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European Network of Health Care Chaplaincy

  Health Care Chaplaincy in Bulgaria

2002 Standards Document in Bulgarian

Mario Yonov
Hospital chaplain, Sofia, Bulgaria.

After his ordination, Mario Yonov wanted to be a chaplain in the army or in a hospital. Something quite unusual for his country. After one year of being a volunteer visiting patients in the Alexandrovska hospital (Sofia), he organised a meeting between the management, the medical staff and theologians. It took many discussions but with the blessing of his bishop and the agreement of the minister of health, he became a hospital chaplain in 2002.  He was the first chaplain in Bulgaria, paid by a hospital. In the two following years he designed a job description for chaplains, using the Standards (2002) and his own personal experience.

After a while, he became a team member of the MS centre and of the centre for treatment for drug addiction. He provides a religious program for patients in the psychiatric day clinic and is available for staff, patients and their families at all the other units in the hospital. He takes a special interest in pastoral care for people who experienced a loss and tries to bring them together.

Fr Mario keeps training himself. Among others in psychotherapeutic competencies aiming to focus on the religious and existential dimensions of life. Next to individual care for the drug addicts, he also works with groups. He even teaches them boxing and Taekundo (he was a trainer in both for children and soldiers of the air force from 1990-2002). For his inspiration and formation in pastoral care, he draws upon literature and experiences from Polish and Russian colleagues. Recently he spent one month in White Russia on training.

It is Fr Mario’s aspiration to write a PhD because he feels the need to teach theology students and medical students about pastoral care. Especially so that the last ones would be more alert for the religious needs of their patients.

Fr Mario concludes: ‘My example, to work as a hospital chaplain, is not followed by other priests. One of the reasons for that is the very modest pay and maybe another reason is the instinctive avoidance of people who are sick…’

Mario Yonov (born 1970) has a master in theology and was ordained as a deacon and priest in 2001.

[May 2006]


Dr Jordan Vuchkov 

Unfortunately in the past 2 years health care chaplaincy in Bulgaria has not had the good results, which we all (medical professionals, clergy and the whole society) awaited.

The number of good news stories from Bulgaria are not so many:

1. At the moment there is one hospital chaplain (Fr Mario Jonov), paid from the State. He works in the University Hospital “Aleksandrowska” in Sofia – the capital city of Bulgaria. The former Director of this Hospital was an anaesthetist and he decided that the patients, their families and the staff need spiritual care and appointed Fr Mario a hospital chaplain. Fr. Mario works and lives 24 hours a day, 7 days a week in the Hospital. Because we haven’t got clergy Spiritual Care education, many physicians like Dr. Vladimir Bostandjiev help him to learn guidelines for good practice in medicine and psychotherapy.

2. Some other pastors (Fr. Constantine from the Town of Kazanlak) sometime serve liturgies in Hospital chapels in other Bulgarian cities.

3. The European Standards for Health Care Chaplaincy are published in “Health Care Management” – a well-known Bulgarian medical magazine.

4. In 2003 a 2 year scientific project started in the Medical Faculty, Thracian University-Stara Zagora. The subject is, “The Necessity of an Interdisciplinary ICU-Team”. The aims of the Project are to help the development of Bulgarian society, to confirm and support the incorporation of our country into European spiritual and cultural values and practical standards. That means:

To declare that the patients and their relatives are the centre of ICU;

  • To present this fact to the patients, colleagues and society;
  • To lay down the necessity of building an ICU-Interdisciplinary team;
  • To involve the Church in healthcare practices;
  • To define the role and tasks of all team-members;
  • To improve on medical education.

A variety of people take part in the project (Chairperson Dr Jordan Vuchkov, PhD) - medical (physicians, ICU-nurses, Medical Faculty/Medical College students) and non medical (psychologists, chaplains, social workers, social work students) professionals. All members believe that modern intensive medicine has the task of treating not only physical pain, but also social, psychological and spiritual suffering of critically ill patients and their relatives. The necessity of salving this important problem is among the reasons for building an ICU interdisciplinary team, which integrates efforts of different healthcare professionals - physicians, nurses, social workers, chaplains, psychologists, and volunteers. Our 2-year project includes development of:

  • Initiatives for legal guarantees for the rights of patients for spiritual care in Bulgaria (we published 5 books);
  • Teaching programs for medical faculty/medical college students, social work-students, physicians and nurses to understand and support spiritual needs and values of patients, their families and staff (In 2003/2004 in the Medical Faculty started a teaching module called “Social work with terminally ill patients in ICU”);
  • Teaching programs for chaplains, to be able to work as key member of an Interdisciplinary team;
  • An Interdisciplinary team in the ICU, including physician, nurses, social worker, chaplain, psychologist, volunteers.

The following activities were carried out:

  • 2003 – International Introductory course “Building of an ICU-Interdisciplinary team”; [More information]
  • 2004 – Second International Conference “Building of an ICU-Interdisciplinary team”. [More information]

I have attached separate files from 2003 and 2004.

The reasons for this minimal achievement in Bulgaria are many and varied.
1. The Bulgarian Orthodox Church is still passive and stays away from the reality of modern Bulgarian society. The Bishops say always: The Church doesn’t have money for Health Care Chaplaincy.
2. On the other side Directors of our Hospitals also say: We haven’t got money for the chaplains.
3. The Charity and Non-governmental organizations, which are trying to care for patients and relatives haven’t got financial stability, so they haven’t got the opportunity to work in Bulgarian Hospitals.
4. Naturally, the problems aren’t only financial. Perhaps the people need time to realize the necessity of spiritual support. Perhaps the people need time to say: Let it be.

Dr Jordan Vuchkov 
University Hospital, Stara Zagora, Bulgaria

[July 2004]