By Francesca Istrate and Angel Angelov
Twelve years ago, I suffered from a form of blood cancer called Acute Lymphoblastic Leukemia, a disease that marked my childhood and matured me in a way due to the challenges I faced during a year of hospitalization at a public hospital in the capital of Romania, the Fundeni Clinical Institute. Receiving such a diagnosis changes your life. You are forced to spend all your time in the hospital, often lying in a bed in a ward that becomes your room, shared with other children, far from home and your family. The medical staff and other patients become the “society” you interact with.
I was in my first year of school, a time when I should have been making friends, discovering the world, and enjoying childhood by playing and socializing. However, fate brought me to that hospital, depriving me of all the joys a six-year-old should experience. Twelve years ago, hospital wards were not as modernized as they are now. Patients were typically 6 to 8 children per ward, along with their parents, who slept uncomfortably on any available space — the child’s bed, chairs, or a foam mattress next to the patient’s bed. The wards lacked private bathrooms, with toilets located in the hallway and only 3 or 4 showers for approximately 10 wards. The playroom, where children could escape their health concerns, was a small room that could accommodate no more than 10–15 children.
During that year, I also witnessed significant changes in the infrastructure of the Pediatric Oncology ward, as Professor Doctor Anca Colita managed to raise enough funds for its modernization. She added private bathrooms to each ward and built an isolated section for children with severe conditions who could not interact with others due to their ill health. Despite the joy of seeing improvements in these conditions, it was a difficult period for me because my situation worsened when I contracted a hospital-acquired infection, making me one of the first to use the newly isolated wards.
The only country in the European Union without a children’s hospital
The absence of a modern national children’s hospital has been an ongoing concern for years in Bulgaria. Advocates like the Bulgarian Pediatric Association and the “For the Good” Foundation emphasize the urgent need for a national children’s hospital, urging the National Assembly and the Council of Ministers to prioritize pediatric care and set clear deadlines for its creation. However, this still remains a significant issue for Bulgarian citizens.
Children’s hospitals offer welcoming environments, expert care, and a comprehensive approach that considers the physical, emotional, and cognitive needs of the child. Many families waste valuable time going from doctor to doctor about a health concern, which can sometimes lead to very tragic situations.
“Children are not a smaller version of adults, and this applies to development. Which requires a modern approach,” says Doctor Boris Tablov, an anesthesiologist. “The healthcare system is a conservative system, changes happen slowly, their effect is delayed in time, and at the same time the social response is very large,” he continues.
“Worldwide, it has been a practice for many decades to create medical institutions in which to gather specialists from various fields of pediatric care who can provide complex medical care and assistance for children,” says Nadezhda Tsekulova, a member of the Public Council for the National Children’s Hospital. “There is no other country in the European Union that lacks this type of highly specialized National Children’s Hospital. Bulgaria is the only one!” .
Donate life to children
While the situation is concerning in Bulgaria, Romania has accomplished a major achievement in the healthcare sector. “Dăruiește Viață” (which translates as “Donate Life”) Pediatric Oncology and Radiotherapy Hospital is a facility built through donations from Romanian citizens, foreigners, and businesses. It was initiated by Carmen Uscatu and Oana Gheorghiu, the founders of an association with the same name.
Carmen Uscatu and Oana Gheorghiu, the founders of “Dăruiește viață”
Source: Donate Life / Credit: Adrian Vizireanu
After 34 years since the fall of communism in Romania, a period in which no hospital for children has been built, they managed to create more than just a hospital dedicated to children. They have built a remarkable community made up of donors and medical staff who contribute to better care that has naturally led to an increasing survival rate among those suffering from severe illnesses.
The two founders went through a long process that required time, patience, and a lot of effort, initially starting with the idea of renovating the pediatric oncology department of the Marie Curie Hospital in Bucharest, and began raising funds as early as 2015.
Over time, Oana and Carmen became increasingly excited about this idea, and more and more people began to donate. As a result, construction of the new hospital started in 2018.
