I have a sick boy. He lay on the couch for two days with a temperature, dozing on and off, watching tv and hardly eating a morsel. Monday, day 1, he was a bit sniffly and complained every now and again of a sore throat and sore ears, only later to announce when questioned that No, they didn't hurt. His main symtoms have been tiredness and a fever.

Then on Wednesday he fell asleep under the kitchen table just after 5pm and slept through to the next morning. Thursday he slept for almost 3 hours during the day and was still tired. So today, Friday I decided that perhaps I'd better ring the doctor and get him checked out - perhaps it isn't just a virus but something more serious.

To get a doctor's appointment on the day you need to ring the nurse at the local clinic and she calls you back - which they did after almost an hour. I outlined his symtoms and she asked what it was I was wanting(!) Of course I was wanting to make an appointment for him to be checked out. She then went through a questionnaire that she had in front of her and clearly it was a "swine flu screening questionnaire". They don't want anyone in there who has shown swine flu syptoms in the last 7 days, she informed me. She would leave a message for the doctor to ring me back sometime today.

Sweden is reaching the peak for the outbreak of Swine Flu, according to an article today in The Local, and the government hope to vaccinate some 90% of the population. Ever since it was announced that the vaccine would be freely available to all I've been pondering this attempt to thwart a local pandemic and I can only put it down to the cost of VAB and sickness benefits.

VAB stands for Vård Av Barn - or child care - the type of caring for a child when they are sick, the type of caring I've been doing this week. You see the government pays me 80% of my salary up to a certain amount when I am "vabbing" or caring for my sick child. They pay it every day I am at home with my child and there is no need for a doctor's certificate unless they are off for longer than a week. Their only demand is an explanation and a signed document from school or daycare saying that the child has been away. And there is no limit to how many days a year a child can be off sick. It must cost the state an absolute fortune. Compare that to a system where the parent gets nothing for staying home with a sick child - how sick must a kid be then to justify a day without pay?

Adults also get sickness benefits. The first day off is without benefits but after that they receive 80% of their salary. A doctor's certificate is needed after a week and again there is no limit on the number of sick days a person can have off in a year, although questions do get asked after a while.

We have a long winter in this country and for six months of the year viruses run rampant and both kids and adults are regularly at home with colds, coughs and flus. If the swine flu hits Sweden like they are anticipating it will it will without doubt lead to a serious budget blow-out. Add that to the already high unemployment levels (also get 80% of salary with exceptions) and the Swedish economy is going to take quite a beating!

No wonder the Swedish government is both willing and hoping to vaccinate 90% of the population - I just wonder how anyone will get a doctor's certificate when the doctors clearly don't want anything to do with those of us who are sick!

More information available in English from Försäkringskassan http://www.forsakringskassan.se/sprak/eng

If you have a baby in Sweden or arrive with a very young infant, you may be invited to join a parents (föräldrar) group at the clinic. This is normally attended by the mums since they are the ones at home with the child in the early days – but this need not be the case if your circumstances are different. The BVC would normally aim to have the first meeting when all the babies are about one month old but much depends on how many babies have arrived around the same time as yours does. You may find a wider spread of ages. If you are going to a standard BVC, the meetings are likely to be held in Swedish although there are some BVCs who run special international parents groups if they have a number of non-Swedish parents with similar aged babies. This is only likely in one of the big cities, and even then just within certain areas.

The group will probably have a few sessions scheduled in to discuss specific baby related topics – feeding, sleeping, activities, safety and so on. Once those sessions have been completed, it is then left up to the parents involved to arrange follow-up meetings locally.

Parents groups can be an excellent way of meeting other new mums who almost certainly live very close to you. It is also an excellent way of meeting Swedes on a social level which is not necessarily the easiest thing to do. However, you probably will need to be able to get by in Swedish, or have a partner or friend who is willing to help out with translating. If not, ask your nurse in advance what she recommends – she may know some of the other mums already and have an idea whether they would be happy to speak English for at least part of the time. Unfortunately this is not always the case and we have heard of several cases where foreign mums have been told they are not “suitable” for the group and no other alternative has been given.

Up unit your child starts school, his or her progress will be monitored by the BVC (barnavårdscentralen). If you give birth in Sweden, you should already have been told which BVC to go to. You may even be contacted directly by your BVC nurse, and in many places she will do a home visit in the first few days to see how you are both settling in.

If you arrive in the country with children, you will need to phone the BVC to inform them of your arrival and ask for a nurse to be assigned. The easiest way to find your local BVC is either through Yellow Pages (gulasidorna - either the phone book or on line), or by phoning your doctor and asking them.

The nurse you meet at the BVC is responsible for checking that your child is growing at an acceptable rate – they monitor weight, height and head-size – is meeting acceptable developmental targets (physical skills, vocabulary and so on), has no medical issues (hearing, sight, autism etc.) and is immunised according to the Swedish immunisation schedule. Your child will also see a doctor on a regular basis and may also have dental appointments arranged. 

During your first meeting, they should outline how often you will meet (for a newborn, there will be weekly checks scaling gradually down as the child gets older) and explain what they monitor in more detail. If you have moved into the country with children, check how the immunisation schedules and progress checks you have been following elsewhere will fit into the Swedish system.

As with so many aspects of healthcare in Sweden, you may find the attitude more laid back than you have come across elsewhere. A small example is on the growth charts – no percentiles are given, that would be too comparative. Instead, as long as your child continues to follow a certain growth curve, nobody will be concerned. If you have specific concerns over your child’s development, ask, and if you want to arrange more frequent appointments, be prepared to insist upon it. You may feel as though you are being treated as the paranoid foreign parent but many Swedes are treated just the same so go with your gut instinct.

One thing to make clear about the BVC system is that it is not for treating sick kids. In fact, if your child is ill, you shouldn’t attend even a pre-booked BVC appointment. Sick children should be taken to your regular doctor – see the first section in this chapter. However, if you child is aged under one, you can phone the BVC for advise about what to do. If the BVC nurse thinks they should visit the doctor, they will book an appointment with them on your behalf. 

Once your child starts school, the school health system (skolhälsovård) takes over from the BVC. Unless your child has a specific chronic condition, the school doctors and nurses will just be responsible for general health education, administering vaccinations and general health checks of height, weight, sight and hearing (which should be conducted three times during compulsory school and once at gymnasium).

During the actual birthing of your child you may see several teams of midwives. They work their shift and go home at the end of it - no matter what is happening with you. This is a little disconcerting for many people as there is no continuity. However you can be confident that all information is passed on to the new team – everything that has happened will have been documented and the two teams will meet and discuss each patient. Patient records are public documents so be sure to ask for a copy of it before you leave the hospital.

Another thing worth knowing is that while the medical staff will advise you, it is always your decision. They make the recommendations and you choose to act on them. So be prepared to act on your instincts if you feel that is the best thing to do.

Before you go home, check what your next step should be. If you are released before your baby is five days old, you will probably need to go back to the hospital for his initial check and PKU blood test. If you go home after this appointment, you will normally need to contact the local BVC (barnavårdscentralen) yourself to arrange for a home visit or a first appointment at the clinic.

Hopefully your MVC midwife will have told you which BVC to contact and who to speak to, but if not phone her up to check. You will also need to inform your MVC midwife that you’ve had the baby. Despite the impressive use of your personal number to track your every move while in Sweden, various health departments rarely talk so it’s up to you to keep them informed.

Most MVCs also offer birth preparation courses, which can also create an opportunity to get to know other women expecting around the same time. Your midwife will be able to inform you of the details