Introduction - Environmental and Human Security in the Arctic - page 8

Th e chapter by Line Linstad looks at health security as an aspect of human
security, arguing in favour of technological innovations such as telemedicine
to improve access for people living in remote communities. Linstad uses the
concept of regional security as a way of understanding the interconnected-
ness between remote communities and their mutual health security needs.
Linstad highlights a number of issues where states and communities need
to work together to strengthen health security. The first regards epidem-
ics, both regional and international. The second issue she addresses is the
lack of access to health care services, and lastly a deficiency in numbers of
health care personnel. As Linstad states, health care became primary when
the health of populations is concerned, and here international efforts towards
cooperation are of paramount concern. The threat of disease does not stop at
the border. She shows the ways in which this is relevant in the Arctic, par-
ticularly with regard to tuberculosis. Further, part of disease management and
health security is supporting better controls, which means access to health
care. This includes access to well-trained health care personnel, who are not
always present in remote locations. Taking into account special Arctic/sub-
Arctic factors and conditions including low density of population, difficulties
of communication and lack of transportation logistics, the chapter argues that
telemedicine should be considered as a crucial tool that could increase the
personal well-being of Arctic peoples, especially in isolated communities, and
enhance the health security in the region, in general.
Although telemedicine has recommended itself as a proven tool to provide
primary medical care, it is still a quite exceptional and expensive practice
which cannot largely respond to everyday health problems from the Arctic
communities, in forms of mental health, violence and accidental death. Lars
Rowe, Elana Wilson Rowe and Geir Hønneland analyse the Arctic cross-
border cooperation between health providers regarding the threats posed by
chronic and communicable diseases, predominantly HIV/AIDS and tuber-
culosis. Based on interviews with people working in the health care sector
in the Barents region (Russia and Baltic countries), the authors present con-
flicting evidence on how health care cooperation, which could be perceived
as working towards health/human security, actually operates. Although
many of the respondents to the interviews seemed overall to be positive
towards the efforts of the Task Force on Communicable Disease Control,
a foreign-led, World Health Organization (WHO) programme originally
designed for developing countries and focused upon pre-determined vulner-
able groups (prisoners, drug-users, prostitutes), there were also significant
expressions of resistance to the programme. The authors demonstrate the
different cross-cultural perceptions of the notions of 'health risks', 'health
care' and 'treatment' from the position of post-Soviet medical staff, who took
issue with the idea that foreigners could identify and tackle health security
issues better than they could. The mixed 'success' of the programme dem-
onstrated a problem with the human security concept if the concept refers