Migrant Roma and access to healthcare in Spain: Travelling in time

Beatriz Aragón Martín

University College London

In this paper I examine the different factors that influence migrant Roma access to healthcare and the way health care practitioners differentiate them from other Romanian migrants. Drawing on ethnographic data collected during twelve months of fieldwork in Madrid (Spain) I reflect on how the “Romanian Roma patient” is locally constructed in a healthcare facility that attends to Romanian Roma among other patients. I aim to disentangle the multiple elements creating such a “Romanian Roma patient”. Representations and stereotypes about Spanish Roma play a fundamental role. Socioeconomic factors are interpreted as ethnic and cultural differences, which reinforce the perception of Roma (migrant and not migrant) as a homogeneous group that is differentiated from non-Roma. Substandard housing, early age pregnancy and a perceived capricious use of healthcare facilities are the main topics healthcare workers use to compare Spanish Roma with migrant Roma. This comparison entails a narrative in which migrant Roma are depicted as resembling Spanish Roma 30 years ago, when inclusion policies aimed at Roma in Spain were yet to be implemented. Institutional organization and daily clinical practices also play a role in the construction of this “Romanian Roma patient”. In a context of continuous budget cuts and restrictions to the previously universal coverage of healthcare provisions, healthcare personnel face an increase in their workload with scarce time resources. It is in these complex clinical encounters, where the “Romanian Roma patient” idea is reenacted and reinforced. Finally, media representations of Romanian Roma contribute to strengthening the representation of Romanian Roma as an old-fashioned version of Spanish Roma.