The architect they were working with, Raluca Șoaita, suggested they build a new hospital from scratch that would bring innovation in patient care through the modernization of medical equipment and provide a space where both the children and their parents would feel safe, making their hospital stay as pleasant as possible.
The process was a long and drawn-out one, which came with many challenges and obstacles for the coordinators of this project. One of the biggest challenges was obtaining the construction permits and the 22 approvals needed to advance the project, which took six months.
“One of the biggest challenges was building a modern hospital that meets the standards of the century we live in, while having to adhere to outdated legislation from the last century, specifically from the 1970s,” says Oana Gheorghiu, co-founder of the “Dăruiește Viață” Association.
A modern hospital is not just a new building
But the construction of a hospital in itself is not enough. Both countries also need to adopt modern medical standards in children’s medical treatment.
“In Bulgaria, for the same condition, a person can receive radically different advice, a radically different type of care, depending on the ideas of the medical specialist or the medical team to whom they find themselves. In today’s world, this is absolutely unacceptable,” says Nadezhda Tsekulova.
Oana and Carmen have managed to establish partnerships with some of the largest pediatric oncology hospitals in Europe and the United States, such as the Princess Maxima Center in Utrecht (Netherlands) and the St. Jude Children’s Research Hospital in Memphis (USA). Such partnerships have contributed considerably in terms of the professional training of medical personnel, injecting innovation into the treatment methods for patients, and informing Romanian doctors to help reach the modern standards of medicine already existing in Western countries.
There have been discussions with doctors who were accustomed to a different system, making it difficult for them to understand the new way of doing things in a hospital with modern infrastructure and advanced technology, as seen in the West.
“Since it wasn’t easy to get them out of their comfort zone, we had to engage in endless negotiations, I could say. I think we spent more than half a year discussing various aspects with the doctors, which required a major effort,” said Oana Gheorghiu.
The lack of children’s hospital beds, a chronic disease for Bulgaria
Another problem is the insufficient number of beds for children in Bulgarian hospitals. According to a report made in December 2023 addressing the needs of a future Children’s Hospital in Sofia, the capital, there were 3,935 available children’s beds in the whole country, from which 1,450 were neonatal and 2,485 were pediatric. But only 215 of them were indicated for pediatric care in individual specialties (treatment of cancer, broken limbs, surgery, etc.), and they were located mainly in the hospitals of large cities like Sofia, Plovdiv, Varna, and Pleven.
In Romania, according to the Financial Resource Allocation for Child Health in the Romanian Healthcare System report and the National Institute of Health Insurance Houses (NHIH), in 2018–2019 there were 18,380 pediatric beds. In 2020, however, the number decreased to 17,232.
This means that smaller towns or villages in Bulgaria have very few to no beds and citizens have to travel to the big cities to seek help. Even then, it’s not guaranteed that there is going to be an available bed.
Moreover, even if they build this hospital, there may not be enough pediatricians and nurses.
“Bulgaria lacks 512 needed pediatricians, in total. In the region of Sofia where the National Children’s Hospital would be, the deficit is 123. The bigger problem is the lack of nurses, because in Bulgaria for several decades there has not been a purposeful training of nurses who work with children, the so-called pediatric nurses. At the same time, working with children requires specific skills, as it is physically and mentally more difficult,” says Nadezhda Tsekulova.
“Not that long ago, the children’s ward in the National Cardiology Hospital (NCH) was closed because there were no nurses to look after the children,” said Boris Tablov.
One of the biggest problems is the financing of the hospital. Many children stay in hospital for conditions that can be cured at home, which leads to unnecessary costs.
“In modern medicine, in fact, only about 10% of conditions in children require children to go to the hospital to be treated. Children very often lie in hospitals for things that can be treated without going to the hospital. This should change in order for the National Children’s Hospital to be adequately funded,” said Nadezhda Tsekulova.
