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Final Report Summary - ROMA AND HEALTH CARE (Health, hygiene and Romani assimilation in Austria and Hungary from an intersectional perspective, 1956-1989)

Health, hygiene and Romani assimilation in Austria and Hungary from an intersectional perspective, 1956-1989

Project goals
This project looked at the similarities and differences between health care/health education policies and practices in relation to Roma and non-Roma populations under two different political regimes: in Western Hungary under the post-Stalinist phase of state socialism and Eastern Austria during the same period, following the end of the country’s occupation by the Soviet Union in 1955. It addressed health care-/health education-related empirical evidence in order to enrich the theoretical exploration of the Cold War, especially continuities/changes in the uses of medicine as a form of politics in the Cold War. The project aimed to answer the following questions: What continuities and changes did the Cold War politics of health entail in patterns of differentiation towards Roma on the two sides of the Iron Curtain? What were the intersections of health and politics? To what extent did medicine serve as a form of politics and was politics medicalized in Cold War Europe?
The research was based on the comparative qualitative analysis of discourses, policies and practices in the field of public health and regarding Roma populations between the 1950s and the 1980s using acts, decrees, ministerial and institutional documents, and medical journal articles related to health care and health education as well as in-depth interviews with health professionals. I paid particular attention to differences between policy-making and local level practices in order to address practices of discrimination and divergence between policy intention and implementation. I applied an intersectional perspective on sources taking into account especially gender and racial/ethnic-based social differentiation in order to qualify statements made on basis of a homogenizing approach to women and Roma as a social group.

Main results/conclusions

The project focused on two main issues in the field of health care/health education: 1) reproductive politics and sexual education, and 2) the role of local physicians in health education across systemic divides.

1) Reproductive politics and sex education in Hungary and Austria, 1950s-1980s: Continuities in discourses about Roma between the interwar and post-World War II periods in Hungary and Austria

Although the repression and elimination of Roma from Hungarian society in the 1940s did not reach the same extent as in the German and Austrian part of the Third Reich, their characterization as lazy and work-shy, used to justify their persecution, was similar. Discourses on Roma in the official publication of the Hungarian Ministry of Health and local-level public health sources from northeast Hungary, where the proportion of the Romani population has been higher than the national average point to the presence of racial hygienic discourse related to Roma during the late 1930s and the first half of the 1940s in Hungary as well as the survival and influence of these discourses on regional policy-making in the postwar period.
While state socialism has been overwhelmingly conceived of in terms of a rupture in relation to political, economic and social structures preceding it, a focus on the regulation of reproduction, that constituted a central element of public health building, also revealed specific continuities. Following the legalization of abortion in 1956 eugenic discourses that were widespread in interwar East and Southeastern Europe, including expressions related to a racial hygienic vocabulary that was in use during World War II, reappeared. Representatives of these ideas in the field of medicine and public health advocated a selective form of pronatalism that directed at increasing birth rate among educated and better-to-do women, while women with a worse educational and economic background were targeted by antinatalist discourses and practices. These phenomena reflected eugenic efforts to improve the collective health of the population by encouraging the procreation of those who were seen to be able to secure the birth and the raising of healthy children. From the early 1970s onwards this idea constituted the reproductive policy program of the state under the heading of “qualitative reproduction.” Eugenically selective pronatalism was connected to the shaping of the “Gypsy-question” in state socialist Hungary. This happened through the frequent, automatic equation of Gypsiness with an inability to provide for their children. The reproduction and “the constantly growing size” of those defined as Gypsies was in turn considered a burden on the state and a danger to the “quality” of the population.
In Hungary and Austria not unlike in other European countries, both East and West of the Iron Curtain, there was a growing abundance of sex education literature from the second half of the 1950s onwards. Sex education was linked to efforts towards increasing birth rates and ensuring “healthy birth” by coupling information on sexual relationships and the sexual act to marriage and child birth. Interestingly so-called family life education publications, which were sex education material that formed an integral part of pronatalist reproductive politics in state socialist Hungary were in terms of their gender content more egalitarian than other sex education publications based on a variety of sources and publications from Western Europe and the United States.

2) The role of local physicians in health education across systemic divides

Roma were a substantial ethnic minority in the Eastern Austria, who were however, almost completely exterminated during the war based on racial grounds. Their victim status was nevertheless not recognized immediately after the war. Existing research on returning Romani victims, who were deported from or interned in Austria, point to the role of physicians in hindering and/or preventing their compensation after the war. Research has also drawn attention to various continuities in the pre-and postwar professional histories of physicians and researchers in the field of medicine and anthropology in Germany and Austria, who were prominently involved in the atrocities committed during the National Socialist regime. Less attention has so far been paid to physicians working at local levels. Research conducted in the present project pointed to the influential role of eugenicist physicians in shaping discourse on the “solution of the Gypsy question” between the late 1930s and the late 1940s and the early state socialist period in Hungary. They contributed to the categorization of those perceived to be Gypsies along a racial hygienic definition combining the theory of the racially “less valuable,” “mixed-blooded Gypsies” used in Nazi Germany with Hungarian racial nationalism during World War II. In the immediate postwar and the early state socialist period they advanced an approach to Roma that retained an understanding of their inborn work-shyness. Physicians in North-East Hungary also played an active role in the transformation and adaptation of racism and eugenics to the socialist ideology of equality based on citizens’ participation in productive work in the early state socialist period. The first Party declaration on the situation of Roma in Hungary in 1961 reflected the survival of an understanding of Roma as work-shy through their categorization along their degree of assimilation into Hungarian society as measured by their “attitude to” work. Medical professionals were furthermore also important agents in the popularization and the execution of reemerging eugenic ideas at both national and local levels between the 1960s and the 1980s in Hungary. While generally supporting the need to educate Roma in the field of health and hygienic practices as a way towards improving their health status, they also voiced their belief in the inborn negative characteristics of Gypsies hindering this process. This highlighted the centrality of public health and its representatives in shaping mechanisms of social inclusion and exclusion in state socialist society.

Potential impact

The objective of the research was to theoretically enrich and fill gaps in research on the history of Roma, and the social history of medicine, health and hygiene. The direct and indirect discrimination Roma suffer in the health systems of Europe, and especially Central Eastern Europe, are well-documented. These are often based on persistent negative stereotypes about Roma. The present project findings could also provide useful input for policy makers and civil society representatives to deconstruct such stereotypes by pointing to the long-term historical roots and structures of the systematic ‘othering’ of Roma within health systems and by health care professionals.

Porject homepage: http://www.ios-regensburg.de/forschung/drittmittelprojekte/health-hygiene-and-romani-assimilation.html
Contact: Dr. Eszter Varsa <varsa@ios-regensburg.de> <varsae@yahoo.com>

Related information

Documents and Publications

Reported by

Stiftung zur erforschung von Ost-und Suedosteuropa
Germany
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