Contacts : Friends, Families and Travellers

Contacts

Health Resources for Travellers

Contacts and Organisations

Reports

Books

Magazine and Journal Articles

Health Resources for Travellers

Travellers’ heart disease and stress, Travellers and arthristics, Travellers and diabetes, Trailer safety -
a series of leaflets produced with Derbyshire Gypsy Liason Group, funded by the NHS ethnic Health Unit and North Derbyshire Health Authority, with large text and illustrations, exlaining the basics about different conditions, what to do and contact numbers.
Available from: Derbyshire Gypsy Laison Group.
Tel: 01629 583300;
http://www.dglg.org

Gypsy and Traveller women say NO to violence and abuse
A leaflet about domestic violence for Travellers, with large text and pictures drawn by children, explaining what action women can take, what refuges are, a safety paln and contact numbers. Written by Gypsy and Traveller women living in Sheffield together with three professionals, produced by the Community Health Sheffield NHS Trust, now the Sheffield Care Trust.

On the road to better health
A leaflet for Travelling men, with larger than average text, photos and illustrations, listing possible health problems to get checked, and with simple, key health messages on staying well and contact numbers. Written byRichard O’Neill with support fromMHF (Men’s Health Forum).
Available from rroneill@aol.com

Ladged no longer:advice from Gypsies and Travellers about drugs
A drug awareness and information video written and produced by Gypsies at the Gypsy Media Company, funded by the Home Office National Drugs Strategy. Available from: COI Communications. Email: travellers@coi.gsi.gov.uk

Contacts and Organisations

NHS Direct Call 24 HRS Helpline:
Tel: 0845 4647
Web: www.nhsdirect.nhs.uk
Search for your local health services under ‘our guide to accessing to health care’.

THE NEUROLOGICAL ALLIANCE
The Neurological Alliance would very much like to work with Irish Travellers. What we can offer is:- information about the patient groups that deal with particular neurological conditions
- information about useful helplines
- information about Getting the Best from Neurological Services
- information about Government policies on health and social care for people with neurological conditions

What we would like from you is information about how Irish Travellers are affected by neurological conditionsJudith Kidd
The Neurological Alliance, Southbank House, Black Prince Road,London SE1 7SJ
Tel: 020 7463 2074
Email: jmkidd@neural.org.uk

The National Association of Health Workers with Travellers-To promote and improve the health of all Gypsy/Travellers – settled or mobile
- To improve the access of Gypsy/Travellers to mainstream medical services
-To support and reduce the isolation of health workers with Gypsy/Travellers
-To seek recognition of Gypsies and Travellers as an ethnic minority and for health care to be provided in a framework of equality and non discrimination
-To provide a forum for the exchange of knowledge, information and resources
-To act as a national voice to highlight the impact of legislation and local policies on the health and welfare of Gypsy/Traveller communities

Chair - Janine Adkins
CHD Travellers
Clwydian House, University of Wales, College of Medicine, Technology Park, Wrexham
Tel: 01978 352880

Newark and Sherwood Primary Care Trust’s Travellers’ Health Steering Group.
Stephanie Morrisey
Tel: 01636 670646

Reports:

Fountain, J. (2006) ‘An overview of the nature and extent of illicit drug use amongst the Traveller community: an exploratory study.’ Dublin, National Advisory Committee on Drugs. http://www.nacd.ie/publications/prevalence_traveller.htmlThe research methods of this study were a comprehensive literature search and review, including relevant policy documents, and semi-structured interviews and focus groups on perceptions on drug use and the related issues with 137 Travellers (including illicit drug users) and 34 agency workers.The overarching message from the research findings is that:
Travellers’ drug-using patterns appear little different than those of the settled population in Ireland, but the social exclusion of Travellers puts them at risk of problematic drug use, and there are indications that this is already occurring. However, overall, Travellers lack the information to tackle drug use and problematic drug use, and there is inadequate consideration by drug policy and drug services of Travellers’ drug-related needs.The risk factors for the development of problematic drug use, particularly amongst young people, are well-documented, and can be categorised as interrelated problems in nine areas: education, health, employment, accommodation, previous and current drug use, criminal justice, family, social networks, and the environment (in terms of social deprivation, community disorganisation, and neighbourhood disorganisation). In the case of Travellers in Ireland, many of the risk factors for problematic drug use and few of the protective factors in each area are present.Although the drug-using patterns of Travellers are not very different from those of the whole population of Ireland, it does not follow that Travellers can simply slot into existing services: responses may have to be different in order that the barriers to drug service access that Travellers face can be overcome. These barriers include Travellers’ lack of awareness of the existence and nature of drug services, stigma and embarrassment, the lack of cultural competence by services, and racism, discrimination and stereotyping by services.The evidence presented in the report can be used to address developments in drug services in the following ways:
1 Develop procedures on ethnic monitoring within drug treatment reporting systems and drug service planning systems.
2 Carry out equality proofing of drugs policy and of drug service planning and delivery.
3 Increase awareness amongst Travellers of drugs, drug-related issues, and drug services.
4 Adapt the organisational culture of drug services to consider the cultural diversity of Ireland by considering Travellers’ drug service needs.
5 Implement an effective Traveller community engagement programme.
6 Conduct further research and disseminate the results widely.

