(Tuesday, 2nd Sep, 2014)
Health and the Travelling Community
The Travelling community is Irelands only significant indigenous ethnic minority. There are around 22,000 Travellers in Ireland, making up about 4,000 families. Another 15,000 Irish Travellers live in the UK, and there are 10,000 people of Traveller descent in the USA. Travellers account for 0.5% of the entire population of Ireland. They are a tight-knit community with a strong tradition and culture built around a nomadic existence. Though they are not related to the Roma peoples of Europe, Irish Travellers share with Romanies the sense of being excluded and marginalised in society.
Life expectancy levels are much shorter among the Travelling Community. Travellers are more likely than members of the settled community to die from any given complaint. In particular, Travellers health is affected by accidents, metabolic disorders in the under 14 age group, respiratory ailments and some congenital disorders.
Travellers seem more prone to deafness than their settled counterparts, and are more likely to have uncorrected vision defects. This latter may be due to an association of spectacles with literacy and the settled community. It is estimated that three in four travellers have never visited an optician.
Travellers have a much higher infant mortality rate than the remainder of the Irish population, more than twice that of the settled community. Traveller women are more than three times as likely to miscarry or have a stillborn child as other pregnant Irish women.
Travelling women are three times more likely to be affected by depression. A survey conducted by the Pavee Point Travellers Association revealed that up to one in three Traveller women experience long-term depression.
Endogamy is the term used to describe marriage within the community. The Travelling community is very closely knit, and Travellers tend to get married at a particularly young age. In the 1986 survey, 74% of Travellers had been married by the age of 20. There is a strong tradition of endogamy within the Travelling Community, as Travellers seek partners who understand their culture and wish to share in their way of life.
Endogamy often leads to consanguinity, meaning "same blood" marriages. Technically, any marriage between second cousins or closer is consanguine. Consanguine relationships are commonplace in many parts of the world, but much rarer in Europe.
While there are no health risks specifically associated with cousin marriages, consanguine relationships may have health risks for any children produced. Inherited genetic disorders are more common when parents are related, as the chance of both parents carrying a mutant gene is much greater.
It is estimated that 1% of Irish Travellers carry genetic disorders which may result in health risks for children of consanguine relationships. These disorders are common to the settled population, but occur in the Traveller population at a greater rate. Pavee Point is lobbying for resources to develop appropriate educational and training materials so a genetic screening and counselling service can be provided for Travellers. In this way Travellers will be able to make informed choices.
Ireland as a country has a young population compared to our European neighbours, but the Travelling Community has an even younger population. The 1986 census of the Travelling Community revealed that the average age of Travellers was 14, compared to 27 for the general population.
One reason that the Travelling Community is so young is because life expectancy is much shorter. Traveller men are likely to die 10 years earlier than their counterparts in the settled community, and Traveller women have an expectancy 12 years shorter than settled women. The Travelling Community, in other words, is only now reaching the life expectancy levels that the rest of the population experienced by the 1940s.
Living standards are often cited as the reasons for ill health among the Travelling Community. Certainly, living without the heating, shelter and fresh water that settled accommodation can offer may have some effect on health levels. Often, hygiene in a confined halting site, with poor or non-existent toilet facilities, can be insufficient to halt the spread of disease.
The quality of services provided at official halting sites is frequently the subject of Traveller complaints. For example, when the inhabitants of an unofficial site were evicted from Galway and the families moved to an official site at Carrowbrowne, the new site was situated between a main road and the city dump. Travellers found that people were dumping rubbish at the halting site to avoid charges at the dump.
There is also a culture among Traveller men to consult Traveller women about health related issues, rather than visit a doctor or hospital. New initiatives have led to Travelling women doung courses in primary health care, and acting as intermediaries between their community and the health services.
The Department of Health has a special unit dedicated to developing health and social services for Travellers under the auspices of the Traveller Health Advisory Committee. More information can be obtained from www.doh.ie
Pavee Point is a national Travellers representative association, and has conducted research into many aspects of Travellers health issues and needs. Pavee Point was also instrumental in setting up the primary health care course for Traveller women. Pavee Point can be contacted at www.iol.ie/~pavee
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