A review of literature, 2006 ( pdf - 438 KB) - ARCHI

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Macedonian Women’s Health Project Review of literature ___________________________________________________________________ In the 2004 Annual Report from the St George Migrant Resource Centre, the Macedonian Welfare Association (MAWA) reported that health (both general and mental) was one of the main issues with which their clients required assistance. The Association has experienced double the number of health-related enquiries since the Macedonian Health Worker position based in St George was de-funded. Although demand for the services of the Macedonian Australian Welfare Association has increased, the Macedonian community remain significantly under-resourced. They also have low participation rates in accessing mainstream services due to a lack of awareness of the services that exist. Other factors that contribute to low participation rates of the Macedonian community are culturally inappropriate services, language barriers, client attitude to disabilities and stigma, negative past experience of services, lack of trust and cultural expectations that family members are responsible for the wellbeing of their significant others (Macedonian Australian Welfare Association n.d.) In the St George Division of General Practice’s consultations with the local Macedonian community in 1997, young people, new migrants and older people in the community were identified by participants as being most disadvantaged or having the greatest health needs. Although there was general satisfaction with local health services expressed, it was also apparent that participants had limited knowledge of the range of services available. Language was seen as a major barrier in accessing services and appropriate health and service information. Mental health, alcohol and other drugs, family and women’s health were identified as areas of concern and the need for more bilingual workers, educators and counsellors and adequate numbers of interpreters was documented. In focus groups conducted among Macedonian men and women by the St George Hospital and Community Health Service (2001), participants talked of long waiting times, the availability of parking and interpreters and a lack of information as issues when asked about accessing services. Although these local consultations have been informative, issues and barriers to using health services among Macedonian women have not yet been identified. Also, misclassification of Macedonians in data collection procedures for both census collections and health service records may well have contributed to an inequitable allocation of resources for the Macedonian community in south eastern Sydney. - 15 -
Macedonian Women’s Health Project Review of literature ___________________________________________________________________ Factors influencing the health of women ‘Women’s health is seen to depend upon complex interactions between individual biology, health behaviour and the historical, economic and socio-political context of women’s lives.’ (Cohen 1998 p188) This section of the review will summarise the available literature relating to the historical, cultural, social and behavioural factors that may influence the health and well being of Macedonian women. A broader and deeper understanding of the influences on the health of Macedonian women will hopefully be achieved through the next phase of information gathering when Macedonian women and those working in the Macedonian community will be asked to share their perspectives on women’s health. Historical influences Given Macedonia’s long history of war, oppression and political violence, it is likely that most, if not all, Macedonian women in south eastern Sydney would have been touched by these experiences in some way. Case studies involving women (between 50 and 70 years of age) from Macedonian villages reveal lives scarred by war, poverty, hunger, deaths of loved ones and family separation (Sapurma-Petovska 1990). In addition to surviving war, Macedonians have been subjected to long periods of repression and subjugation. The dividing of Macedonian territory in the 1912–1913 Balkan Wars resulted in the renaming of Macedonian cities and villages, unfair Greek government assimilation policies (Vidanovski 2003) and severe persecution of Macedonians during the Greek civil war (Danforth 1993) in Aegean parts of Macedonia. Many Macedonians became political refugees at this time (Danforth 1993) and again in the late 1990s after experiencing ‘harassment, threats, damage of properties and dispossession by Albanian extremists’ (Karoski 2004). Unfortunately it is difficult to know the impact that such events as those described above have had on the health of Macedonian women. Assessments of the short or long term effects on civilian populations who have experienced war are scarce and changes to lifestyle resulting from war are also difficult to measure and attribute significance in terms of life expectancy or resulting morbidity and burden of illness (Pederson 2002). It is likely that these events have challenged some Macedonians’ confidence with their Macedonian identity. This issue dominated informal interviews with Macedonian women in Melbourne, Victoria, where some women explained how their feelings about their identity had become more positive when they gained a better understanding of the history of the Macedonian people (Stanovska 1995). Erosion of cultural identity may result from prolonged racial oppression. - 16 -
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