Roma Access to Emergency Healthcare in Romania: Manufacturing Exclusion

The passage from the egalitarian ethos of socialist medicine to the more pragmatic norms, values, and practices characteristic to neoliberal healthcare led to novel criteria for sorting people out and, inherently, to new geographies of inclusion and exclusion in the former Eastern Bloc. This paper examines the social production of ethnic exclusion in medical settings by focusing on the case of Roma showing up at the triage counter of a county hospital in Romania. Based on four months of ethnographic fieldwork in the emergency ward (May-June 2013), it unveils the practical accomplishment of ethnic marginalization and the underlying logic that makes possible the translation of moral evaluation into clinical categorization of the patients.

The empirical evidence gathered during fieldwork suggests that recent Romanian social integration policies aiming to improve the Roma access to quality healthcare failed to effect a positive change on the access to emergency services. The paper argues that while the European Union, through the Commission’s Framework for national Roma integration strategies and the European Social Fund, created the conditions for actively addressing Roma access to health, the effort was hindered by the lack of political commitment at national level. A brief analysis of the National Strategy for Roma (2011-2020) adopted by the Romanian Government indicates lacunae in the approach of Roma access to health, unclear distribution of responsibilities among the institutional actors involved in carrying out the integration measures, and lack of targets and indicators for the monitoring and evaluation of the implementation.