Sanitation Infrastructure at the Systemic Edge: Segregated Roma Settlements and Multiple Health Risks in Slovakia

Richard Filčák,Daniel Škobla

doi:10.3390/ijerph18116079

Abstract

This article explores how multiple health risks in municipalities with Roma settlements in Slovakia are related to the varieties of local governance and the authorities’ conduct towards the local Roma population. The first part of the paper describes the situation in Roma settlements from the perspective of unequal access to sewerage and water pipelines. Introduced here are data on identified contagious diseases that correlated multiple health risks with the lack of sanitation and/or water infrastructure. The second section of the paper put forth typologies of government approaches towards the Roma, which based on ethnographic fieldwork, allows us to identify factors of attitudinal, structural and policy-oriented nature. Research results point to a “triad” of key circumstances: these are the structural conditions in municipalities and the history of local inter-ethnic relations and attitude of authorities towards Roma. Finally, possible solutions and approaches regarding how to mitigate the multiple health risks are discussed. It is suggested that on the one hand, in many villages there is a profound institutional discrimination of Roma with respect to water and sanitation infrastructure; on the other hand, water services are increasingly becoming an expensive commodity that not everyone can afford. The article concludes with discussion on enabling conditions and ways to ensure access to basic infrastructure in rural Roma communities. The solution is not only a compliance with principles of non-discrimination and existing technical norms and standards but also in securing the accessible funding for construction of the sanitation infrastructure in a smart way, including innovations and operation of cheaper and environmentally responsible sanitation technologies.

Highlights

Poor health among Roma in Slovakia living in segregated communities is often incorrectly interpreted as being the result of their “traditional” way of life or, as a consequence, of a “culture of poverty”
This article explores how multiple health risks in municipalities with Roma settlements in Slovakia are related to the varieties of local governance and the authorities’
The aim of the research was to explore the conduct of local governments in addressing multiple health risks in Roma settlements, which we considered to be located at the socalled Systemic Edge [32]

Summary

Introduction

Poor health among Roma in Slovakia living in segregated communities is often incorrectly interpreted as being the result of their “traditional” way of life or, as a consequence, of a “culture of poverty”. Pictures of hundreds of shanty dwellings lacking very basic access to water and sanitation are one of the characteristics of many localities in which poverty-stricken Roma live. Sewerage is often absent and a receptacle such as a pit in the earth for use as a toilet located on slopes above settlements or in close proximity to water sources is not rare. This article explores how multiple health risks in municipalities with Roma settlements in Slovakia are related to the varieties of local governance and the authorities’. It is argued that the absence of basic physical sanitation infrastructure inevitably leads to higher exposure of inhabitants and this correlation is clearly manifested by the disproportionately higher prevalence of contagious

Objectives

Results

Discussion

Conclusion