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Roma health mediators – empowering communities

The Krasnici family, together with Aleksandra Paunovic, a Roma Health mediator.
© UNICEF Serbia/2018/Vas

Five years ago, Roma health mediator Aleksandra Paunovic entered the home of the six-member Roma family Krasnici. The parents, Nadjija and Naser, expected help from her, and it soon became clear to the children that they would grow to love her, as they say, as an aunt.

Djevahire, who is now thirteen years old, recalls that day: “It was my birthday”, she says smiling, “She was kind, she’s still kind to us, she always help us”.

The health mediator remembers that she could not even afford to buy a birthday cake for the girl that day, although she wanted to. At the time, Djeva and her brother, two sisters and parents needed much more than just a cake.

“We didn't have anything, just bare walls”, recalls the mother Nadjija Krasnici.

Back then they moved from an informal settlement into a public housing apartment. They had been displaced from Kosovo*, and lived for more than ten years without basic necessities. The family didn’t have a registered place of residence, documents or a steady income, and they relied on Aleksandra’s help.

“First we went through the registration procedure to obtain ID cards, healthcare insurance cards and registration at the local Primary Healthcare Centre for their new address, as well as social assistance”, explains the health mediator.

Immunization of the four children followed. Until then, the children had not received a single vaccine.
“If my child is not vaccinated, it's as if I don't have them, many diseases can attack them”, Nadjija is now aware.

Health mediators know if every child is vaccinated, and they are up to date with the immunization schedule. They have insight into the situation on the ground from the database that they regularly update on the computers in their offices in the primary healthcare centre. Roma health mediators believe that the measles epidemic was avoided in the Roma settlements that they visit precisely because of the programme they are part of.

Roma health mediator Aleksandra Paunovic helped the Krasnici family the most in eight-year-old Gzim’s first years of life, who was born with a neurological health condition.
© UNICEF Serbia/2018/Vas

"In every family we know the situation of every child, their age, and whether their vaccinations are up to date or not. With this data we go to the paediatric nurse, see what is needed and then we call to warn the parents, and go with them to get their vaccinations,” Aleksandra explains.

The Krasnici family is just one of 160 in the settlement whose children have, thanks to the mediator Aleksandra, received the protection they need from contagious diseases, including measles. This was particularly important during the measles epidemic in Belgrade that began in the beginning of November 2017 and saw 408 registered cases.

Vaccination campaigns were organized in Roma settlements, involving epidemiologists, doctors and nurses, in cooperation with the Ministry of Health and the “Milan Jovanovic - Batut” Institute for Public Health.

“There were dozens of children [vaccinated] during one of the vaccination campaigns. Many of them received their first vaccines as teenagers, but since we have been working with them, the response is great,” says Aleksandra.

The database contains information, not just about vaccination, but about everything that Roma health mediators do for the families whose homes they visit, whether they live in public housing or in informal settlements.

Roma health mediator Aleksandra Paunovic helped the Krasnici family the most in the first years of the life of eight-year-old Gzim, who was born with a neurological health condition. When these kinds of difficulties are recognized in a timely manner, their mitigation or elimination is more likely. That is why it is important for health mediators to help parents become involved in early interventions. Aleksandra says she is familiar with the complete history of the child’s illness.

Aleksandra has been helping the Krasnici family for five years.
© UNICEF Serbia/2018/Vas

“She scheduled every examination and followed up on it, sometimes even several times a week. We could have hardly done it without her”, admits father Naser Krasnici, while he practises addition with Gzim and his sister Fatmira, who attend the second and third grade of primary school. The children each give correct answers to their proud father.

“She also secured child allowance payments and disability support for Gzim”, adds Naser.

The place at the computer is usually reserved for the two older daughters. They spend most of their time using social media, Djevahire admits. Eleonora, who is three years older, is currently attending a practical lesson at the hairdressing school. Djeva says that she will follow in her sister’s footsteps when she finishes primary school.

The health mediator often advises their mother how to resolve the adolescents’ puberty-related issues, just as she also provides parenting advice for the younger son and daughter.

The health mediators are themselves Roma women and mothers. That is why it is easier for the families they are helping to take their advice.

“When we enter a family, first we meet the parents, the children and the elderly family members, write down all the information about them, and put it in the database. Then we start resolving specific problems. There are many cases where we have to explain everything from the beginning: we also bring personal hygiene products and advise the family how to use them, and we particularly tell women how to protect themselves. They can always call us. Once we got a call at 1 a.m. from a woman who had gone into labour. We rushed over, took a taxi and took her to a maternity ward”, Tatjana Stankovic, another Roma health mediator, describes just one part of her work.

“We visit new mothers and attend the baby’s first weighing. We tell them about the importance of breastfeeding, and if a mother has lost her milk, we try to provide breastmilk substitute, which is not cheap at all. We also often encounter domestic violence. We have to be very careful then. We usually report it anonymously, through the Primary Healthcare Centre, because we also have to take care of our own safety. But we never remain silent,” adds Tatjana.

The Ministry of Health launched the Roma health mediators project in 2009, as a response to the needs of Roma communities. UNICEF, in partnership with Telenor, is supporting this to strengthen the capacities of the Roma health mediators and empower Roma communities to access their rights.

For UNICEF, Jelena Terzic


*Kosovo in accordance with United Nations Security Council Resolution 1244.



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