[Open letter regarding roma women and discrimination in health care, english version; Campaign on Coerced Sterilization]

“… scrisoarea isi doreste sa atraga atentia cu privire la formele pe care le ia discriminarea femeilor rome in sanatate si a fost elaborata pentru a fi diseminata […] in cadrul conferintei mondiale a femeilor (Mundos de Mujeres/Women’s Worlds 2008) [la o] prezentare a eforturilor realizate in obtinerea compensatiilor ca urmare a incalcarilor violente ale drepturilor omului prin sterilizarea fortata a femeilor rome din europa centrala.” (fwd crina)

Discriminare multipla – Cazul femeilor rome

Motto: “Noi nu suntem de neatins!”

Am redactat aceasta scrisoare pentru a exprima ingrijorarea noastra in legatura cu discriminarea multipla ce exista de multa vreme si continua sa fie prezenta in toate aspectele vietii publice, dar si pentru a face cunoscute circumstantele ei in ce priveste femeile rome.

Ca femei rome si ca membri de organizatii rome si non-rome, dorim sa ne exprimam solidaritatea cu femeile rome din Republica Ceha si Slovacia care au trecut prin drama de a fi sterilizate fara sa-si fi dat consimtamantul si fara a avea la dispozitie informatii adecvate despre efectele care pot aparea[1]. Exista o ampla documentatie ce arata ca femeile rome din toata Europa sunt excluse in mod specific de catre sistemul de asistenta medicala si deseori au acces la ingrijire medicala numai in cazuri de extrema urgenta si/sau la nastere[2].

Alaturati-va campaniei de la Madrid adresata guvernelor Republicii Cehe, Ungariei si Slovaciei cu privire la indreptarea actelor de violare a drepturilor omului, accesand: http://www.errc.org/cikk.php?cikk=2965.

In orice interventie medicala, doctorul ar trebui sa se comporte fata de pacient ca o persoana ce presteaza servicii si un egal in fata legii; nu ca o autoritate publica superioara. Interventiile medicale sunt performante, servicii, nu acte de putere publica.

Din punct de vedere legal, aceste interventii de sterilizare fara consimtamantul pacientei sunt mutilari deoarece afecteaza organe sanataose si duc la daune permanente chiar daca au un scop permis de lege.

Dorim sa ne exprimam sustinerea ferma fata de femeile cehe care rup tacerea in privinta numarului mare de femei supuse de catre doctori la sterilizarea prin constrangere.

Este extrem de dificil pentru activistele rome, care sunt si sotii si mame, sa porneasca pe drumul plin de riscuri si nesiguranta al activismului contra opresiunii din afara dar si din interiorul comunitatii lor.

De ani de zile, Comisia Europeana isi exprima interesul si ingrijorarea in ce priveste in special cazul discriminarii femeilor rome din Romania la capitolul asistenta medicala. In Romania, femeilor rome le sunt refuzate certificatele de nastere pentru noii nascuti la unele maternitati sau nu li se ofera ajutorul medical necesar in spitalele publice[3]. Motivele invocate sunt ca femeile rome nu sunt capabile nici sa plateasca pentru tratamentul medical necesar nici sa demonstreze ca detin vreun fel de asigurare medicala[4]. Ca rezultat, Institutiile Europene au subliniat nevoia de a lua masuri pentru a preveni acest tip de situatii.

In plus, potrivit unui studiu efectuat de European Roma Rights Centre (ERRC) in 2007, 11,54% din femeile rome (din Ungaria) care au raspuns la intrebari privind accesul la ingrijire medicala s-au plans de segregarea in saloanele de maternitate[5].

