When the war in Ukraine erupted in February 2022, the Romanian Government and citizens warmly welcomed hundreds of thousands of Ukrainians seeking sanctuary. By February 2023, over 2.4 million Ukrainians had sought refuge in Romania, with more than 100 000 receiving European Union temporary protection status.
The Romanian Government immediately recognized that the refugees needed access to health care, and offered them the same level of care as that of Romanian citizens with health insurance. However, communication and language barriers, the unfamiliarity of the health-care system, and lack of knowledge and information created obstacles that impacted refugees’ access to services.
In response, the WHO Country Office in Romania recruited 7 Ukrainian-speaking cultural mediators through the United Nations Volunteers programme. The cultural mediators have been deployed in Bucharest, Galați, Cluj, Târgu Mureș and Brașov, where there are significant populations of Ukrainian refugees. They are based in the WHO clinic in Bucharest, in the Blue Dot service in Galați, and in the wider communities of the other cities.
Cultural mediation, a recognized profession in Romania, can ensure that people are able to access high-quality health care. The 7 cultural mediators have professional backgrounds in medical science, psychology and social science. They speak Ukrainian and Russian as well as English, and are attempting to master the Romanian language through classes or online learning applications.
The services are diversity-friendly and aim to prevent discrimination. They include psychological counselling and psychosocial support, information on referral mechanisms and pathways, and health promotion. The cultural mediators also provide support related to sensitive topics such as human trafficking, sexual and labour exploitation, and gender-based violence.
The mediators are responsible for raising awareness about health referral mechanisms and pathways among refugee communities, and for providing introduction sessions on the health-care system. To support their work, WHO has disseminated information about health-care access, availability of medicines, vaccination and proper antibiotic use.
WHO is also supporting 7 family-doctor clinics and collaborating with civil society organizations to provide free-of-charge primary-care services to refugees, including sexual and reproductive health care, and mental health and psychosocial support. To date, around 2200 refugees have accessed these services since June 2022.
“People affected by conflict are vulnerable and require appropriate support to access quality health-care services in a timely way. WHO supports the Ministry of Health and the national authorities to increase access to quality health-care services for patients so they can be cared for by health-care professionals wherever and whenever needed,” explains Dr Caroline Clarinval, WHO Country Representative in Romania.
“We know that people’s behaviour is affected by many different factors. Ensuring that refugees in Romania have health literacy materials available in Ukrainian, showing understanding of different belief systems and addressing issues such as disrespect, discrimination, fear and mistrust, can make a huge difference to patients,” she adds.
“Working with cultural mediators helps WHO to adapt, adopt and create good practices which in turn help to build a culture of health in which everyone is enabled to make healthy choices in their daily lives and in the way they use health services.”