century or two of exploitation has passed there comes about a veritable emaciation of the stock of national culture. It becomes a set of automatic habits, some traditions of dress and a few broken-down institutions. Little movement can be discerned in such remnants of culture; there is no real creativity and no overflowing life.”
Frantz Fanon, The Wretched of the Earth, 1961
At the 2021 Oxford Real Farming Conference, seed keeper Rowen White made a compelling case that “we are in a crisis of culture”. Knowing our own history and culture, according to Amílcar Cabral, does not mean that these have to be static or fixed. Far from it. “Culture, like history, is necessarily an expanding and developing phenomenon”. Cultures are constantly morphing and shifting. In a healthy culture elements other outside cultures are adopted whilst other are ignored, just as elements of their own cultures are retained whilst others are dropped.
At this point it might be useful to go back to the seeds which I started with. “Find your people’s seeds,” writes Martín Prechtel. “Lacking those, find seeds of the edible plants you love the most. Then find their stories. Then go further; find their scientifically explained origins, then find their real mythological origins.” Just like these seeds, not everything we bring to the field is necessarily going to work well. Over time, with a lot of trial and error, we will find that some seeds work really well in this place where as others are not as well suited and disappear.
But with those that work well, we need to go back and find out more about them. These seeds will grow together and mix together; learn how to navigate the specific characteristics of the fields together; and they will begin to thrive together. Over time these dispersed seeds will become what we now call a “landrace”. These fields will not only be filled with beautiful, diverse seeds of all tonalities, shapes and colours, but also filled with beautiful meanings, stories and histories, somehow brought together in a coherent, unified way.
We need to find our own stories, we as humans need to learn to understand this place we find ourselves situated in, and we need to work out how to bring our stories together in a way that works in this specific place. As Rowen White says, “we need to be culture makers”. Quietly, these tasks of belonging and culture making may well be some of the most pressing and urgent that we are faced with at this moment.
by Prof. Liam Glynn, a general practitioner in Ballyvaughan, Co. Clare, Ireland and Prof. of General Practice at the School of Medicine, University of Limerick, which is hosting this year’s World Rural Health Conference in June.
Ireland has one of the highest rural-based populations in Europe. The figure appears to be on the increase as the new working arrangements triggered by the pandemic have given many people new opportunities to live outside major urban centres. This reverse of the depopulation of rural communities has also been triggered by their resilience seen during the challenges of Covid-19.
Recent research conducted in collaboration with the School of Medicine at the University of Limerick, CoDeL and others across the Northern Periphery has demonstrated that rural areas ere advanced in terms of their sustainability, and were organised and effective in responding to challenges with positive health and economic outcomes during lockdowns. The pandemic has generated renewed vigour in re-imagining life on the periphery as an attractive place for people and businesses to work and live.
Rural communities have been served very successfully in Ireland by often small GP-led primary care teams, which research demonstrates can deliver both cost-effective and high quality care to these populations. The continuity of care created by such a system is associated with reduced need for out-of-hours services, reduced acute hospital admissions, reduced emergency department attendance and is also associated with decreased mortality.
“We saw during the Covid-19 pandemic how central and significant the role of general practice is in Irish healthcare.”
Dr. Diarmuid Quinlan, medical director of the Irish College of General Practitioners
WONCA’s 2022 World Rural Health Conference in Limerick will be a showcase for all that is best about Irish, and world, rural practice. The conference theme, ‘Improving Health, Empowering Communities’ will explore how communities can be empowered to improve their health and the health of those around them. We will hear from 1,000+ participants from across the world in sectors including health, science, engineering, the arts, and NGOs.
The chief challenge of delivering healthcare in rural Ireland is the recruitment and retention of a healthcare workforce. The practice I work in employs seven staff directly and two indirectly in a village with a census population of 250. So practices are valuable economic units and investment in a transformed healthcare workforce has the potential to create the conditions for inclusive economic growth and job creation, thereby promoting greater economic stability and security, itself a key factor in better health outcomes – so thus, a virtuous circle is created
Investment in rural health can play a transformative role in expanding and financing decent work opportunities. Equally, the removal of such a workforce has a disproportionately negative effect on small communities demonstrating the truth of the axiom ‘no doctor, no village‘.
The ‘corporate knowledge’, to use a business phrase, of individual and family health profiles that each of these multi-disciplinary, community-based healthcare teams possess in relation to the population they serve and the therapeutic relationships on which these are based, are an enormous health asset in our healthcare system which we should make every effort to maintain, sustain and develop. Once these are lost, they are lost forever, and their ability to reduce the need for out-of-hours services, acute hospital admission and emergency department attendance is also lost.
Over 90% of healthcare contacts happen in the community and any healthcare system that has primary care as its foundation is more cost-effective, and delivers better health outcomes for people.
To maintain, sustain and develop our rural healthcare system, we need:
targeted admission policies to enrol students with a rural background in health worker education programmes
to connect and embed health education institutions closer to rural communities and ensure they are community facing and have a curriculum which is dominated by community-based teaching programmes.
The Scottish Graduate Entry Medical Programme (ScotGEM) is Scotland’s first graduate entry, undergraduate medical programme. ScotGEM, tailored to meet the contemporary and future needs of the NHS in Scotland, focuses on rural medicine and healthcare improvement and is designed to develop interest in a generalist career within NHS Scotland. Building on the existing strengths of medical teaching in the Universities of Dundee and St Andrews and health boards in Fife and Tayside, collaboration with NHS Highland, NHS Dumfries and Galloway, and the University of Highlands and Islands enable a truly distinctive programme which includes extended opportunities to train in remote and rural areas.
to expose healthcare students to rural and remote communities and rural clinical practices and rural health topics throughout the educational continuum.
to design and facilitate access to continuing education, professional development programmes and career development that meet the needs of rural health workers to support their retention in rural areas.
There is a need to switch the current focus on large urban-based healthcare infrastructure development and invest in rural healthcare infrastructure to ensure decent working conditions for rural health workers.
to develop different types of health workers for rural practice, such as expanded paramedic roles and advanced nurse practitioner roles to meet the needs of communities based on people-centred service delivery models.
to employ a package of fiscally sustainable, financial and non-financial incentives for health workers practising in rural and remote areas. The rural practice allowance is one such key support in Ireland, but access to it needs to be widened and it needs to be increased.