[Roma colonies in Hungary--medical care of children and hygienic conditions].

INTRODUCTION The hygienic conditions and the public health safety of the Hungarian Roma living in colonies are poorly known, the health care of Romany children is often subject to criticism. AIM The authors aim was to identify the blank areas present in public health and to analyze the medical care of children living in Gipsy colonies. METHODS Medical care of children living in Gipsy colonies in Hungary and the hygienic situation of these colonies have been analyzed. The examinations, performed by the staff of the National Public Health and Medical Officers' Service included all counties and the capital. Data were gathered from answers given to the questions in the circular sent by the Chief Medical Officer of State, by questionnaire-interview method as well as, by on site hygienic examination. Data from the series of examinations were completed by the data of the National Institute for Basic Medical Care. RESULTS According to the hygienic definition of Romany colonies, there are 767 colonies in Hungary, scattered in 530 habitats, while according to the definition of availability of public utilities and structure of the colonies the number of colonies is 300-400. There are no Romany colonies in the capital, while most of them are located in the counties Hajdú-Bihar, Baranya, Szabolcs-Szatmár-Bereg and Borsod-Abaúj-Zemplén. A population of 3 million is living in the habitats with Romany colonies; 138000 (4,7%) of them are living in Romany colonies, or in colony-like communities with similar hygienic situation. In these habitats 5,8% and 16,3% of the population are children of 0-5 years old and 0-14 years old, respectively, while in the colonies the same numbers are 15,8% and 35,6%. Medical care is provided by 456 family pediatrist for the the habitats with Romany colonies. Consulting hours for the children population of 11,4% of the family doctors seems to be insufficient (< 15 hours/day/5 days/week). Only 60% of care for children is provided by specialist in pediatrics. 94% of emergency care for children is provided for family doctors of the adult population (this proportion is characteristic for the whole country). 12,5% of district nurses caring for the colonies provide care for more than 2 habitats; 147 of them (22% of all district nurses) provide care for more than 750 persons (experiences show that appropriate care can be ensured if the number of care recipients does not exceed 300 and the maximum number of settlements under care is two). Illegal waste deposits and animal carcase disposal site are located within 1000 m of 15% and 11% of the colonies, respectively. Most of the dwelling sites are messy, hygienically neglected, rodents and unvaccinated stray dogs are frequently met in their neighborhood. CONCLUSIONS 1. sufficiently accurate data are not available on the Gipsy colonies (number, location, population, children population), partly due to the related different definitions and partly because this issue of public health importance is not treated uniformly. The repeated examinations of the National Public Health and Medical Officers' Service presented here only improved the relevant information; 2. child health care of the Gipsy colonies does not differ from that of the rest of the Hungarian children, but similarly to that, a lot of corrections are needed--especially regarding the emergency service; 3. the hygienic situation of the Gipsy colonies is not acceptable, it endangers the public health and epidemiological safety of not only their inhabitants, but the whole country.