© Lina Krivoshieva


People do not have medical insurance in Bulgaria, i.e. more than 20% of the population can only get access to emergency care.

27.5 %

Of the population cannot properly heat their homes.

23.8 %

Of the population lives below the poverty line.

Médecins du Monde’s emergency response includes a range of humanitarian assistance programmes. Find out more below about our work and missions in Bulgaria.



In Bulgaria, many people are living precariously and lack access to healthcare and social services.


The Covid-19 crisis has aggravated precarious situations and worsened exclusion all the more for inhabitants of marginalised and isolated neighbourhood.


    Médecins du Monde has been working in Nadezhda since 2004, a “ghetto” neighbourhood, shut off from the rest of the city of Sliven by a wall and train tracks. According to an overview provided by our teams in 2020, 11% of the population of Sliven lives in the segregated neighbourhood of Nadezhda sometimes in extremely precarious conditions. Sliven is the seventh most populated city in Bulgaria, with a population of around 83,000 people. Consequently, 73% of inhabitants in this neighbourhood do not have a bathroom or a shower, 66% do not have toilets and many others do not have access to electricity or even drinking water.


    Nadezhda is perceived by both its inhabitants and outsiders like a lawless area.


    The supply of services is very restricted and the inhabitants, especially the children – who number in the thousands – do not have a safe space to gather and play. For instance, the former library was turned into a casino, thereby increasing the feeling of insecurity and dispossession the inhabitants expressed. The divide between the neighbourhood and the rest of the city is yet another form of discrimination the inhabitants of Romani background already face.


    Isolation and discrimination have a direct impact on the mental and physical health as well as the overall well-being of the inhabitants of Nadezhda. Moreover, unsanitary housing, lack of regular water supply, lack of waste management and pollution, especially of the air and soil, promotes parasites and rodents and the development of vector-borne diseases, weakening the population’s health. Additionally, ambulances refuse to go to certain parts of the district due to the lack of roads and space to travel but also because of the lack of dialogue with the inhabitants. Thus, the numerous vulnerabilities tied to precariousness and segregation further reinforce the lack of access to employment or education, making integration difficult and encouraging violent or risky behaviour, further damaging people’s health.

© Lina Krivoshieva

Our humanitarian assistance in Bulgaria


In Bulgaria, Médecins du Monde aims to improve the health of people living in precarious housing.


For that reason, in Sliven and in the neighbourhood of Nadezha, we work towards promoting a better and more secure living environment while reinforcing access to sexual and reproductive health services like planned parenthood.


We empower women and girls by providing better access to information as well as gynaecological consultations to prevent unintended pregnancies and sexually transmitted diseases.


Furthermore, our organisation is committed to reducing negative impact of living conditions on the physical and mental health of the inhabitants of Nadezhda along with their well-being. We provide and help improve access to safe gathering spaces with psychosocial activities for children helping them develop fine and psychomotor skills. We also provide first aid training.


    In 2021, we:

    • Informed nearly 7,500 people on protective measures against Covid-19 during outreach sessions,
    • Opened two safe spaces in the neighbourhood dedicated to workshops with children, young people and women,
    • interacted with nearly 760 people (of which some 400 young people) during information and awareness-raising workshops about good hygiene practices and mental and psychosocial health,
    • advised 275 women on sexual and reproductive health and rights and referred 163 women to specialists offering contraception methods,
    • provided gynaecological consultations for 285 women,
    • raised awareness on topics such as puberty and changes in the body, along with emotional relationships and prevention of violence for 272 girls aged 6 to 17,
    • intensified engagement and strengthened advocacy at a national conference on women’s health by participating in numerous radio and television press interviews.
  • 7,490

    Bénéficiaires en 2021.

  • 354,388

    Budget in 2021


Bénéficiaires en 2021.


Budget in 2021

© Yves Rouillard

  • 2004
    Intervention in the Nadezhda ghetto
  • 2009
    Programmes focused on hygiene, vaccination and sexuality
  • 2013
    Opening of the information and referral centre (CIO).
  • 2014
    The city council commits to subsidising planned parenthood medical consultations for women
  • 2016
    Support programme for migrants in reception and registration centres
  • 2018
    Launch of a programme to support migrant women and children who are survivors of violence.