The Health Status of Gypsies & Travellers in England
A report to the Department of Health, 2004.
Summary of the Report (pdf)
Qualitative findings (pdf)
Final Report (pdf)

"Irish Travellers Health Access"
Project Draft Report M O’Dwyer, Brent Irish Advisory Service (BIAS) 1997 BIAS Irish Travellers Project, London.
"Disability, Social Care, Health and Travelling People: A Report examining existing research and literature relating to the social and health needs of Travellers.": Rachel Morris and Luke Clements, Traveller Law Research Unit at Cardiff Law School 2001.

"Traveller Mothers and Babies: Who Cares for Their Health?": L Durward, Maternity Alliance, London 1990

"Traveller Gypsies and Primary Health Care in East London": G.S Feder Unpublished phD thesis: St Thomas Hospital Medical School, University of London 1994

Books:

"Gypsies, Traveller and Health Service": Derek Hawes, The Police Press 1997 1 86134 066 4

Journal and Magazine Articles:
In Date order:

Travellers’ tales.
Lynch E.
Nurs Stand. 2006 Jun 21-27;20(41):20-1.Gypsies and travelling families face discrimination in access to health care as well as in the wider community, with the result that infant mortality rates remain high and child immunisation rates low.

Caring without prejudice. Interview by Rebecca Sandiford.
Holt R.
Nurs Times. 2005 Mar 22-28;101(12):26-7.
Gypsies’ and travellers’ health.
Rhodes S.
Community Pract. 2005 Sep;78(9):303.
Travellers’ Health Project, Central Health Clinic, Bristol.

Working with travellers. ‘The worst part is the hassle and discrimination’.
Forrest E.
Health Serv J. 2004 Dec 16;114(5936):28.

Health inequalities. Travellers’ tales.
Bowers J.
Health Serv J. 2004 Dec 16;114(5936):26-8.A Sheffield University report found Gypsies’ health problems to be two to five times worse than in other communities. Anecdotal evidence suggests NHS staff prejudice often denies travelling communities access to healthcare. The appointment of gypsy traveller health visitors has made solid progress with a difficult-to-reach population.

Health care needs of travellers.
Van Cleemput P.
Ivy Lodge Clinic, 254 Rutland Rd, Sheffield S3 9PR, UK. patricev@chsheff-tr.trent.nhs.uk
Arch Dis Child. 2000 Jan;82(1):32-7.
Health status of Gypsy Travellers.
Van Cleemput P, Parry G.
J Public Health Med. 2001 Jun;23(2):129-34.Research and Development Directorate, Community Health Sheffield NHS Trust. pvancleemput@yahoo.co.uk BACKGROUND: Although previous studies suggest that Gypsy Travellers have poorer health status and excess mortality compared with the general population, there is no epidemiological evidence using validated measures in this nomadic ethnic group. The aim of this study was to compare the health status of traditional Gypsy Travellers with norms from the UK population, and with a concurrent comparison group using the Euroqol health status measure (EQ-5D). METHODS: Eighty-seven adult Gypsy Travellers were matched for age and sex with English or Irish residents, registered with an urban general practice in an area of high social deprivation. Both samples completed the EQ-5D questionnaire by interview. A comparison was also made with normative data from the UK general population. RESULTS: Travellers had poorer health status than their settled counterparts on two of the five dimensions (mobility and activity) but not on the overall summary score. Travellers reported significantly poorer health than the matched comparison group on the EQ-5D visual analogue scale. Both the Travellers and the comparison group had much poorer health status on the EQ-5D index than the UK population norms, even when compared with the lowest socioeconomic group.CONCLUSIONS: Health status of Gypsy Travellers was significantly poorer than in the lowest socio-economic UK population group, but was not so markedly different from a concurrent, matched, socially deprived resident group. Gypsy Travellers did have poorer health status than matched comparators in relation to mobility, activity and perception of overall health. Quantitative assessment of health status in the Traveller community is feasible

