As States and Cities Clam Up To Endure Pandemic, Roma Communities Are Left Out in the Cold | Opinion
When I—a public health researcher and advocate—was conducting research on the health experiences of Roma immigrants in the U.K., I also worked a few days per week as a health advocate for a grassroots Roma community organization. One morning in the winter of 2017, I arrived at the office to a panicked phone call from one of my regular clients. She tearfully explained how she had been in the hospital for cancer treatments, and while she was in bed, surrounded by her family, a nurse came into the room, looked at them with disgust and said, "Oh, it's you people again."
For the Roma—Europe's largest and arguably most stigmatized minority group—experiences of stereotyping and discrimination in health care can be a commonplace occurrence. Now, as the COVID-19 pandemic takes hold across the world, I'm seeing news coverage of an imminent public health crisis for Roma. Major media outlets are directing attention to the most marginalized of the global Roma population, highlighting overcrowded living conditions, poor sanitation, limited access to public utilities as predictors of rapid spread of disease. Police and military forces have been deployed to Roma neighborhoods and settlements, confining them to substandard accommodation and predicting that deaths in Roma communities could lead to "unpredictable waves of panic." Roma—like other marginalized, underserved groups—are scapegoated as transmitters of illness, as unable to adhere to physical distancing guidance and as undeserving of support.
While conducting research in the U.K., I would see stereotyping and its impacts time and time again. As part of my advocacy work, I delivered cultural awareness training to health professionals across London. During one of these sessions, a doctor claimed that Roma people refuse to work, that they "might have all the skills to be a mechanic, but you would never find them working in a garage." While accompanying a client to an appointment with mental health services, the psychologist denigrated the patient for requesting an interpreter in the Romani language, insisting that it's "not a real language." Roma people told me numerous stories of hostility, and sometimes active abuse, from health care providers in their home countries of Poland, Slovakia and Romania—countries where, now, Roma are kept in place by military force, online hate speech stirs up public antagonism, and media coverage echos derogatory tropes of Roma as unclean and uncontrollable.
Some may be unable to complete registration processes due to lack of identification documents, physical distance from services, lack of transport and lack of funds to purchase insurance. In other cases, poor past experiences and fears of discrimination may lead some Roma to avoid medical care. If they do choose to access health services, they may encounter segregated facilities, as well as "hostile, patronizing, judgemental, unsympathetic and even abusive attitudes of healthcare staff," leading them to feel that health professionals do not take their needs seriously. As the rapid spread of COVID-19 brings increased reliance on health care to all population groups, existing barriers threaten to deepen the public health crisis for the Roma.
COVID-19 illuminates socioeconomic fault lines and inadequate support services, as marginalized groups across the world struggle to access the health care and material resources needed to weather this crisis. In the United States, Black and Latinx communities have shown disproportionate rates of infection and death from COVID-19. Often without insurance coverage, and with pre-existing conditions stemming from years of inadequate health care access, their vulnerability to COVID-19 parallels the experience of the Roma. Poverty, discrimination in employment and the inadequacy of social safety nets—all perpetuated by media representations that are often indifferent at best, hostile at worst—could be seen as a public health crisis long before the pandemic took hold. Roma and other marginalized groups not only face the fears and uncertainties that come with COVID-19, but also the challenges of navigating public service systems that were built to exclude them.
If and when Roma individuals contract COVID-19, the potential for open hostility from health care providers heightens their risks, as stereotypical representations of Roma identity influence practitioners' attitudes and the quality of care that they provide. This calls to mind reports from Italy, where doctors had to make difficult decisions about who would live and who would die—whose lives they deemed most meaningful. I wonder where Roma—who have faced centuries of dehumanization—would fall in this calculation.
There's an urgent need for a coordinated response to protect the human rights of the most marginalized and stigmatized. This could take the form of robust and immediate monitoring of conditions within health services, as well as increased media efforts to report on the human impacts of the crisis. It's not enough simply to point out that Roma are being scapegoated as transmitters of disease, nor to acknowledge that the conditions in which many live make them more vulnerable to its spread. There's a need for more nuanced narratives of Roma, conveying that they are just as scared but twice as vulnerable. We need to consider the conditions that Roma will face within hospital walls, and to prevent what is already a public health crisis from becoming a tragedy for the Roma people.
Sarah Zawacki is a Core Collaborator of the Roma Peoples Project at Columbia University. She holds a PhD in public health, with a focus on Roma people's experiences.
The views expressed in this article are the author's own.
