May 28 2009

Public Health for Eastern European Roma

by at 4:46 pm under Uncategorized

The Romani Flag, http://commons.wikimedia.org/wiki/File:Roma_flag.svg

My interest in the Roma first blossomed when I studied abroad in Poland for a semester during in 2003. More widely known as “gypsies” (a derogatory term), the Roma population constitutes an estimated 8-10% of the population in both Romania and Bulgaria.[1] When these two nations joined the European Union in January 2007, the Roma became a controversial addition to EU citizenry.  Often excluded from the broader global network and identified by some as victims of systematic discrimination, many Roma live in poverty and without access to social/civil society programs.  Advancing the Romani quality of life is important because allowing such a large population of citizens to live in poverty (and without resources for self-improvement) can ignite impacts throughout the global network – from an uneducated citizenry to cross-population health issues.  The specific issue I want to promote in this blog is the need to increase Roma access to health car, specifically in Romania and Bulgaria.  In improving their access to health care, I would like to work toward a developing a healthier life not only for the Roma, but among the general population.  In this way, I present an unhealthy and ill-fated Roma as a “weak link” of the international network and suggest that helping them can help the health of the broader global citizenry.

The key players in determining the outcome of increasing Romani access to public health include: general Romani population; Romani leaders; NGOs; the general public; leaders of Romania and Bulgaria at both local and national levels; EU leaders; and public health officials.  Through a series of educational programs and program deployments, these nodes can work together to provide better access to health care for the Roma.  First and foremost, it is necessary to educate the Romani citizens on the importance of public heath and provide them the resources to necessary to engage in health initiates.  To do so, NGOs such as the Open Society Institute (OSI) can play a critical role in the structure through raising awareness regarding the “how” and “why” of public health initiatives.[2] Outreach targeting the Romani population as developed by NGOs must incorporate trusted Romani leaders who can be educated on the topic in order to best explain the importance of public health to others within the community.  As Dr. Garcia suggested in class and in “The Architecture of Global Networking Technologies,” the issue of trust is critical in networks.[3] I believe this becomes particularly important when addressing underprivileged populations that may be skeptical of outsiders.

Continuing across the network, the non-Romani public must also grow to understand the importance of maintaining a healthy population throughout the entire nation.  In engaging the general public, NGOs and Romanian/Bulgarian leaders can help spread an understanding of how an at-risk population within a nation can directly impact the health of everyone else.  Doing so would require a structural shift within the Eastern European network regarding how the general public views the Roma – instead of as an outcast sect, a “we are one” mentality would be necessary to help view the Romani health as everyone’s health.  As Dr. Garcia discusses in “The Architecture,” networks place themselves on “path dependent trajectories”[4] and breaking out of the current societal structure will be a difficult but necessary shift.

Further, public health campaigns targeting the Roma must work at both the local levels (as discussed above with local education campaigns) and the global.  Initiatives such as the Decade of Roma Inclusion bring together leaders from individual nations as well as NGOs in an effort to display a globally-focused, united effort to address Roma issues.[5] Incorporating a regional (or even global) focus on promoting public health for at-risk populations such as the Roma can help uncover the links between individuals across the world.  The hope that international attention will bring change to individual nation-state’s dealing with Roma pubic health reflects John Agnew’s discussion of how globalization helped foster “the internationalization of a range of hitherto domestic policies to conform to global norms of performance.”[6] Finally, the critical step of putting that awareness into action would translate into bringing heath professionals to work with the Romani population, as well as encouraging the Roma to become more engaged in medical professions themselves.

Key in engaging each of these nodes would be to elicit an internalization of the issue by each.  While I would like to think that each part of the global network would work together for altruistic reasons, I do believe that there must be an identified incentive for each node to work for the common goal.  In order for each node to exert the optimal level of interest in enhancing Romani access to health, they must recognize the benefits of a healthier minority community.  As each player comes together to address this issue, it is critical to be weary of the fallacies Stliglitz discusses – from too many groups with overlapping goals to an inflated presence of special interest.  Yet, despite those precautions, I think that it is necessary to work with the existential motivation that seems to be the driving force behind making the world a better place.


[1] Balkan Investigative Reporting Network.  “Jobs Boom in Bulgaria Leaves Roma Behind.” 15 November 2007.                http://www.birn.eu.com/en/113/10/5823/

[2] Soros Foundation.  Roma Programs: Public Health.  Accessed 28 May 2009.     http://www.soros.org/initiatives/health/focus/roma

[3] Garcia p 55

[4] Garcia, Linda D. “The Architecture of Global Networking Technologies.” Global Networks, Linked Cities. Rougledge   (2002). p 42.

[5] Decade of Roma Inclusion: http://www.romadecade.org/

[6] Agnew, John.  The New Global Economy: Time-Space Compression, Geopolitics, and Global Uneven            Development.”  Working Paper No 3.  p 10.

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