It is sometimes said that the city of Russe was settled when a small piece crumbled off Vienna and floated down the Danube. It came to rest directly opposite the Romanian city of Giurgiu where it prospered into an elegant river port with long boulevards, stylish cafes and green city parks.
It is also sometimes claimed that its name derives from the Finnish “ruskea” (meaning brown) – but there’s a more seductive tale in which the city got its name from its female founder, a blonde valkyrie called Rusa. Myths aside, the notable residents of this historic city have in fact included several trailblazing women, among them the revolutionary Baba Tonka, the women’s rights activist Ekaterina Karavelova and the suffragist and reformer Dimitrana Ivanova.
These righteous women would have been proud to know that another of their kind is doing everything in her power to prevent stroke in Russe and to give its stroke patients a second chance at life.
Dr Rositsa Krasteva, the chief neurologist at Umhat Medika Russe, is a native of the Danubian Plain, the fertile, hilly region north of the Balkan Mountains and south of the Danube. She was born in a village near the river Rositsa and educated in Russe, returning here after studying medicine in Pleven.
Having loved literature and history, Rositsa’s plans to become a lawyer were scuttled during her final year at school when her parents determined that she would become the first physician in the family. It’s a Bulgarian thing for parents to interfere in their children’s careers, she says. She has no regrets but nor does she have any inclination to interfere with the career choices of her 23-year-old daughter who is already following her own path and working as an assistant pharmacist.
Angels opened the door
Although it’s hard to believe now, Bulgaria had an oversupply of doctors in 1998, which was the reason Dr Krasteva cut her teeth in the emergency department of a state hospital in Rousse before transferring to neurology two years later. She completed her specialisation in neurology in 2008 and joined Umhat Medika Russe in 2013.
Intravenous treatment for acute stroke wasn’t widely available in Bulgaria until 2018 around which time Dr Krasteva made the acquaintance of Angels, a meeting that sparked her interest in the possibility of better outcomes for Bulgaria’s disproportionate number of stroke victims.
Back in 2006 when she observed the first treatment with thrombolysis at the state hospital, her attitude had been one of skepticism. “I was more against it,” she admits. “But the training provided by Angels opened the door. It showed that we could organize ourselves and we learned how other countries worked. Up until then all our information had come from scientific literature; we didn’t know how to implement it.”
By mid 2019 Dr Krasteva had won over even the most recalcitrant members of her team and Umhat Medika Russe received the first of 13 ESO Angels Awards. But they, like other hospitals in Bulgaria, had also discovered a problem that prevented the majority of people from receiving treatment for acute stroke – an uninformed population that couldn’t recognise the signs of stroke and did not know how important it was to seek immediate medical care.
When the FAST Heroes stroke awareness programme was rolled out in Bulgaria after the Covid pandemic, the project leader, Elica Hadzhivalcheva, found an ally ready and waiting in Russe. Dr Krasteva’s support, and that of her namesake Dr Rositsa Georgieva from the regional office for education who made participation mandatory, helped the campaign reach 7,000 children in the city, including the grade three class at Vasil Levski Comprehensive School who knew exactly what to do when their computer teacher had a stroke.
And when a new Angels consultant, Ludmila Sheytanova, was appointed in Bulgaria at the end of 2021, she too found an ally – someone she could call for help with regulations, guidelines and legislation, and whom she could count on for support.
It’s for the patients’ sake
In person Dr Rosista Krasteva creates the impression that she could easily found an entire city if she felt like it. Though small in stature she exudes a cool edginess amplified by an abundance of long blonde hair. The impression is part Agnetha Fältskog (the blond one in ABBA) and part Stevie Nicks (of Fleetwood Mac fame), and it makes perfect sense that she used to record rock music covers with a colleague. (If you can find their version of Ozzie Osbourne’s “Close my eyes forever” on YouTube, you won’t be disappointed.)
Dr Krasteva is a rockstar neurologist in every sense of the word – whether she’s leading workshops at national and regional Angels events or making time to dispense real-time advice to a less experienced colleague. Her influence reaches well beyond Russe’s city limits: she is a member of the working group group for the development of the National Stroke Action Plan 2030, a member of the Bulgarian lytics advisory board, and a member of the executive board of the Bulgarian Medical Association.
During a conversation in Basel, Switzerland, where she is attending ESOC as Bulgaria’s nominee for the prestigious ESO Spirit of Excellence Award, she remarks that change can be easier to achieve at a national than a local level where the dynamics of interpersonal relationships can get in the way.
There is also a widespread skepticism towards the healthcare system to contend with. It’s Dr Krasteva’s view that years under a totalitarian regime are to blame for a distrust of authorities, which creates fertile ground for suspicion and conspiracy theories. But while change can be slow, she is convinced that Bulgaria will in time have the healthcare system its population deserves.
After 13 awards, Umhat Medika Russe has yet to win the highest accolade for stroke care – the diamond award remains tantalisingly out of reach. Dr Krasteva is unperturbed. “In my opinion it is better for the country to have more stroke-ready hospitals that a handful that receive awards from time to time,” she says.
“We work for the patients’ sake.”
