Dr Silvia Paskaleva MD, Bulgarian Spa Tourism Association
Where is Bulgaria placed on the European spa tourism map?
As I've always proudly stated, Bulgaria is one of the leading countries in terms of mineral resources per square kilometre in Europe. We take the honourable 2nd place after Iceland in mineral waters of natural origin, with a unique physicochemical composition, opportunities for Medical SPA tourism (better known in our country as spa treatment), recreational tourism, and last but not least - for drinking application. And not only! We have exceptional treasures of hot mineral springs, incl. the geyser in Sapareva Banya, the hyperthermal waters of Sandanski and others scattered throughout the country, combined with wonderfully beautiful nature - sea, mountains, lowlands, valleys; architectural-historical and cultural landmarks; delicious food and wine. We have about 800 water sources with proven healing properties of mineral water. But, unfortunately, only 30% of them are currently used.
Spa tourism - more treatment or more tourism?
Suppose we're talking about medical spa tourism. In that case, we should emphasize the opportunities for treating various diseases, which is a priority, i.e. the tourist is looking for or has a recommended place because of the offered mineral water and forms of application, various balneo-, physio- and kinesitherapeutic procedures. The tourist has to be treated, but also rest and relax from the busy everyday life, communicate with people with similar problems, see and visit various landmarks, enrich their knowledge, touch the way of life and traditions of the area... So I can't tell whether treatment or tourism is more important. But I can say with confidence that they must be skillfully combined and diversified. This is the only way to offer a complete tourist product, which is extremely important for the physical and a person's mental health. Different types of tourism are closely linked and cannot function properly without each other.
Is there a difference between balneo, spa and medical tourism?
Yes, there is a difference, and it is pretty significant, but it often gets confused, which causes dissatisfaction among tourists and investors.
According to modern international terminology, I'll start with balneotourism or the so-called Medical (Medical) SPA tourism. Balneotourism includes a mineral resource - mineral water or healing mud, and they are used exclusively for healing purposes. The stay lasts at least 7 days, and according to modern standards, achieving a therapeutic effect requires 10-15 days. In addition, there are mandatory 3-5 procedures daily with medical supervision.
Spa tourism or recently known as recreational tourism, does not necessarily require a mineral resource (water, mud), although in some cases, it is used in our country. The stay is usually shorter - usually a weekend or 5 days and doesn't require medical procedures. Relaxation treatments, various types of massages, beauty treatments are typically offered.
In terms of content, medical tourism is related to a medical service offered outside a tourist settlement. Usually, these are consultations for "second opinion", various surgical interventions - dental, cardiac, orthopaedic, aesthetic, oncological and others. The stay is according to the patient's illness and their treatment. Often the accommodation is not in the medical institution but in specialized hotels, provided with medical staff. Recently, more and more hospitals specializing in medical tourism are being constructed.
Where does the majority of foreign tourists come from?
Traditionally, Bulgaria is preferred by German tourists, and our hotels work very well with German health insurance funds and pension funds and insurance companies. Recently, there have been many tourists from Israel and the Scandinavian countries. Bulgaria is a preferred destination, not only because of the richness of mineral waters but also because of the low prices. We just need to restore trust and improve the quality of services.
Does the Bulgarian have a culture for this type of tourism?
Recently, this culture has been growing, and the demand for Bulgarians in this direction is growing. For example, 10 years ago, they were looking for and mainly visiting SPA hotels for a weekend. Nowadays, the modern business and business-oriented person is looking for more health resorts. Therefore, the need for medical spa services is growing. On the one hand, the high growth of morbidity (mainly diseases of the musculoskeletal system and neurological conditions) and the positive effects that the patient has received or his relative has recommended. Thus, various Bulgarian resorts have already become a brand and a name for treatment.
Which are the favourite SPA destinations in our country and why?
The most famous (also on the European market) are Pomorie with the renowned healing mud and saltwater, Pavel Banya, Hissar, Varshets, Sandanski, Sapareva Banya… Don't let me list all of them. It is essential to impose destinations, not individual hotels and tourist sites.
We have approximately 800 mineral springs. What do we need to do for them to be fully utilized for tourism?
Building municipal strategies on the locations of these springs, for their practical use for medical SPA tourism, in combination with the other types of tourism, landmarks and real estate of the region. Part of the funds needs to be returned to the municipalities for investment.
I will share an initiative that I saw with my own eyes. Just a few days ago, I was in Varshets. I was pleasantly surprised not only by the town's cleanliness, by the parks, by the eco-trails near the park, by the Paradise Corner built by volunteers and private funds. It was created by the municipal strategy. Huge signs present all the town's possibilities for accommodation - balneal and SPA hotels, villas, guest houses, accommodation rooms, restaurants with location and category. The Cultural Calendar was presented to every tourist. And all this was related to a spa treatment. This is an outstanding initiative of the municipality and the mayor, which I hope will meet more followers.
Is our country effectively advertised as a SPA destination?
Unfortunately no! There is no such practice and current strategy to advertise our country as a separate region or a whole. Perhaps the reason was that there were many old, depreciated, and only a few hotels offering medical spa tourism for many years. However, recently, investments in this direction have increased to advertise individual resorts and the country. Thus, you can quickly enter the unified European market.
How did Covid-19 affect spa tourism in Bulgaria?
Unfortunately, the number of trips, in general, has shrunk for a more extended period. Still, I also shared that at the beginning of the Covid-19 crisis, our country was an ideal place for treatment and subsequent rehabilitation with its natural and mineral factors. But then, most hoteliers, including doctors, were afraid of such patients. Now, after almost every one of us has either fallen ill or has a relative or acquaintance who has suffered mildly or more severely, things are a bit different. Now we are talking about post Covid syndrome with various manifestations. Every day, I meet patients with multiple complaints from the pulmonary and cardiovascular systems, musculoskeletal systems, nervous systems, gastrointestinal diseases, and others.
What are the most severe difficulties for spa tourism?
I think that there have been many investments; of course, we have a lot of unrealized potential. We have a sound regulatory framework and systems, but the greatest difficulties are with the skilled workforce. We have forced many young professionals to leave the country, and now it is challenging for the industry to work.
As a member of the Board of the Bulgarian Spa Tourism Association (BAB), your idea for dealing with these difficulties?
We should consider keeping our staff here and not importing temporary labour, often low-skilled. I mean all areas of tourism, not just medical spa tourism. To make sure that there is no turnover of the staff, and to systematically increase their qualification. Business and educational institutions (secondary and higher) should work hand in hand. This, of course, is done with proper training and decent pay.
To start presenting our country as different destinations and as a whole with all types of tourism.
Municipalities should be interested in investing in infrastructure in attractions for these tourists. This is the only way we will regain our glory from the 70s when the business flourished.
