Wednesday, June 21, 2006

What passes as good news in Bulgaria

Our second-in-importance TV channel, BTV, regularly features in its central news emission The Good News ("Dobrata novina"). It is interesting to see what passes as good news after 16 years of half-hearted imitation of capitalism. Last week, The Good News showed a single mother of 3-year-old twin girls. The mother was caring for them alone, with 160 leva (EUR 80) monthly welfare and loans. Nothing was said about the father. Bulgarian laws and practice are very kind to men who divorce or make children out of wedlock; these fathers usually are forced to pay only symbolic sums for their children and get away when they prefer not to pay even these cents. The worst thing in the story was the hydrocephaly of one of the girls. It was relatively mild, otherwise the child, who looked normal on TV, wouldn't have survived at all. However, she had some abnormalities in development and couldn't speak. Although speech delay is not uncommon among 3-year-olds (my own son will soon be 3 and still isn't talking), the kindergarten used it as an excuse not to accept the child, forcing the mother to stay at home to provide care. This was all introduction. The story proper: The mother was told that, in order to develop near-normally, her daughter needed a brain-draining implant costing 3000 leva (EUR 1500). You understand that if they had requested a million, it would have been the same for the mother. She put charity-collection boxes in all local shops and people dropped their change, but the needed sum was not likely to be collected this way during the current century. Then, residents of the district had another idea. They emptied their basements from old paper and glass packages and brought all this for sale. The price of recycled materials if very low, but the quantity must have been huge, because the 3000 leva were collected and now the child will have the badly needed implant.
Well, dear reader, do you see anything really good in this news? Should we be so happy that an innocent little girl is given some chance which must have been available from the beginning? What if the residents hadn't come to the recycle-and-sell idea, or had cleaned their basements more regularly during the years? How much precious time was lost until some genius got the idea, and then in the inevitable technological delay while moving old papers and bottles around?
According to Bulgarian law, government pays the health insurance of all children. However, it is not uncommon for a health-insured patient to hear that he needs some treatment that costs EUR 1000 or more and, although essential, is not covered by health insurance or the money is exhausted for the moment. This is incomprehensible for the normal mind, but it is a fact. The most famous case in recent time are the cancer patients, periodically deprived of drugs that must be taken regularly to prevent tumour relapse and progression. Atanas Shterev, surgeon and member of Parliament, got attention with his public remark that "we mustn't waste so much funds on cancer drugs, because patients with cancer are doomed anyway". Drugs taken by transplanted patients to prevent rejection of the organ also go missing periodically. In general, any patient needing a relatively expensive treatment for a relatively rare condition is likely to find himself in this situation.
I think this is because our health care is based on herd mentality. Its philosophy is to keep the population as a whole in fair health to ensure people's fitness as workers and taxpayers, rather than to guarantee the life and well-being of the individual. I suppose this is because Bulgaria has rudimentary civil society, no religious values, small per capita income and a recent totalitarian Communist past.


Maya M said...

Update: a link in Bulgarian about the story
In fact, the residents collected only 500 leva (EUR 250), but caught the attention of a bank, which made a donation.

AlanK said...

hi maya

just found your blog from highlanders, First time read bulgarian blogwill try to link to you, remind me if I forget

also the story itself is very sad, suprised that bulgaria does not have an NHS type health system

programmer craig said...

Don't forget to link Maya, Alan! :D

Maya, I have mixed feelings about this story, that's why I haven't commented before now. It *is* a happy story - I especially like the way people pulled together to help this child. But on the flip side, the back story that makes it necessary for altruistic community involvement is pretty depressing :(

Anonymous said...

By the way Maya I dotn think you should write so certainly about things that you are not familiar with. If you read what the report really said (Atanas Shterev) it was going to protect cancer patients by distributing the money evenly for preventative care and cancer care. In Bulgaria most cancer patients get diagnosed when its already really late in the process, what the law was going to try to do is get some money for people to be able tog et to preventative examinations annually so that if they do get cancer they catch it earlier and therefore have a better chance of surviving. Also, Atanas Shterev is not a surgeon, he is a gynecologist. There is a big difference between the two. Please, next time you write about something, try to not just throw alleged opinions out there.

Maya M said...

In Bulgarian, "hirurg" (surgeon) means only a medical doctor who has successfully completed a residency of Surgery and possesses a document with the word "hirurg" written in big bold letters.
In English, "surgeon", besides "a physician who specializes in surgery" may also mean "a doctor who performs surgery", "a physician with a medical doctorate (MD) degree and advanced training in surgical techniques" (, which doesn't seem to exclude gynecologists.
In particular, Dr. Shterev has published articles about his surgical work (see what is now No. 5 and 6 at
As for the money matter, it is of course a very efficient and cunning way of withdrawing the money from health care to deny it to diagnosed patients and to say you instead relocate it to preventative programs, where it will be safe, because in Bulgaria people are NOT recruited to preventative programs other than immunizations and pregnancy care. I would ask the anonymous author what preventative care he or she has received (current laws already do include such programs).