“It’s just a Matter of Time”: Ambulance Services and the Threat of Violence  from Gangs in Sweden

This thesis explores how gang violence affects emergency medical care (in Swedish akutsjukvård) in Stockholm County, Sweden, focusing on prehospital care. Sweden struggles with gang-related crime, particularly concentrated in socioeconomically ‘disadvantaged neighborhoods’, a term used by the Swedish Police. Based on two months of ethnographic research, including interviews with healthcare professionals and field observations in the southwest of the County, this study explores the impact of gang violence on emergency medical staff. Thematic analysis identifies three key themes. First, the impact of gang violence is unevenly distributed: prehospital care personnel operating in disadvantaged neighborhoods face greater exposure to gang violence, distress, and ethical dilemmas. Second, safety concerns specific to gang violence are recognized, but simultaneously normalized as part of other challenging encounters related to substance abuse. The extent of safety impacts is shaped by the...Show moreThis thesis explores how gang violence affects emergency medical care (in Swedish akutsjukvård) in Stockholm County, Sweden, focusing on prehospital care. Sweden struggles with gang-related crime, particularly concentrated in socioeconomically ‘disadvantaged neighborhoods’, a term used by the Swedish Police. Based on two months of ethnographic research, including interviews with healthcare professionals and field observations in the southwest of the County, this study explores the impact of gang violence on emergency medical staff. Thematic analysis identifies three key themes. First, the impact of gang violence is unevenly distributed: prehospital care personnel operating in disadvantaged neighborhoods face greater exposure to gang violence, distress, and ethical dilemmas. Second, safety concerns specific to gang violence are recognized, but simultaneously normalized as part of other challenging encounters related to substance abuse. The extent of safety impacts is shaped by the dynamic interaction of interagency collaboration, information availability, training, and safety equipment. Third, continuous exposure to violent settings contributes to chronic psychological distress. Despite not often being directly targeted, emergency medical services report a heightened sense of vulnerability and a shifting sense of safety. Their navigation in the realm of violence with high ethical standards underscores their remarkable resilience, but also systemic neglect of the societal crisis. This study contributes unique insights to the understudied intersection of healthcare and gang violence, highlighting how frontline healthcare workers become entangled in the broader consequences of structural violence. The findings call for broader mapping of the healthcare workers’ first-hand experiences in Sweden to inform policymaking.Show less

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“It’s just a Matter of Time”: Ambulance Services and the Threat of Violence from Gangs in Sweden