in Romania

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My name is Daniel Radilescu and I am the coordinator of the health mediators program for Romania.

Why especially do you work with the Roma community?

Why? In Romania there are a lot of Roma people who don’t have equal access to the public health care services. Officially we have around 575, 000 Roma but unofficially we have 2.5 million Roma. There is discrimination and segregation in the hospitals. We want to break these barriers between communities and medical staff. It is complicated. You know, if you want to have access to the public health services in Romania, you must have an ID card and after that insurance. A lot of Roma people don’t have education; they don’t have the opportunity to find work. It is impossible for them to pay insurance. They stay in the poor places. Some of them don’t have fresh water; they don’t have houses; they stay under very difficult conditions. Because of that, when they go to the doctors’, people say “You are dirty, you smell dirty and I don’t want to be in contact with you.”

You mention some living conditions which lead to diseases like TB?

It is related to TB, but TB is not a Roma disease. I don’t want to put in the same place Roma and TB, because it is a stigma for Roma. We don’t want to develop specific projects for Roma and these kinds of diseases: TB, HIV and others. It is very important for them. We tell them that we have a project to prevent TB in the Roma community, not to treat. The health mediator is not a doctor. The health mediator is a person who must give them information that “TB treatment is free and if you are sick please go to the doctor. This is the symptom, this is how to solve the problem”, but in direct relation with the specialist.

Do you know any patient whose life has improved or changed through this tuberculosis programme?

In the first year when we developed an information campaign in the Roma community the beneficiaries were around 35,000 people. 90% of these populations know how the disease spreads. They know that the treatment is free and we also have good relations with the TB hospitals. We work with the coordinators of these hospitals. The relation between the patient and the medical personnel is ok now in 5 counties. But there are about 41 counties in Romania. From my point of view it is a very good idea to develop the programme in all the counties. The people from the Roma communities- When at first the health mediators came to discuss with them, said they didn’t want to listen, “Please go – I am not interested because I am not sick.” And after the information sessions everybody said: Yes, this is very interesting. Please tell us more things about this disease. And they now know it is not shameful to discuss this disease. Now they are open, they know the disease, its effects and risks. We visited one community from Bucharest and found one TB-infected person there. The health mediator helped this lady to go to the doctor to receive treatment and after that she acted as a treatment counselor for this lady. We work with health mediators.

Who are health mediators and how many of them have you trained for this TB project?

We have trained 55, and now we are training another group. All the health mediators in Romania are women who have good relations, who know how to communicate with the public health authorities or with the doctors. It is very important for us to have a person who stays in the community.