Dear Chair person,
Ladies and Gentlemen
Iīm glad today, when
testifying this conference aimed to Roma women and their access to health care
services. Iīm also pleased to see our chair Mrs. Josephine Vershpaget from
Netherlands chairing this part of conference. I have a feeling, that this
event has itīs special mening for her, because she was one of the first
pioneers about ten years ago, who raised up in day-light in the affairness of
international community, the miserable living conditions, social exlusion,
unequal treatment, lack of basic servicies and human rights of Roma, when she
made the first Council of Europe report on the legal position of Roma in
After that, she chaired seven
years the Specialist Group of Roma/Gypsies MG-S-ROM, which has succesfully
produced information and prepaired CoE/Committee of Ministers General
Recommendations aimed to improve the living conditions, education, housing and
embloymence opportunities of Roma in Europe.
Currently MG-S-ROM is
prepairing, among other things, a recommendation aimed to give guidelines to
the 45 Council of Europe member states, on how to improve the Roma /Gypsies
and Travellers access to health care and equal treatment in Europe.
I wish, that you would still
use the rest of the morning to give your comments and proposals on this draft
recommendation, as mrs. Verspaget did do yesterday. We all certainly do agree,
after yesterday interventions and listening the findings of Ms. Pomykalas
report, that the need of Romas access to health care sevices is crying and
urgent, and that, it can not be ignored any more in our civilized and modern
Iīm grateful of the privilege
and opportunity to present here today one positive example of cooperation
between Roma and authorities. How the governemt can, if there is enough of
good will and expertise, promote mutual understaning and fight against the
discriminatory barriers which the grass-root level inividuals do meet, when
trying to get help in their health cricies, particularly if they happened to
belong to a marginalised and poor minority.
The Roma, Gypsies and
Travellers form a group of approximately 8-10 million people in Europe. They
are to be found in almost all 45 Council of Europe member states and indeed,
in some Central and Eastern European countries, they represent over 5% of the
General Features of the
Finnish health care system
In Finland the organisation
and financing of health care has been considered for a long time a public
resonsibility. The main responsibililty for organizing health care lies with
the local authority; municipalities across the country. The obligation of
local authorites to organize these services is based not only on legislation,
but aslo on a long tradition. The social protection and health care system has
been built up over several decades. It is caractericed by universality of
It is primarily residence in
the country, that qualifies a person for social protection and healh care. The
social protection system has quaranteed social cohesion fairness and equality.
Everyone in Finland has the right to social protection and health care
regardless of their abililty to pay, social status or place of residence. The
principle of equality is firmly incorporated into the social protection and
health care system. Health services are funded mainly from taxation and partly
from central governements grants.
developments in Roma guestions
The Finnish Parliament held
their first discussions of Gypsies already in the beginning of last century.
1956 the Counsil of State decided to establish an expert-body, located in the
conjunction of the ministry of social affairs and health, having
responsibility to promote the living conditions of Gypsies. At that time, it
was composed of representatives of the central governement administration,
researches and one Roma member. At the end of 70s this expert body influenced
strongly on the improvement of Romaīs housing conditions affording Roma
families possibility to become sedentary instead of travelling. The Council of
State renewed the decree of this expert-body several times during the decades
and currently this body is called The Advisory Board on Romani Affairs,
having half of itīs 18 memberīs coming from the national Roma organisations.
During 90s the
Constitutional Act of Finland was renewed and in that connection Finland
recognised Roma as a traditional minority having right to maintain their own
culture and language. This led to many other legislative chances on the field
of education and access to all public servicies. In the beginning of the 90s
a Roma Education Unit was established. Shortly after itīs creation it started
to work in the National Board of Education.
This reqocnition of the
existence of Roma as one population group of the society in the Finnish
administration, gave plattform for a common work, which took visible shape on
the serie of guide-books produced to various occupation groups responsibly to
offer basic public servicies to the people, including Roma.
This serie of guide-books
aimed to share information about Roma their origin, language and their
cultural values. The needs, fears and waitings of Roma on the arena of public
services. On the other hand these guide-books aimed also to draw attention to
the existing fears and barriers of prejudices among local authorities
responsibly to provide the public servicies. The guide-books aimed also to
give advises and tools how to work out and open contradictive situations, when
Roma culture and majority rules and practicies dosent meet each other.
Too often the solution is to
cut-up the discussion and close the door in front of Roma, stating that, we
dosenīt serve Roma today, you canīt pay, you are too dirty and smelling, you
do disturb the other clients or patients, you dosenīt behave in the right way.
These excuses are efficiently still today preventing Roma to get the same
treatment and services as majority in many regions of Europe.
Most majority (non-Roma)
people do not know much about the Romani culture although the Roma have lived
in Europe for centuries. It is often difficult for us to accept people who
behave differently, who do not meet our norms. The strange and the unfamiliar
often confuses us. We speak about equity but for many that means similarity.
To tackle with these
questions, was the purpose of the first guide-book The Roma and health Care
Services A guide for the health care professionals, which aimed to help the
health care professionals to understand the Roma better in hospitals, medical
centres, maternity and children clinics and the school health care personnel.
