Mission Bulgaria

The economic situation in Bulgaria is improving gradually with the arrival of the new government led by Sergei Stanichev but social inequalities persist: out of a total population of 8 million, 1.1 million Bulgarians are living below the poverty line. The health situation is precarious, and life in the specialist institutions (institutions for disabled people, orphanages and prisons) is particularly difficult. In addition, the Roma community's situation is still worrying and Bulgaria's EU membership may well be delayed if efforts are not made in this area.

Roma district of Nadezhda, in Sliven

Mother and child protection

Activities: The programme has been set up in a former ghetto, now a Roma district, where around 20,000 people live. The population's sanitary conditions are deplorable (almost complete lack of water, sewerage and electricity in the district). The Roma are victims of segregation and have a much higher unemployment and illiteracy rate than the Bulgarian average.
A Mother and Child Health clinic has been set up by MdM's regional delegation in Corsica. It bears the name of Dr Edouard Delahayes, the project co-ordinator who died in a road accident on the way to Bulgaria. The team is made up of an expatriate co-ordinator and Bulgarian staff: a paediatrician, midwife, nurse and social worker.

Mother and child consultations are organised to pick up pregnancies at risk and childhood diseases, and to refer patients needing it to the general Bulgarian health service. Health information and training sessions are organised for mothers and children and, in particular, a school for mothers has been developed. A public health survey was carried out in the poorest part of the district, known as the “district of the naked”, to pick up the weakest people and support them. Roma district of Nadezhda, in Sliven.

Outlook:
Bearing in mind the size of the problem this population faces, the programme is becoming national in 2006, and will be supported by the Eastern Europe desk. International funding will be sought to provide the clinic with resources more appropriate to the situation: increasing the strength of the team, sending an expatriate medical co-ordinator for 18 to 24 months, seeking premises where child vaccination campaigns can be organised by local doctors, organising training and co-ordination meetings, setting up a pre-hospitalisation hygiene centre, etc.

Sofia

Help for children

Activities: MdM 's activities have two aspects:

• contact with Bulgarian institutions and NGOs which are involved with children, to distribute information on ourprogramme.
• support for the work of the “Child and his symptoms” project. MdM supports the “Development for Children and Families” Foundation which funds the 6 training modules for paediatric institutions' staff. After selecting the institutions to receive this training, the Foundation provides help in organising the modules. The lectures and case studies examined during the different modules are then published for each year of training in French and in Bulgarian.

Training staff from paediatric institutions

Throughout the country (+ training in Sofia)

Activities: The “Child and his symptoms” project is run in two ways:

• each year six training modules are organised in Sofia for staff from 8 institutions and 4 centres for disabled children. They are given jointly by French volunteer trainers from the CIEN (Centre interdisciplinaire de l'enfant) who are paediatric psychiatrists or psychologists, and by members of the Belgian charity “Enfant et Espace” (Child and Space). This training is followed up and valuated by a specific written programme and implemented by the Social Activities and Practice Institute in Sofia;
• two visits per year are made to the institutions and centres, by “supporters” appointed by the Bulgarian project coordinator.They organise team meetings to prepare the modulestogether with them. These visits provide specific training for the whole staff of each institution.

Outlook: In four and a half years, the staff of most of the institutions for disabled children in Bulgaria will be trained.

July 2006