She thinks that Bulgarian citizens should be active, rather than getting tired of observing the process and forgetting to keep asking questions. No one should tell them that this is Bulgaria, and it can’t be like that here in order to support the building of the National Children’s Hospital.
An effective combination of individual and corporate fundraising in Romania
Carmen Uscatu, co-founder of the “Dăruiește Viață” Association, shares their strategy: “On the fundraising side, we primarily targeted companies because, in Romania, there is a tax incentive that allows them to donate from their profit tax. This is a well-known but not widely used incentive. At the same time, we also reached out to individual donors, and the SMS campaign was of great help because, in Romania, there is a recurring SMS option, where a person who donates once can continue to donate monthly, with the same amount being deducted each month. Through this campaign, we managed to raise over 20 million euros, considering that the hospital cost 53 million euros.”
“People like Paula Herlo, Alex Dima (famous journalists in Romania), and Tudor Chirilă (a well-known actor and musician in Romania) have been of great help, both through their public image and as ambassadors of the association, supporting the promotion of the initiative in the news and at various events where they make appearances,” Carmen says.
After this entire process that lasted 6 long years, the hospital opened its doors for patients in 2024.
Looking at the stars: Inside Romania’s brand-new children’s hospital
One of the main specialties of the “Dăruiește Viață” Hospital is cancer treatment, a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. The new building is completely different from the hospitals in Romania that were built during the communist period of the 20th century and manages to enchant all those who pass its threshold, thanks to a unique design that makes you forget that you are in a hospital.
The involvement of doctors and patients was key in this process. Through discussions with them together with the two founders and the architect, Raluca Șoaita, great benefits were added because they discovered the needs of each ward that they built in the new hospital, both in terms of the layout of the space, as well as the purchase of medical equipment.
The entrance is through the old building with which it was connected, followed by a reception area where patients are greeted, and on the ground floor you can find the doctors’ offices, and recreation rooms that are differentiated by the color of the doors. Those belonging to the rooms dedicated to medical staff are gray, and those to the recreation rooms are yellow to cheer up the patients suffering from the disease.
Also on the ground floor is a waiting room called the Atrium, whose design is animated by a giraffe that delights the little ones. The architect Raluca Șoaita thought of the hospital as a tree of life, which is why each floor of the building has a representative animal depending on the level at which it survives in nature. We can also find a panel lit with colored LEDs on the ground floor in the elevator area, which is represented by a turtle.
An innovative thought in the design of the space was the use of natural materials that do not endanger the health of the patients, offering a safe space from this point of view.
The Atrium
Photos by: Francesca Istrate
The hallway
Moreover, the hospital is unique compared to others, standing out through the emphasis that the founders and their entire team have placed on the needs of young patients and their parents. The patient rooms are designed for one or two patients accompanied by a parent each and are equipped with state-of-the-art medical equipment, private bathrooms, and ample storage space. One aspect not commonly found in state hospitals in Romania is that these rooms come with special beds for parents, and the entertainment area was also a priority during the construction planning, because emotional well-being contributes to a child’s health progress.
The operating room
A room for patients
A bathroom
This area is located on the third floor of the building, where you can find a cinema, a gym, a playroom filled with cushions—which is a favorite among children, Dionisia (a member of the “Dăruiește Viață” team) informed me—and an indoor garden that provides children with the opportunity to socialize and connect with a small part of nature, as the plants from the wall are natural.
The indoor garden
The cinema
The lobby
The playroom filled with cushions
Several rooms in the severe isolation area have a view of this garden, and despite their isolation, patients there can communicate with those in the garden through a special phone, as communication is another beneficial aspect that the team has prioritized. Additionally, the children’s privacy is respected: the window separating them can be made opaque to prevent them from seeing each other.
An isolation room
Various activities are frequently organized in all these areas, and patients and visitors can listen to the live broadcasts from the radio studios located on each floor through the speakers installed in every room. In the evening, children can observe the stars from the rooftop using the astronomical observatory.
A radio studio
The astronomical observatory
