| Current services in Bulgaria |
| The following palliative care services are known to exist in Bulgaria: |
| |
Existing Services (2002) |
| Adult |
Inpatient - Freestanding |
1 |
| - Hospital Unit |
0 |
| - Hospital mobile team |
0 |
| Nursing Home |
0 |
| Home Care |
20 |
| Day Care |
0 |
| Total |
21 |
| Paediatric |
Inpatient |
0 |
| Home Care |
1 |
| Day Care |
0 |
| Unspecified |
0 |
| Total |
1 |
| Grand Total |
22 |
|
| Current Projects |
| No palliative care projects, not yet operational services, are known to exist in Bulgaria. |
| |
Known hospice/ palliative care projects (2002) |
| Adult |
Inpatient - Hospital |
0 |
| - Hospice |
0 |
| Home Care |
0 |
| Unspecified |
0 |
| Total |
0 |
| Paediatric |
Hospital |
0 |
| Hospice |
0 |
| Home Care |
0 |
| Unspecified |
0 |
| Total |
0 |
| Grand Total |
0 |
|
| Bulgaria has one paediatric palliative care service and about 20 home care services for adults. There is one free-standing facility - Hospice Milosierdie - which was founded with 8 beds and a home care service in 1996 and has the support of the Kammilian monks.2 There are also some initiatives in the oncology hospitals. |
| In the Sofia Oncological Hospital there is a 'pain committee' of doctors and nurses undertaking work in symptom control for adult cancer patients in the hospital. However the team has only four hours per week for its activities and 'every one of its members is active in another department and people [are] not encouraged to expand the work in palliative treatment. This work becomes overloading for them, no motivation, morale or material. I find the work very difficult, but not impossible. What was built up until now is not a little, but it cost too much and took too long.'3 However, there are other important developments taking place in Sofia, notably the "Hospice Sofia Project" planned as part of the activites of the Palliative Care Fund. |
| In the Neavy Hospital, Varna, the chief nurse has a special interest in palliative care and is responsible for the independent NGO, Queen Eleonora's Hospice, which provides homecare in Varna. There is a team of 20 nurses and other staff, and the majority of patients have cerebrovascular disease and heart disease. The hospice is seeking to establish an inpatient facility of 15 beds. There is also a group of physicians with plans to open a pain service at the hospital in Varna, but without available funds. |
| The 'Hospice Faith' is registered under the Co-operation Law, in the city of Plovdiv and offers a 24-hour service in patients' homes from a team of doctors, nurses, rehabilitation therapists and psychologists. 'A professional hospice staff does the service. The main requirement is observing the rule of timeliness, accessibility and quality of medical treatment … From 4th September 2000 to 1st September 2001 the hospice specialists have worked for about 35,000 hours'. About 30% of the patients have died. Again, there is a plan for a 23-bed hospice, but without available funds.4 |
| A further oncological dispensary has a palliative medicine department with 10 beds and an outpatient consultation room, with one doctor and one nurse. A further three dispensaries have outpatient consultations and the Sofia city dispensary also has a home care service, with three doctors and three nurses. |
| Education |
| The Palliative Care Fund had OSI funding in 2000 for a National Education Program on Palliative Care, comprising a series of two day multi-disciplinary seminars to promote the concept and practice of palliative care. The programme is the first of its kind in Bulgaria. The OSI Foundation in Bulgaria is planning an open tender application for bids to develop short courses (c200 hours) in palliative care for nurses in the country's medical colleges. |
| Standards |
| The Open Society Foundation in Bulgaria is developing a project on framework standards in palliative care, to be conducted by an expert team. |
|
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