Desi neoficial exista un numar impresionant de cazuri de discriminare in maternitati, in mod oficial un numar foarte mic de femei vorbesc despre acest lucru. In majoritatea cazurilor, femeile rome se tem sa-si faca publice experientele deoarece efectul asupra lor ar putea fi ca pe viitor sa li se refuze ajutorul medical chiar si in probleme urgente.
Exemplu de caz – “Am un doctor de familie, dar nu ne da niciodata tratament gratuit. Cand am fost internata cu copilul, noi [romii] stateam intr-un « salon numai pentru tigani » si la copiii nostri ei [asistentii medicali] le administreaza medicamentele cu o singura lingurinta pentru toti; in salon era foarte murdar si nu au schimbat salteaua si asternuturile. E mai bine sa cumparam medicamentele si sa la luam acasa decat acolo, unde poti sa te imbolnavesti mai tare!”: declaratie data reprezentantului Asociatiei “Sanse Egale pentru Femei si Copii”[6] de o tanara mama roma din Jibou/Romania.

Segregarea in saloanele de maternitate si sterilizarea femeilor rome sunt cele mai graitoare cazuri de discriminare multipla si arata ca femeile rome sunt unul din cele mai vulnerabile grupuri din Europa – fiind femei, minoritare rome si, majoritatea, sarace.

In ciuda existentei la nivel national a unor instrumente legale privind discriminarea multipla[7], initiativele guvernamentale, in special cele din Romania, nu mentioneaza in planurile strategice privind sistemul medical sau cele contra discriminarii necesitatea eliminarii segregarii in maternitati a femeilor rome.

Discriminarea multipla afecteaza femeile rome dar si intreaga societate! Efectele sunt multiple si usor vizibile – femeia roma sterilizata fara consimtamantul ei nu va avea sansa de a naste si astfel de a se bucura de viata prin a fi mama. Ca mama, ea ar putea contribui la cresterea si dezvoltarea societatii. Nici unei femei nu ar trebui sa i se ia dreptul de a fi mama!!!!!!!!

De asemenea, o femeie roma careia i se refuza, in mod repetat, accesul intr-un spital public numai pentru ca nu poate plati pentru tratament sau pentru ca e de origine roma va fi afectata din diferite puncte de vedere: moral, psihologic, etc.

Tinand cont de intregul context mentionat mai sus, putem determina care sunt problemele principale ale sistemului de asistenta medicala cu care se confrunta femeile rome din cauza discriminarii multiple – pe baza de gen, etnie si statut social:
• Discriminare privind accesul la servicii publice; dificultatea obtinerii intr-un spital public a minimului de ajutor medical necesar;
• Discriminare directa in spitale in privinta sterilizarii. Femeilor rome nu li se cere consimtamantul daca vor sa fie sterlizate sau nu. Felul in care sunt aplicate serviciile medicale discrimineaza impotriva femeilor rome si creaza o situatie de defavorizare pentru ele in comparatie cu alte femei in aceeasi pozitie;
• Tratament medical neadecvat pentru mame rome si copiii lor;
• Speranta la viata pentru comunitatea roma se estimeaza a fi cu aproximativ 10 ani mai putin decat media nationala[8];
• Segregarea in sloanele de maternitate. Este un lucru deja dovedit ca in maternitati femeile rome sunt plasate impreuna in sloane separate. (a se vedea www.errc.org pentru informatii detaliate).

Recent, intr-un raport intitulat “Tackling multiple discrimination” (“Combaterea discriminarii multiple”)[9], raspunsul unia din ministrii reprezentanti ai Statelor Membre ale Uniunii Europene exprima faptul ca situatia femeilor rome este chiar mai dificila decat a romilor in general. Se arata ca: “Femeile rome intampina discriminarea in propriile comunitati datorita conceptelor traditionale despre femei si sufera de asemenea in afara comunitatilor lor din cauza statutului in general inferior al femeilor si prejudecatilor generale la adresa romilor”[10].

Dorim sa ne exprimam ingrijorarea si sa apelam la Statele Membre al Uniunii Europene sa actioneze urgent si sa considere segregarea rasiala a femeilor rome in maternitati o prioritate. Avem nevoie de masuri proactive pentru a elimina segregarea![11]
De aceea, cerem stabilirea unei intelegeri comune privind discriminarea multipla in cazul femeilor rome. Avem nevoie de o abordare comuna si o strategie construita impreuna printr-un efort comun!

