In Malta last month the fifth European Public Health Conference convened more than 1,000 delegates from around the world to address the theme of “All inclusive public health.” The notion of inclusion is timely. The current economic crisis–the worst in Europe in 70 years–has yielded austerity measures that have imposed savage cuts to health and welfare services, thereby undermining efforts to close health care gaps and tackle inequalities.
The crisis particularly threatens Roma, as the largest ethnic minority and demographically youngest population in Europe. They have long experienced systematic discrimination and social exclusion, which has led to a lower standard of health than most Europeans. Reports from Roma NGOs across Europe raise consistent problems with accessing health care services, poor or low quality treatment, and discriminatory attitudes by health providers. There has been poor progress on health within the framework of the Decade of Roma Inclusion (2005-2015), an initiative of 12 governments to improve the socio-economic status of Roma people, and a lack of concrete actions toward the National Reform Strategies for Roma Integration submitted to the European Commission in 2011. In light of this it was encouraging that Roma issues had a high profile at this year’s conference.
Open Society Foundations played an important role at EUPHA to this end. In her presentation, Alina Covaci, Program Officer of OSF’s Roma Health Project, discussed ways of making vaccination programs more inclusive and effective. As in past years, the Roma Health Project sponsored six Roma students and advocates who presented posters on their health research, which included access to care, smoking behavior, awareness about tuberculosis, reproductive health, and discrimination by health-care professionals (there will be more on this in a subsequent post). And in conjunction with OSF’s Law and Health Initiative, the Roma Health Project presented a workshop highlighting international conventions that set out rights and legal mechanisms to ensure compliance or redress when Roma are systematically denied access to – or are violated within the context of – health care.
Recently Open Society Foundations has begun work on several new initiatives we look forward to discussing at future EUPHA conferences. For example, we have funded several NGOs that will explore legal mechanisms for addressing violations in Roma health rights, including:
- The European Roma Rights Centre (ERRC) will research whether infant mortality rates in Roma communities in Romania are disproportionately high compared to the general population. They also aim to require the government to collect ethnically disaggregated data as a means of ensuring that health inequalities can be tackled effectively.
- The Macedonian NGO LIL seeks to monitor the implementation of the Patients´ Rights Law on behalf of Roma. It will make formal complaints to various ombudsmen and tackle specific cases of failed reimbursement, unlawful detention of Roma patients for non-payment of fees (particularly new mothers) and seek dialogue with stakeholders to resolve administrative barriers to care.
- Macedonian NGO HERA currently supports a local center that provides the only reproductive health care for Roma women in the town of Suto Orizari. They advocate for financial incentives from the government to encourage more providers and gynecologists to offer services there. And they litigate on behalf of Roman women who lack the right to choose between gynecologists in the area due to lack of providers.
- In Romania, the NGO Romani Criss aims to prevent all forms of health discrimination against Roma by building the capacity of local activists to recognize and report violations of health rights. Their data collection will provide evidence needed to advocate for legal and administration provisions to enforce patient rights.
Finally, as we leave this year’s EUPHA conference, we can highlight progress within the conference structure itself. The EUPHA’s Section on Ethnic Minority and Migrant Health has decided to allocate a seat on their steering committee to an academic or researcher working on Roma health issues. Section members–and EUPHA participants broadly–have rightly recognized that Roma health is an issue that demands more attention and further study.