A former miner blows himself up to stop the excruciating pain. Orphans, elderly and mentally ill people face the grisly prospect of having their teeth pulled out without anesthesia.
No, these are not stories from the annals of the Inquisition. This is today's Bulgaria and the stories of its most vulnerable heroes – the terminally ill and the abandoned.
When the medicine can no longer help the patient, there is one last gesture it is obliged to make – try to alleviate the pain.
Shortage of morphine – used in Bulgaria to ease the suffering of cancer patients because of lack of other more sophisticated pain killers – forced the former miner from the village of Novachevo to put his professional skills to good use and find peace in death.
Shortage of money in the health insurance fund – crippled by corruption and used in Bulgaria as a tool for funds siphoning – will force those three disadvantaged groups to just skip the dentist altogether.
The echo of the miner's blast is so loud and the thought of no aneshesia so shocking that it makes any comment sounds silly and cynical. Especially the following quote by Vladislav Goranov, Bulgaria's Deputy Finance Minister:
"Bulgaria lost momentum in the health care sector because there was no clear concept which way to go. The things that can not be planned will have to be left to their natural development... We can make up for the lost time by implementing radical measures such as the closure of hospitals that are not economically viable, but have been kept open out of pure local patriotism."
In other words - survival of the fittest, cheekiest and richest.
The truth is that Bulgaria's finance ministry belt-tightening policy has created the illusion of a healthy economy on the back of the people, who are three times poorer than the average EU citizen and are just getting poorer.
When struck by a severe condition, Bulgarian nouveaux riches regularly go abroad for treatment. The less fortunate have more sinister stories to tell.
For them a light in the tunnel of Bulgaria's problem-ridden and facilities-short health system seem to be only its doctors and patient organizations, which have won many battles so far in defending the patient's rights. The relations between patients and doctors, however, are often strained, mostly because the doctor is considered as part of the dreaded system and has no money and time to pay the patient the necessary attention.
Some say the media is guilty of presenting the state only as a cruel step mother in its care for the cancer sufferers, which is described as genocide.
Well, go to any municipal hospital even in the capital and you will see that after years of lumbering reforms in Bulgaria's health care system, it looks and acts like it has switched into a war-time regime, tapping into the reserves, meant to be used in case of natural disasters and wars. Why? Lack of cash, of course.
Patients, particularly the cancer sufferers, and their families feel abandoned in their struggle to come to terms with the illness, both in terms of treatment and emotional support. Unlike other European countries, whose health care systems do their best to fund extra services to support these people and their relatives through the darkest of times, those who have been diagnosed with cancer in Bulgaria face a chronic shortage of life-saving medicines. Not to mention the lack of support they need to cope with the emotional turmoil of the illness.
I remember an American woman, who allowed her hair to be cut by her 4-year-old daughter, as she was going to lose her hair anyway during chemotherapy. Not only was she worried about her own prognosis, but she was afraid of her daughter's reaction to the news. And she found a great way of alleviating the terrifying task of telling her daughter Mommy has cancer.
A number of cultural and social factors have prevented Bulgarians to talk about illness or body or approach the issue openly. Thousands of parents face the same dilemma of that American woman, but rarely come up with original ideas. Anger, pity and shame are the most common feelings that emerge.
There is only one way out – an open and honest relationship between doctors, patients and non-governmental organizations, combined with pressure on the state to provide for those who need it most.
Otherwise shall we have justification to pout when foreigners snootily refer to us as the vulgar Bulgars?
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Doctor, doctor - how are the rose tinted spectacles today?
Try and read the words of what I say and not draw out conclusions based on what you think I said instead of what I said. Reading, it's an important skill - especially for a doctor.
Now - I love Bulgaria. In many ways it is a great place with a fascinating history. As for its people, I loved one so much I married her.
I'm not especially keen on the name 'Vulgaria' but as a title for the article it was appropriate. I agree, there are lots of lovely, hard working, kind and educated people in Bulgaria. however there are also lots of nasty, lazy, aggressive and ill educated morons as well. This is the case in pretty much every country. I don't think Bg can be described as utopia in any but the most deranged mind.
However - back to the article. The title was appropriate. But you suggest that it should not have been used because it displays a negative side to Bulgarian culture and has negative connotations. Firstly if you really know Bg and have had first hand experience of the health care system you could understand the point. The British NHS may not be the best health care system in the world but going through the various hospitals in Sofia during my poor old mother-in-laws cancer treatment was an eye opener. It is appalling in so many ways, the nursing staff that required backhanders before they would do their job, the surgeons that expected "gifts" after performing surgery and so forth. The crumbling and decaying infrastructure and the lack of proper supervision of staff. Indeed - to be fair - I also came across dedicated medical practitioners who were doing the best against the odds in a broken and corrupt system.
