Although volunteers are widely acknowledged as important members of the palliative care team, their unique contribution to whole-person care has not been well documented or theorized, especially in rural communities. We conducted a focused ethnography in a small rural community, asking key community informants about their understanding of the role of hospice volunteers with dying people and their families. Our results show that these volunteers inhabit a unique third culture of care that fuses elements of formal care with the informal visiting of friends and neighbours. Their role is shaped to a community context where dying is not a private medical event, but rather a whole-person-in-community event, and where care is offered as a natural expression of the interdependence and reciprocity that characterizes rural community life. Our results are a reminder that it takes an entire community to care for the dying, and that hospice volunteers are a crucial link in the network of care that allows people to die with dignity and quality of life.

This research provides a Canadian example of implementing a public health approach to PC in an Indigenous context using PAR. It provides evidence of the effectiveness of a community capacity development as a strategy and illustrates how to implement it. This approach, fully grounded in local culture and context, has potential to be adapted to Indigenous communities elsewhere in Canada and internationally.

This study examined the experiences of a sample of skilled immigrants to Canada from Asia and Africa who were currently experiencing credentialing problems (N=180). Most respondents had advanced postsecondary training and a job requiring a high level of skill prior to emigrating, but many were unable to obtain equivalent work in Canada. In reaction, they took work for which they were overqualified, volunteered, had their qualifications assessed, and upgraded their training. Most respondents were surprised and upset that it was so difficult for them to obtain a suitable job in their profession, and many felt that immigrants were discriminated against by Canadian employers. The policy implications of this "brain waste" are discussed.Résumé Cette étude examine les expériences d'un échantillon représentatif d'immigrants au Canada qualifiés, originaires de l'Asie et de l'Afrique, qui connaissaient au moment de l'étude des problèmes de credentialing (N=180). La plupart des interrogés possédaient une qualification postsecondaire et avaient pratiqué avant d'émigrer un emploi exigeant un haut niveau de compétences, mais beaucoup d'eux n'avaient pas pu obtenir un travail équivalent au Canada. Comme réaction, ils avaient pris un travail pour lequel ils étaient surqualifiés, ou ils travaillaient comme volontaires, ou avaient fait évaluer leurs qualifications ou les avaient améliorées. La plupart des interrogés étaient surpris et vexés qu'il était si difficile pour eux de trouver un emploi approprié dans leur profession, et beaucoup croyaient que les immigrés étaient des victimes de discrimination de la part des employeurs canadiens. Les implications politiques résultant de ce "gaspillage des cerveaux" sont examinées.

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