In late April, a case with a new-born baby beaten by a midwife in a hospital in Sofia angered a great number of people and unravelling the case shed light on the alarming situation of Bulgarian healthcare, plagued by shortage of doctors and nurses, excessive work load, constant stress, low salaries and lack of motivation.

According to data by the Bulgarian Medical Association, each year some 600 young medics leave the country to work abroad for higher wages and better working conditions. There were a total of 35,000 doctors in Bulgaria in 2009, while these days their number is about 28,000. What is more - less than 5% of practitioners in Bulgaria are under the age of 35, while one out of four doctors is 60 and over. Dr. Anatoli Mitov, procurator of the indebted regional hospital in Pernik told us more.

"The number of doctors in the hospital is 127 and we have had 10 vacancies for doctors for years. This affects negatively the smooth functioning of the hospital. We need to pay overtime to the colleagues who are responsible for the additional work and this leads to higher expenses of the hospital. Many district hospitals are experiencing similar problems."

 53-year-old surgeon Dr. Mitov is one of those Bulgarians who welcomed the political changes in 1989 with enthusiasm but today are frustrated by the long transition. He is one of the few doctors who remained in Bulgaria with the hope that the health system will quickly reform. However, this did not happen. Young medics leave Bulgaria as soon as they graduate from the university as working conditions and career opportunities abroad are incomparably better. The lack of doctors in emergency services is huge. According to European standards there must be 60 emergency medical teams for a city like Sofia. Currently they are just 23. More from head of the Sofia Emergency, Dr. Georgi Gelev:

"The shortage of doctors started at the very beginning of the transition period.” Gradually, over the years the number of physicians started to decline because of a number of reasons. When Bulgaria joined the EU and the borders were opened, a great number of doctors started leaving the country. First left those who speak foreign languages ​​- English, German and French. Since 2007 some 30-40 doctors have left the emergency centre in Sofia to work abroad.”

As a result, emergency teams in Sofia serve about 15 calls per shift, while they should do half of this work. Naturally, this affects the quality of services. The work load and stress is huge and a number of doctors and nurses suffer from chronic diseases. "To this we must add the fact that many of them are forced to have another job to be able to secure a decent income" - adds Dr. Desislava Katelieva, president of the National Association of Emergency Medics says. Recently, the union organized a protest against working conditions after a number of attacks against doctors because of late emergency teams.

"Aggression shows the condition of the entire system. Healthcare in Bulgaria has been partly reformed during the past 15 years. Now it is a mix between a system that partly meets the requirements of the market economy and partly resembles the previous model of full state funding. Unfortunately, all this has a negative effect on people who work in the healthcare system, and people who rely on it."

English: Alexander Markov