Feature Story

Roma Peer Health Educators

Doctors of the World-USA (DOW) has been working in Romania since 2003.  As part of a community-based strategy to address TB problems within high-risk populations, DOW established a peer health educator (PHE) program to recruit and train local Roma men and women - members of a community with a high rate of TB. The goal of the PHE project is to reduce stigma related to TB, improve the community’s knowledge about TB and access to treatment, and to encourage people with symptoms to seek medical attention. This profile describes the efforts of one of DOW’s PHEs, Carmen Andrei.

Carmen Andrei is a Roma woman, a mother of two, and a PHE from the village of Cracaoani in Neamt County, where there is a large Roma community. Carmen graduated from high school in 1989 at the end of the Ceausescu dictatorship and the fall of the Communist regime, when high rates of unemployment – particularly within the Roma community - made it extremely difficult to find employment.  Unable to find work during this period, and after her daughter experienced serious health problems, Carmen decided to stay at home full time to care for her child, while finding opportunities to volunteer within the community.

In August 2004, DOW began its search to recruit PHEs in Neamt County. With encouragement from the head of the Public Health Department, Carmen applied for the training program. She successfully completed the course in a few months and began work with DOW as a PHE.

Drawing on the harsh discrimination she has experienced because of her Roma background, Carmen is driven by her desire to promote equal rights and to improve the living and social conditions within her community. Her duties as a PHE have provided her with several opportunities to do just this. She has helped many Roma to obtain identity papers – the lack of which is a barrier for many and limits access to the Romanian health and social service system.  She has also helped Roma receive health care by registering community members with family physicians. 

Carmen has become well known and respected in the Roma community as a person who speaks up for their health and social needs.  Local authorities know her and go to her as a bridge between the community and government.  In response to the difficulties of working within a community dealing with high levels of poverty and often carrying a deep mistrust of medical providers and authorities, Carmen has documented in detail the needs of the Roma in Neamt County.  She has also worked with a team of DOW staff and filmmakers to create a documentary film in hopes of generating attention and support.

Carmen Andrei remains actively involved in many activities and is a partner to DOW.  Along with other peer educators in Neamt, she plans to establish a community association to serve as a vehicle for addressing community needs. DOW’s office in Romania will provide ongoing technical assistance and support for this and other Roma health projects.

Discrimination is as deadly as any disease.  Explicitly incorporating human rights into program design strengthens DOW’s work by reaching those who are consistently marginalized in international development efforts, empowering groups to advocate on their own behalf, and identifying parties accountable for upholding health and human rights.