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Reacting to six deaths from self-immolation in different parts of the country, the Bulgarian Ministry of Health ordered health authorities to provide psychological support to prevent further deaths. In the most recent case, 41-year old Todor Yovchev poured gasoline on himself and set himself on fire on March 20. After being rushed to hospital with burns to 90% of his body, Yovchev died of his injuries two days later and is the sixth case of self-immolation in Bulgaria since February.
The first self-immolation, 26-year old Traian Marechkov, occurred on February 18 and he reportedly described himself as having too much despair to live on. Other cases have laid the blame of economic hardship or as a form of political protest. In one case, 52-year old Dimitar Dimitrov set himself on fire in front of the Presidential building in Sofia, Bulgaria's capital city. Security guards extinguished the flames and took him to hospital with burns to 25% of his body. Though Dimitrov and another man, Ventsislav Vasilev, have survived their self-immolation to date, they are both hospitalized and considered to be still in danger. Along with the self-immolations, Bulgaria is experiencing a sharp upsurge in suicides with daily reports of deaths from hanging, jumping from bridges and high-rise buildings, and throwing themselves under trains.
Bulgaria is still reeling from massive protests over poverty, corruption and extremely high utility bills and the centre-right GERB government was forced to resign March 12 as a result. The current caretaker government, installed by President Rosen Plevneliev, is attempting to deal with the economic crisis as well as implementing new health measures to stem the current rash of suicides. Among the initiatives being considered is using psychologists and health inspectors to identify risk factors which may predict future deaths.
Although self-immolations are more commonly associated with political protests in Tibet and, more recently, with ritual suicides in India, a 2004 study by Medecins Sans Frontiers examining self-immolation cases over a 20-year period has yielded a disturbing pattern in many countries around the world. According to the study, Bulgaria has the highest rate of self-immolation deaths of all European countries with an average of 7.4 cases a year between 1983 and 2002. Establishing the motivation for self-immolation, whether due to mental illness or political protest, is not a simple task though self-immolation in mental patients is most common in European, North American, and Middle Eastern countries. In the case of Bulgarian self-immolators, the percentage involving known mental illness is relatively low compared to neighbouring European countries and may be more clearly linked to the current economic recession.
The current Bulgarian epidemic may represent a suicide cluster involving copycat behaviour which began in February and peaked in March. While there have been no new cases in the past two weeks, it is likely premature to suggest that the cluster has run its course. In the meantime, Bulgarian health officials continue to watch for new incidents and to provide better treatment to prevent more deaths. Whether this will be enough remains to be seen.
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