Bugarie Santé sexuelle et reproductive



people in Bulgaria (over 18.6% of the population) have no health insurance


of the population lives below the poverty line


Bulgaria has the second highest mortality rate for cervical cancer in the European Union – 133.96 per 100,000 women

The need for humanitarian action in Bulgaria

These alarming statistics highlight the need for humanitarian assistance in Bulgaria.


The humanitarian emergency in Bulgaria: empowering and mobilising communities

Many people in Bulgaria are affected by precarious living conditions and lack of access to healthcare and social services. There are no statistics on the numbers of people who are homeless. In Sofia the only centre providing emergency accommodation for people living on the streets is facing an uncertain future. It is often targeted during political campaigns and disparaged by residents. Another issue is that many people have no identity card, meaning they don’t exist in the eyes of the state and therefore have no access to public services.

Roma communities are particularly affected and often live in areas with high levels of poverty. Médecins du Monde conducted a survey in the Nadezhda district of Sliven in 2020 which provided a snapshot of life there: 73% people had no access to a bathroom and 66% had no toilet. Suspicion and a lack of dialogue between the Roma and public institutions results in low levels of community participation in public life and no sustainable economic or social change. Approximately 11,000 people live in Nadezhda, but it is estimated that around 21% of residents are often living abroad. Many children grow up without parental support.

A large-scale humanitarian mission is needed to provide support to at-risk communities.

This concerning picture demonstrates that a large-scale humanitarian mission is needed in Bulgaria to provide support to at-risk communities.

The lack of dialogue with these communities and the resulting isolation has an impact on health and also on other areas of vulnerability linked to segregation: poor and illegal housing, lack of regular water supply, absence of waste management and pollution, especially air pollution and soil contamination, which provide ideal conditions for parasites, vermin and vector-borne diseases to develop.

The residents of Nadezhda already faced multiple obstacles to exercising their rights and accessing basic services, but the health and social crisis triggered by the Covid-19 pandemic has left them feeling abandoned by the public authorities. They haven’t received healthcare support (ambulances refuse to enter certain parts of the neighbourhood) or regular water supplies, not to mention the lack of access to information about Covid-19 and prevention measures.

Un mineur du camp de Voenna Rampa © Olivier Papegnies
Un mineur du camp de Voenna Rampa © Olivier Papegnies

Our humanitarian assistance in Bulgaria: promoting better access to health services and rights

In Sliven, Médecins du Monde’s aim is to promote and support the empowerment of people living in the district of Nadezhda so that they are able to exercise their rights and become actors for social change. MdM seeks to help women who don’t have health insurance to improve their capacity to act through better access to gynaecological consultations and contraception to tackle the issue of unwanted pregnancies.

The health and social crisis caused by Covid-19 further reduced access to social services and healthcare. Therefore from the detection of the first cases of Covid in Bulgaria, Médecins du Monde organised large-scale information campaigns through social networks and community liaison workers in Nadezhda to inform residents about the effects of Covid-19. To enhance prevention and protection measures in the area, MdM also distributed masks, hand sanitiser and information leaflets. The problems experienced in managing the Covid-19 pandemic mean long-term medical assistance will be required in Bulgaria.

Since the end of 2019, MdM has also been encouraging the people of Nadezhda to become actively involved in their neighbourhood. Around one hundred people expressed an interest in taking part in addressing structural problems, such as water supply, the sewage system and waste management. As a result, when access to water was restricted in Nadezhda during summer 2020, the residents came together to demand access to drinking water be restored, as they were aware of the importance of maintaining good hygiene to combat Covid-19.

A woman and her three children in Nadezhda ghetto, Sliven, Bulgaria © Gaelle Girbes


In 2020

We raised awareness of the humanitarian emergency in Bulgaria

  • by educating around 17,000 people about Covid-19 and protective measures against it through social networks and community liaison workers
  • by meeting around 800 people (including about 400 young people) for discussion and awareness-raising sessions about Covid-19, good hygiene practices and mental health and psychosocial support
  • by supporting residents to develop an action plan to call on the authorities to establish regular access to drinking water in Nadezhda


Humanitarian emergencies in Bulgaria

There are multiple humanitarian emergencies in Bulgaria in both the health and social spheres. The following overview highlights the crisis situations in Bulgaria and details of the activities supported by MdM.



Although Bulgaria received large numbers of asylum seekers in 2015 (20 000 asylum claims), the number of refugees has since fallen considerably with 3 500 asylum claims registeredin 2020. The reception and registration centres saw about 1 000 people, taking up around 25% of their capacity. Humanitarian emergencies in Bulgaria therefore include reception: refugees face violent backlashes as civil society views their presence very negatively.


Another humanitarian mission in Bulgaria: preventing gender-based violence

Launched in September 2018, the WE ACT project involves five European countries where Médecins du Monde France and Médecins du Monde Belgium work, one of which is Bulgaria. The aim of Médecins du Monde’s humanitarian project in Bulgaria was to tackle and prevent gender-based violence and to provide assistance to migrant and refugee women and children.

By the end of this project in the first quarter of 2020, Médecins du Monde had worked to strengthen the cooperation between NGOs, the United Nations and healthcare professionals in the country to facilitate better care and treatment for survivors of gender-based violence in migrant communities. Training was also organised to raise awareness among partners about the fact that both women and men can be victims of rape (according to Bulgarian law, only women can be raped) and to convey the importance of respecting confidentiality when treating or referring such cases.





In 2020

Through this humanitarian project in Bulgaria we facilitated greater understanding by local professionals, we:

  • produced a leaflet and posters on ‘The right to live without violence’ in different languages (English, Bulgarian, Farsi and Arabic), to be made available at healthcare centres
  • organised several workshops to improve coordination between the police, healthcare staff and social workers in contact with migrants and refugees




our institutional support

Budget: €328,600
Directorate-General for Justice and Consumers logo
French Embassy in Bulgaria logo
Open Society Foundations soutient Médecins du Monde
Beginning of intervention in Nadejda ghetto to improve the living conditions of inhabitants.
Action centred on hygiene, vaccination and sexuality.
Opening of information and advice centre (CIO).
The town hall commits to financing medical family planning consultations for women.
Launch of programme to support migrants in the reception and registration centres.
Launch of programme to support care and treatment for women and children who experience violence as migrants.

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