New approaches facilitate social work in Macedonia

In the Western Balkans, many towns and cities struggle to ensure everyone has equal access to social services. In Tetovo, a town in Macedonia, an advisory team is now taking the help directly to where it is needed.

A swollen knee, two patients with back pain, one with an upset stomach, two with heartburn, one person requiring a tetanus vaccination, plus a large group of people seeking treatment for high blood pressure – Doctor Arif Pini has his hands full. Today, he is visiting a Roma settlement on the outskirts of Tetovo, Macedonia, to provide medical care to neighbourhood residents.

Arif Pini is a member of an advisory team, a structure that also involves Sonce, a nongovernmental organisation. Sonce, which means ‘sun’ in English, is an organisation that mainly caters to Macedonian Roma, a segment within the population that suffers from discrimination and is pushed to the fringes of society in many Western Balkan countries. Arif Pini has himself suffered from discrimination. As the only graduate of his year, he was not admitted to medical school by the Macedonian state after completing his medical studies. “Because I’m Rome,” he says. „In the end, it was only through a scholarship from abroad that I could become an internist.”

For the past three years, Arif Pini, Sonce staff and local social workers have been driving out to Roma families to provide them with advice and support, by helping with benefits applications, school registration or health problems for example. The people they visit are poor. Hardly anybody here has a higher secondary school leaving certificate, a secure job or even enough money to get by. Most Roma also have no access to health care services. According to Arif Pini, ‘most only seek medical attention when it’s already too late’. Many Roma have no health insurance and can’t afford a doctor’s appointment. A further problem is that there are nowhere near enough doctors in Macedonia. Many have moved to countries where they can earn a higher salary.

The solution – a partnership between the city council and an NGO

For the city council of Tetovo, this problem is not new. However, a lack of money and personnel has meant efforts to improve the health care provision to socially disadvantaged groups have repeatedly stopped short of the mark. Things only changed with the GIZ regional project Ahmet Quazimi of the municipality of Tetovo: ‘We can finally offer help where it is needed.’ Social Rights for Vulnerable Groups. The project promotes innovative approaches to social work aimed at improving the living conditions of people from socially marginalised groups in Western Balkan countries.


One such new approach was to create synergies between the city council and nongovernmental organisations. The NGO contributes to municipal social work and offers services the city itself cannot provide. In Tetovo, this idea brought about a partnership between the city administration and the Sonce NGO, which receives support from the GIZ regional project Social Rights for Vulnerable Groups. They worked together to identify neighbourhoods with particularly needy populations and developed a plan to improve the services delivered to them which includes medical attention. Project partner efforts focused on developing the concept of mobile teams that visit the identified neighbourhoods and offer immediate counselling or medical attention to the people there. Doctor Arif Pini is a member of one of these teams.

‘We don’t wait for people to go and see a doctor; we take the doctor to them.’

For Ahmet Quazimi from the city council, the project has been a huge success: ‘Through working with Sonce, we were finally able to offer help where it was needed. If people don’t go to see a doctor, or if there is no doctor near where they live, then we take the doctor to them.’

However, this new approach cannot fully resolve every issue. ‘Many people still have reservations about, or are even afraid of, talking to municipal and NGO staff, even when we visit them at home,’ says Quazimi. For the Tetovo city council, having Arif Pini on board makes a considerable difference as he is Roma so many patients see him as one of their own.

‘Arif Pini is our icebreaker,’ says Biljana Dijanisieva from the GIZ regional project Social Rights for Vulnerable Groups, which facilitated the partnership between the city council and Sonce. ‘He builds trust and opens doors. With him on board, we are finally able to reach all of Tetovo’s families.’ This will help ensure the project achieves its target which is securing the social rights of marginalised groups – in this case, the local Roma population.


Text: FLMH | Photos: ©BENNY GOLM