Translated from original article by author Aida Panikian, Joint inquiry of newspapers “Osteoporosis” and “We are healthy”, Photo: The author

“I have written down almost all the expenses – my expenses, as well those of the state. It turns out that, if, for example, the Health-Insurance Fund had covered the cost of medicine for osteoporosis 2 years ago, when it was prescribed, I and the state would have spent an average of 1000 BGN yearly for me (or for someone like me). At present, only from November till June, we have spent more than 15 000 BGN for treatment following my hip fracture.”

Maria T, BulgariaMaria, 75-years old, stated this loudly and emphatically. She lives alone on the 11th floor of a metropolitan apartment house... The loneliness either breaks people or makes them improbably strong. That’s what I thought hearing Maria’s almost unreal story. From her mouth, however, it did not sound unreal...

In 2003 Maria broke her wrist. At the beginning of 2006 an X-ray photograph of her spine showed some fractured vertebrae and at the end of November she fractured the coxo-femoral neck (hip) of the right leg. "I was waiting for a bus at the stop near the school, when a big cheerful dog jumped up at me “to kiss me”.  Such a reaction was unexpected and I staggered. Luckily, there was a parapet, I leaned on it so as not to sprawl on the roadway. In front of the school, fathers were waiting for their children, they came to help me to rise, but alas I could not get up because of the sharp pain. I tried many times to take a step, but couldn’t due to the excruciating pain in my pelvis. So I stayed at the stop about 3 hours long – I felt awkward about asking passers-by for help. Then a woman who happened to be a neighbor saw me and stopped to talk. Understanding what had happened, she went home and called “First Aid”.

...So Maria’s troubles began. She was taken to hospital immediately and operated on. After 22-days lying in hospital, Maria lost 13 kg. When they discharged her, she remained immobile for about one more month. The neighbors helped her – they made some copies of her key from the flat and in shifts took turns cooking and bringing her food, others helped her to the toilet, while others helped by cleaning and buying her medicines.  Even volunteers from the Association “Women without Osteoporosis” participated in these ‘duties’.

Maria makes an effort and starts to get up from the bed before the control check up... "I had to get up and move, because lying sick for a long time leads to thrombosis and I am hypertonic since 1979. Long term immobilization and formation of thrombi is one reason why every fourth woman with osteoporosis dies within a year after breaking her hip.

After the first month, when I went for a control examination, they ascertained that my bone had healed sideways and my leg is about 3 cm shorter. I was taken to the hospital again and operated on for the second time...My first getting up from the bed was a real feast, then – the first 2-3 steps were taken with a walking device, and later – the first steps with a walking stick... Now I experience strong dizziness and don’t dare go out. Look, before you came I had dizziness, staggered and bumped into the cupboard in the kitchen…breaking glasses... But I did not fall – I held myself upright!" Maria said proudly.

Maria has paid more than 2800 BGN only for her treatment in hospital – consumer charge, artificial joint, consumptives, anti-thrombosis medication. The injections continue at home and Maria pays 4 BGN additionally for the assistance (not including for the medicine), money for a physiotherapist..., etc. According to her reckoning, the state has paid about 8 000 BGN for her 52-day stay in hospital, including toilet set, wheel-chair, walking device, medicines, money for clinical paths given by the Health-Insurance Fund. Maria has not included here the cost of rehabilitation which is supposed to be covered by the state, but in fact isn’t really...

And not only this – every month she must pay 34 BGN for medicine to prevent against blood clots and aspirin, as well as a significant amount for medicines against high blood pressure. "So, how could I afford about 70 BGN more for medicines against osteoporosis and additionally 10 BGN for calcium with vitamin D? Two years ago, the Health-Insurance Fund allowed it so that we paid a little sum in addition and I took my osteoporosis medicine regularly, but had to stop when the reimbursement was cut back.

And now look, 10 000 BGN were spent for only for 2 months...", continues Maria, who is frankly puzzled. As someone who has been in the construction business all her life – from designing to investment and building, always working based on economic effectiveness, Maria is puzzled by the health officials’ ‘logic’.

Obviously, our contemporary health insurance system does not look for economic effectiveness either in terms of disease prevention or health protection.

Read more stories of people with osteoporosis.