Traveller Health A National Strategy which was circulated this May 2002 represents the next step in addressing the disadvantage suffered by Travellers. Minister Micheal Martin states in the introduction that the Irish Traveller community experiences a level of health which falls far short of that enjoyed by the general population.
Travellers are a small minority group in Ireland. They make up less than 1% of the population with 23,000 in the Republic and 1,500 in the North. There are 15,000 in Britain and 7,000 in the U.S. Thirty per cent of the 4,898 families in Ireland reside in the ERHA. area. They have their own beliefs and customs which have been made stronger over time due to their marginalisation and exclusion from mainstream society. Their origin is unclear but many are thought to be descendants of people who were dispossessed of their land in the 16th century while others were left homeless as a result of the Irish potato famine in the 19th century. Others were nomadic tradesmen dating back to 200 AD. Travellers used to speak Irish with a special vocabulary known as Shelta.
Over the last 4 decades successive Governments have made attempts to address the many problems encountered by Travellers. In 1960 a Commission on Itinerancy was established which formed the basis for a later assimilation programme. It was largely unsuccessful. This we know best approach has been abandoned and authorities have come to recognise the separate culture of Travellers. In 1981 Travellers took a test case to the Court of Human Rights in Strasbourg claiming that their constitutional rights to educate their children were being denied. The Court ruled in their favour. The National Council for Travelling People was subsequently set up. In 1996 a National Strategy for Traveller Accommodation was announced to provide 3100 units of accommodation consisting of 1,200 permanent caravan sites, 1,000 transit pitches and 900 houses. Over the last 20 years the proportion living on the roadside has reduced from 46% to 22% and a corresponding rise in halting site accommodation from 7% to 23%.
The health problems of Travellers are closely linked to their social, education and housing disadvantage. Up to 80% of adult Travellers are unable to read. Life expectancy is 10 years less than the general population. The 1987 figures showed that the infant mortality rate among Travellers was 18.7 per 1000 compared with 7.4 in the general population. Cot deaths are 12 fold higher than the national figure. They tend not to avail of health services as demonstrated by low immunisation rates and poor utilisation of maternity services despite their high fertility rate.
The Strategy discusses the issue of consanguinity and cousin marriages. Travellers tend to marry within their communities. Although this does increase the risk of hereditary conditions, the precise impact is unclear and the findings of the Traveller Consanguinity Working Group are awaited.
This current document contains 122 recommendations. Many of them emphasise than health care workers who come into periodic or regular contact with Travellers must have appropriate additional training. Travellers will be actively encouraged to sit on committees concerned with their health care. Traveller Health Units are to be set up in each Health Board. These Units will implement the proposals in the Strategy within 6 months. Health promotion and education programmes are to be culturally sensitive and appropriate. The development of Primary Health Care is strongly emphasised. Special mention is made of the Pavee Point initiative and its success. A notable feature of this project was the recruitment and training of Community Health Workers drawn from the Traveller community itself. The additional funding required will be 2 million Euro per year. The money will be allocated to the Traveller Health Units, designated Public Health Nurses, Community Supports and Primary health Care projects.
The Strategy aspires to improve the health of Travellers by bringing together health care staff, administrators and traveller organisations.
JFA Murphy Editor