Reviving Swiss mountain communities - Is there a future for these isolated regions? | DW Documentary

Onsernone Valley: A Mountain Doctor’s Search for a Successor

Key Concepts:

• Mountain Doctor: The unique challenges and rewards of providing comprehensive medical care in a remote, mountainous region.
• Rural Healthcare Access: The difficulties in maintaining medical services in sparsely populated areas and potential solutions like doctor-sharing models.
• Alternative Lifestyles & Repopulation: The historical draw of the Onsernone Valley for those seeking a different way of life and current efforts to attract younger residents.
• Community & Interdependence: The strong social fabric of the valley and the reliance on neighbors for support.
• Work-Life Balance: The evolving priorities of younger doctors and the challenges of integrating professional and personal life in a rural setting.

The Challenge of Succession: Dr. Beppe Savary Borioli

For over 40 years, Dr. Josef Savary Borioli, affectionately known as Beppe, has served as the mountain doctor for the Onsernone Valley in Ticino, Switzerland. Now 72, Beppe faces the critical challenge of finding a successor to continue providing comprehensive medical care to the valley’s residents. He acknowledges his good health but recognizes the inevitable need for a younger doctor to take over. “I have the advantage of being in good health. Right now, I’m healthy— but you never know…” he states, adding with a touch of humor, “maybe I walk a little more elegantly.”

The demanding nature of his work is highlighted by a house call to 81-year-old Laura Mordasini (Lali), requiring a strenuous hike of 300 meters down and 400 meters up a steep hillside, taking approximately an hour each way. Beppe emphasizes the holistic nature of his practice, encompassing preventative care (vaccinations), pediatric care, and emergency medicine. A single house call can consume up to three hours, allowing him to build deep relationships with his patients and understand their overall well-being.

The Valley’s History & Current Revival

The Onsernone Valley, situated between Locarno on Lake Maggiore and Spruga at 1,300 meters altitude, experienced significant poverty and emigration until the 19th century. A revival began in the 1970s with the arrival of “hippies” seeking an alternative lifestyle, who helped stabilize the valley’s demographics. Today, attracting young people and ensuring continued medical care are crucial for the valley’s future. Mike Keller, whose father was one of the original hippies, exemplifies this new generation, having returned after living and working abroad to build a future for his family and contribute to the valley’s revitalization. He notes that the hippies “saved the valley demographically.”

New Residents & Community Building

Recent arrivals like choreographer Eleonora and former project manager Mike, who purchased a house in 2022, demonstrate a growing trend of individuals able to work remotely choosing the valley for its quality of life. Daniela Huber, a shaman, moved to her grandmother’s house in Berzona, seeking harmony with nature and community. Mike Keller has established a business managing and renting out vacant homes, aiming to bring more life to the villages, particularly during the winter months. He observes a shift in values, stating, “People spent more time in nature and learned to appreciate nature again,” and believes more people will seek out places like Onsernone. Berzona is described as the most beautiful village in the valley, reflecting a discreet luxury from its past as a haven for poets like Max Frisch, Alfred Andersch, and Golo Mann.

The Doctor-Sharing Proposal & Initial Setbacks

Beppe is actively involved in finding his successor and proposes a “doctor-sharing” arrangement – a part-time position in the valley combined with work at the regional hospital in Locarno (La Carità). He believes this model could serve as a precedent for other remote regions. His initial attempt to find a replacement was unsuccessful, but Fausto Widmer, a young doctor, began a six-month shadowing period with Beppe. This period serves as a mutual evaluation: assessing Fausto’s suitability for the role, patient acceptance, and his willingness to integrate his life and career as Beppe has.

Beppe’s vision is to create a sustainable healthcare system for the valley, reflected in his involvement with the Centro Sociale Onsernonese, a retirement and nursing home with integrated medical care. He emphasizes the importance of understanding the needs of the community, recalling a survey of residents who overwhelmingly expressed a desire to remain in the valley even in their later years.

Challenges & Uncertainties

Despite initial optimism, the doctor-sharing proposal faces challenges. Marco Pastori, another potential successor, accepted a senior position at the hospital, putting his plans on hold. Fausto Widmer, while enjoying his time in the valley, also prioritizes his hospital work and avoids raising Beppe’s expectations prematurely. Beppe acknowledges the changing priorities of younger doctors, noting, “This obsession with work-life balance, I don't quite understand it.”

Another concern is the future of the local school in Loco. Maintaining a minimum enrollment of 12 students is crucial for continued cantonal support. Laila Rüesch, a local farmer and mother, highlights the importance of community and the benefits of a small school environment where children can enjoy freedom and independence. The school’s survival is a symbol of the valley’s ongoing struggle to attract and retain young families.

A Legacy of Care & Hopeful Outlook

Three months after the initial shadowing period, Marco Pastori returns to full-time hospital work, and Fausto Widmer continues to balance his hospital duties with his time in the valley. Beppe, though disappointed, remains hopeful. He reflects on his own life, acknowledging he may have sacrificed some personal time for his work, but ultimately finding fulfillment in his dedication to the valley and its people.

The video concludes with Beppe’s unwavering love for the Onsernone Valley and his belief in its future. He expresses his desire to remain in the valley even after retirement, stating, “I hope that the valley will remain in me.” He continues his daily swim in the local stream, a testament to his enduring connection to the land and his commitment to a life lived in harmony with nature.

Technical Terms & Concepts:

• Toccasana (Italian): A life elixir or remedy; something that promotes health and well-being.
• White Coat Hypertension: Elevated blood pressure readings taken in a medical setting due to anxiety.
• Pomace: The solid remains of grapes after pressing, used in some grappa production.
• Ambulatorio: Italian for outpatient clinic or medical practice.
• La Carità: Italian for "Mercy," the name of the regional hospital in Locarno.
• Anesthetist: A doctor specializing in anesthesia, pain management, and critical care medicine.