1. Working Together Improving the relationship between Healthcare Professionals and Gypsies and Travellers Rehana Hanif Leeds Gypsy and Traveller Exchange

2. Aims and Objectives  Provide cultural awareness of the Gypsy and Traveller Community  Establish rapport between Gypsies and Travellers and Healthcare Professionals  Highlight the health needs of Gypsies and Travellers  Improve Service Delivery  Create working partnerships

3. A Brief History  Gypsies and Travellers originate from India  Gypsies first recorded in the UK 500 years ago  500,000 killed in the Holocaust  Forced sterilisation  Estimated 300,000 Gypsies and Travellers in the UK  Identified as a distinct ethnic group by the Race Relations Act 1976

4. Culture in Context  Romani language  Occupations - crafts, horse-trading, selling, fortune telling  Reservations towards education  Strong family values  Rules on cleanliness

5. Current Problems  A GP receptionist calling the police when Travellers walked through the door  A GP throwing a book, and shouting ‘who is the doctor here’ at a Traveller woman  Ambulance staff refusing to assist a woman in labour until the police arrived  A Health Visitor expressing surprise of how clean a woman’s caravan is  A Health Visitor telling a woman to go on the housing list

6. My Experience… Eileen Lowther

7. Health  Significantly poorer health status than any other group in the UK  Life expectancy of 50  Those who rarely travel have the poorest health  Attitudes towards health service demonstrate cultural pride and self- reliance

8. Women and Pregnancy  Highest maternal death rate of all ethnic groups in the UK  During the study six Gypsy and Traveller women died  Many women go in to labour with very little idea of what is happening  20% of women who died had not booked maternity care until 24 weeks expecting  29% of women had one or more miscarriages  6% of women had one or more stillbirths  18% of women suffered a death of a child

9. Current Barriers…  GPs reluctant to register Travellers or visit sites  Communication difficulties  Perceived discrimination  No knowledge on numbers of Gypsies and Travellers accessing the health service  Lack of policy statements

10. …Current Barriers  Women are forced to travel long distances to access maternity care  Lack of basic pregnancy information geared towards women  Low expectations of health service  Lack of interest and knowledge among service providers

11. Moving Forward  Working in partnership with Gypsies and Travellers  Commission specialist workers, to improve cultural competence of staff  Travellers with temporary registration to receive full range of primary services  Include Gypsies and Travellers on ethnic monitoring documents  Access to information through audio tapes/discs

12. Summary  Gypsies and Travellers originate from India and were killed in the Holocaust  Identified as an ethnic group under the Race Relations Act 1976  Significantly poorer health than any other group with life expectancy of 50  Gypsy and Traveller women have the highest maternal death rate than any other group  Problems due to lack of knowledge and recognition of needs by the health service  Need for specialist provision, to address inequalities and improve practice

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14. Bibliography  Derbyshire Gypsy Liaison Group (2004). A Better Road: An Information Booklet for Health Care and other Professionals. Robert Dawson: Derbyshire  The Health Status of Gypsies and Travellers in England. Summary of a report to the Department of Health 2004  Baker, M (2005) Leeds Baseline census 2004-2005. Leeds racial Equality: Leeds  Jenkins, M (2005) A report on Gypsy and Traveller Women’s experience of Maternity Care. Recommendations and Guidelines to improve Gypsy and Traveller Women’s experience of Maternity Care Midirs: Bristol  www.gypsyadvice.com