Reviving the EU's poorest region with technology

Reviving the EU’s poorest region with technology

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The following article is written by Yonko Chuklev – Board Member of PARAi and Venture Partner at AlfaStar Ventures.

Imagine there is a region that is the poorest in the EU by regional gross domestic product, the same region has the lowest life expectancy in the EU and just around 16.1% of the region’s population has never used the internet. If you were asked the question “Can this region, be revived via technology?” the intuitive answer may seem to be negative. However, you may get a surprising answer.

The region in question is Bulgaria’s Northwest region or “Severozapaden” region in the local language. Some of the main towns in the region are Pleven, Vratsa, and Vidin. This article takes us on a journey through each of these towns and the region. But the journey tells a story not only about poverty, weak social infrastructure, and depopulation but also about how technology can redefine possibilities in multiple sectors – from elderly care, education, healthcare to employment. But more importantly, the stories of each of the region’s major towns show how technology charts a new course toward regional prosperity and well-being.

Vratsa – tele-assistance to the elderly via IoT  

Through the years many measures for fighting poverty have been utilized in Bulgaria’s Northwest region. Some have had their small success stories, others not so much. But if technology must address one issue first in the EU’s poorest region, that would certainly be health services. Given that around 35% of the region’s population is over the age of 60, easy access to health and social services as well as regular monitoring for people with chronic diseases is vital for improving the quality of life.

This is where technology steps up to fill the gap left by a deficit of health and social workers. In 2022 the Bulgarian Red Cross in partnership with a couple of institutions started a center for providing teleassistance and telecare services in the town of Vratsa. The center aims to provide services in the regions of Vratsa, Vidin, and Montana. Its innovative model for remote monitoring of chronic diseases is something quite new for the region, though teleassistance relies on a relatively simple IoT-enabled system with two devices.

Project’s website –

The first device used is a bracelet along with a mobile device. The bracelet is placed on the person’s arm and its sensors measure parameters such as saturation, heart rate, stress level, body energy, and number of daily steps. It is provided along with a communication device, which is necessary for data transmission to the center. The second device is a certified ambulatory telemonitoring system that measures heart rate, ECG, blood pressure, saturation, and body position – whether in motion or at rest, monitors sleep, temperature, and for all of this in case of an emergency, it has the possibility of signaling to professionals from the center. This is especially important for people who have previously experienced any cardiac manipulation, as being able to quickly react in such a situation is extremely important. The data from both devices can also be recorded and printed, so users can present it to their doctors. The system can be upgraded further to provide feedback or encouragement based on the person’s physical activity levels and help them maintain a healthy lifestyle.

So far more than 290 people with different types of conditions have used the health status tracking service and additional medical care is provided by nurses, including basic medical services such as blood pressure and blood glucose measurements, wound care, general health monitoring, and other services prescribed. Improved quality of life is not the only benefit of the project as it will also create local jobs. The project envisages the construction of three new teleassistance centers, one call center in Vratsa and the introduction of 24-hour monitoring of the health and status of users. The goal of the project in a 4-year period is to create more than 81 jobs and to cover more than 700 people in the region.

Pleven – treating patients with robotic-assisted surgery

What may be even more futuristic than IoT-enabled teleassistance for a region like the Northwest Region of Bulgaria is robotic-assisted surgery. Yet one town in the Northwest region – Pleven holds leading-level know-how in the field of robotics therapy and surgery. Robot-assisted surgery and therapy is a technology that is one of the building blocks of healthcare 4.0 as it offers precise movements with a greater range of motion compared to human hands alone, enables minimally invasive procedures, helps achieve faster recovery times, offers enhanced visualization and some systems allow for remote surgery or teleoperation. 

