After more than a year in Bulgaria, Médecins Sans Frontières (MSF) has ended activities in the country. Due to declining numbers of people in refugee reception centres, we closed our medical programme at the Harmanli reception and registration centre in October 2024.

Launched amid surging asylum demands and ongoing crises in neighbouring countries in July 2023, MSF’s presence in Bulgaria was intended as a response to an evident gap in the healthcare system for asylum seekers. For over a year, our teams provided essential healthcare at the Harmanli reception centre, housing the country’s largest open reception facility.

Our work included providing general medical care, sexual and reproductive healthcare, mental health, and treating chronic diseases, totalling over 8,800 healthcare consultations. To prevent outbreaks like scabies, we disinfected 147 rooms and 823 mattresses, and trained both camp staff and residents in hygiene practices. 

Residents faced frequent outbreaks of scabies and bedbugs due to overcrowded conditions, limited sanitation, and insufficient access to medical resources. Our teams implemented a vector control programme, training both camp staff and refugees in health promotion and disinfection.

A year on, shifts in migration patterns and stricter government policies for people to obtain refugee status have diminished the initial urgency, and the occupancy rate in camps has significantly dropped. Today, the Harmanli camp hosts about 900 residents – less than half of its capacity – primarily composed of Syrian asylum seekers, many of whom seek to continue their journey further into Europe. Refugee policies have led to a recent increase in asylum rejections for Syrians, with many people now left in a precarious legal situation.

Despite improvements, through a more regular presence of medical doctors, the broader healthcare needs of Harmanli’s residents remain only partially met. Mental health care – a critical area given the trauma experienced by many asylum seekers – has been one of our core contributions, but even this service remains limited.

“We would like to take the opportunity to thank all our colleagues and partners in Bulgaria for their hard work and commitment to humanitarian values we hold high as an organisation,” says Sonia Balleron, MSF head of mission in Bulgaria. “MSF continues to stand in solidarity with people impacted by migration and remains steadfast in our commitment to provide humanitarian assistance to those in need.”