Travellers’ friend.
Daniel K.
Nurs Times. 1999 Nov 17-23;95(46):32-3.
The road less travelled.
Gulland A.
Nurs Times. 1997 Oct 22-28;93(43):16.

"Health Concerns and Needs of Travellers"
E Anderson, Health Visitor (70) April 1997: 148-50

Community mothers’ programme: extension to the travelling community in Ireland.
Fitzpatrick P, Molloy B, Johnson Z.
Health Information Unit, Dr Steeven’s Hospital, Dublin, Ireland.
J Epidemiol Community Health. 1997 Jun;51(3):299-303.STUDY OBJECTIVE: To see whether the community mothers’ programme, using lay volunteer mothers to deliver a childhood development programme, could be extended successfully to the travelling community in Ireland. DESIGN: This was a prospective study of the travelling community; comparisons were made with results of a previous randomised trial of settled mothers. SETTING: A regional health authority in Ireland. PARTICIPANTS: These comprised 39 traveller and 127 settled intervention mother/ infant pairs (randomised controlled trial (RCT) intervention); settled community mothers; 105 settled control pairs (RCT control). All mothers received standard support; traveller and RCT intervention groups also received the services of a community mother. MAIN RESULTS: The travellers’ sociodemographic profile differed significantly from the other groups. At the end of the study, traveller and intervention children were exposed to more cognitive games and nursery rhymes. There were significant differences in the proportions who received all three shots of their primary immunisation schedule before 12 months of age and who received "three in one" vaccination, with traveller children doing least well. The diet of traveller children surpassed that of RCT controls in all food groups except fruit; they were less likely to begin cows’ milk before 26 weeks of age. Traveller mothers’ diet was superior to that of RCT control and similar to RCT intervention mothers. Traveller and RCT intervention mothers were less likely to feel tired, feel miserable, and want to stay indoors than RCT control mothers. CONCLUSIONS: The results of the community mothers’ programme in the travelling community are encouraging; poor immunisation uptake remains a challenge.

The health of Gypsies.
McKee M.
BMJ. 1997 Nov 8;315(7117):1172-3.Click here to read

Oral health care in the lives of Gypsy Travellers in east Hertfordshire.
Edwards DM, Watt RG.
Department of Public Health, Bedfordshire Health, Luton.
Br Dent J. 1997 Oct 11;183(7):252-7.OBJECTIVE: To explore Gypsy Travellers’ perceptions of dental health and dental service use within the context of culture, environment and the use of other services. SETTING: The author was a community dental officer and the study formed part of a MSc dissertation in dental public health. SUBJECTS AND METHODS: Information was obtained from semi-structured interviews with 43 Gypsy Travellers supplemented by a questionnaire and clinical screening of 72 Travellers. MAIN OUTCOME MEASURES: Place of residence, registration with GMP and GDP, school attendance, caries, normative and perceived barriers to care. RESULTS: The Travellers in the study had a high level of unmet need, low dental registration and very little use of preventive services. Travellers have no cultural barriers to dental care. Control of their travelling was the major factor determining access to education and health services. CONCLUSIONS: There is inequity of dental health and dental service use with more disadvantage being experienced by Travellers on unauthorized and transit sites.

"Travellers are the unhealthiest people in Britain"
BMJ 1996;313:963 (19 October)
http://bmj.com/cgi/content/full/313/7063/963

The health of traveller-Gypsies.
Vernon D.
Br J Nurs. 1994 Oct 13-26;3(18):969-72.Travellers are not a healthy group. They experience widespread prejudice and discrimination from the settled population. In the sphere of health care, they have poor access to services. This article reviews the prevalent health care needs of this group from the perspective of client factors and service factors.

Meeting the health needs of gypsies.
Batstone J.
Nurs Stand. 1993 Jan 13-19;7(17):30-2.

