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Bulgaria - Health and safety
With Dr Felicity Nicholson
There are state-run hospitals, private medical centres and local polyclinics. Doctors are extremely well qualified and able, but they are often let down by poor equipment and facilities. Nurses are efficient but often without the friendly, personal touch which makes hospital treatment bearable. You will not find many English speakers, so try to take a Bulgarian friend with you if you do need hospital treatment.
You are entitled to free medical and dental treatment, but all visitors must pay for medicines. The availability of private medical treatment is on the increase and it is not expensive for foreigners; keep your receipts if you intend to claim on your travel insurance. The E111 form is no longer valid and citizens of EU countries need to obtain a European Health Insurance Card (EHIC). This is NOT a substitute for comprehensive medical and travel insurance which you are recommended to obtain. The EHIC entitles citizens of EU countries to medical treatment on the same terms as Bulgarian nationals. You can get your EHIC online or from post offices using form T7.
Those planning to spend their holiday in mountain or rural areas are at some risk from ticks. This is especially important to bear in mind during the spring and summer months, when there is a risk of tick-borne encephalitis. You should dress defensively, wearing long trousers tucked into socks or boots, and long-sleeved shirts. Also apply tick repellents to your skin. You should check warm areas of the body (armpits, groin, behind the knees and ears) after walking through forests or long grass. If you do find a tick you should use tweezers to pull it out without twisting it. Do not use irritants such as olbas oil or lit cigarettes, as this will encourage the tick to regurgitate its stomach contents and will increase the risk of infection. Remember, if you have been bitten by a tick you should seek medical advice as soon as possible for treatment. Tick-borne encephalitis vaccine is available in the UK for those who prefer to protect beforehand. A primary course consists of three vaccines over several months but, if time is short, two doses given a minimum of two weeks apart will do.
Travel clinics and health information
A full list of travel clinic websites worldwide is available on www.istm.org. For other journey preparation information, consult www.travelhealthpro.org.uk (UK) or http://wwwnc.cdc.gov/travel/ (US). Information about various medications may be found on www.netdoctor.co.uk/travel. All advice found online should be used in conjunction with expert advice received prior to or during travel.
Despite Bulgarians themselves believing that crime is at a high level, it is actually much lower than in the UK. Theft, particularly of cars, is the most common crime in cities, but very rare in the countryside. However, there are plenty of inexpensive guarded parking lots available in cities.
Obviously you should behave with reasonable caution, particularly in crowded places, such as markets and bus and train stations, as you should in any country. Keep money and expensive belongings out of sight, wear a money belt, and have your handbag across your body rather than on the shoulder.
Although homosexuality is no longer illegal, outside the main cities and resorts there is little tolerance towards gay people, who should avoid overt displays of affection and flamboyant dressing.
Regarding general safety, be careful, but don’t be worried. I have been travelling in Bulgaria for over 30 years, during which time I have had just one negative experience involving money-changing, which could easily have been avoided if I had taken my own advice: don’t change money on the streets, you will always be the loser!