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za porodicu, koja je stub i oslonac svima, jedan model ponašanja izrastao na osnovama patrijarhalnog društva, a koji nije nepoznat na ovim prostorima. U čemu se ogleda bolesno zdravlje Romkinja: u svakodnevnim rečima »nije mi ništa«, »samo mala prehlada«, »proći će«, »lekari ionako ništa ne znaju«, »biće mi bolje«. Rezultat ovoga su hronične upale pluća koje su nastale iz nepreležanih prehlada, hronične upale jajnika, pojačane migrene – i sve to ove žene leče na nogama. Zdravstvene posledice nasilja Nasilje u porodici je tek od nedavno postalo predmet krivičnog zakona sa dosta neujednačenom praksom za sada. Iako prestaje da bude zabranjena tema ili nešto što se događa nekom drugom a ne nama, reakcije institucija, ali i okoline na nasilje nanesu više štete nego koristi. Pokrenuti krivični postupci dugo traju, stambena i ekonomska zavisnost žena od nasilnika, nepostojanje sigurne kuće koja ima dovoljno mesta za majke i decu samo su neki od delova opšte ženske priče kad je reč o nasilju. Zapažanja aktivistkinja RŽC BIBIJA govore da je svaka DRUGA Romkinja pretrpela neki oblik nasilja u porodici, da tek 2% Romkinja prijavi slučaj nasilja policiji, a da policija reaguje na svaki PETI poziv iz romskog naselja. Diskriminacija Ovaj široki pojam obuhvata zdravstveni sektor u dva smera: direktni i indirektni. Direktna diskriminacija ispoljava se u situaciji kada zdravstveni radnik odbija da pruži pomoć Romu. Ovde ubrajamo i verbalno nasilje, degradirajući tretman, odvajanje od drugih pacijenata. Ne postoje relevantni podaci kojima bi mogla da se izmeri zastupljenost ove pojave. Rad na terenu RŽC “BIBIJI” doneo je ove podatke: od 40 romskih naselja u Beogradu u kojima smo radile najmanje 65% Romkinja izjavilo je da se susreće da diskriminatornim tretmanom od strane zdravstvenih radnika. Prenebregavanje specifičnih potreba romskog stanovništva, nedostatak informacija na njihovom jeziku, nepoznavanje državnih institucija generalno, a zdravstvenih posebno, nedostatak kadra dovoljno senzitivnog na romsku kulturu i verovanja, nedostatak zdravstvenih radnika romskog porekla - su sve vidovi i razlozi indirektne diskriminacije. Za kraj o zdravlju Na kraju potrebno je istaći i moguća rešenja ovog krajnje nezavidnog položaja koji ima tendenciju pogoršavanja. Pre svega, treba stvoriti čvrste mehanizme koji će omogućiti lakšu dostupnost primarne zdravstvene zaštite i specijalističkih službi, zatim važna je primena postojećih zakona i/ili njihova dopuna, kao i podizanje dostupnosti informacija od značaja za zdravlje na daleko viši nivo od trenutnog. Uspostavljanje uloge medijatorke – kao spone između romske zajednice i zdravstvene institucije, predstavlja takođe mogućnost prevazilaženja vekovnog jaza koji je stvoren između ove dve strane. I na kraju, jedna od vidnih potreba svih zainteresovanih strana je ustanovljenje validne baze podataka o ženskom zdravlju koja bi doprinela potpunijoj slici o zdravstvenom stanju žena iz marginalizovane populacije, ali i bila dobar temelj za građenje jedne sveobuhvatne strategije za konačnu eliminaciju ovakvog stanja. ■ role of the woman, who sacrifices herself for the family, who is a pillar of support for all, as a model of behavior rooted in a patriarchal society, and by no means new in this region. What are the indicators of ill health in Roma women? They are in daily statements such as: “I am all right”, “it’ just a mild cold”, “it’ll pass”, “doctors are ignorant anyway”, “I will feel better”. Results of all this are chronic lung inflammations resulting from untreated colds, chronic inflammations of ovaries, strong migranes – all of which these women take on their feet. Health consequences of violence Family violence has only recently become subject to penal legislation, accompanied by a rather varying approach in practice to date. Although it is no longer a taboo topic, or something that happens to others, never to us, the reactions of institutions, but also of the milleu to violence bring more harm than good. Initiated criminal proceedings take a long time, and the housing and economic dependence of women on the violator, the nonexistance of a safe house which would have sufficient space for mothers and children, are only parts of the universal tale about women and violence. Activists of Roma Women’s Center BIBIJA have noted that ONE OUT OF TWO Roma women have suffered some form of family violence, that only 2% of