Association 'Women without Osteoporosis'
January – March’2004
At a great public interest caused from the events in connection with WOD’2003, the screening examinations of bone density countrywide went on. The actions were preliminary announced by active participation of the local authorities, health services and media. Association “Women without Osteoporosis” organized reception-rooms where the citizens filled in the One-Minute Test for the personal risk of osteoporosis. An ultrasound densitometer was at disposal for examination of the bone density. The needy ones were directed for medical advice to the specialized consulting rooms at the settlement. The public efforts of Association “Women without Osteoporosis” also in this action received the strong support of the medical specialists all over the country. 1/3 of all the 40 private ultrasound devices in the country were provided for this screening measurement. The medical specialists left their stationary diagnostic-consulting centers and together with Association “Women without Osteoporosis” traveled all over hundreds kilometers in order to help a lot of people to establish their risk of osteoporosis and put the beginning of a timely prophylaxis and treatment. Moreover, within the framework of the campaign they were making examinations and measurements of bone density at preferential prices, which was very important for the poor Bulgarian with income of 100 EUR per month.
The database obtained will be given for statistical processing to the specialists of the National Center of Hygiene, Medical Ecology and Nutrition, and after that – to the health authorities and the Health-Insurance Fund. /At the present time, the reimbursement of the treatment for the disease in Bulgaria is based on the data of the ultrasound densitometers/.
Within the framework of the cycle public meetings – discussions, under the motto “The management of osteoporosis is in your hands”, at the Sofia branch of the Association was carried out a patient’s meeting with the lecture “Vitamins and nutrition”. Lecturer was Dr. Med. Nikolay Damianov. Lottery with awards provided the sponsor of the event - “Kendy” Ltd.
The office of the Center “First aid for the bones” continues the started previous year work with the patients on treatment with Fosamax providing information materials, direction to consultation with specialists or examination of bone density. The most interesting themes and common questions to the Center are published in the newspaper “Osteoporosis”.
Since the beginning of 2004 began the preparation for fulfillment of the project “Early advice the women at 50 about the risk of osteoporosis”, for which Association “Women without Osteoporosis” won Lilly-Grant during WWC’2003 in Istanbul. For this purpose, some working meetings with the management of the Central Direction “Citizen’s registration” were carried out (they agreed to give us the addresses of women being at 50). In connection with the recently approved “Law for protection of personal data” was involved sub-agent from the system of organizations authorized for work with the citizen’s personal data.
Aiming at extension the project’s range in more regions of the country, it was created an organization of work providing additional means by self-financing.
It is prepared, coordinated with the Bulgarian representation of “Ely Lilly” and printed the text of the brochure for the women at 50, as well as the envelopes with a special stamp.
On the grounds of IOF report “Osteoporosis at the working place” Association “Women without Osteoporosis” developed national project directed to advice of workers and employers about the damages, which osteoporosis causes on the working place and to collecting of data for assessment of the financial burden from this problem. In February, this project was submitted to the Ministry of Health.
April – July ’2004
The project “Osteoporosis at the working place” was officially submitted at the national meeting of departments “Prophylaxis of diseases and health promotion” from the regional structure of the Ministry of Health including 28 districts of the country, which was carried out on March 31 and April 1 in the village Chiflik. Partners for its realization are Ministry of Health with its regional HEIs and Association “Women without Osteoporosis”. Head of the project is Prof. Lidia Koeva, D.M.S., head of the Clinic for endocrinology and metabolite diseases at the University Hospital – Varna. She held a report on the subject containing her data from some enterprises of the region of Varna. Technical details on the project delivered the coordinator on the part of Association “Women without Osteoporosis” Dr. Med. Vania Stoenelova – rheumatologist leading MC “Health” in the town of Vidin. By means of media, an open letter to the employers was spread (its text separately published).
Mrs. Olga Manolova – coordinator of Association “Women without Osteoporosis” and Mrs. Vania Stoenelova, Dr.Med. – coordinator of the program “Osteoporosis at the working place”
Started the fulfillment of the project “Early advice the women at 50 about the risk of osteoporosis”. Simultaneously with sending letters, by support from the local authority, Association “Women without Osteoporosis” organized temporary reception-rooms according to the model accepted in the campaign WOD’2003. The women there can fill-in the One-Minute Test and examine their bone density. The interest to these reception-rooms speaks that the approach to qualified help for prophylaxis and treatment of osteoporosis is still difficult. From March to June, the project covered the regions of Vidin, Montana, Gabrovo, Lovech, Pleven, Vratza, Targovishte and Razgrad. We met great interest on the part of media and publics everywhere and a strong support from the local authority in the face of the town councils and the specialists of sections “Health” at the municipalities.
