Sep 6 2022
Teaming up to Tackle Complexity in Healthcare
News article

Teaming up to Tackle Complexity in Healthcare

SUSWELL complex


News article from Hanze UAP about the E+ funded project Suswell

SUSWELL stands for sustainable wellbeing. It is a European project in which the European Union helps Russia and Kosovo to better organize their health care welfare. Paul Beenen, Margarita van Dijk and Jos van Kempen talk about the value of European collaboration on complex themes in healthcare and welfare. 


Paul Beenen is a professor-researcher at the Institute for Sports Studies and the Academy of Health Studies and project leader at SUSWELL. “Keeping a dialogue about European values and looking at what we can do for each other. Germany Portugal, Finland, Belgium and the Netherlands are connected in SUSWELL. We are doing three projects in Russia. In Saint Petersburg, Perm and in Belgorod, which is 15 kilometres from the Ukrainian border. And two in Kosovo, in the capital Pristina and Gjakova. Russia is of course difficult right now. Formally, we are not allowed to work with institutions that belong to the state, and almost all of them are. We also have NGO partners and partners from a private institution, and you are still allowed to work with individuals. Half of our partners have fled because they have different ideas than Putin. Communication is also becoming increasingly difficult. If there hadn’t been a war, I would have been in Perm this week.”

Community of Practice

SUSWELL is building a community of practice around an urgent health theme, in which citizens, knowledge institutions, local government and companies participate. Together they look at an issue. Paul: “We initiate social and local changes. We tackle what is locally urgent. In Gjakova it is about women who experienced sexual violence during the war. In Pristina about children with autism, who disappear in the periphery and who are given insufficient opportunities to participate in society. It is interesting that we in the Netherlands can also learn a lot from this. We often act as if we know how to do it, but even in the Netherlands children with autism sometimes fall through the cracks. Some things they just do better abroad. Because healthcare is sometimes less well organized, informal care is often better organized. 

Looking critically at your own context

“One cannot solve complex issues in healthcare and welfare on their own. By looking at a different context, you also look more critically at your own context. Due to scarcity, because there are few facilities, you will work together more locally. In Groningen, more and more facilities are disappearing from the province, while more and more elderly people live there. We have to get people used to the fact that not all facilities are around the corner anymore. For example, we are also poorly geared to remote monitoring, they are much better at this in Russia and Finland, because they have to deal with greater distances.


The Dutch Margarita van Dijk and her family have been living in Kosovo for ten years. She teaches Physiotherapy and is responsible for the Occupation Therapy programme within the Kolegji Heimerer, the Faculty of Health of a private University in Pristina. Kolegji Heimerer has a therapeutic centre where children with autism are treated. “We are working on autism at all kinds of levels”, says Margarita via Teams. “We want to take a good look at the role of these children in society and what we can add to it. We investigate what children need outside of therapy to be able to participate successfully in society. We do this by bringing stakeholders together. People who are responsible for their part in the picture of autism, such as the government, NGOs, education, therapists and parents. Children with disabilities are generally hardly included in society here. Parents sometimes don’t even want to hear that their child has something. It’s a bit of a shame. For parents who do see this, and experience it as a burden, there is often no help at all. There is no luxury in Kosovo to offer the child what it needs.”


“It gives parents in Pristina hope that so many different people are thinking about autism. That teachers know that the government thinks along, and parents that therapists think along. We have mapped out the bottlenecks and the opportunities together with the stakeholders. The lack of extra help at schools is a problem for both teachers and parents.’

Practice-oriented education

Margarita: ‘In the field of education we are working on new themes such as futures literacy. How do we look to the future and how are we going to approach it differently now? To do this, we receive more in-depth knowledge from our mentors, so that we make education more practice-oriented. We hope that we can also apply the concept of the community of practice to other target groups. Kosovo has a lot to offer, but there is still a lot to gain in terms of cooperation. People here really want to think and act towards Europe, so we are always very interested when there are foreign guest speakers. That helps to get things done.”


Every community of practice has a mentor. Jos van Kempen is a mentor of the community in Pristina. From the start in 2020, the university professor at the Institute of Business Administration and the Master Healthy Aging Professional of the Hanze University of Applied Sciences will supervise the process. Jos has just returned from Pristina, where he mentors the community towards their ideal of health. “We organized a round table in Pristina in which we talked about SUSWELL in Pristina. The mayor was invited, the media, parents of children with autism and professionals involved in care for health. In addition to developing social innovations related to health, we also develop education for specific regions and for professionals. For example, I gave a presentation to the round table on futures literacy. About the place that futures literacy can take in a social innovation and what place it could take in education in that region. Futures literacy is not about predicting the future, but about developing skills to deal with an unknown future. You can predict whether the sun will shine tomorrow, but when it comes to complex issues such as poverty, war victims, security, obesity, autism, corona… there are so many elements that come into play that you cannot predict what will come out of them. Being resilient to changes rather than trying to get a handle on that change. That is a very important skill for all those communities of practice. People are open to it. Every now and then I get a critical note. “Jos, do you think we have the luxury to think about the future and at the same time trying to survive every day.”

Growing as a teacher

Jos finds the question of what SUSWELL will bring him as a teacher a difficult one because everything has common ground. “I learn from the people in Kosovo from their hospitality and from their collectivity. They think it’s important to do things together. As a professional, I learn from the complex situation with all those stakeholders. As a teacher, I have grown in flexibility and creativity. We are used to having everything planned in education. My knowledge about futures literacy has developed enormously. I learn a lot about guiding interdisciplinary groups around complex questions, such as the issue of children with autism. For example, by simultaneously paying attention to paradoxes, such as unity and diversity. Without unity, there is no common direction, but without diversity, there is no broad view of the issue. That is sometimes quite difficult. Dealing with complexity is becoming an increasingly important skill.”

Long term

Project leader Paul Beenen emphasizes: “We want the communities of practice to work together in the long term because if you want to improve care for people with autism, for example, it might take twenty or thirty years. You don’t do that in a project. Take care of health instead of health care.” Also read Paul Beenen’s opinion article: The uncanny and destructive consequences of the breaking of dialogue in times of war.


SUSWELL consists of nine higher education institutions and six civil society organizations from seven European countries that embrace the complexities of health systems and accept the need for co-creation to enable social change. SUSWELL will run for three years, started in November 2020 and received an Erasmus+ Capacity Building in Higher Education grant. The subsidy has been stopped for the entire project because of the war in Ukraine. SUSWELL’s predecessors were the E+ funded projects COP4HL and Score. Those projects also linked health care and welfare with the same partners in the same environment.