Predel Mahala in Blagoevgrad and Decree 17
(a field report by Ventzislav Kirkov)
May 16, 2025, around noon.
I pull over at the usual spot where I meet Katya. Today we’re meeting so she can tell me about the campaign to raise awareness among the Roma population in Predel Mahala, Blagoevgrad. We’ve worked on all sorts of initiatives over the years, and now we’re together again under the project “Serving the most in need – measures for assuring better access to healthcare of the most vulnerable communities.” One of the goals of this project is to inform the public—especially the most vulnerable—about how Decree 17 works. The decree sets the conditions and procedures for using targeted funds for diagnostics and treatment in hospitals for people who have no income and/or property that could qualify them to participate in the health insurance system.
Katya is a legendary figure in the network of health mediators.
“Tell me about yourself,” I ask her. “I’ve decided to introduce you and your work to the readers of the website.”
Katya smiles. Telling her story is a long journey—I know that from experience.
“How much time do we have?” she laughs, knowing full well there’s no getting by with just a few sentences. “My name is Katya Kirilova, and I’m a health mediator for the municipality of Blagoevgrad. I’ve been working as a health mediator since 2013. I’m on the board of the National Network of Health Mediators, and I’m also a regional coordinator. But even before that, I had experience in the healthcare sector—though I could go way off-topic there.
A health mediator—for those who don’t know—is a bridge between vulnerable groups and the state system. And people might think that’s strictly in the healthcare realm, but that’s not always the case. More often than not, access to healthcare comes through the social system. Even the procedure under Decree 17 is handled by the Ministry of Labor and Social Policy, but it grants the most vulnerable people access to medical services.”
We walk through the neighborhood. Everyone knows her, waving, smiling.
“I’ve helped a lot of people here. This is a Roma neighborhood, I’m Roma myself. I know the people well—what they say, what they think. And they know me, so things move smoothly. You can’t run any kind of campaign here without that. Prevention is important, and prevention starts with information. But there are people here who don’t have access to information, or they don’t understand it. So I’m kind of like the neighborhood news agency.”
About 3,000 people live in the mahala. But a portion of them live in dire conditions. Some don’t even have running water—they go to fill containers from a pipe at the far end of the settlement.
“How can we talk about hygiene when people don’t even have water?” Katya asks rhetorically. “And how are ambulances supposed to reach the houses up there, where there are no streets?”
We make our way uphill. At first, it’s a gentle slope. But then it gets steep—really steep. The houses up top are stacked tight, one next to another, sometimes one over another… And inside, ten people might live together. There’s no pavement—just narrow dirt paths, trampled by thousands of feet, climbing and descending all day long.
“What are the most common health issues here?” I ask.
“Cardiovascular diseases top the list. There’s also diabetes, and a lot of gynecological issues among women. Injuries too—broken legs, arms… I mean, accidents happen on these steep paths. And the poorest don’t have health insurance. For them, only emergency care is available. And once they’re discharged, there’s no way to continue treatment. That’s why Decree 17 is important—it can provide hospital care for exactly these people, as long as they meet the criteria laid out in the document.”
“You were one of the initiators of this project—why?” I ask.
We stop to catch our breath. A woman joins us and starts chatting with Katya about some prescription. We’re introduced.
“My name’s Asya,” the woman says.
“She,” Asya points to Katya, “is from the target group. In other words—no health insurance, no income, no property—movable or immovable. She has nothing to rent out, she hasn’t transferred any ownership. Those are the conditions to qualify for hospital treatment under Decree 17. But often, people like her don’t even know they’re eligible. That’s why this project was necessary. And you know what? The materials we made for this project are incredibly valuable. I’ve worked on many initiatives, but this is the first time I’ve seen people take our leaflets, fold them up, and tuck them into their wallets… That means something!”
“It’s true,” Asya agrees. “I always carry the leaflets with me—you never know when you’ll need them.”
She pulls out our neatly folded leaflets from a worn wallet.
“And it was great that we also made a longer version for the hospitals,” Katya adds. “Because often the hospital staff don’t even know this decree exists. Here, in the regional city, things happen—people get admitted. But in the smaller municipalities, they either don’t know or don’t want to deal with it.”
“Did you memorize what’s on the leaflet?” I ask Asya.
“That’s why I carry them,” she laughs. “When I go to the hospital, I just show it to them. They’re educated, they’ll read it. Honestly, I didn’t even know this was an option for getting into a hospital. Now I know. Most people know now.”
We say goodbye to Asya and head to a local café with Katya. It’s one of those places where you can buy whatever you want. I pique their interest—some faces look familiar. They’re chatting in Romani. Katya hears something and joins in.
“I was telling them about the decree,” she explains, then adds with a smirk, “Does this count toward the project report?”
No. These moments aren’t formal—but they’re the ones that create real change. Informal contact is spontaneous and sticks, because it’s a natural part of daily life. It’s not forced. And it’s all the more valuable when it comes from someone trusted.
One last question:
“Do you have a message—something someone might read and find meaningful? Come on, you’re known for your unfiltered wit and street-smart wisdom.”
“Oh, no! That’s just what people think when they’ve lost touch with real people and forgot how to speak like folks do on the street. That’s where our strength lies.”