Balkan Expat Medical Care – BALKAN NEWS MAGAZINE

 

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The variety and number of expats, living in the Balkans, is legion. Coming from different parts of the world, but mainly from the EU – the UK presently included – they represent all groups of society, ages, backgrounds, colours and creeds.

The very rich can be found in Athens, the less well off on the more affordable Greek islands and some, like me, live in the Greek provinces. Many of the more adventurous expats now live in Turkey – whilst regretting having done so under the present unfortunate circumstances – but a considerable number now live in Bulgaria, Romania, the former Yugoslav republic of Macedonia, and various parts of the Dalmatian Coast, including Albania.

All have left their county of origin, knowing full well that their lives would change – hopefully for the better – and many have enjoyed happy experiences after making the move. But, there are some who have regretted their optimism, especially older people, many of them retirees, and of course, those who have suffered ill health.

Twenty five years have passed since the changes – a soft definition for the virtual end of communism – and having carefully researched their destination, the politics, the people and their soon to be civil society, they have sold up, packed up and moved. But, are there any regrets, and have their expectations been altered, or even shattered during their stay in South Eastern Europe? And, what about doctors, medicine and illness? We are all getting older.

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My story is very simple. I am a diabetic, and for many years I remained undiagnosed. During my permanent stay in Bulgaria, this illness – then unknown to me altogether – become noticeably worse, when I literally started crashing out. Luckily, as the editor of the Sofia Western News magazine, I had a doctor on board, who wrote about medical matters. He was a part of the SASHA humanitarian aid team – operating from their base in Staffordshire in England –  which the SWN  fully endorsed. They were contributing free medical equipment, front line ambulances and medicines, to the then crisis hit Bulgarian Ministry of Health. Distributed by SASHA to deserving Bulgarian hospitals, some ambulances and medical equipment were even presented by HRH Prince Charles, at a special ceremony in Sofia.

Bulgarian President Petar Stoyanov (L) and Britain's Prince Charles review Bulgarian army honour gua..

HRH Prince Charles and President Peter Stoyanov inspect the Presidential Guard.

One blood test later, and Dr. Plamen Tomov gave me the bad news. I was a full blown Type 2 diabetic, and he prescribed the only medicine available at the time in Bulgaria, a little pink pill. A later visit to Col Ivanov, the department head at the Military Hospital in Sofia, fared little better, and having regaled me with photographs of his meetings with important politicians, accompanied by my bewildered inspection of countless certificates and diploma’s – whilst he chain smoked his way through a whole packet of Victory cigarettes – I left; minus 50 Leva, as though I had just had tea with the President, and absolutely none the wiser.

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Later I discovered that medicine in Greece, was like being back home in the UK. Doctors were professional, concerned, and efficient. With the onset of angina, I also felt that I had got to Greece in the nick of time, proof of which was a trip to the Blue Cross Clinic in Thessaloniki, the same day fitting of two stents, closely followed by a flight to the UK, in order to attend my son Matt’s engagement party in London. A Bulgarian professor – who shall remain nameless – from St. Anna’s Hospital in Sofia, had previously recommended a triple bypass for 20,000 Euro’s, with full payment in advance!

Recently. a friend living near Haskovo, needed a minor procedure, and he told me how the equipment was old, but the staff were very good to him, which has been my experience too. But the question remains, of how well trained and competent the medical staff in Bulgaria really are, and in other parts of the Balkans.

In the past, ex-communist states were fully influenced by the Soviet Union and Russia, which until 1990 was where they received their medical training and experience. I remember being in Plovdiv during the New Year in 1985, when a friend – who had recently returned to Bulgaria – decided to have a swimming competition with the Director of the then embryonic IBM factory. Two very fit men in an Olympic sized swimming pool, my friend George suddenly collapsed. So, off to the Plovdiv emergency hospital, we all went.

A rather self important Russian doctor was in attendance that afternoon, and in halting French informed me that George had experienced a heart attack. There followed the familiar diatribe of self praise – pointing out the Soviet’s clear superiority in the field of medicine, and the wonders of advanced Russian doctor training – when who should walk down the hospital corridor, but George himself.

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‘You okay,’ I asked him, ‘sure,’ he replied, ‘it was just a kidney stone, I’m fine!’ I looked around, but I couldn’t find the superior Soviet doctor to tell him about George’s miraculous recovery, although I did look in a few cupboards, but by then he had gone.

