Gypsies, otherwise known as Roma, came to the Americas with the very earliest settlers. Throughout the course of the past 500 years, the Roma, their preferred name, have held on to their traditions and practices. Historical written record says that the Portugese exported Gypsies to South America. According to legend, the Portugese did the same thing in what is now South Carolina, long before the English came to settle the area. The long tradition of Gypsies in the United States is almost as interesting as the origination of Gypsises as a people. Gypsies originated in India over 1000 years ago, migrating to Europe in the Middle Ages. No one knows for sure how or why they began to wander the globe as they have. Today, there are more than twelve million Roma located in many countries around the world. Because the Romani are almost never included on official census counts, there is no way to confirm that number.

Many Roma around the world do not admit to outsiders their true ethnic and cultural origins, mostly for economic and social reasons. Howvewr, even though they may not admit it, the Roma are a distinct ethnic minority, distinguished by language, Romani or Romanes and blood from other types of people. Despite the ill treatment and injustice they have been subjected too, the Roma have thrived for centuries.

There have been several diaspora in the history of the Romani. The first migration, was, of course, the initial dispersal from India about 1000 years ago. Some scholarshave suggested that there might have been several dispersions from India around the same time. The second great migration, known as the Aresajipe, was from southwest Asia into Europe in the 14th Century. The third migration was from Europe to Americas in the 19th and 20th centuries after the abolition of the enslavement of the Romani in Europe theat took place between 1856 and 1864. Some scholars suggest that there is yet another graet movement of gypsies today, beginning with the fall of the Communism in Eastern Europe.

Like biological species, the Romani culture is very dependent upon the area in which a specicifi9c group of roma live. There are many tribes, and like biological creatures, they adapt culturally to their surroundings. There is no definition of Romani culture, no classification scheme for these people. They are a people that defy classification. There are, however, several attributes common to all Roma tribes. The first of these is loyalty to the family, whether it be extended or clan; a belief in Del (god) and Beng (devil). Roma believe in predestiny, Romaniya, the standards and snorms of the people, which change in degree form tribe to tribe, and adaptability to changing conditions.

The integration of many Roma into Gajikane (non-Roma, or foreign) culture has diluted many Romani cultural values and beliefs. Not all tribes have the same definition of what "Roma" is. What one group may accept as being true Roma, may be gadje to another tribe. Romani culture is diverse, with many traditions and customs. Tribes all around the world have their own individual beliefs and rules. It would be an invalid generalization and a severe oversimplification to paint all Roma with the same brush.

Over the past 1000 years, there have been many large-scale, state sponsored persecutions against the Roma in all the lands they have traveled in. Perhaps the most well-known is the Nazi ethnic cleansing. The Third Reich is responsible for the deaths of up to 1.5 million Roma. The collapse of communism in Eastern Europe over the past 15 years has re-kindled anti-Roma sentiment in eastern and western Europe. Violent attacks against Romani immigrants and refugees have been permitted to occur with little or no restraint from government authorities. After many years in Europe, The Romani people remain the least integrated and the most persecuted people of Europe. Almost everywhere, the fundamental civil rights of the Roma are threatened. Racist violence targeting Roma has been rising since the fall of the Iron Curtain. Roma face discrimination in every aspect of life, employment, education, health care, administrative services like welfare, and other services that many people take for granted. Hate speech against roma is somehow socially acceptable in many ocieties, which perpetuates the cycle of racism even further into the future.

Anti-Roma attitudes also exist in the Americas, to some extent. Roma are stereotyped and misrepresented in news, books, films, television. Some areas even have special "Gypsie" units in police forces to deal with and warn the population of 'Gypsy" activities.

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In the past several years, the issue of the Roma has been addressed by several non-governamental organizations, national and international. Economic, social, political, and cultural approaches have been applied in the hopes of raising the living standards, promoting a more just social policy, encuraging Roma political participation, and strengthening Roma cultutral identity. Solutions to the many problems faced by Roma are being sought in the context of the struggle against racism and nationalism as well as in the context of enhancing cultural pluralism.
Gypsies are a largely unknown ethnic population in the United States. As stated earlier, most countries do not keep accurate census data on their Roma populations. However, most estimates suggest that there are between one-quarter million and a half-million Roma living in various regions of the United States.

All told, Romani in the United States are not a healthy group. They have high rates of heart disease, diabetes mellitus, as well as hypertension. On the rare occasion that an American Roma will seek professional modern medical care, the hospital staff will find the behavior of a Roma troubling and confusing. The Roma will often times be labeled as troublemakers. Not that all this trouble is the fault of the hospital or clinic staff. Roma are often suspicious of non-Roma people, places, and institutions, believing them to be unclean. For the Roma, ideas about the cuses of health and illness are closely tied to the ideas about good and bad fortune, purity and impurity, and inclusion and exclusion form the group. The basic principles affect everyday life for the Romani, including such basics as eating, bathing, doctors, hospitals, illness, medicines, birth and death.

There are many cultural barriers that can prevent a Romani from going to a hospital for medical treatment. Much of this trepidition ensues from cultural differences in the orgiginds of illness, what is considered clean and unclean, and what is permissible and what is not permissible in regards to maintaining personal purity.

Some of the problems facing the medical community in regards to delivering health care to this group of people is often the confusion that ensues over the medical treatment that Roma can demand. For example, a Romani person may ask for a famous doctor and demand a specific treatment, even though the treatment and the doctor may be totally inappropriate to what they actually need. A Roma may also ask for a specific color of pill that they will share with relatives who need the same colored pill. They will refuse treatment by an oung doctor or nurse, preferring older, more mature doctors and nurses to care for them.

It can be extrodianrily difficult to get a roma to follow prventative and long-term treatment. When a relative is sick, large groups of family members will show up, camping out on the hospital grounds, disregarding visitation hours and rules, and creating general chaos in the hallways of the hospital. Hospital personnel often do not know how to deal with the Romani.

As difficult as this situation may seem to a health care professional, Roma can be good patients. They respect authority, within their own families; they have an unusually large network of friends and family for support. They are eager to learn about the best treatment for themselves and their families. Doctors, nurses, and other health care professionals can use all these factors to their advantage in assisting and providing health care to Roma, all the while reducing the general disruption and chaos that can result from an ill Roma.

In the United States, Romani usually live in urban areas, on the main streets, in the poorer areas of the city. Romani can usually not be identified as such by a person walking down the street. The men wear American clothes. The women however, particularly older women, wear long colorful skirts and low-cut sleeveless blouses. As mentioned earlier, Roma, for social and economic reasons, often prefer to pass themselves off as another ethnic group. They may claim to be American Indian, Mexican, or Romanian. Sadly, they are accustomed to the discrimination they face all over the world. People often stereotype them either romantically as free spirits or as thieves. Like most stereotypes, neither of these are necessarily true. Although they do not publicly admit their ethnicity, if a doctor, nurse, o other medical professional intimates that it would help them to care for the patient if the hospital knew the patient were a Roma, then most Romani will freely admit to…