While Europe is getting
increasingly multicultural and international it is important to first
familiarise oneself with the different ethnical and linguistical population
groups of the country. That will also help to understand other people (and
their cultures) who come from all around the world. It is quite difficult to
understand and appreciate a foreign culture if one does not have enough
information on that culture. Correct information diminishes prejudice.
The service and customer
staff may daily meet with many different kinds of people. In order for them to
be able to relate to their different clients and their cultures in a positive
and correct fashion, they need proper information concerning the background of
The subject in this
guide-book has been handled from the inside: from the Roma point of view. To
Roma, a good caretaker is professional, co-operative and friendly. Positive
attitude is important. A caretaker can have a good relationship with Roma by
being open and warm.
The Roma hope their cultural
background is taken into consideration, in the care taking. In order to be
able to fulfill this wish the caretaker needs correct information, that helps
to build a positive attitude towards the different patient. Proper information
on ethnic minorities should be included in the training of the health care
staff. Due to their lack of knowledge many caretakers are shy to approach a
Roma patient. Aspects of Romani culture should be discussed throughout the
training on suitable connections.
The cleanliness and chastity
customs of the Romani culture as well as the importance of the family and the
kin can cause many problems and confusions. After receiving information on the
Romani culture many hospitals have been able to meet the customs of the Romani
culture with respect and flexibility.
Synopsis of the roma
and health services
The Guide is divided to two
parts: an introduction section of Roma orgin, language and main cultural
caractars. The second part is presenting the Roma view on good health care,
problems related to health crises in family, beeing laid in hospital,
operations and other treatment, role of the family, relatives, friends and
rest of the Roma community in case of sickness and death, funerals, fears and
prejudice on Roma side towards sicknesses and health treatments.
This first Guide-book was
made by The Finnish National Board of Educationīs, Roma expert group on 1993.
The guide-book was up-dated during the 90s together with the ministry of
social affairs and health Roma advisory board. Still today, it is one of the
most interested guide-books used freguently also by social and health care
schools and even universities having courses on how to meet patients coming
from Roma minority but also other migration groups.
A translated copy of this
guide-book, in English, is available on the tables near entrance. Mrs.
Pomykala who personaly visited 15 countries when making the research of Roma
Women and their access to health care services, took note in her
recommendations of the guide-book, as one example of the positive measures
which could be unertaken and used as a model in other countries also.
Ladies and gentleman
We humans have different
cultural values, modes of living, ways of thinking and acting, rules of
conduct. Those our roots guide our everyday living, expectations and
actions. The meaning of our cultural background is emphasised when two people
meet in different situations.
This clear and practical guide is meant to promote mutual understanding in
between different cultures. The guide offers expert Roma knowledge on the
baseīs of the Romani culture and the Roma. It describes the colourful
experiences of the Roma and the centuries-old culture.
I talk especially about the
situations where Roma meet each other and non-Roma. It offers advice on what
should be taken into consideration and how to act in those situations.
The guide encourages getting
information, asking when needed and challenges the non-Roma meet the Roma, our
fellow human beings and the spectrum of cultures with an open mind.
General features on
Roma women and health care
After this presentation you
may wonder if we in Finland do have any problems related to Roma, particularly
Roma women and access to health care. Unfortunately I have to answer, yes Roma
do still meet racism on daily basis.
IRWNs president Soraya Post
told us yesterday how her mother was forcely sterilizied on 50s. My mother
managed to escape from a Swedish hospital after giving birth to my youngest
sister of our five children. A year after that, she was strerilized in Finland
waiting, for twins, which was aborted at the same time. This happened in the
beginning of the 70s. She was illiterate and did not understand what really
happened to her. Many times the Roma in Finland, and as I know elswere also,
are extremly afraid of hospitals and all kind of treatment. They leave the
hospitalīs as soon they are capable to go with two feets often without
permission from the doctors. We Roma do still lack information on preventing
health care, maternity, importance of child-vaccinations etc.
The Roma women meet
frequently double discrimination phenomen, they are prohibited entrance to
public places and denied employment because of their ethnic background,
traditional dresses and gender.
Roma/Gypsies and Traveller
are confronted with racism and discrimination still today throughout Europe.
What is important to be noticed in my positive Finnish example is two extremly
- first, the governement and national health authorities have safeguarded
access to all basic social benefits and health care, equally to all resident
members of the country also Roma, regardless of their social or economic
position or belonging to certain population groups;
- Secondly, the Finnish
governement has enabled the Roma possibility to participate on equal footing
with majority, in all levelīs of society in matters concerning Roma.
Particularly the Ministry of
Social Affairs and Health and the National Board on Education functioning
under the Ministry of Education has concertly stretched an open and
cooperative hand to Roma.
Democracy development does
not mean only creation of cosmetic legislation and ratifience of international
treaties, which are not imlemented on practical terms. In the long term policy
development, the national infrastructure has to meet the needs of all
population groups in societies. Functioning public services are the firm of
the citizens well-beeing and a guarantee of progress and well-fare of the wole