In February this year, I had the pleasure of visiting Iceland—also called the Republic of Iceland—which is a beautiful Nordic island country between the North Atlantic and the Arctic Ocean.

Iceland has a population of 329,100 and an area of 40,000 square miles, making it the most sparsely populated country in Europe. Iceland is volcanically active and visitors come year-round to see its strikingly beautiful and diverse landscapes along the coastline and interior, the brilliance of the Northern Lights, fantastic geysers and geothermal pools, as well as the sophistication and friendliness of Icelanders and their tourism industry.

Before embarking on the winter vacation, I visited AOSW’s online member directory to see if there were any colleagues in Reykjavík, the capital of Iceland. There were none. My curiosity was peaked. In a country that has a smaller population than the city where I currently reside, what psychosocial oncology services are available and who provides them? So I reached out to one of the cancer support organizations to see if their staff would be interested in meeting with me. To my delight, the Manager of Counseling and Patient Support at the Icelandic Cancer Society (ICS)—Sigrún Lillie Magnúsdóttir, RN—replied, and on February 26th I met with her and Gunnjóna Una Guðmundsdóttir, a social worker.

According to the Icelandic Cancer Registry, an average of 1,450 people are diagnosed with cancer annually and there are approximately 13,000 cancer survivors. More than 90 percent of cancer patients receive their cancer treatment at Landspítali, the National University Hospital of Iceland in Reykjavik. The hospital employs social workers and distress screening is primarily done with cancer patients in the outpatient wards. Iceland maintains a universal healthcare system, under which the Icelandic Social Insurance Administration covers all legal residents. The healthcare system is largely paid for by taxes and, to some extent by service fees, and is administrated by the Ministry of Welfare.

The ICS is an umbrella organization of 29 member associations and it focuses on prevention, education, research and patient services. ICS’ Counseling and Patient Support Center (CPSC) offers information, education, psychosocial support and other services at no cost to adults who have been diagnosed with cancer, their families and caregivers. The CPSC is located in an outpatient facility in Reykjavik and it is completely funded by charitable contributions. Currently, there are three nurses—the manager is the only full-time staff member—and one oncology social worker, plus CPSC contracts other professional services (e.g., facilitators for Qigong). CPCS has been a field instruction site for several social work interns from the University of Iceland.

Sigrún has more than 20 years experience in oncology and palliative care, including teaching, and she joined CPSC four years ago. Gunnjóna has been employed with ICS since 2004 and she has been an integral part of the counseling center since its inception in 2007. Gunnjóna has a graduate degree in social work, as well as specialized training in cognitive behavioral therapy, hypnotherapy and Eye Movement Desensitization and Reprocessing therapy. There is an Icelandic Oncology Nursing Society, but not a specific oncology social work professional association, although there is the Icelandic Association for Social Workers. Gunnjóna is a member of the Association of European Cancer League’s Patient Support Working Group.

The range and scope of the services/classes offered by CPSC is impressive. In 2015, ICS offered 210 support group sessions and psycho-educational classes and had just fewer than 4,000 face-to-face telephone and email contacts with patients, caregivers and their family members. Part of CPSC’s services appear similar, to a degree, to U.S.-based organizations like the Cancer Support Community and CancerCare, except that psycho-educational programs or support groups are only available face-to-face, not online or by telephone. Patients needing intensive psychotherapy, psychotropic medication, physical rehabilitation or dietitian services are referred to local providers. In addition to offering services for patients, caregivers and family members, CPSC staff also provides psychosocial oncology education to health care professionals at Landspítali.

Based on my interview with Gunnjóna and Sigrún, as well as a review of articles and an informative 32-page educational booklet that Gunnjóna created, “Cancer Rights: Information About Financial, Social and Rehabilitation,” it appears that there are some parallels that professionals and patients in Iceland and the U.S. face—e.g., psychosocial needs can exceed available resources or staff, some inadequacies with entitlement programs. Although Iceland maintains a social welfare system that provides universal health care, there still are out-of-pocket costs associated with being treated for cancer that can impact compliance and access to care, as well as be a source of emotional and financial distress. Another parallel is the compassion and commitment of organizations and the community to help bridge some of these gaps. To lessen the transportation and lodging challenges that patients from the countryside face—one third of Iceland’s population—ICS maintains eight apartments in Reykjavik where patients can stay with their significant others while undergoing treatment.

Although there was a definite chill to the wind in Iceland, I felt the warmth and goodwill of Sigrún and Gunnjóna and truly appreciated the unique opportunity they afforded me. If you find yourself on an international adventure, perhaps you will network with a cancer center when you reach your destination. A diverse membership is invaluable on multiple levels, so please remember to also help spread the word that AOSW offers a no-cost “Region V Affiliate” membership to any social worker who is currently a member of a non-U.S. based oncology social work group. The application, which must be approved by the AOSW Membership Director, also provides access to the members-only section of the website and makes the applicant eligible for the Annual Conference rate.