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Nurses Working As Cleaners, Doctors Working As Waiters: Why Bulgaria Is Failing Ukrainian Refugees


There is no shortage of jobs in Bulgaria's health-care sector, Svitlana Denichenko could not find a job in her profession.

SOFIA -- For most of her adult life, Svitlana Denichenko has worked as a nurse in an anesthesiology department. Every day, she prepared the anesthetic and then monitored patients during operations and procedures. She also saved lives, sometimes having to resuscitate patients or administer critical care.

When she arrived in Bulgaria, fleeing Russia's February invasion of Ukraine, she soon got the impression that her nursing skills were not wanted. So, instead of continuing her chosen profession, she accepted the only job offers she could get: as a maid, a cleaner, and an assistant cook.

"I applied for a job in all the hospitals in Varna, but they never called me back," Denichenko told RFE/RL's Bulgarian Service, referring to the resort city on Bulgaria's Black Sea coast where she now lives.

Denichenko's case is not an exception in Bulgaria, a country of 6.5 million people and the poorest in the European Union. Volunteers and experts working with Ukrainians in Bulgaria have told RFE/RL that many refugees with relevant experience can't find jobs in the health-care sector, despite a shortage of doctors and nurses.

Rather than jobs, the political debate in Bulgaria has focused on the refugees' accommodation. A nationwide program housing refugees in tourist hotels has often been threatened with closure, with refugees being told by local authorities to pay up or go home.

On October 31, Interior Minister Ivan Demerdzhiev announced that the state would stop paying for the hotels that housed Ukrainian refugees. Under his proposed plan, refugees who couldn't pay their own way would be moved to state accommodation.

Despite Demerdzhiev's announcement, the Bulgarian Council of Ministers, the government's senior decision-making body, in November extended the hotel-lodging program until February 24, 2023, the first anniversary of Russia's invasion of Ukraine. As a member state of the European Union, Bulgaria must abide by the Temporary Protection Directive, which means refugees are entitled to work, shelter, education, financial support, and access to health care for three years.

EU entitlements, however, do not always translate into successful outcomes on the ground. And the problem in Bulgaria is much bigger than just accommodation.

Not Filling A Need

More than nine months after the invasion, critics say that Bulgaria has no strategy on the integration of refugees into society, with successive governments making hasty and chaotic decisions. According to the World Health Organization, more than 500,000 Ukrainian refugees have crossed the border into Bulgaria since the war began, although according to July figures from the UNHCR and UNICEF, only 87,000 refugees remained.

Denichenko is from Chernihiv, a city one hour's drive north of the Ukrainian capital, Kyiv, that suffered for weeks under a Russian siege. She arrived in Varna in May, as she has an acquaintance in the city who offered her a place to stay.

"I have a 26-year-old son, who is participating in the war as a volunteer," Denichenko said. "He made me leave to be in a safe place." She has been living in Bulgaria for six months now, she says, and has nothing to complain about. The only problem is that she can't practice her profession.

"I've been in the operating theater all my life," Denichenko said. "But I wasn't specifically looking to work as a nurse anesthetist [here], I was just looking for work as a nurse or any medical worker."

After working a number of menial jobs, Denichenko again tried to find permanent employment as a nurse, but once again failed. When, at the end of October, she was offered a job as a warehouse worker in a pharmaceutical company, she immediately accepted.

There is no shortage of jobs in Bulgaria's health-care sector. Many doctors and nurses, especially those in the early stages of their careers, prefer to work abroad, seeking better wages, a higher standard of living, and more opportunities for career development.

According to Bulgaria's National Statistical Institute, there were 1,730 fewer nurses in 2021 compared to 2019, a 6 percent drop. In June, Radio Bulgaria reported that there was a severe shortage of medics across the country. According to a report by the Open Society Institute, only 5 percent of Bulgarian doctors were under the age of 30 and up to one-third were of retirement age.

