Guide to Health
FFT remains extremely concerned about the difficulties faced by the Traveller community in accessing adequate and appropriate health care. Throughout the year, representatives from the Unit have dealt directly with a number of Travellers (predominantly traditional Travellers) with serious health needs that have either been disregarded by the authorities or inadequately addressed. Incidents include repeatedly missed pre-op appointments, repeated police eviction of one family group while their three year old son was receiving emergency treatment in the local hospital and the eviction of a woman from council land the day before entering hospital for a hysteroscopy. This type of problem is directly linked to lack of sufficient and secure site provision and low or zero tolerance policies by local authorities.
For advice on how to access healthcare, click here.
This document has been devised by FFT in order to set a precedent for future health care analysis and research regarding Gypsies and Travellers.
We at FFT aim to explore a new paradigm of health based upon a holistic definition of health, as opposed to models of ‘health’ which are rooted in disease and biomedicine. This concept of health, although not new, has yet to be fully developed, and takes its initiative from the New Public Health Movement which emphasises the key social determinants of health.
"Good health is the bedrock on which social progress is made. A nation of healthy people can do these things which make life worthwhile, and as the level of health increases so does the potential for happiness. The health care system, however is only one way of maintaining and improving health. For the environmental and behavioural threats to health, the organised health care system can do little more than serve as a catchment net for the victims. The goal (of the Government of Canada) will continue to be not only to add years to life, but life to our years." (Lalonde 1974:5 cited Bunton et al 1995:16)
Following on from the Lalonde Report came the Alma Ata Declaration of 1977 published by the WHO, which argued that health was primarily about politics and called upon governments to take responsibility for the health of their people, with emphasis upon empowering and enabling communities and individuals. This theme was taken up and elaborated at the Ottawa Charter for Health Promotion (WHO 1986) which emphasised the need for action within health promotion that enabled people to increase control over their health. This in turn was followed by the Adelaide Conference which stipulated that
"The prerequisites for health and social development are peace and social justice; nutritious food and clean water; education and decent housing; a useful role in society and an adequate income; conservation of resources and the protection of the ecosystem." (1988:4)
It would appear that there is an increasing recognition that health should not be regarded in isolation from the socio-political environment, medicine is not even mentioned in the above quote! It is apparent to us at FFT that it is the effects of ’social exclusion’, which primarily undermines the health of Gypsies and Travellers.
The concept of social exclusion is now widely discussed amongst those of us concerned with the increasing inequalities between people. One aspect of social exclusion is the disparity in health status between those who are excluded compared to those who people who are not.
This document aims to highlight the effects of social exclusion upon the health of Gypsies and Travellers, who exist as a minority group within a dominant culture of sedentarism. The Criminal Justice and Public order Act (1994) has heightened the sense of confrontation between the authorities and Gypsies and Travellers. Mobility has increased due to a lack of stopping places and thus many families who would otherwise have utilised health service provision have simply moved on or only partially finished any treatment prescribed. The following factors outlined by the International Minority rights Group (1995), in relation to Gypsies do not stand to improve:
- Life expectancy is poor, significantly less than the dominant culture.
- The birth rate is very high and perinatal mortality, stillbirth mortality and infant mortality significantly higher than the national average. Traveller children are between one-and-a-half and two times more likely to die in the first year of life than children in the settled community.
- There are numerous chronic illnesses (respiratory diseases, rheumatism, digestive illnesses).
- Unbalanced nutrition, leading to deficiencies. Smoking is very common. Drugs are coming onto the scene.
- Little if any dental care, even more so since nearly all the dental practices have opted out of the NHS.
- New Travellers may experience similar health problems as a result of their social exclusion, although their has been significantly less research into new Traveller communities.
Read about the most recent report: "The Health Status of Gypsy Travellers in England: A report to the Department of Health, 2004 by the University of Sheffield. For more, click here.
As a response to these issues, FFT hosts The Sussex Traveller Health Project. Click here to find out more.
By Zoe Matthews
Health Project Manager, FFT
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