Toate cele bune,

Alina Covaci, Coordonator programe, Roma Health Project
Alina Dragolea, Centrul de dezvoltare curriculara si studii de gen: FILIA Romania
Alisenia Zabalovici, Bucharest – Romania
Andrei Marckosan, Director, ADOSERS Romania
Cezara David, Coordonator relatii publice, Centrul romilor pentru interventie sociala si studii “Romani CRISS”
Corina Florina Constantin, asistent social, Bucharest – Romania
Crina Elena Morteanu, European Commission, DG Regional Policy, Unit D2 – Thematic Coordination and Innovation, Trainee – crina_morteanu [at] yahoo [dot] com
Crina Marina Morteanu PhD NSPAS, Bucuresti – Romania, crinamorteanu [at] yahoo [dot] com
Elena Dumitrina, asistent social, Timisoara – Romania
Georgiana Neacsu, Secretar General, SASTIPEN, Bucuresti – Romania
Larisa Schifirnet, Cluj – Romania
Letitia Mark, Presedinta Asociatiei Femeilor Tiganci ”Pentru Copiii Nostri”, Timisoara – Romania
Lia Gaudi – studenta, Facultatea de Stiinte ale Educatiei, Timisoara – Romania
Mirela Faitas, Director Executiv, Asociatia “Sanse Egale pentru Femei si Copii”, Romania
Nicoleta Bitu, Centrul romilor pentru interventie sociala si studii “Romani CRISS”
Oana Baluta, Presedinte, Centrul de dezvoltare curriculara si studii de gen: FILIA Romania
Robert Vaszi, Director Executiv, Asociatia “Sanse Egale”, Romania
Ruxandra Costescu, F.I.A. Collective, Romania
Semiramida Balan, Director Executiv, Agentia de dezvoltare comunitara “Inter-Activa”, Botosani – Romania
Simona Panduru, Institutul pentru Politici Publice, Bucuresti – Romania.

Note:
1. Aceste cazuri pot fi gasite pe website-ul Centrului European pentru Drepturile Romilor (European Roma Rights Centre) la www.errc.org cat si in colectia HUDOC a Curtii Europene pentru Drepturile Omului (European Court of Human Rights);
2. Rezolutia Parlamentului European privind situatia femeilor rome in cadrul Uniunii Europene – 2005/2164 (INI), pct. G;
3. Consiliul European, Comitetul de Consultanta privind Conventia Cadru pentru Protectia Minoritatilor Nationale (Council of Europe, Consultative Committee on Framework Convention for Protection of National Minorities), 04/06/2001, Strasbourg;
4. Idem;
5. Comentarii scrise din partea Centrului European pentru Drepturile Romilor privind Ungaria pentru considerare de catre Comitetul ONU privind Eliminarea Discriminarii impotriva femeilor, a 39-a sesiune, 23 iulie – 10 august;
6. Asociatia “Sanse Egale pentru Femei si Copii” este un binecunoscut ONG rom din Salaj activ in domeniul ingrijirii medicale;
7. Legea 202/2002 privind egalitatea dintre femei si barbati, cu modificari si completari ulterioare, defineste discriminarea multipla drept „orice act de discriminare pe baza a doua sau mai multe criterii”;
8. Comentarii scrise din partea Centrului European pentru Drepturile Romilor privind Ungaria pentru considerare de catre Comitetul ONU privind Eliminarea Discriminarii impotriva femeilor, a 39-a sesiune, 23 iulie – 10 august;
9. “Tackling Multiple Discrimination”, Comisia Europeana, Directoratul General pentru Locuri de Munca, Probleme Sociale si Sanse Egale (Directorate-General for Employment, Social Affairs and Equal Opportunities), Unitatea G4, septembrie 2007,
http://ec.europa.eu/employment_social/fundamental_rights/pdf/pubst/stud/multdis_en.pdf
10. Idem, page 36
11. Aceasta cerere este mentionata si in rezolutia Parlamentului European privind situatia femeilor rome in Uniunea Europeana – 2005/2164 (INI), pct 2.

——–
Multiple Discrimination – The Case of Romani Women
Motto: “We are not untouchable!”