Government Inaction

Those inherent problems have not been eased by the country's ongoing political turbulence, which critics say has prevented political leaders from establishing a coherent strategy on Ukrainian refugees.

Since 2020, Bulgaria has been in political deadlock, with protests sparked by public anger over state corruption. The conservative Citizens for the European Development of Bulgaria (GERB) party and its leader, Boyko Borisov, who served as prime minister for much of the 2010s, were the target of the public's ire.

However, on October 2, Bulgarians went to the polls for the fourth national elections in 18 months, giving GERB a plurality of around 25 percent. With the former ruling party unable to form a government, and with snap elections again a possibility, the country is now being led by a caretaker government.

Some politicians have spoken out against the government's treatment of Ukrainian refugees. Speaking to RFE/RL's Bulgarian Service, Kremena Kuneva, a parliamentary deputy for the anti-corruption, pro-EU Democratic Bulgaria alliance, said that 1,500 Ukrainian refugees working in the health-care sector had been in Bulgaria. According to her own figures, only 150 of them stayed. "Our country did absolutely nothing to retain these people," Kuneva said.

Kuneva says she sent questions to caretaker Prime Minister Galab Donev and to the ministers of health, labor, and social policy at the end of October. One of the questions she asked was whether the government had any plans for the integration of Ukrainian refugees.

According to Kuneva, one of the main stumbling blocks in Bulgaria is the recognition of foreign diplomas in the health-care and education sectors. Contrary to the recommendations of the European Commission, Bulgaria has never adopted simplified procedures for accepting foreign qualifications from people fleeing the war in Ukraine.

While the current interior minister has launched a new National Council on Migration, there is still a general lack of strategy, Kuneva says. "The main problem is that eight months later, there is no integration plan. The only thing Bulgaria is doing is paying for hotels and expenses in state housing," she said.

'Must Do Better'

Iliana Savova, director of the Program for Legal Protection of Refugees and Migrants at the Bulgarian Helsinki Committee, agrees that politicians have taken an ineffective approach.

According to Savova, in the case of Ukrainian refugees in Bulgaria, the authorities decided that the problem would be temporary, meaning that there was a need to deal with their accommodation but little else. "The point here is to give these people the opportunity to support themselves and lead some kind of normal life...including the right to work," she said.

"We have a hunger for people who have education and careers. It will be a huge plus for Bulgaria if we manage to integrate these people...so they can practice their professions," Savova said. "And so we're not in a situation where a qualified doctor or engineer is working as a waiter."

For this to happen, Savova said, more targeted and structured measures are needed, such as profiling refugees and assessing their vulnerabilities and needs.

Bulgaria isn't the only country in the EU where Ukrainian refugees have struggled to find work. With women and children making up an estimated 90 percent of refugees, women are often burdened with child care, their partners and support networks still in Ukraine. A survey cited by Deutsche Welle in June found that only 50 percent of Ukrainian refugees in Germany had found work. The new arrivals sometimes fare better in countries like Poland or the Czech Republic, which already have established Ukrainian communities and a less intimidating language barrier.

The previous government took some action, introducing incentives for employers who hire Ukrainian refugees, but, according to Savova, these measures have been "sporadic," poorly advertised, and aren't widely known, even among Ukrainians.

"They are a legacy of the previous government. The current caretaker government does not coordinate anything and does nothing. They follow events, they don't lead them," Savova added. "This caretaker government is only responding to public pressure, as in the current case with housing."

While the caretaker government might not be kicking Ukrainian refugees out of the country, she says, they certainly aren't doing much to keep them around.

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    Damyana Veleva

    Damyana Veleva is a correspondent for RFE/RL's Bulgarian Service. She graduated from the University of Heidelberg and the Free University of Berlin.

  • 16x9 Image

    Vidka Atanasova

    Vidka Atanasova joined RFE/RL's Bulgarian Service in Sofia in 2022 after 20 years working in online journalism, including with Dnes.bg and Dnevnik.

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