Travellers to tackle racism in healthcare

Dangerously low immunisation rates among Traveller children, a cot-death rate 12 times the national average and the effect discrimination has on health will be high on the agenda of five Traveller women about to embark on new careers as community healthcare workers.

The women, aged between 30 and 50, will be presented with their qualifications by President Mary McAleese at a ceremony on Thursday. The ceremony will take place in the small community centre at St Margaret's halting site near Ballymun in Dublin.Sitting in the centre yesterday, Mary McDonagh and Rosaleen Lawrence said the main thing they felt at the moment was "very nervous, but proud".

"We've been to so many graduation ceremonies before but I never thought I'd be up there," said Mary. "It is a big deal for us."

Having completed the four-year Fás-run course, the women are to be employed by the Traveller advocacy group, Pavee Point, from September.

They will work, in conjunction with the Health Service Executive, as healthcare workers with Travellers in the north Dublin area. The women cite numerous reasons as to why their becoming health workers for their community is important.

"It means we can go and talk to people about their health and what they should be doing, maybe helping them make appointments, or reminding them about things they should be doing," said Rosaleen.

"And Travellers would be more willing to listen to us maybe than a doctor or nurse arriving in to the site," she said.

The Department of Health's Traveller Health Strategy alludes to this when it says the Travelling community's distinct "customs, traditions, symbols, values" are relevant in communicating about important health issues.

The community's distinct culture, it says, "shapes Travellers' definitions of health, perceptions of illness and responses to illness" and also "influence the manner in which Travellers take up health services".

Traveller women who had spoken of the discrimination they felt when they approached GPs or other health professionals said these were deterrents to accessing these services.

The women in St Margaret's also point to the health disparities - some of them enormous - between the Traveller and settled communities as reasons for becoming their own health workers.

For instance, Traveller women live on average 12 years less than settled women and Traveller men 10 years less than settled men; the infant mortality rate for Travellers is 18.1 per 1,000 live births compared with 7.4 nationally; the occurrence of cot-death among Traveller babies is 8.8 per 1,000 live births compared with 0.7 nationally.

"We'll be concentrating now on women and children's health especially. Cot deaths, specific childhood illnesses like meningitis, ante-natal care. And for women things like post-natal depression, BreastCheck, the importance of going for smear tests." They said Traveller women were reluctant to come forward for such services as these last two.

Asked why they thought the overall health of their community was worse than that of the settled, the women pointed to their living conditions.

Although they said their site was "a nice place" and its walls were yesterday being repainted in anticipation of the Presidential visit, they said "it's damp and cold all the time".

The Department's Traveller Health Strategy too said their living conditions had the single biggest impact on Travellers' health.

The women also speak of the stress, depression, low incomes, discrimination and poor upkeep of halting sites by local authorities as other important contributory factors.

The other women being presented with certificates on Thursday are Kate Maughan, Helen Stokes and Ellen Mongan.