This letter was prepared in order to express our utmost concern about the long standing and persistence of multiple discrimination in all fields of public life, but also to raise awareness on its circumstances on Romani women.

As members of Roma and Non Roma organisations/ as Romani women1, we would like to express our solidarity with the drama of Romani women who were sterilized in Czech Republic and Slovakia without their consent and without having enough adequate information about possible effects that might appear. And to express our appreciation on the recent decision of European Court of Human Rights in these two cases.
There is ample documentation indicating that Romani women all over Europe are particularly excluded from the health care system and often they only have access to health care in the case of an extreme emergency and/or childbirth2.

While performing medical interventions doctor should acts towards the patient as a legally equal provider of a service; not as a superior public authority. Medical intervention is a performance, a service, not an act of public power.
From a legal point of view these interventions are mutilations because they are carried out on healthy organs and result in permanent damage, though with a legally permitted purpose.
We strongly support the Czech women which are breaking of the silence by a large number of women who had been subjected to coercive sterilizations at the hands of the doctors.
Is extremely difficult for Romani women activists, who are at the same time wives and mothers, to embark on a road full of risks and insecurities – the road of activism against oppression from outside and even from inside of their community.

The European Commission has been expressing for years its interest and concern particularly about Romanian’s Romani Women discrimination case in the field of health care. In Romania in some of the maternal hospitals, Romani women are refused to be given birth certificates for their newborns or they are not given medical help when needed in a public hospital3. The reasons argued are that Romani women are not able either to pay for the needed medical treatment or to prove that they have some kind of medical insurance4. As a consequence, European Institutions underlined the need of take measures for preventing this kind of situations.

More over, 11, 54% of Romani women (from Hungary) who answered questions related to access to health care, according ERRC research (2007), complain about segregation in maternity wards5.

Even though unofficially there are an impressing number of cases involving discrimination in maternity wards, officially there are a very low number of women who speak about it. In most of the cases, Romani women are afraid to express publicly their experiences especially because this could affect them and they could be rejected from being given medical help even in an urgent matter.
Case example – “I have family doctor, but never give us free treatment. When I was interned with my baby, we (Roma people) stay in a “ward just for gypsy” and to ours children, they (medical personal) deliver the medical treatment with just one spoon to all of them; in the ward was very dirty and they didn’t change the mattress and the clothes. It was much better to buy the medical treatment and to take at home than there, where you can fall sick more!”, declaration of a young Romani mother from Jibou city/Romania for the representative of “Sanse Egale pentru Femei si Copii” Association6 (“Equal Opportunity for Women and Children”).

The segregation in maternity wards and sterilization of Romani women are the most telling multiple discrimination cases and show that Romani women are one of the most vulnerable groups across Europe – there are women, Roma minority and most of them, poor.

In spite of the existence of legal instruments at the national level regarding multiple discrimination7, the governmental initiatives particularly those in Romania do not mention in health care system or anti-discrimination strategy plans the need to eliminate segregation in maternity wards for Romani women.

Multiple discrimination affects Romani Women but also the entire society! The effects are multiple and well visible – the Romani Woman sterilized without her consent will never have the chance to give birth and therefore to enjoy life and to be a mother. Through giving birth, she also could contribute to the growing of society and development. No woman should be taken the right to be a mother!!!!!!!!

Similarly, a Romani woman who, repeatedly, is refused access to a public hospital just because she cannot afford to pay for the treatment or because she is of Romani origin will be strongly affect from all kinds of perspectives, morally, psychologically etc.

Therefore, keeping in mind all the background context mentioned above, it can easily figure out the main problems with the health care system that Romani Women confronted with due to the existence of multiple discrimination – based on gender, ethnicity and social status:
• Discrimination in access to public services; difficult access in getting a minimum of needed medical help in a public hospital;
• Direct discrimination in hospitals with regard to sterilization. Romani Women are not being asked to give their consent if they want to be sterilized or not. The medical service discriminates Romani Women and creates a more disadvantaged situation for them compared to that of others women in same position;
• Inadequate medical treatment for Romani mothers and their children;
• Life expectancy of the Romani community is estimated to be with approximately 10 years below the national average8;
• Segregation in maternity wards. As it has been already proved, Romani Women are put together in separate wards in a maternity. (please check www.errc.org for more detailed information);

Just recently, in a titled “Tackling multiple discrimination”9, one of the Ministry respondents of the Member States of the European Union expressed the fact that the situation of Romani Women is even worse than that of Roma people in general. It is pointed out that: “The Romani Women face discrimination within their own communities due to traditional views on women and also suffer outside of their communities because of women’s generally lower status and general prejudices against Roma people”10.

