MINELRES: ERRC Report: Roma and Health Care

minelres@lists.microlink.lv minelres@lists.microlink.lv
Sat Oct 14 09:03:19 2006

Original sender: European Roma Rights Centre <errc@errc.org>

Announcement of Publication
Report by the European Roma Rights Centre

Ambulance Not on the Way:
The Disgrace of Health Care for Roma in Europe

Claude Cahn, ERRC Programmes Director: ccahn@errc.org, (36 20) 98 36 445
Savelina Danova-Russinova, ERRC Research and Policy Co-ordinator:
savelina.danova@errc.org, (36 1) 41 32 215

Warsaw/Budapest, 4 October 2006:                
The European Roma Rights Centre (ERRC) announces the publication of the
report "Ambulance Not on the Way: The Disgrace of Health Care for Roma
in Europe". The report explores major systemic causes for exclusion of
Roma from access to health care, as well as provision of inferior
medical services to Roma.

A number of studies reveal a serious gap in health status between 
Roma and non-Roma in many European countries. Roma live shorter lives 
and show markedly higher instances of diseases such as tuberculosis, 
long thought eradicated but now making a dramatic comeback in Central 
and Southeastern Europe, as elsewhere. There have also been a number 
of recent outbreaks of diseases avoidable by routine vaccine, such as 
measles. One recent measles outbreak in Romania caused the death of 
fourteen children.

The World Health Organization (WHO) reports that many Roma are not 
vaccinated against other serious or deadly diseases, such as polio. 
Roma are also regularly excluded from emergency care. Where Roma do 
gain access to emergency care this may in fact be the only meaningful 
contact they are able to secure with the health care system: Roma 
often have no access whatsoever to primary or preventative health 
services. These issues and others implicate the international law ban 
on racial discrimination.

For a number of years, the ERRC has documented the interference of 
racism in the provision of health care services to Romani men and 
women in a number of European countries -- Bosnia and Herzegovina, 
the Czech Republic, Croatia, Greece, France, Italy, Kosovo, Romania, 
Serbia and Montenegro, Slovakia and Slovenia. Research during 2005 in 
Bulgaria, Hungary and Spain elaborated and reinforced the findings in 
previous years of persistent and widespread practices that deny Roma 
the quality of health services available to others. As documented by 
the ERRC, in many instances, health services are entirely unavailable to

Racial discrimination against Roma in health care is manifested in 
exclusion from health services and in the provision of health 
services of inferior quality. Roma frequently lack one or more 
personal documents crucial for gaining access to health care, and in 
some cases may even lack the citizenship of any state. Many Roma have 
no health insurance whatsoever. In some cases, access to health care 
is obstructed by the physical separation of Roma from the mainstream 
of social and economic life, in segregated communities where public 
services are restricted or entirely unavailable. In its most 
egregious forms, racial discrimination in the provision of health 
care manifests itself as denial of treatment of Roma by health care 
providers and/or in inappropriate and negligent treatment. Reports of 
segregation of Roma in medical facilities, verbal abuse and degrading 
treatment reveal a pattern of substandard level of health care 
provided to Roma.

In the case of Romani women, the complexity of influences on health 
status and access to health care, stemming from the rejection of Roma 
in their societies at institutional and individual levels, is 
magnified by gender-related discriminatory barriers and forms of 
abuse. Lack of access to medical services and inferior medical 
services have a particular negative impact on Romani women's health, 
especially where reproductive and maternal health are concerned. In 
some countries, Romani women experience extreme forms of human rights 
violations by health professionals, such as coercive sterilisation.

Racial discrimination outside the health care system also affects the 
health of Roma in a number of ways. One area in which the impact of 
racial discrimination on the health of Roma is particularly visible 
is housing. Patterns of housing discrimination against Roma have 
forced numerous individuals into inhuman and degrading conditions of 
segregated slum settlements; exposed Romani individuals to 
environmental hazards; and made them vulnerable to forced evictions 
and other violent abuse by state and non-state actors. Higher 
vulnerability of Romani women from excluded communities to 
trafficking, domestic violence and early marriage are other factors 
having a negative impact on the health status of Romani women.

The exclusion of Europe's largest minority from vast areas of the 
health care system should in principle constitute among Europe's most 
significant social inclusion policy concerns. To date, however, the 
interface between Roma and the health care systems of Europe has 
received limited policy attention, in particular by comparison with 
several other key areas. Government policies to facilitate the access 
by Roma to medical care are for the most part nascent, where they exist
at all.

Where such policies do exist, by failing to acknowledge and confront 
discrimination against Roma in the health care system, governments 
postpone the solutions to these problems to the distant future. 
Policy measures on Roma health tend to be designed and implemented 
outside the mainstream health policy framework of governments. The 
effect of implementing separate health policies on Roma while not 
integrating solutions to Roma health problems in mainstream policies 
is to diminish the impact of Roma-specific health policies and in 
some cases to render such policies effectively meaningless.

Effective health care policies on Roma should involve revision of 
laws and policies which are shown to have a disparate effect on Roma 
in the field of social and health services, as well as the 
development and implementation of specific targeted action to ensure 
equal access to such services. Furthermore, health policies are 
contingent on the effectiveness of policies aimed at reducing levels 
of exclusion of Roma from mainstream and quality education, reducing 
exclusion from employment, and improving housing standards.

"Ambulance Not on the Way" includes detailed recommendations to 
policy- and lawmakers aimed at bringing about fundamental change in 
these areas.

Research toward -- and publication of -- "Ambulance Not on the Way: 
The Disgrace of Health Care for Roma in Europe" has been paid for by 
a grant from the Open Society Institute's Public Health Program 
(PHP). The full text of "Ambulance Not on the Way: The Disgrace of 
Health Care for Roma in Europe" is available in English at: 

Hard copies of "Ambulance Not on the Way: The Disgrace of Health Care 
for Roma in Europe" are available by contacting the offices of the 
European Roma Rights Centre.


The European Roma Rights Centre is an international public interest 
law organisation which monitors the rights of Roma and provides legal 
defence in cases of human rights abuse. For more information about 
the European Roma Rights Centre, visit the ERRC on the web at 

European Roma Rights Centre
1386 Budapest 62
P.O. Box 906/93

Phone: +36 1 4132200
Fax:   +36 1 4132201



The European Roma Rights Centre is dependent upon the generosity of 
individual donors for its continued existence. If you believe the 
ERRC performs a service valuable to the public, please join in 
enabling its future with a contribution. Gifts of all sizes are 
welcome; bank transfers are preferred. Please send your contribution to:

European Roma Rights Centre
Budapest Bank Rt.
1054 Budapest
Bathory utca 1

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