Since 6% of the gypsy population is very poor and 27,6% are able to consume only 50% or less of “medium-consumption” (Ladányi, 2002. My translation.) , the importance of ‘gratitude’-payments in the Hungarian health care system affects the gypsies very strongly.
The other factor that contributes to the bad level of health care of the gypsies has to do with ethnical discrimination. A study by Erös in 1998 indicates that the gypsies are the most rejected ethnic group in Hungary: “Very strong antipathy is present towards the gypsies by major parts of the society, ... in this respect the gypsies are only outstripped by homosexuals, drug-concumers and skinheads.” (Gyukits, 2002. My translation). Thus it is not surprising, that the interviewed Gypsy patients experienced different kinds of discrimination by doctors and nurses: “ The doctor does not want to provide the patient with healthcare, because he or she is a gypsy ... the doctor confronts the patient with common stereotypes about gypsies ... the patient is rudely treated ... the doctor does not provide the gypsy patient as thorough as the others ... the gypsy patient is isolated from non-gypsy patients” (ibid.). However, in the field of ethnical discrimination there are huge differences between the GPs and specialists, especially those working in hospitals. The interviewees were much more satisfied with their GPs and mainly assessed the doctor-patient relationship as “sufficient” (ibid.). This can be explained by the fact that the GP dismisses his prejudices through the direct and regular contact with the gypsy patients. Furthermore he sees the differences between gypsies and non-gypsies in a cultural and social context; gyukits describes GP’s as “socially more empathic” (ibid.). The ‘head-quota’ which determines financial provisions could also be a reason for less discrimination of gypsies by GPs.
Education and employment
There are several inner fault lines among the gypsy population concerning their level of education, but the most alarming data is that only 50% of the 17-29 year old gypsies finished elementary school.
As you can see in the table, 19,8% continue education in vocational schools, but only 1,4% graduates, and far less than one percent of the 17-29 year old gypsies take part in higher education.
The first of the two main faultlines is between men and women. Here the overall trend is, as illustrated by the next table and Table 3 in the Appendix, that both genders learn until they get children.
As soon as a couple has one child or more, the tendency for women is to stay at home, keep the household and raise the children. This mostly detracts these women from unemployment, because on the one hand she is occupied at home and gets financial help during and after pregnancy, on the other hand families with many children also get financial help. Since the latter is higher than the salary a gypsy woman could get if she engages as an unskilled workforce, it is more advantageous for her and her family to stay at home. The tendency for men is to work; or at least to actively engage in searching or registering as unemployed. As you can see in the table above, two times more of gypsy men work if they have children. (cf. Babusik&Jáger, 2004).
The second faultline concerns the types of housing. Main distinctions are made between gypsy ghettos, areas where only gypsies live but it is not a ghetto, and mixed areas. Inside these categories the quality of housing is relevant.
The results shown by this table and Table 2 in the Appendix are the following:
- the segregation in the sphere of housing “ discriminates clearly the finishing of elementary education” (Babusik&Jáger, 2004.) 20-30% less of the gypsies living in ghettos finish elementary education.
- The effects on vocational training are similar, gypsies living in mixed areas have the greatest chance to attain vocational training, those living in ghettos in the rural area have the lowest.
In order to assess the changes of the situation from communist to post-communist order and to assess the situation of the Roma in Hungary in an international context, I will refer to a study by I. J.-Sz. Ladányi called “Gypsies and the poor in Hungary, Romania and Bulgaria”.
Ladányi asked gypsies as well as non-gypsies, who were at least fourteen years old in 1988, four questions which he called “indicators of subjective pauperty” (Ladányi, 2002. My translation.). According to these questions people were called very poor, if they reported about starving; poor, if they did not starve but missed enough meat in their nutrition and/or missed clothes and shoes in wintertime (cf. Ladányi, 2002.).
The living conditions decreased in general in these three countries since 1989, with Hungary having the highest standard of living, Bulgaria the lowest and Romania lying somewhere in between. The differences between gypsy and non-gypsy population more or less remained the same between 1988 and 2000. Until here I see no surprising facts, since Hungary is economically better-off, becazse of pressures and subventions from the EU on the one hand, and very belated and slower reforms in Romania and Bulgaria on the other hand. The fact that the cleavage between gypsies and non-gypsies did not change substantially after the fall of the communist regime underlines that the pauperism of the gypsies mainly has to do with ethnical discrimination (especially in schools and on the labor market) by the major population that has nothing to do with the economical system. Furthermore it shows that the new governments in the 1990’s did not engage (or at least not succeed) in improving the situation of the gypsy minority.
