Mediating between cultures

 

A FEW years ago, a young Roma woman was admitted to the Rotunda hospital because of complications late in her pregnancy. Her English was poor and staff felt she needed a translator to explain what was happening.

Her baby was stillborn and when she was discharged three weeks later, she still had no idea why her baby had died.

She had also signed a number of documents without knowing what they were and was upset to later learn that she had signed a permission letter for her baby to be buried in the Holy Angels plot in Glasnevin Cemetery.

Access Ireland set up the Roma Cultural Mediation Project in 2007 precisely because of cases like this.

Ann Moroney, who was involved in setting it up, heard of the need for cultural mediation both from the Roma community and from Irish health professionals who saw that Roma patients had very particular needs that they weren’t fully able to understand.

The idea behind the programme was to recruit and train people within the Roma community to act as a link between service providers and the Roma. The mediators completed six months of training and got hands-on experience in Temple Street hospital. Access Ireland’s funding ran out last year but the mediation programme is still running and looking for a new base.

Accessing health services can be difficult for the Roma for a number of reasons. Low rates of literacy make hospital consent forms, written prescriptions and dates for follow-up appointments challenging. Many Roma are not well integrated into mainstream society so have little opportunity to learn English. There are also significant cultural differences. Roma society tends to be traditional and has a complex set of norms that are hard for non-Roma people to understand.

Rodica Lunca came to Ireland from Romania in 2001 and works as a Roma cultural mediator in hospitals, schools and child protection services. “When I came to Ireland I didn’t speak English. I used to just answer all questions with “yes, yes, yes” but I didn’t understand anything, I just wanted to escape. But when I heard about the project, I felt it would make things better for our people,” she says.

Most of the estimated 3,000 Roma in Ireland came here from Romania during the mid-1990s. Rodica explains that daily discrimination has taught them to close ranks and distrust people in authority. Roma men and women look for help and information within their own community instead of seeking outside help. “We copy each other. We are very closed. I will give you an example. If a woman has her child vaccinated and something happens to that child, like an allergy, after that all Roma women will say that vaccinations are not good. This is a big problem.”

Florica Gabi Munteanu, who also works as a mediator, says a big part of their role is to step in when cultural differences cause misunderstandings with Irish health professionals. The issue of young Roma women having children at a very young age often crops up. “Sometimes they have a problem with a Roma girl if she is pregnant at 13 or 14, which in Ireland is not normal. They don’t understand why she is pregnant at 14, why she doesn’t go to school or why she is outside begging.”

The mediators explain to people in the Roma community if they are breaking Irish laws by having babies at a young age or not sending their children to school.

Initiatives like the Cultural Mediation Programme are gradually improving life for the Roma community here. Rodica says Roma society is changing along with the expectations and ambitions of the generation who grew up here. “I was taught to clean, to cook, to be a good wife and to have 10 children but today they don’t want to be married early. My son is 17 and everybody asks me, ‘You don’t have a daughter-in-law yet?’ But he says no to getting married. They have grown up in Ireland and they see different things.”

She was embarrassed that a man would hear the details of her pregnancy

Rodica Lunca explains a typical case in her work as a Roma Cultural Mediator:

“I got a call from a social worker at a Dublin maternity hospital about a Roma woman who had a high-risk pregnancy and the doctors were very worried about her. She was 41, six months’ pregnant and was diagnosed with diabetes, high blood pressure and suspected fetal abnormalities.

“The social worker said she needed to be monitored every week and take medication but for some reason she was not following doctor’s instructions or attending appointments. In fact, at the last appointment she fled from the hospital in the middle of a consultation.

“I rang the woman and explained who I was. She agreed to come to the hospital later that day and meet me and the social worker. She was very keen to come as she was worried and felt like she had nobody to ask for help.

“She was a mother of nine children, a grandmother of two and this was an unexpected pregnancy. She had hidden it from her children as she was embarrassed to be pregnant at her age. She was also terrified of diabetes and administering the insulin to herself. She could not read or write and found it difficult to figure out when she needed to take her blood pressure medication.

“She ran from the last appointment because they had hired a male Romanian interpreter and she was embarrassed that a man would hear the details of her pregnancy.

“I was able to explain things to her in the Roma language so that she could understand. We figured out a way to help her remember when to take her medication through a system of colour coding and symbols.

“I went with her to the next few hospital appointments and the diabetes got under control.

“I was also at the birth of her son who was born healthy by Caesarean section. Caesarean are misunderstood in Roma culture, which may have contributed to her developing postnatal depression. I was called in again to help the public health nurse support her through the depression and eventually she got through this and began to enjoy her new baby.

“Without mediation to sort out the misunderstandings, the outcome of her pregnancy may have been very different.”