Friday, March 12, 2010

Dying In Bulgaria

Dying in Bulgaria

This will be a different blog entry for me. No pictures - - no tongue in cheek comments. Probably more “stream of consciousness” and a lot less organized. But the subject is more important and more universal. We all do this - - but only do it once. We all die. But as I get older, I gradually begin to slowly understand how different that one-time event can be for each of us. And… how much your country, culture and government may impact it.
You may be wondering what is prompting this blog. Actually it is several things wound together with a fuse which got lit yesterday afternoon. Krum’s father died yesterday at about 1:00pm. Krum is my counterpart. A counterpart is the person the Peace Corps picks to be your primary work partner while you are “in country”. It is kind of like an “arranged marriage”. And, like any marriage, some work well and others don’t. Mine is very good! In the past 10 months, Krum has become much more than just a colleague - - he is a friend. Krum is 29. His father was 55. His father had stomach cancer. He died two days after having his first surgery, which was only a few months after being diagnosed with the cancer. Krum never saw his father after he went into surgery. Two weeks ago, Krum found out he was going to be a father - - and his Dad would become a grandfather.
I am blessed to be working with several amazing people here in Bulgaria. George is one of them. George is a college professor teaching business strategy. He knows almost everything about Bulgaria. He worked for a short time in America, and speaks excellent English. He was my primary partner working on this very large project we just finished. He is kind of like my “Yoda” over here.
Just before Christmas, George found out his best friend had lung cancer. George knew this person since there were in kindergarten together. George made several trips to Sofia with his friend and his friends’ wife to try to get help. But, by mid-January the friend was in the hospital. And three weeks later he died. Like George, he was 48.
Two weeks after that George got another call. His uncle had died. It was cancer - - again. And it happened quickly - - again.
In the middle of all this, Lynn and I have had the opportunity to talk and learn about Bulgarian health care. During our conversation English class, we dedicated one entire night to health care. We have also had dinner with the Peace Corps doctor from Sofia. And, of course, there were several conversations with Krum during the past four months.
This is probably where the blog will get even more confusing. I’m not sure I have all my facts and data correct. And I probably will not remember all of the quotes I have heard accurately. But I would like to try to share them with you.
It seems to be commonly understood that medical procedures and health care here are not good. People do not pay much for it, but you also get what you pay for. This is one of the reasons if any Peace Corps volunteer needs surgery, we are generally flown out of country. It is also part of the reason Peace Corps Bulgaria has two full time doctors to service 120 volunteers. And, it is why (as I write this) I am on a 2.5 hour train ride to see a dentist and get my teeth cleaned.
Bulgaria has a rapidly aging population. Outside of a few large cities, most villages have few young people. These villages are literally growing older and dying along with their aging inhabitants.
As you travel in Bulgaria, you can find lots of hospitals. Most of them are small communist block buildings which are not recognizable as hospitals. There are no large emergency room entrances where ambulances rush in with sirens wailing. In fact, Lynn and I have only seen two or three screaming ambulances in the past ten months. I have been told the hospitals are darker and drabber places than hospitals at home. Two weeks ago, Krum was trying to explain this to me. He jokingly said that hospitals in Bulgaria should have a slogan like “ARE YOU SICK? LET US ASSIST YOU IN DYING”. Today that quote has a bitter sting and seems so hollow.
During our conversational English class on health care similar themes were discussed. The Bulgarian government does not provide much money for health care, and very few guidelines or rules. One of the people in the class felt it was part of a governmental “grand plan”. “If you don’t develop a sophisticated health system, people just get sick and quickly die. It keeps the costs down.” He was not joking. He believed it!
Shortly after that class we had dinner with the Peace Corps doctor. She explained that since Bulgaria had become part of the European Union in 2007, the EU requires higher standards for many things. This includes health care. But Bulgaria can not meet those standards without more money which it does not have. So… the Bulgarian solution is to close 150 hospitals rather than upgrading them. Almost all of these hospitals are in the rural areas of the country, where the villages are filled with those same mostly old people. Now those village people may have to travel 60 to 120 miles to get to a hospital and health care. But, most of these people do not have cars, and many have problems walking to the local grocery store. So… every emergency will be too late and many will have the same deadly result.
All of this brings me back to home - - to America. Now I don’t want to make any political statements, or get into a debate. But I do know that health care is the big issue home. However, sometimes I wonder if we can truly make decisions or have respectful debates without experiencing something dramatically different.
And – at the same time – I know some folks following this blog are very sick, or have spouses and loved ones who are struggling with serious illness. I think the operative word is “struggling”. In America we can struggle with sickness. We have the infrastructure to fight! If we are sick, we can get quality help and we can beat it. What ever – IT – is! I have always taken that hope for granted. It is just there! In America, you may decide NOT to fight. But it is your choice! Not something made for you.
I wish I had some brilliant conclusion to all these ramblings - - but I don’t. They are just part of the complex patterns and puzzles of life. Just a glimpse of life - - and death – from another perspective – and another part of the world.

Thanks for reading.


Ken said...

Paul O. told me about your adventure with the Pace corps. Congratualtions. He just sent me a link, I read one or two entries. Wow!! Good for both of you to do this.

I'm curious, what lead you to the Peace Corps and what exactly are you doing.

Good luck

Ken Simpson

Daniel Jasper said...

Hello Mike! My name is Dan and I'm in the Peace Corps as well. I was doing some research on Bulgaria because I will be passing through there this week on vacation and I came across your blog. We were curious as to how volunteers get along out there and if you had any suggestions what to see or do. If you have some time and the opportunity please email me at would be very apprectiated! Thanks and if I don't get the chance to talk to you good luck with the rest of your service!
Dan Jasper
PC Turkmenistan