NGOs are calling on European Union countries to ramp up efforts to vaccinate the Roma community, seen as particularly vulnerable to COVID-19.
Official vaccination guidelines from Brussels have suggested giving priority access to groups with chronic diseases, comorbidities, frailty and disabilities. It also suggested that "vulnerable socio-economic group" could be categorised as "possible priority groups".
But Slovakia is currently the only one of the EU's 27 countries to explicitly recognise its 500,000-strong Roma community as an at-risk group in its vaccination campaign despite them being more likely than the general population to suffer from cardiovascular diseases, develop severe disabilities, respiratory and musculoskeletal system diseases, diabetes, asthma, bronchitis, pneumonia and obesity-related diseases.
It comes as International Roma Day is marked on April 8.
Europe counts about 12 million Roma, half of whom are EU citizens, making the community the continent's largest ethnic minority.
In Romania, half of the Roma population over the age of 45 suffers from disabilities or chronic diseases, according to a 2014 EU Commission report.
In Hungary, Roma are "dropping like flies" because of the COVID-19, an activist told Reuters. One member of the Roma community interviewed by the agency compared the pandemic in his small Hungarian town to a bomb explosion.
In some Serbian communities, mortality from COVID-19 is reported to be as high as 26 per cent, according to one study.
However, there are no reliable statistics on the number of COVID-19 infections, hospitalisations and deaths among these communities either at the EU level or from individual member states.
'Marginalised, uncounted or undocumented'
One of the main issues is that access to health care generally necessitates some form of national identification.
Many Roma do not have these just like millions of other "invisible" people including the homeless, migrants in an irregular situation and stateless people.
"I'm afraid they will be the last to be considered when there is herd immunity," Carlo Stasolla, president of Italy's 21 July Association told Euronews.
The Roma community in Italy is estimated at about 20,000, two-thirds of whom are Italian citizens and thus have no problems using the national health service, according to Nazareno Guargneri, president of the Fondazione Romanì Italia. But up to 30 per cent of them live in illegal camps and do not have a health card or tax code.
"As they do not have them, they cannot access the vaccine booking systems," said Marco Paggi, a lawyer at the Associazione Studi Giuridici Immigrazione (Asgi).
As of April 8, more than 11.7 million doses of the vaccines have been administered across Italy and 3.6 million of the country's 60.4 million inhabitants have been fully inoculated.
Lack of data makes it impossible to track whether those living in illegal camps have had access to the vaccine but Stasolla says none of the people he's met have been vaccinated "and neither have we, the NGOs who visit these communities".
In Germany, Zeljko Jovanovic, director of the Open Society Roma Initiatives Office, told Euronews, "there are many more Roma than the 150,000 officially declared. But they are afraid to be counted. They know that there is freedom of movement in Europe, so they don't declare themselves to the local authorities".
"Many are marginalised, uncounted or undocumented. This is due to many reasons, including endemic racism, school segregation, negative representation in the media and the physical violence they have suffered for centuries," Jovanovic said.
In Greece, more than 50,000 people — most of whom do not have a social security number (AMKA) — do not have access to the public health system and cannot be vaccinated. Many of them are Roma.
Kostas Paiteris, president of the Union of Greek Roma Mediators, called for a special plan to reach the Greek Roma community. In total, the EU estimates that there are more than 230,000 Roma in Greece.
Digital skills and literacy are another problem slowing down vaccination within Roma communities.
"In the camps, people do not always have devices that allow internet connection. The level of literacy is low, online access is complex for people who do not have technological tools or are illiterate," Stasolla stressed.
Another is age. The average age of the Roma population is very low — 55 per cent of Romani in Italy are children and in general life expectancy is 10 years lower than that of the rest of the population.
"The elderly have priority in vaccination campaigns, which means that a generally younger population does not fall into the priority categories," Jovanovic said.
Access is made all the more difficult by the fact that many Roma camps are in remote and isolated locations.
Jovanovic emphasised that in too many Roma communities, "people live in unregulated, overcrowded spaces, where isolation is impossible. Not only that, but spatial segregation, outside of public transport routes, makes it much more difficult for Roma to obtain masks, disinfectants or reach local health centres".
In Hungary, the government has closed 10 per cent of small local clinics, according to Reuters, especially in areas with a high concentration of Roma.
