EPHA participated in a country visit to Romania, as part of a ’Together for better health, for us, by us’ delegation to discuss with key Romanian stakeholders (including civil society representatives) burning questions on Roma integration. A field visit to the Romanian villages ’Araci/Árapatak’ and ’Hetea/Hete’ reinforced evidence that the Roma population is found at the very bottom of the socio-economic spectrum. Roma in Romania and Europe suffer worse health than the other populations due to their higher exposure to unfavourable factors such as poor housing, lack of access to appropriate water, bad education and low socio-economic status which affects their health. The training, professional recognition and employment of Roma Health Mediators (RHMs) is key to breaking this vicious circle.
Background - ’Together for Better Health for us, by us’ (T4BH)
Tb4H is a consortium of four non-government organizations - National Network of Health Mediators (Bulgaria), Partners Hungary Foundation (Hungary), OvidiuRo Association(Romania), and Association for Culture, Education and Communication (Slovakia) - working to improve access to healthcare for socially excluded Roma communities in Central and Eastern Europe. The project was established in 2011 with GlaxoSmithKline (GSK) and the three-year programme seeks to address some of the gaps of Roma integration by promoting the training and employment of Roma Health Mediators.
Country visit to Romania - Roma Integration as a public health emergency
EPHA joined the T4BH delegation to visit isolated locations in rural areas of Romania, including a study visit to the school and kindergarten of Araci/Árapatak village and a field visit to a Roma settlement in Hetea/Hete in Transylvania.
The field visit reinforced available evidence on poor Roma health. Roma are found at the very bottom of our society; they suffer worse health than the majority because of the range of unfavorable factors that influence health, such as education, employment, food, indoor and outdoor air quality, housing, access to water, access to transport, poverty and access to healthcare.
One of the most visible signs of Roma segregation were the very poor housing conditions: the large majority of dwellings were made of wood, large families live in very small rooms with no access to appropriate water, sanitation or even public transport. The village visited among the mountains is completely isolated from the surrounding urban areas. 
How to improve Roma Health in Romania?
Romania has the largest population ratio of Roma in Central and Eastern Europe with available data showing that there is a disparity in the major health indicators between Roma and non-Roma populations (see Table 1):
The hosting Romanian NGO, OvidiuRo‘s (OvR) tries to break the vicious circle of poverty and Roma exclusion.
Asociatia OvidiuRo’s co-founders, Romanian teacher Maria Gheorghiu and American volunteer Leslie Hawke, observed first hand that if poor children were deprived of early learning opportunities, most never caught up again with other children. Their experience in the field, beginning in 2001, reinforced what international research reveals: early education has the highest return on investment of any poverty intervention. The mission of OvidiuRo is to make quality early education available to every poor child in Romania – so they have a chance to become active members of society.
The ’Together for Better Health’ project added a health component to OvidiuRo‘s early educational programme, by providing funds to cover some of the most pressing health needs of impoverished preschool children.
The project aims to:
A roundtable discussion with key stakeholders to address the pressing need of Roma integration in Romania
The stakeholder dialogue hosted by Jan Gabor, Ambassador of Slovakia to Romania, gathered key stakeholders in Romania, including officials from Romanian national institutions, from the Ministry of Health, Labour, and European Funds, the Bulgarian and the British Ambassadors, Roma Health Mediators and representatives from Romanian civil society.
Based on their experience of working with Roma Health Mediators (RHMs), NGOs could inform officials of what is really happening on the ground when it comes to Roma access to health care, and what the real obstacles are in everyday life.
The discussion focused on common issues and lessons learned and on ways NGOs and the private sector can influence governments in addressing the most critical problems and ways to disseminate and replicate good practices.
EPHA’s contribution to the debate
By actively participating in the discussion, EPHA highlighted the following key points in respect of progress made in different countries:
The field visit to Romania and the roundtable discussion gave additional ideas of what can be done in the short to middle term so that Roma life expectancy and quality of life are on par with that of the rest of our countries’ population.
Photo’s source: © [Pictures made in the Romanian village Hetea/Hete]
EPHA Position on Roma Health in Europe (1 page summary, pdf)
Roma-related EPHA articles
 FRA data showed that in the Roma households surveyed, on average more than two people were living in one room. About 45% of them were living in households that lack at least one basic amenity, such as an indoor kitchen, toilet, shower or bath, as well as electricity. 42% of the Roma surveyed live in conditions of severe housing deprivation, e.g. having no piped water and/or sewerage and/or electricity in comparison to 12% of non-Roma living nearby. Roma households with four or more children face a higher proportion of severe housing deprivation.