The submitted in the beginning of the year project of the Center “First aid for the bones” aiming at covering the more remote regions of the country with information materials and osteometric measurements by use of the devices of MSD Co. imported last year, as well as provision of specialists on osteoporosis where they are missing, did not receive the approval from the Bulgarian office of the company. That’s why, since the mid of April the office was closed. The Center continues its work on information service and consultation publishing in newspaper “Osteoporosis”, but at present without direct work with people. Undoubtedly, this is a step back and insufficient appreciation of the capacity of the patient societies in cooperation with the specialists on osteoporosis.
In May, a meeting with the Bulgarian office of PR-agency “Weber Shanwick” in the face of its leader Rositza Stefanova was carried out and plans for mutual work outlined.
Within the framework of the cycle public meetings – discussions “The management of osteoporosis is in your hands” was carried out patient’s meeting on theme “Osteoporosis and nutrition” with lecturer Lyudmila Ivanova, Assoc. Prof., head of laboratory “Nutrition” at the National Center of Hygiene, Medical Ecology and Nutrition. The theme caused lively discussions and many questions about how by nutrition to be supported the treatment and prophylaxis of osteoporosis under conditions of high prices of medicines and low reimbursement. Interest provoked also the second theme of the meeting – presentation of the products of Himalaya Co. made by Dr. Med. Marijan Ivanov, homoeopathist and phytotherapeutist.
The preparation of the project for National Program on osteoporosis is in its final stage. As member of the working team at Ministry of Health, the Association “Women without Osteoporosis” is active participator in this preparation. In the part of the project “Propagation of osteoporosis in Bulgaria” it participates with database for propagation of the risk factors among the population of the country, which includes 9 000 people. In accordance with the report “Osteoporosis in EU: Plan for action” it developed the part “Public support of the National Program”. By its initiative IOF provided the participation of the leader of the working group Prof. Michail Protich in the meeting of the European Parliament during November’04 in Brussels. Association “Women without Osteoporosis” at its own forces and expenses translated the report “Osteoporosis in EU: Plan for action” and submitted it to the Ministry of Health. Based on this report was developed a new variant of the project for National Program, which found broad support from the scientific medical societies on rheumatology, orthopedics and radiology and the Bulgarian association of sterility and reproductive health. It is forthcoming in July to take place the last meeting of the working team and the project to be submitted for approval.
In May, Bulgaria joined to the announced by WHO call for active longevity organizing a Week of the motion for health – traditional joint initiative of Association “Women without Osteoporosis” and the Capital HEI. In the start of the initiative in the Boris’s Garden took part members and sympathizers of the Association, media and companies offering healthy products. So was put the beginning of the so-called “Routes of health”, which gather together people of each age for a pleasant walk in the nature on the green paths of the mountain or the city parks. Responded also participants in the country: we received information from the town of Shoumen about Routes of Health including quite various participators – from children of kindergartens and schools to the pensioners. The second Route of Health was carried out on June 12 on the picturesque panoramic path between the villages Jeleznitza and Bistritza at the foot of the Vitosha Mountain. The participants were greeted from the mayor of the village of Jeleznitza Mrs. Selimka Stojanova. The walk completed with songs, gayety and very good spirits as a result of the motion in the nature. The supporting companies offering healthy additives and food on the market provided awards for the most active participants.
Despite the active actions taken by Association “Women without Osteoporosis” against reduction of the reimbursement for treatment of osteoporosis from 50 to 25%, this question remains still unsolved. According to our investigations, a significant part of patients, which have applied active medicamentous treatment till the end of 2003, after the unfavourable decision of the Health-Insurance Fund are already not under treatment. On our tentative assessment, at the present time only 5000 patients take treatments. According to data of Dr. Med. Pl.Popivanov and Dr. Med. M.Boyanov /“Epidemiology of osteoporosis in Bulgaria”, Journal “Osteoporosis” ¹ 1, 2001/ the women with risk of osteoporosis are 317 483 and these with risk of osteopenia - 504 558. Total 820 000 Bulgarian women have enhanced risk of osteoporosis fractures. That’s why, on July 2004, Association “Women without Osteoporosis” sent a new letter to Dr. Med. Ivan Bukarev, Director of the Health-Insurance Fund, demanding the recovery of 50% reimbursement for treatment of osteoporosis and full reimbursement for diagnostics of seriously-ill patients /having one or more fractures/. We have attached to the letter the following documents: European Plan for Action in the field of osteoporosis /November 2003, Brussels/; Project for National Program of Osteoporosis / July 2004/; Investigation of Association “Women without Osteoporosis” about the propagation of the risk factors for osteoporosis in the country /July 2004/
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