Traveller Gypsies and childhood immunization: a study in east London.
Feder GS, Vaclavik T, Streetly A.
Br J Gen Pract. 1993 Jul;43(372):281-4.
PMID: 8398244 [PubMed - indexed for MEDLINE]The immunization status of the children of Traveller Gypsies presenting to two general practices and a paediatric accident and emergency department in east London between July 1988 and February 1990 was compared with that of a control group presenting to the same services. Study of parental reports and other records for 72 Traveller Gypsy children and 106 control children aged 10 months to six years revealed that Traveller Gypsy children had significantly lower completion rates for pertussis, measles, diphtheria/tetanus and poliomyelitis vaccines than the control group. The difference between the uptake of the first and third diphtheria/tetanus, pertussis and poliomyelitis vaccines was significantly greater among the Traveller Gypsy children than among the control group. The low immunization rates are due to poor access to services as well as rejection of certain vaccines by Traveller Gypsies. The 1990 general practitioner contract and reforms to the health service may result in decreased access for Traveller Gypsies unless steps are taken by family health services and district health authorities to meet the health care needs of this group. Possible solutions to this problem include outreach services to caravan sites, opportunistic immunization, better records and targeted health education.

Gypsies and health care.
Sutherland A.
Department of Anthropology, Macalester College, St Paul, MN.
West J Med. 1992 Sep;157(3):276-80.Gypsies in the United States are not a healthy group. They have a high incidence of heart disease, diabetes mellitus, and hypertension. When they seek medical care, Gypsies often come into conflict with medical personnel who find their behavior confusing, demanding, and chaotic. For their part, Gypsies are often suspicious of non-Gypsy people and institutions, viewing them as a source of disease and uncleanliness. Gypsy ideas about health and illness are closely related to notions of good and bad fortune, purity and impurity, and inclusion and exclusion from the group. These basic concepts affect everyday life, including the way Gypsies deal with eating and washing, physicians and hospitals, the diagnosis of illness, shopping around for cures, and coping with birth and death.

Tales of travail.
Kargar I.
Nurs Times. 1992 Sep 16-22;88(38):22.

Travellers. Health behaviour and beliefs.
Taylor J.
Health Visit. 1991 Jul;64(7):223-4.
Travelling families make poor use of the health services available to them. Jayne Taylor challenges the ethnocentric assumptions behind attempts to change or explain low take-up. Health care must be offered in a way acceptable to travellers’ own cultures, beliefs and traditions, she argues.
Traveller mothers and babies.
Streetly A.
BMJ. 1990 Aug 11;301(6747):342. Links

Traveller mothers and babies.
Feder G, Hussey R.
BMJ. 1990 Jun 16;300(6739):1536-7.

Current comment. (xxii) Traveller-Gypsies and general practitioners in East London: the role of the Traveller health visitor.
Feder G, Salkind MR, Sweeney O.
Health Trends. 1989 Aug;21(3):93-4.Traveller-Gypsy communities in the United Kingdom (UK) have higher morbidity and mortality levels than the national average and their members have only limited access to primary and preventative health care services in most areas. Results of a questionnaire survey of general practitioners (GPs) in East London support previous evidence that the appointment of specially trained health visitors could help improve levels of understanding between GPs and Traveller families and so help Travellers make more effective use of conventional local primary care networks. The relevance of this specific example for other minority populations is evident.

Equal opportunities for Gypsies.
Hussey R. Public Health. 1989 Mar;103(2):79.

Travelling boy.
Houlston A.
Nurs Times. 1989 Jul 26-Aug;85(30):66-7.

"The health of Gypsys"
BMJ 1998;316:1824 ( 13 June )
http://bmj.com/cgi/content/full/316/7147/1824/a

Health and health care among travellers.
Pahl J, Vaile M.
J Soc Policy. 1988 Apr;17(2):195-213.Travellers, or Gypsies, constitute a minority group with its own culture and traditions for whom access to health care can pose problems. A study of Traveller women and children showed that the sites where they lived were often lacking in facilities and provided a poor environment in terms of cleanliness and safety. Perinatal mortality was above average, and was especially high on sites with inadequate facilities and among the more mobile families. Immunisation and preventive care of children were both inadequate, especially among the more mobile. There continues to be a need for more, and better, permanent sites for Travellers. Other responses include allowing Traveller families to carry their own medical records, providing mobile clinics for Gypsy sites, and appointing specialist health visitors to ensure that Travellers get the heath care to which they are entitled.