A 2020 report by the Slovak Academy of Sciences found that large numbers of Roma live around toxic landfills and flood-prone areas, without access to clean water, sewage or waste collection. All of these conditions, the report says, have facilitated the spread of COVID-19 in these communities.
In the Bulgarian settlement of Sliven, there are no paved roads and no ambulances can get there. During the first lockdown, residents were also cut off from electricity and running water.
According to the European Commission, 30 per cent of Roma homes in Europe have no water.
Distrust in institutions
A survey conducted in January by the University of Pécs, in Hungary, showed that only 9 per cent of Roma respondents wanted to be vaccinated against COVID-19.
Zsuzsanna Kiss, a Roma biologist who carried out interviews for the survey, indicated that Roma people have long been suspicious of governments and doctors because of the discrimination they have suffered for decades.
In Serbia, out of a sample of 1,383 Roma respondents for a January 2021 survey, 43 per cent said they had enquired about vaccines on the internet; 52 per cent said they preferred not to be vaccinated, and 41 per cent of those who expressed a willingness to be vaccinated indicated the Russian vaccine Sputnik V as their preference.
"Vaccination campaign adherence rates were already low before COVID-19," Jovanovic pointed out. "The anti-vax movement is strong online, and when you combine that with the Roma's distrust of institutions, you get a very negative mix."
What is being done at the European level?
Exactly 50 years ago, in 1971, a flag, a national anthem and a transnational identity were created for Europe's 12 million Roma. But even today, "Roma lives are 7-20 years shorter than the average European citizen", Jovanovic told Euronews.
NGOs assisting Roma communities are focusing their efforts on getting as many of them as possible to take part in the next general census, scheduled to take place across Europe in 2021. Member states will also have to send their national strategies for the inclusion of Roma communities to Brussels as part of the European Anti-Racism Plan 2020-2025.
Jovanovic points out that in Serbia his mother has been vaccinated, as have many of his friends and fellow activists. The same goes for Romania and North Macedonia.
"Serbia cannot be immunised without immunising the Roma," Stevica Nikolić, of the NGO Opre Roma Srbija, said. "Roma should become a priority group for information and access."
In Spain, as José Heredia, president of the Camelamos association, told Euronews, "we have not detected any cases of lack of access to the vaccination campaign" and "there are no bureaucratic impediments that we know of" preventing elderly Romani from getting vaccinated.
But he also said that there are "no ad hoc vaccination campaigns either for Spanish Roma communities or for migrant Roma camps" and that there are concerns "about the health care and vaccination efforts in the Roma migrant camps, where there is almost no information about the impact of the pandemic".
In Romania and Bulgaria, priority has been given to Roma health mediators, who are considered essential health workers.
Some countries, such as the UK, are conducting aggressive vaccination campaigns to cover vulnerable communities as much as possible. Bilingual GPs, who are trusted in Roma communities, have recorded videos in several languages to encourage as many people as possible to get vaccinated. GPs are also encouraging this.
In the Czech Republic, Jan Dužda, the regional coordinator of the Effective Health Support programme (working for the National Institute of Public Health) is calling for an information campaign on targeted vaccination for Roma.
Across Europe, NGOs are urging their governments to do the same, so as to combat misinformation and increase herd immunisation.
Visits by doctors to settlements, information sessions, materials in Romani languages, training of Roma doctors are all strategies that contribute to raising awareness in order to make a more informed decision about anti-COVID vaccination.
None of these strategies have been applied in Italy according to Stasolla.
"Awareness-raising campaigns? Not that I know of. No one has contacted us, there has been no change of pace with the new government," he said.
A dozen Italian organisations, including Asgi, Caritas, Emergency and Médecins Sans Frontières, have asked the government for active involvement in this issue.
"We wrote to the Ministry of Health in February, but we have not received any reply," Asgi's lawyer Paggi said. "From a strictly legal point of view, it is an indisputable fact, and recognised by the law: all irregular immigrants have the right to benefit from prevention, treatment and vaccination campaigns."
Paggi recounts how a Roma citizen, irregular in Italy and without papers, was given a tax code but only because it was automatically generated following a fine for begging.
"The fear that illegal immigrants would also have access to the vaccine has political implications that are easy to imagine, even if we are not talking about protecting illegal immigrants but rather the community," he concluded.
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