Pediatric care – problematic unit in Bulgaria’s healthcare

The hundreds of stigmatizing comments made in the recent weeks and, most of all, the lack of trust and respect for the most humane profession in the healthcare field - pediatrics, provoked the interview with Dr. Zhana Staneva, a pediatrician and neonatologist who has been struggling with the problems in this sector for 45 years. She was head of the neonatology ward at the Multi-profile Hospital for Active Treatment in the town of Vratsa and several years ago, she headed the neonatology ward of a hospital in Bulgaria’s capital Sofia.

Do I want to be a pediatrician in Bulgaria? Here is how the answer to this question sounds in today's Bulgaria:

For me and my colleagues the sick child is the center of our universe. Our efforts are directed towards the children and their parents and we are constantly trying to improve our professional qualification, the diagnostic and healing methods, as well as to receive and work with cutting-edge equipment. Our efforts are directed towards radical change and restructuring of the system for access to qualified medical care for every child. We have been trying to find our way in the reforms of the health system for 30 whole years and the answer of each young specialist who is yet to choose this specialty is usually No!, Dr. Staneva says.

The Bulgarian Pediatric Association warns that many hospitals in this country may experience sharp deficit of pediatricians. According to latest statistics, there are only 1,400 pediatricians in this country. However, most of them are pensioners, which means than in ten years or so they will leave the healthcare system for obvious reasons.

The number of pediatricians has been decreasing with an alarming pace. Pediatrics requires a difficult and long specialization accompanied with relatively low remuneration. Although pediatrics is among the most humane specialties, it is most often subject to criticism and discontent, because children are the most precious thing for Bulgarians and parents often act emotionally. The serious lack of equipment and shortage of pediatricians with the knowledge to train the young colleagues in the small pediatric hospitals also leads to an alarming ageing of this profession. These factors discourage the young doctors who prefer to study abroad and choose easier specialties.

Stepping inside the doctor’s office, we rarely realize how hard this profession is and we are asking ourselves questions such as should we rely solely on the conscientiousness of the citizens, on the Bulgarian Christmas charity campaign, on text messaging fund-raising campaigns and the collection of plastic bottle caps to help the pediatric wards in this country, or should we reform the system instead? 

Yes, the healthcare system must be fundamentally reformed and the Bulgarian population must be well-informed about how this system is functioning, Doctor Staneva contends. 

I rarely meet parents who are fully aware with the duties of their pediatrician, what does emergency medical care mean, what is an emergency case, where the quick reactions of the medics are of extreme importance, etc. Parents must categorically know that the general practitioner is the medic who must be on disposal all the time when they have health problems. If parents fail to contact their GP on the weekends or on any national holidays, they must have the phone number of a pediatrician of the clinic with which the GP is required to have a contract. In case of emergency, parents should contact emergency teams, including the hospital for emergency aid Pirogov, pediatrician Staneva advises.

All people employed in the child healthcare in Bulgaria have been interested in the idea about a multi-profile university pediatric hospital for a long time. Several projects started over the years, but all of them turned unsuccessful. Currently, Bulgaria is the only EU country without a national pediatric hospital. The building which was once meant to be a pediatric hospital was abandoned unfinished decades ago and currently there is a serious debate on whether the same building can be used again for the purpose. We are yet to learn the decision of the experts and the Bulgarian government.

English version: Kostadin Atanasov

Photos: library

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