Bulgarian paramedics Tsvyatko Ludzhev and Ina Staleva won third place in the Paramedics Cup – an international emergency medicine competition, which was held some time ago in Paris. The competition is part of the European Congress on Emergency Medicine EUSEM 2026. The Bulgarian team reached the podium after three consecutive practical scenarios, which put the participants in conditions as close as possible to real work in emergency care. In the final standings, two teams from Thailand took first and second place, and Bulgaria ranked third. Paramedic Tsvyatko Ludzhev spoke to FACT.
- Mr. Ludzhev, congratulations on third place in the Paramedics Cup in Paris! What was your first feeling when you found out that you and Ina Staleva were among the three best teams?
- The ranking didn't matter. We went to prove to Europe that there are paramedics in Bulgaria. And we left with third place and something much more valuable: the proof that our paramedics are ready for anything. That they have the strength, knowledge and heart to fight for human life in its darkest hour, when every second is the border between life and death
- Did you expect such a result and what turned out to be decisive for your performance?
- We went without any expectations. We were simply the first to have the courage to go and gain experience for the next competitions. And in our work, every second is crucial. The basis of such competitions is the correct judgment in seconds. Recognizing life-threatening conditions, stabilizing the patient and directing him to a medical facility.
- The competition includes three practical scenarios, close to real conditions in emergency medicine. Which of them was the most difficult…
- The third scenario faced us with a real nightmare. A man, fainted in the garden, was found by his terrified wife next to the electric machine. The most terrible diagnoses echoed in our heads: trauma from a fall, concussion, electric shock... Then my colleague Ina performed a miracle. In seconds she unraveled the hidden threat — it was not trauma, but severe anaphylactic shock caused by an insect. Her brilliant and quick judgment guided us on how to act immediately.
- You are a paramedic with many years of experience, a former military serviceman and commando, who participated in international missions, and today you are also the mayor of the village of Ivaylo. How do these different roles complement each other and to what extent does the experience of military service help in providing emergency medical care?
- Being a mayor is temporary. Today you are here, tomorrow you are gone. But a paramedic remains for life – it is a seal on the soul. The army gave me discipline, honor and dignity. All qualities that are missing among our politicians today. Emergency care taught me the most important thing: to live to help a person in need, without asking for anything in return. I carry this entire palette of qualities within me and it is precisely this that gives me the strength to resist one of the most thankless positions in Bulgaria – Mayor of a small town, where you are to blame for everything until proven otherwise. My chair may change, but my principles – never!
- Participation in Paris drew attention to the work of Bulgarian paramedics. What does the profession in Bulgaria look like from the inside — What are the most serious difficulties you face in your daily work?
- It hurts to say it, but in Bulgaria, paramedics are invisible. The state turns its back on us, and the medical community often pretends that we don't exist. But we are here. Despite the obstacles, despite the cold indifference, a handful of us are still fighting on the front lines in the Emergency Centers. And do you know what breaks my heart the most? That for every one of us who is left to fight here, fate has pitted three others against us. Three times as many of our colleagues - young, smart, capable Bulgarians - were forced to leave their homeland. Today they are saving foreign lives in England, Romania and Germany. Expelled from their own country, they are giving a future to foreigners because their own homeland refused to give them a chance.
- As the mayor of the village of Ivaylo, you know firsthand what access to medical care means for people outside of big cities. Does emergency care reach residents of small settlements quickly and adequately enough, and what changes are needed to ensure a timely response to life-threatening conditions?
- It used to be different. In the past, every small village had its own dispensary, its own office, its own paramedic - a person who watched over people's lives. Instead of building on this heritage and preserving life, today everything is being snatched up and destroyed before our eyes. We here, in Ivaylo, are among the blessed few - we are only five kilometers from the largest hospital in Pazardzhik. But my heart cries for those villages forgotten by God and the state, to which the ambulance travels for hours. Hours when time stops, and the relatives of the patient stand on the road, staring into the darkness, praying for a miracle while life slips through their fingers.
- Preparing for an international competition requires time, training, equipment and financial resources. How was the participation in Paris organized…
- In front of those who stand under the spotlights, there is always an invisible army of angels. Our victory had only two faces - mine and Ina's, but the real team was much bigger. My whole heart and gratitude today goes to the Union of Paramedics in Bulgaria for the trust they placed in us, and to Dr. Teodor Tsankov, who put his soul into it and spent his entire summer preparing us. And most of all, I thank those 10-12 people who remained in the shadows, but without whom we would not have taken a single step. People who simply believed in us at times when we ourselves hesitated. They set aside their own funds, provided us with registrations, plane tickets, overnight stays... They gave us wings to fly. We were just the face, but they were the soul of this triumph. Thank you for believing in the Bulgarian paramedic!
- After the third place in Paris with Ina Staleva, you received an invitation to the World Emergency Medicine Competition in the Czech Republic in May 2027. What is the goal there?
- Here we faced several European teams, but there... in the Czech Republic, the scale leaves you breathless. The reality turned out to be much larger and grander than anything we had imagined. Imagine this ocean of rescuers: 200 teams of students, 200 teams of doctors and 200 teams of paramedics from every corner of the earth, gathered with a single mission - to save human lives. And while I was watching this forum of hope, a holy dream was born in my heart. I sincerely hope that one day I will experience the moment when a team from the Bulgarian Emergency Medical Care Center will step onto this world arena. I know that in our homeland there are incredible, much more prepared specialists than us, who deserve the world to hear them. Professionals who can glorify Bulgaria in this format that is so unknown and neglected in our country - the emergency medicine competition.
- Please indicate specific changes in Bulgaria that can improve the work of paramedics and the quality of emergency care in Bulgaria?
- It is high time that the state finally stood by us and said clearly: “You have a place here and where is our place“. We do not want to seize other people's functions - we simply want to be shoulder to shoulder with an already suffocating emergency medicine that is languishing under the weight of the chronic shortage of personnel. It hurts, it is so hurtful that our boys and girls find recognition everywhere in the world, but not in their own home. I know this pain all too well. I myself took my first steps as a paramedic abroad, far from my homeland.
- What would you say to young people who are considering choosing this profession, but are hesitant because of the responsibility, workload and working conditions?
- Today, in front of all of you, I want to rewind the tape 10 years ago. Back then, when I decided to study to be a paramedic, I had no guarantees that I would ever be able to work in my homeland. In that moment of uncertainty, I turned to Dr. Teodor Tsankov, who was working as a paramedic in Sofia at the time. I will never forget his words, they were imprinted in my soul: “Come on, finish! We will develop this profession in Bulgaria.“ Thanks to the tireless, daily struggle of Mrs. Iva Pehlivanska, President of the Union of Paramedics in Bulgaria, the wheel finally turned. Today I know that that timid dream is alive. In the near future, paramedics will be in almost every city, ready to stand between life and death. We have endured 10 years in darkness to bring light to Bulgarian patients.