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Partners & Projects

Eastern Europe

TFW in Bulgaria

Bulgaria is a middle income country in south-eastern Europe, with a population of about 8 million. The country's living standards have improved since democratic reform began in the 1990s, and on January 1, 2007, Bulgaria joined the European Union. Yet Bulgaria remains one of the EU's poorest members.

Healthcare and CLP

Each year, about 110 babies are born with cleft lip/cleft palate (CLP) in Bulgaria. Although evidence remains mainly anecdotal, it has been estimated that up to 30% of children born with CLP in Bulgaria are abandoned by their families and placed into state institutions.

Surgery for CLP is covered by the state's National Health Insurance Fund. However rehabilitation services, such as dentistry, orthodontics and speech therapy are not covered by state healthcare, and families must pay out of pocket. This cost-sharing system is a barrier and financial burden for low-income households.

Faced with a lack of support services and economic pressures, many families resort to giving up their children to state care, even though cleft lip/cleft palate is a treatable condition. For many of these children, institutionalization means a life of deprivation of liberty and social contact, poor education, and sometimes abuse and neglect.

Education, Support and Awareness

TFW has partnered with the European Cleft Organization (ECO), and the Bulgarian Association of Patients with Facial Anomalies and their Parents (ALA), to develop a support and referral network for families with newborns with CLP.

With the participation of both parents and local health professionals, the project will:

  • Train front-line health workers to provide counselling and referrals for new parents;
  • Provide skills and tools for parents to form group support networks;
  • Produce and distribute educational material on CLP; and,
  • Launch a hot-line phone number for parents seeking support and assistance.

Over the long term, the project aims to increase rapid referrals to cleft teams (within a 48 hour target), and to strengthen parental support networks.

After a pilot period of one year, the team anticipates replicating the project in other parts of Bulgaria.

What's New

Within the first few months of the project launch, 2 infants with CLP who had been sent to state-run orphanages have been reunited with their families because of interventions by the newly trained feeding nurses. This is proof of the dramatic impact proper follow up and support can have on the lives of children born with CLP.