Lived Solidarity in the Austrian Healthcare System

Healthcare workers’ solidaristic practices with refugees


Disadvantaged groups, such as migrant patients facing language and cultural barriers, often have a harder time getting medically necessary services. Drawing upon data from interviews with, and observations of, healthcare workers in Vienna, Austria, Barbara Prainsack and Wanda Spahl suggest that they play an important role in closing structural gaps within a solidarity-based healthcare system. Their analysis of the lived solidarity of healthcare workers suggests four different types of practices: First, by practices of concretising solidarity, healthcare workers act as the mouth, ear, and arm of a solidarity-based healthcare system. They shape solidaristic institutions through their everyday practice. Second, they fill gaps left open by institutionalised solidarity in the healthcare system. Such practices of compensating solidarity become an inherent corrective to the system. A third form of lived solidarity, creating solidarity, goes one step further by trying to create new rules that change the existing norms and instruments (new laws, but also new criteria for the allocation of resources, etc.). Fourth, care providers from non-governmental organisations or civil society help in entering the healthcare system, engaging in bridging solidarity.

In this talk, Wanda Spahl will argue that paying systematic attention to these practices of lived solidarity can help us to improve healthcare services and to ensure that they do not leave disadvantaged and marginalised people behind. Wanda Spahl will specifically discuss adequate policy instruments for addressing structural gaps in more institutionalized manners, and reflect about the meaning of institutionalized solidarity in today’s healthcare systems.

Note: Wanda Spahl’s talk builds upon and extends previous work together with Barbara Prainsack (published in EASST Review Volume 40(1) 2021:

Wanda Spahl is a university assistant at the Department of Political Science at the University of Vienna. As a pre-doctoral research fellow at the Centre for the Study of Contemporary Solidarity she analyses policies and practices pertaining to health needs of refugees. She is also co-lead of the qualitative research project “Solidarity in times of a pandemic: What do people do, and why?” (SolPan) – a cross-country comparative and longitudinal interview study about how people experience everyday life during the COVID-19 pandemic.

Her PhD project asks how health needs of refugees emerge as they navigate through the health system and the asylum system? And how these are (not) met? To answer these questions, she engaged in ethnographic fieldwork with refugees in the pursuit of their health needs in Vienna over a period of two years. She also conducted qualitative interviews with caregivers (e.g. doctors and social workers) as well as with politicians and other relevant professionals (e.g. members of the Viennese Medical Chamber).

This seminar is a joint event between CECS/Centre for European and Comparative Legal Studies and WELMA/Centre for Legal Studies in Welfare and Market

Click here to register for the event.