At the time, the paramedics from SASHA , were also a part of the UK’s top paramedic team. And, not only did they distribute some 19 vehicles, and a huge array of second hand NHS hospital equipment, but they also brought some basic day to day medicines. When they saw Bulgarian ambulances, they were amazed. They were so basic and dirty, that they called them ashtrays, which made the used British front line ambulances look more like holiday homes. They were full if gizmo’s – defibrillators, oxygen, backboards, and radio’s – as well as very noisy sirens.

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Some UK Ambulances Outside the Bulgarian Ministry of Health – Photo SWN

Little was said in the Bulgarian press, although during the previous Vidinov government’s tenure, this was hardly surprising, and Stephen Sofianski’s caretaker government was little better. What got up my nose, was when the then minister of health announced, that he had arranged the whole thing, thus proving, what a floored administration he represented. His mendacity would, I fear, be regarded as normal these days– in the light of Boris Johnson and Donald Trump’s outright lies – but then it was assumed that the foreigners would not know about his lies, and knowing of their siege mentality, nothing would be said. But, then the Sofia Western News came to the rescue.

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Stuart Alves MBE (center) and the SASHA paramedic team – Bulgarian Ministry of Health in 1997

Bulgarian Ambulances, at the time, had a chain smoking driver and a doctor on board, although the doctor was from the lower orders and little more than a basic paramedic . They all sat in hot steamy café’s with a telephone hanging on the wall, where between games of cards, the phone would ring and they would reluctantly take to the road. I watched them closely, to see if SASHA had made any difference, but surprisingly, during the next seven years, I only saw one British ambulance in action, and inspected two further vehicles only to note that all their front line equipment was missing. And what about the medical equipment, were these valuable items evenly distributed among the various hospitals in Sofia, for the benefit of ordinary citizens? Well the ones I saw, were usually in private clinics, and so one can make a shrewd guess at what happened to the vehicles!

The beginnings of democracy made a difference, and as the accession talks began for Bulgaria’ s entry into the EU, so brand new shiny ambulances began to appear, from France, Italy and Germany, and suddenly the police were seen driving brand new Land Rovers. But as the police said, they were not as good as Mercedes 300 Jeeps – which cost five times as much – but never mind, they would put up with them. Saying thank you has never been a big issue in Bulgaria.

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Bulgarian Medical Book

Apart from the mind boggling bureaucracy in Bulgaria, the medical system works quite well if you pay – despite the self advertising – but this is only really for minor ailments. I joined a posh clinic in Mladost – I will not say which one – and they could not even fit a catheter into my arm, when I had an angina attack. They even managed to spray the walls with my blood, before getting rid of me to the Sofia City Hospital. I remember crawling into the ground floor reception room of this particular and well advertised clinic, and not finding a chair to sit on, because the painter was standing on it. I further discovered that the receptionist was most displeased with my arrival, because it was her coffee break, and her mouth was full of chocolate.

Many Greeks, Serbian and Balkan medical students, doctors and dentists, study in Romania, and I am told on good authority that standards there are on a par with Greece. My dentist in Orestiada studied in Romania, and because she has modern equipment, I cannot imagine a better treatment anywhere. Inexpensive, professional and caring, perhaps Greece has overlooked its chances in the realms of medical tourism.

Until recently, Greek medic’s have enjoyed a good standard of living in their own country, but alas no more. Austerity has virtually emptied out their waiting rooms, as well as their savings accounts, and although the government has reduced the price of medicines, they are priced much the same as the rest of Europe. As a pensioner, I pay about 10% of the cost of medicines and nothing for my doctor. That is all taken care of by the British Government, and easy to do, because everyone speaks English.

Bulgaria has always been  notable for underpaid, unappreciated and disenchanted medical staff, most of whom have their eyes focused on the British National Health System, and many have gone to the UK from Bulgaria, but subject to a mandatory retraining programme.

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Come to Greece For Medical Care

Just briefly, on the subject of medical insurance, it would pay for you to choose a well known insurance company, if you can afford it, such as Allianz, which is both familiar and popular throughout Europe. An insurance policy I once took out, before retirement in Greece, had no takers, despite the fact that it was part of a then big bank. But now everything has changed here in Greece, many banks have amalgamated, and they are operating quite normally.

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ALLIANZ

A doctor from Vidin once said to me, that it was important that you trusted your medical practitioner, and am inclined to agree, but, what are the rules? Be happy, stay fit, and enjoy the Mediterranean diet!

By Patrick Brigham