My destiny or your responsibility???

The improvement of medicine would eventually prolong human life, but improvement of social conditions could achieve this result even more rapidly and successfully- Rudolf Virchow

The Roma community is the largest ethnic minority in Europe. According to Health World Organization in Europe live 12 to 15 million of Roma population(1)  which is characterized primarily by the situation of social exclusion and wide-ranging poverty experienced by a significant proportion of its members. Inadequate access to housing, education, employment and other needs, along with the existence of barriers to Roma access to health services and an ineffective use of these services due to their lack of adaptation and even to discrimination, all contribute to a range of avoidable injustices suffered by this community with regard to their health situation. (2)

UNDP survey data from 2004 and 2011 on Roma show that:

• One third of Roma respondents aged 35 to 54 reported health problems limiting their daily activities. (2011)     
• Approximately 20 per cent of Roma respondents were not covered by medical insurance or did not know if they were covered. (2011)
• 66 per cent of Roma said they could not afford prescription drugs compared to 29 per cent of the majority population. (2004)  
•  15 per cent of Roma children under the age of 14 are not vaccinated compared to four per cent of children from non-Roma households. (2004)(3)

In Albania the health situation of the Roma people is generally bad, due to the unhealthy environment where most of them live. Moreover, the Roma often do not have access to basic health services. High health service costs are the main obstacle towards the medical treatment of the Roma population. Only 25 percent of Roma earn enough income to buy medications. The government considers vaccination of children aged 1-14 years old as a priority measure, but in some cases, the vaccination of Roma children remains problematic particularly in the case of unregistered children or where families do not reside permanently in their place of residence. The Roma population has not enough information about the rights that the law guarantees in the field of health, including the vaccination system.(4)

This video was produced by ADRA 

But is this the destiny of Roma Community or it can be changed?

The social determinants of health influence in the health status of each population but in any case most of the health problems related to social conditions can be prevented. Governments have undertaken concrete steps to integrate Roma Community and improve their health status but the strategies should not be built for Roma Community without Roma Community. It is not only needed to offer free health care to Roma people but also to inform them about the right to health access, vaccination, family planning program. There are needed programs that foster the Roma parents to register their children in order they can access free vaccination. As Virchow says we should have a look to social conditions in order to prolong human life. It is our responsibility, not their destiny. 

E. Tresa

Bibliography

1.  Newsletter. World Health Organization; [cited 2015 Mar 9]; Available from: http://www.euro.who.int/en/health-topics/health-determinants/roma-health/newsletter

2.      Rodriguez. NS, Derecho NR. HEALTH AND THE ROMA COMMUNITY, ANALYSIS OF THE SITUATION IN EUROPE. Bulgaria, Czech Republic, Greece, Portugal, Romania, Slovakia,  Spain [Internet]. Fundación Secretariado Gitano, editor. Madrid; 2009 p. 180. Available from: 

           http://ec.europa.eu/justice/discrimination/files/roma_health_en.pdf

3.     Roma Health Report. Health status of the Roma population Data collection in the Member States of the European Union [Internet]. 2014 p. 153. Available from: http://ec.europa.eu/health/social_determinants/docs/2014_roma_health_report_en.pdf

4.     Duka R. The decade of roma inclusion. National Action Plan 2010-2015 [Internet]. Tirana, Albania; 2015. Available from: 

      http://www.al.undp.org/content/dam/albania/docs/The Decade of Roma Inclusion - National Action Plan.pdf

Doing what is right

Access to health care is a basic human right. The UN Declaration of Human Rights Article 24 propagates the right to basic health services. As much as I agree with the UNDHR, this would and should be the case if we were living in the ideal world. In the majority of the underdeveloped nations of the world, this is not a reality. You don’t have to go as far as the underdeveloped countries to see that this is the case. The United States is included in the list of countries where health care is not a right and not everyone has access to medical services.

 

 

Thanks to President Obama’s landmark initiative, the Affordable Care Act, it is now compulsory for one to maintain health insurance in the United States. This has changed only the fact that it will provide more than 18 million people health care for the first time and people will finally not be rejected by health insurance companies for having a pre-existing condition. This is a great stride in the right direction for the US, however, there is a large part of the population that is being excluded from any right to health care. Undocumented immigrants living in the United States do not have access to any non-ambulatory services. Even though they are afforded this minimal care, they must live in the shadows and fear that if they are to seek these services they may be found by Immigration and Customs Enforcement and ultimately deported. 

“Legislation has reinforced this restriction time and again—the Personal Responsibility and Work Opportunity Reconciliation Act, the Illegal Immigration Reform and Immigrant Responsibility Act (both passed in 1996), and even the Affordable Care Act of 2010 have all made clear that the federal government does not intend to use tax dollars to help pay for the medical care of those who have entered this country without a visa. The majority of undocumented immigrants are Latino and poor, with jobs that rarely provide them with health insurance. Very few see primary-care doctors. When they seek non-urgent medical attention, they often do so through private doctors who see them for cash, some of whom take advantage of this arrangement by ordering excessive procedures—a complaint I’ve heard from many of my patients. While the Affordable Care Act prohibits the undocumented from purchasing insurance from state exchanges, no other legislation expressly forbids the purchase of health insurance otherwise.”(1)

With these types of laws, we are unable to provide care to so many that desperately need it. Many may remember the crisis that occurred last year with the enormous influx of children coming to the United States from Central America. There were rumors coming about that these children were ill with tuberculosis and other infectious diseases. The truth is that they were no more ill than unvaccinated children in the United States. The issue here is that these children were sent by their parents or decided to flee their war torn or extremely dangerous countries. El Salvador, Honduras, and Guatemala are all suffering from extremely high rates of gang violence, lack of power and control in government institutions, and economic issues.

 

When these children arrived in the United States, risking their lives to cross borders with abusive and murderous coyotes in perilous conditions they arrive to have their hopes and dreams crushed. They are housed in detention centers and eventually sent back to their country of origin. With the political climate in the United States, these children arrived at an inopportune time wanting something more. They have come to the US seeking everything that their countries cannot and are unable to offer them- peace, safety, health, education.  They came seeking health but that is not something the US government chooses to afford them. It is something that the United States government barely accomplished with its own citizens. The need for Universal health care and for laws that protect all of those that find themselves within our borders seems so far away it may be a faded distant star.

-J.Nuila

 

 

1.       Nuila, Ricardo. “Taking Care of Our Own”. Virginia Quarterly Review. Winter 2015 Edition. 2015.