In the following, findings from the interviews are presented focusing on the reasons why Bosnian refugees return to Bosnia when they age and become ill and on the role that health issues play in the decision to return migrate.
3.1. Considerations Related to Access to Health-Care Services
In accordance with the previously mentioned assessment of the Bosnian health-care system’s capacity to treat chronic illness, the informants described access to health care and cost of medicine as being unfavourable in Bosnia compared to Denmark. One married couple (Participants 37 and 38) who had returned to Bosnia explained that they spent 60% of their income on the husband’s diabetes medicine, whereas in Denmark most of their medical expenses had been covered by the state. Besides considerable expenses, several informants also mentioned how access to health-care services in Bosnia was obstructed by long waiting lists and corruption in the system. Many informants explained that they had to bribe health-care professionals in order to obtain the appointments they needed. As one woman said:
Over there (in Denmark) we had everything. Here you pay for everything.
However, the interviewees did not describe access to the Danish health-care system as unproblematic: language barriers and a lack of available interpreters were cited as factors contributing to communication complications with health-care professionals. This was mentioned as being a great problem by some of the informants. A few informants preferred the type of medical treatments available in Denmark, but most found the quality of treatments in Denmark and in Bosnia to be relatively similar.
Despite medical treatment being described as more easily available in Denmark than in Bosnia, only a minority of the interviewees residing in Denmark mentioned barriers in accessing health care in Bosnia as one of the reasons why they had chosen to stay in Denmark; the vast majority had not prioritised easy and inexpensive access to health care when deciding where to live. The case of one informant, whose illness worsened upon his return to Bosnia due to the unavailability of medication, illustrates how access to treatment was often not prioritized when the decision to return was made:
Interviewer: If you had known before you returned that your psoriasis would worsen or spread, would you then have stayed in Denmark?
Informant: We did not want to stay (in Denmark).
The decision to return was very well-informed for most informants with regard to the advantages and disadvantages for their health status and access to health care; they had considered things thoroughly. When a couple who had returned to Bosnia and who were suffering from chronic pain and PTSD respectively were asked about their concerns on returning to a health-care system with less easy access, the husband replied:
We thought about it (access to health care in Bosnia), we wrote everything down on a piece of paper. In the end we decided to return. We knew everything.
So, did people deliberately not prioritise their health when they decided to return? If optimization of health is regarded as pursuing good physical health and good access to health-care services, it can be concluded that in general the interviewees were driven by other factors when they decided where to reside. On the other hand, if health is regarded as a broader notion that involves more than physical health and access to health care—as implied by the World Health Organization (WHO)’s definition: “complete physical, mental and social well-being and not merely the absence of disease or infirmity” [28
]—one could argue that the returning Bosnians did indeed prioritize health when they made their decision, as they prioritized factors that would give them better physical, mental and social well-being.
A quote from a returnee couple who both suffered from chronic illness illustrates how deliberate the decision to choose well-being in a country with lower levels of welfare and prosperity had been for them:
I’m fine with just eating once a day, as long as I am here.
Instead of eating five times somewhere else, we prefer to eat once here.
The following sections in this paper will explore the significance of general well-being further by examining the relationship between return migration and the physical, mental and social aspects of well-being. Even though the aspects are intrinsically interconnected and therefore not necessarily meaningful on their own, we will attempt to disentangle them in order to acquire a deeper understanding of this issue. As the questions on the motives for return migration were open ones, informants were able to define themselves what was important in their decision. The three aspects presented in this article were mentioned in almost all interviews.
3.2. Physical Well-Being
The physical aspect of well-being related to return figured as an important consideration when people decided where to reside. One informant, who suffered from PTSD and who had experienced many violent and upsetting things in Bosnia but nevertheless had returned after twenty years in Denmark, explained his decision as follows:
Interviewer: Why are you so happy to be back (in Bosnia)?
Informant exhales deeply and smiles.
Informant: Something like that, but it is hard to compare. But let’s imagine I am sitting on a chair that is shaking and I then move to a chair that is solid; it’s that inner feeling.
A feeling of general physical well-being accompanied the return for many of the informants. Factors such as the climate and the physical environment were often described as decisive in drawing informants back to Bosnia. One man who had returned with his wife three years prior to the interview and who had a history of several heart operations and Parkinson’s disease described what had made him return:
What I have here (in Bosnia) is a nice atmosphere. The air is good, the water is good, the water from the spring is clean. Here I have flowers. Every morning I go out and exercise. I breathe. When I was in Denmark I had the apartment, the balcony. I only looked to the left and to the right. I didn’t have anything else.