Roma women report cases of violence to the police, and that the police reacts only to ONE FIFTH of calls from Roma settlements. Discrimination This broad concept encopasses the health care sector from two aspects: direct and indirect. Direct discrimination is expressed in a situation when a health care worker denies assistance to a Roma. This also encompasses verbal violence, degrading treatment, segregation from other patients. There are no relevant data that would permit measuring the level of this phenomenon. Field work by Roma Women’s Center BIBIJA rendered following data: in the 40 Roma settlements in Belgrade in which we worked, at least 65% Roma women stated that they are faced with discriminatory tretment by health care workers. The oversight of specific needs of the Roma population, the lack of information in their language, the lack of knowledge about state institutions in general, and health care institutions speciafically, the lack of staff sufficiently sensitive to Roma culture and beliefs, the lack of health care workers who are Roma – all represent types of and reasons for indirect discrimination. In conclusion – about health In conclusion, one must indicate also the potential solutions for this extremely unfavorable position with a worsening trend. First of all, strong mechanisms need to be created that will enable easier access to primary healthcare and to specialist services. The implementation of existing laws and/or their supplementation is also required, as well as raising the level of access to information important for health to a much higher level than it is presently. The establishing of the role of a female mediator – as a link between the Roma community and the health care institution, also represents a possibility to overcome the centuries long gap between the two sides. And finally, one of the visible requirements of all interested parties is to establish a valid database on women’s health, which would contribute to a more complete picture about the health of women belonging to a marginalized population, but would also form a good basis for creating a comprehensive strategy for the final elimination of this state of affairs. ■ 28
5. Zdravlje žena u zdravstvenoj politici Srbije Women’s Health in the Health Care Policy in Serbia U okviru serije okruglih stolova posvećenih ključnim pitanjima zdravstvene politike Srbije, PALGO centar je, u Sava Centru, 20. juna 2006. godine, u saradnji sa Fondom za otvoreno društvo iz Beograda, organizovao okrugli sto na temu „Zdravlje žena u zdravstvenoj politici Srbije”. Cilj skupa bio je da okupi relevantne stručnjake, odnosno organizacije, vladine i nevladine, kako bi se otvorila važna pitanja iz ove, donekle zapostavljene, problematike. Uvodna izlaganja su imale Snežana Simić (pomoćnica ministra zdravlja), Hajrija Mujović-Zornić (Institut društvenih nauka) i Đurđica Zorić (nevladina organizacija “Bibija”). ■ As part of a series of round tables dedicated to the key problems of health care in Serbia, PALGO Center organized, in co-operation with the Fund for an Open Society from Belgrade, on June 20, 2006, in Sava Centre, a round table on the topic of “Women’s Health in the Health Care Policy in Serbia”. The goal of the meeting was to gather relevant experts, governmental and non-governmental organizations, in order to open up discussion on pertinent issues related to those somewhat neglected problems. Introductory speeches were delivered by Snežana Simić (assistant to the minister of health), Hajrija Mujović-Zornić (Institute of Social Sciences), and Đurđica Zorić (“Bibija” NGO). ■ 29
Page 1 and 2: KA REFORMI JAVNOG ZDRAVSTVA U SRBIJ
Page 3 and 4: Uvod Introduction Nema lakih tranzi
Page 5 and 6: Finansiranje zdravstvene zaštite K
Page 7 and 8: Decentralizacija u sistemu zdravstv
Page 9 and 10: cijom povećana. Međutim, i u ovoj
Page 11 and 12: adnika. Imajući ovo u vidu, naprav
Page 13 and 14: za zdravstveno osiguranje. Zakonom
Page 15 and 16: nivou, u skladu sa svojim mogućnos
Page 17 and 18: S toga svako neispunjenje ili delim
Page 19 and 20: prikazuju u bilansu Zavoda. - Sreds
Page 21 and 22: 2. Ozdravimo zdravstvo! Korupcija i
Page 23 and 24: Šta donose novi zakoni u zdravstvu
Page 25 and 26: suštini to je oblik decentralizova
Page 27 and 28: Zdravlje Romkinja Potrebe i problem
Page 29: prihvata dužnosti od kojih je najv
Page 33 and 34: se ne ispoljavaju na isti način ko

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