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Title: Containment : an examination of Roma health mediation in Romania
Author: Kühlbrandt, C.
ISNI:       0000 0004 6497 201X
Awarding Body: London School of Hygiene & Tropical Medicine
Current Institution: London School of Hygiene and Tropical Medicine (University of London)
Date of Award: 2017
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This thesis critically examines the ways in which “Roma health” is physically and discursively enacted in communities. Following a year of participant observation of the Roma health mediation programme in Romania, I borrow productive elements from post-colonial and intersectional theories to analyse the tensions and ambivalences that arise from interactions between mediators, community members, health professionals, and local authorities. Beginning with the case of a community which was rehoused in shipping containers after being evicted from their homes, the “container” emerges as an apposite metaphor which I have used to structure my thesis. The thesis investigates the “contained” nature of many segregated communities and how this influences their material and health conditions, as well as asking how this affects the construction of “Roma” communities. I analyse attempts at “containing” ethnicity within a categorical binary of “Roma” and “non-Roma”, while observing how the contestation and negotiation of this binary, along with its implicit hierarchies produces “leaky” categories. The thesis attends to the “containment” of health, exploring how in regard to hygiene, vaccination and reproductive health, participants map concepts of “good” and “bad” patients onto Roma ethnicity. In this context mediators are often constructed as actors who transform “bad patients” into “good patients.” I show how mediators use their involvement in creating “good patients” to produce local meanings of “citizenship” and “non-citizenship”, and how people responded by participating, resisting, negotiating, or perpetuating their positions within these classifications. Finally, while acknowledging the important contribution that health mediators bring to accessing health care, I discuss the mediators’ role in promoting a neoliberal approach to governing Roma communities. I suggest that Roma health mediation could learn from dialogical and emancipatory approaches to participatory interventions in health, which aim for transformative encounters between parties while also fostering critical consciousness and aiming to change communities’ structural environment.
Supervisor: Renedo, A. Sponsor: ESRC
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral