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It's the height of summer. The scene is a small city-center restaurant, with seating outside. Two men take a table. Both are enormous. Each has a belly the size of an inflated "gaida"(Bulgarian bagpipe).
As they sip their beers and eat their salads, the conversation turns to their poor state of fitness and what to do about their excess weight. One of the pair concludes: ”It's a simple choice for me – it's either two weeks of shame on the beach, or a year in the gym. Nazdrave!”
Lovely Bulgarian humor … but behind this true story there are some serious underlying problems.
A succession of recent news stories and official reports has centered on the general topic of good health here in Bulgaria. The positive news was the large number of public events organized to promote World Heart Day: public talks, concerts, sporting events and even free medical checks at hospitals around the country.
The negative side is that Bulgaria has a dramatically high rate of premature deaths from heart disease, provoked principally by excessive smoking, bad diet and lack of exercise. Cardiovascular diseases account for 65% of all deaths. High blood pressure takes up 40% of the total disease burden.
There are three main causes of heart disease in Bulgaria: cigarette smoking, bad diet and lack of exercise. It may be easy to believe the first factor – smokers are everywhere, among the worst in Europe (46,6% of men, and 32,7% of women, are regular smokers), according to 2007 national statistics.
The Finance Ministry of the new government has recently decided to increase the amount of duty applied to cigarettes. This was already the intention, but the percentage has been drastically raised. It means that a pack of normal cigarettes that currently costs BGN 3,5 will rise in 2010 to about BGN 6. These costs (EUR 1,7 – EUR 3) are still way below western European prices – but so is the per capita income of Bulgaria. The Finance Ministry is, of course, interested in generating tax revenues, but one wonders whether this severe action will help many to give up “the weed”?
But – bad diet? This factor is more intriguing. Go to any open-air market in Bulgaria, and you'll find beautiful fresh fruit and vegetables for sale, at reasonable prices. Visit a restaurant and you are guaranteed a huge choice of crisp salad. So, where's the problem? Apparently, in consuming an alarming excess of home-produced dairy products and tender, tempting meat dishes.
And, exercise? This one is split down the middle: people either do, or don't take regular extended exercise, just as everywhere else. Take a walk in one of the many large parks in Sofia, and watch an impressive number of adults and youngsters jogging, cycling, playing ball games – and they mostly look pretty fit. Then check the little cafes on the fringes of the parks, and you'll surely find the “other half”.
The final piece of bad news was this. Bulgaria has the worst European quality of health care services, according to the 2009 Euro Health Consumer Index (EHCI). There are several factors to take into account, but one of them is surely the unacceptably high rates of fatal diseases referred to above. It looks like a vicious circle, but there must be a way out.
How about this? If all of us, born or living in Sofia, eat a bit less, give up the ciggies, and take a hike on Vitosha, we won't need to queue in hospital waiting rooms, and we'll all be happier. We'll enjoy going to the gym, and we won't be ashamed to be seen on the beach. "Nazdrave!"
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