Taking TB awareness to Roma communities in Bosnia and Herzegovina
The town of Kakanj, just north of the capital Sarajevo, is home to Roma settlements of homes like this one, cobbled together from scavenged materials. A resettlement plan was initiated by the Bosnia and Herzegovinan government in 2009 but has not been able to keep up with demand. There are numerous structural challenges facing Roma families, who often have no access to public infrastructure such as power, water and sewerage. Most families splice their own electrical wires to the existing grid; few have jobs in the formal sector so among the coping mechanisms they use to support themselves is waste recycling.
A typical Roma family has many children, though schooling and literacy present a major challenge. This family was visited by World Vision outreach workers promoting easy-to-understand behavior change materials around communicable illness including HIV and TB.
Mufid Besic is a member of the Roma community in Kakanj, and has been trained by World Vision as a TB outreach worker. Official statistics cited by World Vision show that in 2010 there were 50 new cases per 100,000 inhabitants. The country's Roma population bears the brunt of these new infections.
Outreach worker Biljana Simikic during field visit in Roma community in Bijeljina, near the Serbian border. Biljana works at a regional TB center in Gradishka that caters specifically to the Roma community. The four centers support the work of 16 Roma outreach workers and 76 polyvalent patronage nurses, all of whom have as their main goal to improve awareness of TB among the Roma community. Financial support from the Global Fund underwrites the program in its entirety, to the tune of 500,000 euros annually.
In addition to doing house visits, World Vision , and outreach partners from HIV and TB centers, regularly host public events to draw in larger numbers of Roma people to discuss TB prevention and how to recognize and react to symptoms. These public events are very well-attended because they are an informal and easy way to share information with the community. Around a table laden with snacks and drinks, families and neighbors get together to talk about the health issues that confront the population, and how to overcome the stigma that accompanies a TB diagnosis. For the Roma, who already face serious marginalization in Eastern Europe, TB infection only adds to the discrimination they experience.
Some of the public events are designed to attract a specific group within the wider Roma community. This event in Mihatovici settlement, near the city of Tuzla, was aimed at mothers and children, to promote healthy living, TB prevention, transmitting and treatment. TB outreach workers - Roma themselves, involve them in their presentation via asking for their opinion and ideas, which builds trust and ensures understanding of important health issues.