We would like to express our concern and to call for the European Union’s Member States to urgently take action and to prioritize racial segregation issue in maternity wards of Romani Women. We need proactive measures for the elimination of segregation!

Therefore, we call for a common understanding of what multiple discrimination means in the case of Romani Women. We need a common approach and a strategy built together in a common effort!11

Regards,

Alina Covaci, Program Officer, Roma Health Project
Alina Dragolea, Centre for Curricular Development and Gender Studies: FILIA Romania
Alisenia Zabalovici, Bucharest – Romania
Andrei Marckosan, Director, ADOSERS Romania
Cezara David, PR coordinator, Roma Centre for Social Intervention and Study “Romani CRISS”
Corina Florina Constantin, social worker, Bucharest – Romania
Crina Elena Morteanu, European Commission, DG Regional Policy, Unit D2 – Thematic Coordination and Innovation, Trainee – crina_morteanu@yahoo.com
Crina Marina Morteanu PhD NSPAS, Bucharest – Romania, crinamorteanu@yahoo.com
Elena Dumitrina, social worker, Timisoara – Romania
Georgiana Neacsu, General Secretary, SASTIPEN, Bucharest – Romania
Larisa Schifirnet, Cluj – Romania
Letitia Mark, President of the Gypsy Women Association
“For Our Children”, Timisoara – Romania
Lia Gaudi – student, Science Education Faculty, Timisoara – Romania
Mirela Faitas, Executive Director, “Equal Opportunity for Women and Children” Association, Romania
Nicoleta Bitu, Roma Centre for Social Intervention and Study “Romani CRISS”
Oana Baluta, President, Centre for Curricular Development and Gender Studies: FILIA Romania
Robert Vaszi, Executive Director, “Equal Opportunity” Association, Romania
Ruxandra Costescu, F.I.A. Collective, Romania
Semiramida Balan, Executive Director Agency for Development Comunity “Inter-Activa”, Botosani – Romania
Simona Panduru, Institute for Public Policy, Bucharest – Romania.

Notes:

1. The cases can be found on the European Roma Rights Centre’s website at www.errc.org as well as in the HUDOC collection of the European Court of Human Rights;
2. European Parliament resolution on the situation of Roma women in the European Union – 2005/2164 (INI), pct. G;
3. Council of Europe, Consultative Committee on Framework Convention for Protection of National Minorities, 04/06/2001, Strasbourg;
4. Idem;
5. Written Comments of the European Roma Right Centre Concerning Hungary for Consideration by the United Nations Committee on the Elimination of Discrimination against Women at its 39 Session, July 23 – August 10, 2007 ;
6. “Sanse Egale pentru Femei si Copii” Association (“Equal Opportunity for Women and Children”) is a known Roma non-governmental organisation from Salaj county/Romania active in health care field;
7. Law 202/2002 regarding, equality between women and men, with ulterior modifications and complements define multiple discrimination as „ any act of discrimination based on two or more discrimination criteria”;
8. Written Comments of the European Roma Right Centre Concerning Hungary for Consideration by the United Nations Committee on the Elimination of Discrimination against Women at its 39 Session, July 23 – August 10, 2007;
9. “Tackling Multiple Discrimination”, European Commission, Directorate-General for Employment, Social Affairs and Equal Opportunities, Unit G4, September 2007, http://ec.europa.eu/employment_social/fundamental_rights/pdf/pubst/stud/multdis_en.pdf
10. Idem, page 36
11. This demand is also mentioned in the European Parliament resolution on the situation of Romani women in the European Union – 2005/2164 (INI), pct 2.