The couple experienced great financial difficulties after their return to Bosnia, and they had no children who could support them, so they faced even harder times ahead. However, well-being related to the physical aspects of being in Bosnia compensated for the difficulties they encountered, and they were happy with their decision.
Nearly all informants said that, despite having less material wealth and worse access to health care, they felt better and more content after having returned to Bosnia. Often any possible deterioration of physical health that had happened after the return was explained by the ageing process and seen as being countered by an increase in contentment and well-being. As one returnee said:
When it comes to illnesses, I age every day. The older you get, the more ill you become. But overall, the sun is shining on me. Even if I have less, I am more content here (in Bosnia).
3.3. Social Well-Being
Another important dimension of well-being mentioned in the interviews was the social aspect. Many of the interviewees had family members in different parts of the world. They lived somewhat transnational lives; visits to family members in various places were common, as were long vacations in Bosnia. Despite the frequent visits to see family, nearly all the informants who had returned to Bosnia mentioned their desire to be with their children as the main reason for their return. The children had, for political reasons, often returned before the parents. Many of them had fled the war earlier than the parents and went to Germany, where there was already a large population of Yugoslav labour migrants. By the time the parents had fled the war, Germany had closed its borders to refugees from the Balkans. This forced the parents to go elsewhere, among other places to Denmark. When the war ended all Bosnians were expelled from Germany, and the children therefore returned to Bosnia, whereas those who had been granted asylum in Denmark stayed there. As seen in Table 2
, only one of the returning couples and one of the returning singles did not have children in Bosnia (apart from one couple who had no children). The fact that all of the informants who resided in Denmark had children who lived in Denmark (apart from one informant who had no children) further stressed the importance of physical proximity to one’s children (data presented in Table 1
). It seemed to be a matter of course that the informants wanted to be with their children. As noted by one man who had children in Bosnia and who had lost his wife when he returned to Bosnia:
If my children still lived in Denmark I wouldn’t have returned… You follow the children... We didn’t want to stay (in Denmark)… Because of the children we couldn’t stay at all. You know how it is.
Another man who lived in Denmark and whose son also lived there put it this way:
I thrive here (in Denmark) because of my son. I love Denmark because of my son.
The importance of being with one’s children as a motive for return migration was stressed by the fact that several of the informants who had returned to Bosnia had settled where their children were living, not where they themselves had been living when they fled.
In some cases, where parents had more than one child, the children lived in different countries. This compelled the parents to choose which child to live near, and this was usually determined by weighing who had the greatest need for their parents. Often children who did not have a spouse or children who were sick and whose family therefore needed help were given the highest priority. One of the interviewed couples had two children, one living in Sweden and the other in Bosnia. As their son who lived in Bosnia was ill, they decided to return there, though he died shortly after their return. In explaining why they had returned, they emphasized that his death had confirmed the appropriateness of their decision, as they were now able to support their surviving relatives. As the woman said:
At least we can live with the grandchildren, side by side with his children.
The couple also explained that being physically near their son’s grave was very important to them and gave them a sense of being near him.
The informants who had returned to Bosnia described how they had missed their children deeply while living in Denmark and how being near them and their grandchildren gave them peace of mind. Some informants mentioned how they valued having a role in their children’s lives again, among other things by helping them take care of the grandchildren. Being able to help their children and being close to their grandchildren seemed to give joy and meaning to informants’ lives. It was something they had longed for.
Both the returnees and those who stayed in Denmark explained how being near the children and grandchildren also provided them with assistance with household chores such as cleaning and cooking, as well as assistance in case of emergencies. As one woman who had returned to Bosnia and now lived in the same house as her children said:
When something hurts or I am in a critical state, then my children are here. They immediately call the ambulance.
Another woman who had returned to Bosnia explained how her grandchild who lived nearby helped her and her husband:
Our grandchild visits us, calls on us. She visits, buys bread for us, picks up cigarettes and stuff like that. She also buys medicine for us. They are good kids, really good.
Similarly, a man who lived in Denmark described how he relied on assistance from his son in many ways:
Well, it’s a good thing that I have my children, because it’s really difficult to be in a foreign country with a foreign language. If we need help, my son comes over and drives us to the doctor and fixes everything. I don’t know what I would have done if it hadn’t been for him.
