Ten years after EU accession, the public health system in Romania still faces major challenges. Rural areas are particularly affected, suffering not only from the difficult economic situation, but also from the steady exodus of medical professionals to the cities or abroad. In order to ensure basic medical care in hard-to-reach communities, Switzerland is supporting a project to set up integrated health and social care centres in seven villages.
In these centres various health and social care professionals work together: community doctors examine patients, nurses carry out house visits, and social workers advise the members of their community on various concerns in their everyday life.
Help for people in remote areas
Denisa works in an integrated health and social care centre. She qualified as a registered nurse in Tulcea, the largest Romanian city on the Danube Delta, and now works as a nurse in her native village of Maliuc. Maliuc is about 40 km from Tulcea and can only be reached by boat. Together with a social worker and five geriatric nurses, Denisa is therefore the first and most important point of contact for the 900 inhabitants of the community for all matters regarding medical and social care. Switzerland’s contribution to the enlarged EU paid for the installation of offices and consultation rooms in Maliuc's community centre. In addition, the team has three quad bikes and a boat at its disposal. This is the only way to reach patients in remote areas in a timely manner.
A model for the future
About an hour's journey by boat from Maliuc is Beştepe. Daniela-Ana is the community doctor and lives and works in the new health and social care centre here. For two hours a day she provides consultations in the centre, while the rest of the time she is out visiting patients, checking up on their physical and mental well-being and prescribing treatments and visits by geriatric nurses. Almost 500 people receive care from Daniela-Ana and her team on a monthly basis. News of this success is spreading: the nurses report that neighbouring villages have expressed an interest in the system. The pilot projects in a total of seven different communities are testing and implementing the concept of integrated health and social care services. Based on these models, the Romanian government plans to introduce community healthcare in other parts of the country.
