Relatives and friends of people in need of blood transfusion are the only blood donors in today's Bulgaria, according to the head of the National Transfusion Centre.

"Bulgaria managed to overcome the shortage of blood mainly thanks to the relatives and friends of people who need transfusions," Andrey Andreev told the state news agency BTA.

Those who can not rely on relatives to donate the needed blood, fall an easy prey to the black market dealers.

Lingering around the National Transfusion Centre, groups of gypsies may look like any other Roma men who roam along the suburban streets of the capital, but their real purpose is trading blood for money.

The Roma charge from BGN 300 to BGN 400 for the priceless document that proves one of them has donated at least 450 ml of blood.

The black market for blood has recently seen some upgrade with the dealers starting to do business online, which only cemented their status as a staple, though stark, example of health care reminiscent more of a third world country than an EU member state.

It is only after the start of the transition period that Bulgarian hospitals became chronically short of blood for transfusion. Under the communist regime hospitals disposed of sufficient amounts of blood reserves as blood donation campaigns were obligatory.

The number of blood donors shrank dramatically since the fall of communism, leaving patients with yet another psychological obstacle to overcome beside the disease itself and the hospitals' insufficient capacity.

Data shows that Bulgaria lags far behind international standards for blood donation – 23-25 donors per 1,000 people against the required 50 donors per 1,000 people.

Poor economic conditions and low living standards top the list of reasons, together with the fact that blood donation costs time, some pain, and occasionally unpleasant consequences.