Bulgaria

BULGARIA. Area 103,146 sq. km. Population (in 1925) - 5,301,420 inhabitants; population density - 49.4 inhabitants per 1 sq. km. Population movement for 1921-1925 (per 1,000 people): Years Birth rate General mortality Natural increase 1921 1922 1923 1924 1925 36.3 40.0 36.4 38.9 36.7 19.8 20.1 20.3 19.9 19.3 16.5 19.9 16.1 19.0 17.4 Infant mortality (under 1 year) per 1,000 newborns was: in 1921 - 134.6, in 1922 - 147.6, in 1923 - 164.0, in 1924 - 149.9, in 1925 - 150.9. Morbidity from the main infectious diseases for 1921-25 (per 10,000 inhabitants) was as follows: Years Smallpox Typhus Typhoid Scarlet fever 1921 1922 1923 1924 1925 0.05 0.05 0.04 0.01 0 1.79 0.98 0.83 0.29 0.44 3.93 5.57 5.63 14.22 7.08 12.45 14.49 31.40 14.90 7.09 Morbidity from diphtheria during these years fluctuated per 10,000 inhabitants from 1.6 to 3.2, from measles - from 14.8 to 64.3, from whooping cough - from 4.5 to 15.9. In 1924, 2 cases of plague were registered in Varna, the last epidemic of cholera was observed in 1916, when in Dobrudzha during 3 months (October-December) 8,456 cholera patients were hospitalized. Malaria is quite widespread in Bulgaria. During the imperialist war, in three malarial regions: in Macedonia, Dobrudzha and Thrace, about 400,000 people in the army fell ill with malaria. The most affected malarial regions are located on the coast of the Black Sea and in the basin of the Danube, Maritsa and Struma rivers. Trachoma is also quite widespread in some districts of Bulgaria. For example, in the Ruse district, the number of trachoma cases in 1925 was 24.6%. Mortality from tuberculosis in cities with a population of over 5,000 people for the period from 1905 to 1922 was annually from 2.4 to 3.0 per 1,000 inhabitants. Venereal diseases spread widely during the imperialist war: 14% of all soldiers of the Bulgarian army were infected with syphilis, and 21% with gonorrhea. A survey of the rural population of Bulgaria in 1923 showed that in some villages up to 46% (Kopilovtsy) and 62% (Cherekhovtsy) of the population suffered from syphilis. Organization of healthcare. The Directorate of Public Health ("Direktsiya na narodnoto zdrave"), which is part of the Ministry of Internal Affairs and Public Health, includes the following departments: 1) public hygiene and statistics, 2) infectious and social diseases, 3) hospital and 4) pharmacy. The Directorate includes a Supreme Medical Council of 10 members. The entire country is divided into 16 medical districts, each district into sanitary "okoliya" (in 1928 there were 252 okoliya doctors), each okoliya is divided into feldsher districts; there were 935 such districts (1928). Each medical district has a hygiene council consisting of 14 members, including 3 doctors, an engineer, an architect, a veterinary doctor, a lawyer, a school inspector, etc. Similar hygiene councils exist in okoliya (of 11 members) and in communes (of 6 members). The Directorate of Public Health is responsible for the Institute of Public Health in Sofia (departments: bacteriological, chemical and hygiene) and 4 communal laboratories. For border sanitary protection, there are quarantine facilities in Burgas and Varna on the Black Sea, and in Svilengrad on the border with Greece, on the railway line Constantinople-Sofia. Of the major public medical organizations, there are two: the Bulgarian Red Cross Society (founded in 1883) and the Society for the Fight against Tuberculosis (founded in 1909).- Communal sanitation. There is a state fund from which loans are issued to communes for the improvement of populated areas. Of the 57 populated areas with more than 5,000 inhabitants, 35 have water supply systems and 7 have full or partial sewerage. The housing crisis became acute after the imperialist war. According to the census of December 31, 1920, there were 860,276 residential houses in Bulgaria, of which 178,142 were in cities. In cities, on average, there were 5.42 inhabitants per residential house, in villages - 5.69. If in 1900 in Bulgaria there were 18 apartments per 100 inhabitants, then in 1920 their number decreased to 17.5; in Sofia, the number of apartments per 100 inhabitants decreased from 11.2 in 1910 to 10.2 in 1920, in Plovdiv - from 17.3 to 15.4, in other cities - from 19.3 to 18.4. For the construction of housing, the state has allocated subsidies to communes: in 1924 in the amount of 70 million leva, in 1925 - 36.5 million leva. Protection of infant and child health. In 1925, there were 5 children's consultation centers of the Red Cross Society and 42 colonies for schoolchildren. School sanitary supervision has existed since 1904 (examination of children upon admission to school and at the end of each academic year).- Medical institutions. In Bulgaria in 1925, there were 97 hospitals with 5,969 beds; 66 hospitals belong to the state, 7 to districts, 4 to public organizations, 1 to a commune and 19 to private ones. State medical institutions are divided into 3 classes. Hospitals of the first class, numbering 15, are located in large cities, each with 80-300 beds; hospitals of the second class, numbering 13, are in district centers, each with 20-100 beds; hospitals of the third class are in large villages, each with 10-20 beds; in 1925, there were 600 beds in them. The largest hospital is in Sofia (Alexandrov Hospital), founded in 1879, has 15 departments, 7 of which serve as university clinics; it has 1,200 beds. Of specialized medical institutions in Bulgaria, there are: a maternity hospital in Sofia with 140 beds (which is also an obstetric clinic), 3 sanatoriums with 440 beds and 4 psychiatric hospitals with 360 beds.- Medical personnel. In 1918, a medical faculty was opened at Sofia University. The duration of study is 6 years. The first graduation of doctors took place in 1923. In 1914, there were 728 doctors in Bulgaria, in 1925 - 1,360, of whom about 1/3 worked in Sofia. In addition, in Bulgaria in 1925, there were 253 dentists, 378 pharmacists, 1,231 midwives (of whom 783 in cities) and 1,774 feldshers. The veterinary personnel in 1924 consisted of 167 veterinary doctors and 408 veterinary feldshers. The budget of the Directorate of Public Health was 179.4 million leva in 1924/25, 176.2 million leva in 1925/26, which is 3.8% of the total state budget. The main part of expenses (according to the 1924/25 budget) falls on the hospital department - 94.5 million leva, on the pharmacy department - 26 million leva, on the department of infectious and social diseases - 12 million leva and on the department of public hygiene - 5 million leva. For sanitary service of departments, 26.3 million leva is provided in the budget.- Periodical medical publications in Bulgaria: "Medical Magazine", "Bulgarian Clinic", "Annals", "News of the Main Directorate of Public Health" and "Doctor". All are published in Sofia.