Harmanli registration and reception centre, located near the border with Türkiye, remains the main government-run centre for asylum seekers, migrants, and refugees arriving in Bulgaria.

Overcrowding, poor hygiene, and limited access to medical services contribute to health problems, including frequent outbreaks of scabies and respiratory infections. MSF began working there in July 2023, conducting general healthcare consultations, including mental health support and chronic disease treatment, as well as providing health promotion sessions. To tackle hygiene-related issues, our teams ran a vector-control programme, in which they disinfected rooms and mattresses, and trained both the reception centre staff and residents in good hygiene practices.

In 2024, stricter government policies, supported by the European Union and Frontex, led to a sharp decrease in the number of people crossing the border to seek asylum and protection. In view of the low occupancy rate in Harmanli, we decided to hand over our activities to the national authority in charge of refugees, the State Agency for Refugees, in October.

At the time of the project’s closure, there were still some structural challenges at the centre; for example, a doctor was not regularly available, and there was limited access to mental health support, despite the needs of many residents who had experienced trauma and violence. However, the overall provision of medical care had improved, and a dermatologist conducted regular consultations.

MSF’s activities at Harmanli highlighted the ongoing gaps in Bulgaria’s reception and healthcare system for refugees, migrants, and asylum seekers. While our programme in Bulgaria has ended, we continue to monitor the humanitarian and medical needs in the country, ready to return again if needed.