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BulgariaStemming spread of STDs and HIV/AIDS
Bulgaria's healthcare system is in transition. General practitioners are now paid according to a managed care model, and most hospitals are being transformed into commercial companies. Because of the economic situation, access to care is difficult for many people, particularly for the poor and ethnic minorities. MSF started work in Bulgaria with the distribution of drugs in hospitals during the economic crisis in 1997. MSF then decided to focus on sexually transmitted diseases (STDs) because it noticed a tendency to prescribe unnecessarily high quantities of drugs due to outdated treatment protocols from the Soviet era. In the capital Sofia, MSF treats patients with STDs and carries out HIV/AIDS prevention and counseling. Emphasis is on raising community awareness of STDs and HIV/AIDS. For better outreach towards at-risk groups, a mobile unit is being set up in addition to the existing clinic. In 2002, a research program involving 400women with vaginal discharge is being used to confirm STD treatment protocols that put less strain on the patient (fewer exams, shorter hospitalization) than those traditionally used. The protocols will later be promoted at the national level. In the town of Targoviste, MSF runs a primary healthcare program for the marginalized Roma and Turkish minority peoples. In mid-2002 a similar project began in the Sofia suburb Faculteta, home to 80,000 Roma. MSF has been working in Bulgaria since 1997. |
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