d
gynecological hospitals with a total of 740 beds; one hospital for
infectious diseases; and one for orthopedic and plastic surgery. In
addition to these district-supported hospitals, the central government
operated six hospitals with a total bed capacity of 1,036 in connection
with the special medical research institutes. Extended care and physical
therapy for patients suffering from chronic ailments were offered by 182
sanatoriums and health spas with a total bed capacity of 16,104.

The Sixth Five-Year Plan (1971-75) envisages increasing the number of
hospital beds to 8.4 per 1,000 inhabitants and focusing on those areas
of the country that are underserved. An increase in operating funds for
the hospitals is to be channeled mostly into improving plant and
equipment. Although most hospitals suffer from poor or outmoded plant
and equipment, they also suffer seriously from a shortage of staff,
particularly of nurses and auxiliary medical personnel. The plan states
specifically that alleviation of that shortage will have to be delayed.

In 1971 the country had a total of 16,183 physicians, 1.9 for every
1,000 inhabitants. The number of physicians had more than doubled in the
twenty years since 1952; most of them, therefore, were between the ages
of twenty-five and forty-five. The number of other medical personnel had
expanded along the same lines. In 1971 there were 2,464 pharmacists;
26,381 nurses; 6,016 midwives; and 5,012 feldshers. Feldshers are
paramedics trained to perform a variety of medical functions, including
simple surgery, in the absence of a fully qualified physician. Many
rural health centers are in the charge of feldshers and receive periodic
visits from specialized physicians.

Physicians and auxiliary medical personnel are all employed by the state
in the national health service. They are classed as nonproductive
workers, therefore their salary scales are lower than those for
productive workers. This has been causing a great deal of
dissatisfaction and is the principal reason for the serious shortage of
medical personnel. One Bulgarian newspaper in 1971 reported the case of
a hospital administrator trying to recruit women streetcleaners to fill
the many vacancies for nurses and aides in the hospital. The
streetcleaners refused because their wages and working conditions were
better than those for the more highly skilled positions in the hospital.

PERSONAL INCOME AND EXPENDITURES

Cost of Living