- primary medical exams which are significantly delayed and taking samples for the
running tests for all individuals seeking protection. The poor coordination between the
competent institutions can be identified as a reason for the delay of such exams. These
exams and tests can be delayed between several days and several weeks, if not more. The
registration of the individuals accommodated in centres in Voenna Rampa, Vrazhdebna
and Ovcha Kupel Residential Estates is slow, and those accommodated in the buildings in
Voenna Rampa and Vrazhdebna are transported gradually to Ovcha Kupel by buses.
Women and children are given priority in the registration process. The primary medical
examination is carried out during the registration and samples for laboratory tests are
taken.
Issues related to the immunisation and re-immunisation of the children of people
seeking protection
Vaccines for the immunisation of children have been provided by the Ministry of Health.
The NPM team found a problem with the immunisation status of these children. On one
hand there are no documents proving what immunisations have been given to the
children,. On the other hand no immunisations compliant to the requirements of the
World Health Organisation have been done since the occurrence of the events in Syria.
Provision of health care before and after the inclusion of the protection seekers in the
republican healthcare system
All individuals seeking protection are given health assured status at the time of
registration of the filed status application. Before that health care to individuals staying
in the open-type centres is provided by medical professionals working for SAR, who are
mainly doctor's assistants. The only doctor currently employed under labour agreement
with SAR works on the territory of the RAC - Ovcha Kupel.
People seeking protection are included in the health assurance system and are granted
rights of mandatory health assured persons (NHAP) in accordance with the provisions of
art. 33, para 1, item 4 of the Health Assurance Law (HAL) in relation to art. 29, item 4 of
the Asylum and Refugee Law (ARL) not as of the time of the filing of the application, but as
of the time of the registration. A long period of time may elapse between these two events.
This right is realised in different ways in the different regions. In Haskovo District for
example, all refugees who have been granted rights under the HAL are automatically
included ex-officio in the patients' list of a general practitioner from Svilengrad. The
turnover of these individuals poses an additional problem - new ones arrive and register,
others are delisted due to change in their residence.
No such ex-officio inclusion is practiced in Sofia, however, and the people who have been
granted health assurance rights receive an explanation, that they are expected to choose
general practitioner and dentist, by filling in the forms for the selection of the latter.
However, not all of the people who were granted rights of MHAP, choose general
practitioners due to the lack of funds to pay the user fee in case of visits to the general
practitioner. Another serious problem is related to the software used by the NSSI. Upon
the inclusion of the refugees in the national health assurance system and as of the time of
the registration the SAR commences transfers of the health assurance contributions for
the respective person to the NRA, but the person is not seen as a health assured person in
NSSI's software over a period of at least two months. Therefore, in case of potential need
for medical treatment, the registration documents and the paid health assurance
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