The fact that the informants had a chronic illness and were facing old age with an expected loss of functionality emphasized their need for assistance with practical matters and health-care services, and thus their need to be with their children. One woman, who had serious cardiovascular problems and had returned with her husband one year prior to the interview, simply stated that:
The older you get, the more you need your children.
A childless couple who had returned to Bosnia illustrate how difficult it is to live without children in Bosnia as an elderly, chronically ill person:
Nobody can help us; we have no children. It’s hardest now. I have suffered a lot, but now is the hardest time. In Denmark, if you have no children, you have insurance, isn’t that so?
The need for assistance from children also reflects the fact that no real alternative method of obtaining assistance existed for many, as they could not afford elderly care and nursing homes in Bosnia.
The prospect of spending one’s old age in a nursing home in Denmark was another reason for the interviewees to return to Bosnia. As one woman, who at the time of the interview was residing in Denmark, said:
If I have to go into a nursing home, I’d prefer to stay in a nursing home in Bosnia. Because I know the language they speak. I do understand some Danish, but I would move to Bosnia. … What would I be doing at a nursing home here?
Several other informants expressed an unwillingness to stay in Danish nursing homes. They mentioned the language barrier as the main reason why these homes were so undesirable. However, while Danish nursing homes were very unpopular, nursing homes in general were disliked. One man who had returned to Bosnia explained why:
Informant: We don’t want to go into a nursing home. It would be embarrassing to go into a nursing home when we have family.
Interviewer: Embarrassing for your children or for you?
Informant: Embarrassing for our children. If the neighbour, for example, heard about it, they would right away say that the children were bad children.
Altogether, being near the family and having a role in it gave the informants social and—as appears from the following section—mental well-being.
3.4. Mental Well-Being
One final aspect of well-being which was also important for why the elderly, chronically ill Bosnians interviewed in the present study returned was their mental well-being. Informants linked mental well-being closely to a feeling of belonging, and they expressed in various ways how the pursuit of belonging had made them return. One man who had returned to Bosnia said:
Nowhere but here (in Bosnia) do I feel at home. I was born here, I have lived here. If I had felt the same way in Denmark, I would have stayed in Denmark and not returned.
He continued by quoting a local song: You can go everywhere, but you will always return.
One woman (Participant 36) who had returned to Bosnia described how she cried when she saw young people in Denmark because, as she said, “they were so lucky to be at home”. Seeing them being where they felt they belonged and where they felt at home made it clear to her that she did not feel at home in Denmark, and that made her deeply unhappy.
It seems that ageing emphasized the desire to be where one belonged. One woman who had returned, despite her traumatic experiences during the war, said:
The older you get, the more you want to go where you belong.
Many described how they always expected to spend their old age in Bosnia and how they had regarded it as a matter of course that they would return at some point. It was a matter of following one’s fate, but also a matter of returning before it was too late. Some mentioned that they had focused on returning while they were still alive so they would spare their relatives the hassle of bringing a corpse back to Bosnia in a coffin:
We decided to return so they wouldn’t have to tow me; in this way I came in a wheelchair.
Connected to this was the fact that many of the informants did not want to die in Denmark; it was important that they died and were buried in Bosnia alongside their ancestors. As a man who had returned said:
All our relatives are buried at the graveyard here, so we are next.
Besides the desire to be close to their ancestors in the grave, there was also a strong desire to be close to the graves of relatives while they were still alive; the family bonds extended beyond death. In many cases, family members who had died in Denmark had been sent to Bosnia to be buried. An additional explanation is that Danish and Bosnian burial traditions differ in terms of religious and cultural practices [29
The fact that these informants—unlike labour migrants—had been forced to migrate also had an impact on where they felt they belonged and why it was so important to return. As one man who had returned to Bosnia, but subsequently had had to return to Denmark again, put it:
I returned because of a desire to go back to my own country; I didn’t come to Denmark because I wanted to.
Another informant (Participant 9) residing in Denmark said that the fact that she did not choose to leave Bosnia made her feel that something in her life was unfinished. This informant had other reasons not to return (she had been abused during the war and was afraid of meeting the offenders in Bosnia), but she very strongly felt the need to do so.
The interviews thus showed that the returned informants had obtained higher levels of physical, social and mental well-being by returning to Bosnia. This was supported by the fact that none of the informants who had returned regretted doing so.