But you - you don't want to mention that. You would prefer the local media exercised a form of self censorship that has underlined of the introduction of some of the worlds nastiest regimes. Fortunately the media in Bulgaria is still largely free to criticise any arm of government it fees like and that is an essential part of the hard won freedoms exercised. Well done them. If you are really that fond of censorship - try Belarus.
The Bulgaria state, that being the PM and the parliament - vulgaria is an appropriate title. Sadly lacking in genuinely civic minded people that want to bring the country on and overloaded with people that defend and protect corruption and line their own pockets. You defend that all you like old fruit - me - I prefer to see the truth even when the truth is ugly.
I feell so sorry for the English commoner who seems so keen on the name Vulgaria, which he considers 'resaonable' as a way of describing the Bulgarian state and its people . In the same time I am so proud of the Bulgarians who have completely reject this awful and wrong descripton of Bulgaria and its lovely, hard working, kind, educated and tolerant people.
“It is deeply annoying to anyone arriving into a shambles of a hospital in a capital city like Sofia where private nightclubs and discos reach a level of luxury unseen here, in this rich Basque Country, and expensive cars roam around until the aearly hours of the morning.”
This is the first time I have heard (read) of Bulgaria (not Vulgaria, though) being identified as a rich Basque country. As a Bulgarian-born (not Vulgarian in any way, I hope) I can say that I have no idea why would anyone call Bulgaria rich country too. It is beautiful one, but rich it ain’t.
Feeling annoyed on account of the inadequate medical care of Bulgaria is almost insulting. Outraged would do better, in my opinion. But then, as a Bulgarian born (not Vulgarian or Bulharian, as some other smart you know what, like to refer to themselves) I might be a bit too sensitive. But in no way on account of a parallel drawn between the state of the Health care in BG (that is better than Vulgaria me thinks) and the private (what else?) night clubs and expensive cars roaming around blah, blah, blah…
Am I hearing echoes of class struggle rhetoric? Hmm….
She's not wrong about the problem though...
As Alexis de Toqueville said (or was it Josephe de Maitre?), "in a democracy, people get the government they deserve".
A root cause analysis would in my view reveal that the lack of funds for healthcare mentioned in the article were brought about by the behaviour of an utterly depraved and shameless political class, with its collective head firmly in the trough of public funds on an unimaginable scale. Not to mention its well-known alliance with organised crime, who, of course have their snouts in the same place.
The combined product of this, as in any other kleptocracy (for Bulgaria is a kleptocracy) is the reason why cancer sufferers are left to die in agony, why the pavements are full of dangerous holes and packs of feral dogs; and why the rubbish and pollution spiral skywards, as testaments of shame.
The ultimate culprit such an analysis would uncover, however? The apathy, shrugging acceptance and, yes - connivance - of the Bulgarians themselves. Bulgaria could be the Switzerland of the East if the apathetic natives had better leaders than they deserve.
Wake up, Bulgarians - only *you* can resolve this.
It seems shocking that a person that classifies himself as a doctor (uk or not) is so bloody stupid that he thinks the problem with the article is the title.
The article is well written, and the title is reasonable. There would be something terrible wrong with journalism in Bulgaria if it were not allowed to express negativity about the state in which it operates - an open media is perhaps one of the good things about Bulgaria. Anyone that has experienced care for serious or terminally ill can judge that this article, if anything, is over gentle on the Bulgarian system.
The problem with the article is its accuracy. the problem is the state of health care in Bulgaria. the problem is that, as a proportion of GDP, spends less on health care than any other EU nation (at least it did in the last set of statistics I saw, which may be out of date) and that is unforgivable.
What a shocking name to use. it seems unthinkable that a bulgarian journalist would ever use such a derogatory name to describe her own country. Possibly she does not feel Bulgarian or despite her average grasp of the English language she seems unaware of the impact of a name such as 'Vulgaria' could have abroad. Some articles on this site despite being checked for grammar and phonetic errors deffinitely lack style, which reflect poor understanding of the language used.
I have been reading with certain alarm the news coming out of Bulgaria these days. Your writings are really clarifying and draw the picture of a nation whose big heart is being destroyed by a few....no society can develop under the circumstances affecting Bulgaria, which seems to be in the hands of a group of unsocial economic and political individuals.
Cancer is in itself awful enough for anyone to bear and having to face it without a minimum level of hospital care is really disturbing. It is deeply annoying to anyone arriving into a shambles of a hospital in a capital city like Sofia where private nightclubs and discos reach a level of luxury unseen here, in this rich Basque Country, and expensive cars roam around until the aearly hours of the morning.