Much more striking than this are the current differences between the three countries in the different kinds and rates of discrimination.
Frequency of different types of discrimination in percent
Now it becomes visible that Hungary is not, as we would expect concerning its current economical and political advantages against Romania and Bulgaria, ahead of the other countries in this respect. The housing discrimination is very high in Bulgaria, and less severe in Romania and Hungary with Hungary having a slightly higher rate of discrimination than Romania. The data concerning the labor market point to a “strong ethnical discrimination in the labor market” (Ladányi, 2002. My translation). Note that in Bulgaria and Romania housing discrimination is three times as high as that of other people, while in Hungary it is seven times as high. The discrimination rate at school is similar in Hungary and Romania, while it is very high in Bulgaria.
Ladányi assumes a main faultline between the kinds of discrimination of gypsies in Bulgaria and the other two countries: “ in Bulgaria the discrimination of gypsies is really caste-formed, which means that the whole of the gypsy population is excluded. ... the situation of the Hungarian gypsies strongly differs from the latter ... in Hungary the falling-apart along socio-economic classes of an ethnic group is ongoing ...” (ibid.). There is a heterogenization among the gypsies which is also observable in Romania, but there it started much later than in Hungary, thus Ladányi assesses Romania as lying between the cases of Bulgaria and Hungary.
Conclusion
It is very interesting to see that Hungary tries to catch up with Western societies on almost all levels, but that the situation of a significant minority, the gypsies, is not much different from the situation of the gypsies in Romania (or even worse), a state that is not yet developed enough to get accession to the European Union. The field studies about health care and education show, that gypsies are discriminated by major parts of the society, and according to discrimination in the sphere of education, they remain in the vicious circle of getting many children, maintaining their life mainly through financial aids, and again having not enough education and money to offer their children a better starting-point. Gypsies do not get the same treatment as other patients in the health care system and thus they often avoid going to hospital as long as possible. Thus their life-expectance remains much lower. Furthermore exactly the discrimination itself leads to the manifestation of stereotypes about gypsies.
Finally it is clear that Hungary has to engage in enormous programs to improve the living conditions of the gypsies and in particular work out a program against the discrimination by the society and the prejudices apparent among doctors, employers, etc.
Appendix
Table 1:Ratio of the poor in different countries and acc. to different ethnicities
Table 2- educational qualification as a function of housing
Translation: on the y-axis you see the category of housing in percent. The x-axis is divided into “less than eight classes” , “finished elementary school” and “finished vocational training” (from the left to the right). In Hungary elementary school lasts eight years.
The different subdivisions of the x-axis indicate, from above, 1) segregational type of housing in Ózd (a city) 2) mixed type of housing in Ózd 3) segregational type of housing elsewhere 4) mixed type of housing elsewhere
Table 3- (Un)employment as a function of having children
↑ these categories indicate from above “student” , “actively looking for work”, “unemployed” and “occupied in the household”
the categories on the x-axis are from the left to the right: men, no children; men, one child; men, one, two or more children; women, no children; women, one child; women, one, two or more children.
References:
Babusik, F. & Jáger, Z. (2001). Kutatás az ózdi régió cigány népessége körében. Retrieved April, 23, 2004, from the World Wide Web:
Elster, J., Offe, C., Preuss, U. (1998). Institutional Design in Post-communist Societies. Rebuilding the Ship at Sea, Cambridge: Cambridge University Press, 36-62, pp. 203-246.
Ferge, Zs. (2004). A magyar szociális törvényezés tíz éve. Retrieved April 23, 2004, from the World Wide Web:
Ferguson, S. & Irvine, B. Background Briefing, Hungary’s Healthcare System. Retrieved April 23, 2004, from the World Wide Web:
Gyukits, Gy. (1999). A romák egészségügyi ellátásának szociális háttere. Retrieved April 25, 2004
from the World Wide Web:
Ladányi, J. Sz.-I. (2002). Cigányok és Szegények Magyarországon, Romániában és Bulgáriában. Szociológiai Szemle, 2002/4, pp. 72-94.
I refer to the datas from the first table in the appendix.
Refered to by Gyukits, 2002.
Provisions are calculated according to the number of patients a GP doctores.