Pictures: Domnick Walsh
The 400-strong Roma community in Kerry has experienced significant levels of adversity including racism, exclusion and financial hardship, further exacerbated by experiences of historical persecution, a new study has found.
The research and compilation of a health strategy for Roma families in Kerry and Cork, undertaken by the HSE in association with the Tralee International Resource Centre, has concluded that, to deal with the issues, a trauma sensitive approach across domains of policy, culture and practice is necessary.
The Tralee centre, which has worked directly with Roma families in Kerry for the past decade, commissioned research in 2018 to establish a socio-demographic profile of the community. The need for a clear action plan to support Roma health needs was recognised and, with HSE funding, the latest strategy was commissioned.
The findings are based on a consultation process which was conducted between January and April 2023.
The consultations focused on the social determinants of health and the needs of Roma from pre-natal to old age, what they need in relation to accessing health services, if there are barriers. what they are and how they can be overcome.
The findings have been translated into actions, some of which can be progressed immediately, while others will require longer term planning and resources.
Evidence suggests that there is a lack of understanding by the public and service providers regarding the diversity of Roma as regards age, gender, nationality, religion and migration status, which is reinforced by cultural and gender-based stereotypes.
Roma in Ireland now represent several generations of Irish born and non-Irish born adults and children and while there is very little information on their health status, the Covid-19 pandemic unearthed some evidence regarding their marginalised position.
Barriers to accessing health services include precarious living conditions, discrimination, the habitual residence condition, accessing PPS numbers, health literacy and language, cultural and economic barriers.
Access to screening throughout the life course was identified as a particular need and mobile clinics and outreach work were identified as essential.
Screening in relation to hepatitis, bowel, and breast cancer and STIs was identified as important while improved access to the cervical screening programme is vital for Roma women at a younger age than currently, as is the availability of the HPV vaccine.
The consultation found that for the most part, Roma appear to have access to GP services but the current stresses in the system mean that it can be difficult to access an appointment in Kerry.
Recently arrived and homeless Roma have difficulties accessing GP services and paying for prescriptions while older Roma, who join family members in Ireland for support, can have complex health needs, exacerbated by their inability to access health services.
Poor mental health was identified as an issue for some, associated with historical and intergenerational trauma and discrimination, precarious living conditions, overcrowding, insecurity of tenure and homelessness.
For women, there seems to be a very heavy burden associated with becoming mothers at a young age, being multiparous and caring for children, while at the same time carrying the responsibility of caring for parents 0or in-laws.
There is strong evidence that Roma families value education, but sometimes precarious living conditions, poverty, early parenthood and marriage and other caring responsibilities can be a barrier to regular school attendance and completion.
Access to education, training and employment has been deemed crucial to participating in society and to achieving positive mental health.
In Kerry the Tralee International Resource Centre is currently the focal point for Roma but the need is enormous and a multi-agency response is required.
Community transport could be an important resource for Roma in rural areas where services are more difficult to access and could be of tremendous benefit to Roma isolated due to mobility issues and caring for babies and young children.
There is also a need to develop a visible ‘Roma Hub’ where they can meet to celebrate their culture and access support.
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