Health and Medical Information for Bulgaria
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On the western coast of the Black Sea lays the country of Bulgaria, officially the Republic of Bulgaria. Roughly 110,880 km² in size, Bulgaria shares its borders with Romania to the north, Turkey to the south east, Greece to the south, and Serbia and Macedonia to the west. Bulgaria was a country that was locked for over 40 years behind the Soviet Union’s iron curtain, but now shows very little resemblance to its former communist self. Bulgaria government works as a parliamentary democracy within a unitary constitutional republic.
The Bulgarian health system
is mainly controlled by the Ministry of Health. The Ministry of Health is responsible for the progress, execution and supervision of the National Health Service and policy within Bulgaria. In 2010 the Bulgarian health care was still under a state of return. The poor healthcare system makes the need for reform that much more pressing, with Bulgaria having one of the worst health care systems within the European Union. Bulgaria also spends one of the lowest percentages of the GDP on healthcare in the EU. The National Health Insurance Fund (NHIF) controls and manages the medical insurance system for Bulgaria. NHIF carries out its administrative duties through its 28 territorial divisions, known as regional Health Insurance Funds. Availability for the public state provided healthcare varies bigger cities and towns having more access to clinics, doctors, medical supplies, and hospitals when compared to restricted rural areas. Though with the NHIF set up out-of-pocket and informal means of payments for medical care is still widespread. Expatriates working within Bulgaria do have the ability to use the NHIF to help subsidize costs but medicals costs, especially in private facilities, have the possibility of running high. Traveler insurance covering healthcare is needed for expatriates and tourists staying within Bulgaria for a short period of time. The Bulgarian government requires it in order to be admitted into the country.
While Bulgaria’s public sector does have over 1,600 medical facilities, 262 of which are hospitals, the level of care is lacking. Most hospitals are only able to provide basic care and are old-fashioned when compared to western standards. Bulgaria has over 60 private facilities, mainly situated within bigger cities and towns, such as Sofia. Private hospitals do contain better facilities, equipment and more access to medical supplies. Both private and public health facilities have had issues with hygiene. In 2009 and 2010 Bulgarian public facilities had been having problems of shortages of medical staff, worsening the availability of proper medical care within the country. Expatriates looking to work in Bulgaria should obtain and international health insurance plan. This will ensure their ability to receive high quality medical treatment from the nearest healthcare facility, which might not be within Bulgaria.
With Bulgaria being part of the European Union, European Health Insurance Card (EHIC) holders are entitled to some medical services within Bulgaria; though the EHIC does not act as a sufficient substitute for proper international medical and travel insurance coverage. The EHIC grants the holder emergency medical treatment that is necessary on the same terms as Bulgarian nationals. But medical repatriation, on-going medical treatment and non-urgent medical care are not covered by the EHIC. But there are some private hospitals that do not accept the EHIC.
Several diseases still effect Bulgaria’s population, tourists and expatriates should be aware of the possible danger they pose while visiting Bulgaria. Hepatitis A & B, HIV/AIDS, travelers’ diarrhea, cholera and Lyme disease have all been seen in Bulgaria within the year 2010. In January 2011 the Health Ministry alerted of an outbreak of H1N1 within 6 regions in Bulgaria; Burgas, Vratsa, Shumen, Blagoevgrad, Veliko Turnovo and Kyustendil. The locations of Sofia city, Sofia region, Pazardzhik and Pleven are affected by the flu, which had reached its peak by February 22 2011. This had caused some businesses and a majority of the schools to be closed within said areas. HIV/AIDS is present in Bulgaria but its prevalence is rather low, with less than 0.1% of the adult population carrying the virus.
Sense Bulgaria had joined the European Union in 2007; the overall security environment for expatriates and tourists has improved. In the start of 2011 there were still problems of violence related to criminal groups, which occurs sporadically within public locations. In January 2010 a journalist was assassinated in Sofia during the day, supposedly due to a book containing details of Bulgarian organized crime. The areas of Pleven, Topolovgrad and Sofia have had incidents of residential break ins. Vehicle theft is a concern, especially newer sedan type four wheel drive automobiles. Very few vehicles are ever recovered. Expatriates looking to live in these areas should discuss with their international insurance provider the possibilities of property theft/ damage coverage. In some smaller towns within Bulgaria do not even contain a police station, which means help from the police won’t be immediately available. The police can be contacted by dialing 166 anywhere in Bulgaria, whether it is a landline or mobile. For all types of emergency services a person can dial 112 anywhere in Bulgaria.
If European visitors or any of their dependants are suddenly taken ill or have an accident during a visit to Bulgaria, free or reduced-cost necessary treatment is available - in most cases on production of a valid European Health Insurance Card (EHIC). All nationals are advised to take out comprehensive travel insurance.
Food and drink:
Mains water is normally chlorinated and, whilst relatively safe, can cause mild abdominal upsets if in remote areas. Some travellers may prefer to drink bottled water for the first few weeks of their stay. Milk is pasteurised and dairy products are safe for consumption. All food is prepared with a good level of hygiene.
Other risks:
Hepatitis B is endemic. Hepatitis C may occur. Tick-borne encephalitis exists. Immunisation against tuberculosis is sometimes recommended.
