There are many difficulties facing people from new and emerging communities within Derby and conversely many challenges that the City’s institutions face in ensuring that the new arrivals can become properly settled. Health support and provision presents some of the most complex areas that have to be tackled.
Derby is home to many nationalities, many of whom are familiar with accessing the National Health Service. For the majority of these communities its idiosyncrasies are well understood, and don’t represent a major health burden; the exception to this is the Roma community.
Roma who have migrated to Derby have typically come from the Czech Republic or Slovakia ; smaller groups have come from Bosnia and the Baltic States. Historically, most Roma have been subjected to racist persecution, abject poverty with poor housing and living standards, sub-standard education and poor health care in their home countries. Many now suffer from the legacy of those conditions.
Accessing the National Health Service and navigating the different entry points and procedures can be daunting for anyone. For many Roma people, who have not experienced a state run, free Health Service, it can be a source of much confusion and frustration. Initially there was large scale, inappropriate use of, Accident and Emergency as they were either not registered with a local Doctor, or didn’t understand the notion of a General Practitioner. This non-engagement with the Health service also meant that they didn’t get the standard immunisations and the pregnant women also didn’t access the right ante-natal support until too late into their pregnancies. It became important that something had to be done to facilitate a better connection with the Health Service.
Sue McCrea is the Specialist Health Visitor at the Pear Tree Clinic on Pear Tree Road, Normanton. She, together with Marek Hoffman, comprise the New and Emerging Communities Team. This dedicated team, committed to working with this section of the population, was originally set-up as a pilot. It was considered to be so successful that it subsequently became a commissioned service.
Sue has been working with the Roma community for 6-7 years and has developed a very close working relationship with them. At the start it was hard-work to get new arrivals to engage with her but as she has gained the confidence and respect of the resident population then new people know where to find her through word-of-mouth as well as the more formal sign-posting routes via A&E , GP surgeries, Council, and local schools.
Some of the key conditions that they suffer from are listed below:
• Many Roma from Slovakia come from the Michalovce district. This was also home to Chemco, a chemical plant which produced polychlorinated biphenyls (PCB) during the Communist period. These PCB’s, which are toxic and carcinogenic, found their way into the local reservoirs and other natural water sources. As Roma, typically, would live in accommodation with poor water supply they would heavily rely on contaminated sources. There is evidence that the drinking of this water during pregnancy and early years of growth can seriously impact on the enamel production of the teeth thus allowing them to rot.
• Their environmental upbringing and poor educational support means that a high proportion of Roma have learning difficulties. There is no proven link with PCB poisoning but it may be a factor to be considered.
• Polio is very rare in the UK, but a number have physical disabilities resulting from this disease
• Profound deafness
• Cerebral Palsy
• Obesity – borne from a generally poor, fatty diet, e.g. red meats, dumplings etc and high sugar-content drinks. In Derby this is exacerbated by the availability of cheap, convenience foods.
• Alcoholism, and drug taking.
• Hepatitis B and C – not aided by too much needle sharing and poor hygiene on drug-taking paraphernalia.
• Bed bugs and scabies from the poor housing conditions in Derby – as most are in low rent accommodation.
• Life expectancy is about 10 years below the regional average.
It is inevitable that the local bigots will remonstrate that our over-burdened NHS should not have to be subjected to extra people with such a catalogue of complaints. It is the mark of a civilized society that we consider the health care of a newly arrived foreigner to be of the same importance as to that of a long-established native. Sue, and Marek’s work is full of many complexities, not least of which is the challenge of being seen by the Roma as a valuable point of help. Ensuring that everyone is accessing the health system, and receiving the level of care that they need is their ultimate goal; their many years of diligence in working with Roma seems to bringing its just rewards.