Bulgarian Medical Mission Bringing hope to health care

by James W. Walton, DO, DCMS Community Service Committee

It's been more than 10 years since the fall of the Soviet Union, and our small medical team is making the first of what may become an annual medical mission trip to the old Eastern European Bloc, this year to Guliantci, Bulgaria.

The accommodations are old and tired. As our bus travels along on a two-lane asphalt road, we pass wagons pulled by mules trying to share the road with large buses and aging Russian and European sedans. The town we are working in is one of 18,000 people, with a surrounding farming community of 50,000 people. The community has rich farmland because of its proximity to the Danube River. The Baptist church with which we are working meets in a single room of approximately 300 square feet and seats 48 people, and it is the family home of a retired communist Army colonel. The church is growing rapidly under the influence of a young Bulgarian pastor. We are received royally by the community, its physicians, and church leaders.

The clinical situation is difficult. Each doctor is working in a separate room. Each "exam" room is empty except for the surplus equipment we brought or sent ahead. An abundance of patients have diseases that are untreated because they can't afford the medication.

The dire consequences of the economic situation are dramatically illustrated in the rural healthcare system. The hospital appears to have been built before WWII (maybe WWI) and has not been updated. The "bed" that one patient laid on to receive an ultrasound was covered with a single dirty sheet that probably hadn't been changed or cleaned in weeks. The physicians explained that in some months they don't have enough money in the hospital budget to do the laundry. No IVs were being used when we visited the hospital. It seemed more like the worst illustration of a nursing home, rather than a hospital.

We divided the teams into OB, pediatrics, and family practice/internal medicine. We worked in three buildings alongside a Bulgarian physician of our specialty. The Bulgarian physicians are proud of their new equipment and are extremely happy to see patients with their American counterparts. The transfer of learning was incredible, and by the end of the week, I had the impression that the patients probably would return to see their physician for ongoing care.

Still, it was clear that the Bulgarian physicians were discouraged about their working conditions. Although the physicians are brilliantly trained and knowledgeable of modern therapy and diagnosis, the poverty of their patients and their own low position in the society (they earn $150/month) extremely limit them. They expressed a collective frustration: to be so well-trained and yet unable to be of much help to patients who need modern assistance to improve their health. Never was a preventive health strategic plan more clearly needed. As an example, people don't seek health care for hypertension while it is asymptomatic, and even if they did, it would seem like torture to tell someone that he has an asymptomatic disease that most likely will cause a stroke. Our presence and the medication we brought are a great encouragement and give hope that these physicians can help their patients.

Another ray of hope seems to be in the church and its message linked with its connection to western philanthropy and technical investment. Where the political and economic realities create an impression that physical health improvement might take some time, spiritual health improvement is a very reachable and immediate goal.

If you would like to volunteer on a medical mission, contact Connie Webster, DCMS director of community service, at 214-948-3622 or connie@dallas-cms.org.