The idea to develop robotic-assisted surgery in a town such as Pleven with a population of approximately 100,000 people has its roots in 2006, when a professor from the local Medical University, Pleven visited the USA for an exchange related to robotic-assisted surgery. During the visit, the professor recognized the potential of technology to revolutionize surgical procedures and wanted to implement it in Pleven as well. Two years later – in 2008 the first robotic-assisted surgical system (Da Vinci) in Bulgaria was purchased and integrated precisely into the Medical University in Pleven. It was initially used for gynecologic cancer surgery, but later the medical teams started performing surgery for prostate and colon cancer as well. In 2014, the Medical University in Pleven implemented a second Da Vinci robotic-assisted system for mini-invasive surgery. Due to the multi-year practice, four surgical teams, specialized in working with the robotic system, have been created – two in onco gynecology, one in urology, and one in general surgery. 

As a result of the long-term efforts, Pleven has emerged as a training center for gynecological robotic surgery and the Medical University in the town accepts international students in Medicine every year. However, robotics-assisted surgery helps not only academics but also the general population in the region as today solely in one hospital in Pleven named ‘Heart and Brain’ 14 robotic abdominal surgeries of medium and high complexity have been performed in just one month.

Vidin – igniting a passion for reading with the help of EVs

The benefits of electric vehicles are widely known – energy efficiency, lower costs, quiet operation and many more. However, one question that is relevant to the Northwest region of Bulgaria can you also use an electric vehicle to spread knowledge, curiosity, and passion for reading? 

Vidin, which is currently one of the poorest towns in the EU with a population of approximately 55,000 people sets a good example of how to do so. In 2022 the town’s administration in partnership with the local library purchased a small electric minibus that it decided to utilize as a bookmobile. With the new EV-powered mobile library, the local library reaches audiences in the nearby villages where most libraries were closed due to depopulation and municipal austerity. The electric bookmobile promoted books, authors, events, and special reading games for children. As a result, more and more children completed the lists of books assigned for summer by their schools and picked up the habit of reading. 

Though EVs are often associated with urban areas, the case of Vidin’s electric bookmobile shows how electric vehicles can help the local population. This is especially true in regions such as Vidin that suffer from reduced municipal investments and therefore lack of transportation options between the town and the small villages surrounding it. Therefore, the model of EV-enabled bookmobile can also be transferred to social and medical services as well as childcare.

But going back to the electric bookmobile case of Vidin, the initiative successfully engaged an audience that had previously shown little interest in books, encouraging them to embrace reading. A couple of initiatives aimed at incentivizing reading followed such as a “Reading marathon in Vidin” and the celebration of the World Reading Day.  This is why in the next year – 2023 another library in Vidin also invested in a bookmobile.

Botevgrad – boosting local employment with tech transfer 

Innovations in elderly care, healthcare, and education improve the quality of life in each region, but what is also needed for a region to prosper is sustainable employment and professional development opportunities for residents. Small towns often cope with limited resources and limited workplaces. One way in which a town can reverse this trend is by becoming a testbed for new technologies that are not yet on the market but are still being developed in university laboratories. This is a process better known as technology transfer. Getting any technology from the university laboratory to the free market is a process that is not easy and requires both world-class research and a market with a high demand for innovations. This is why most analysts look to uncover successful tech transfer stories in the major markets of the Union such as Germany, France, or Italy. But apart from the major markets, one small Bulgarian town named Botevgrad with a population of 30,000 people near the Northwest region has its tech transfer gem.

Botevgrad acts as the HQ of a company that successfully transferred know-how in the field of soundproofing, acoustics, and vibration control from the lab to the market, which allows it to sell in major markets around the world and to employ over 50 people. The company is called DECIBEL and it is a noise engineering, acoustics consultancy and project execution company offering services and materials for residential buildings and specialized premises. DECIBEL’s research and development department is led by PhD eng. Tsvetan Nedkov and despite the fact it is based in small town, it has its own testing laboratory for soundproofing materials and own research and development department for new sound-control solutions. In the development of new products, the company has successfully collaborated with three universities based in Sofia and because of its research and development activity, the company has managed to introduce leading products such as the world’s first 100%, non-flammable, biodegradable heat and sound insulation material. Because of its product innovations, DECIBEL has a network of distributors and partners and operates in 42 countries in Europe, North America, Africa, and Asia. This allows the company to boost employment in the small town of Botevgrad, to create opportunities within the town’s vicinity, ranging from manufacturing and logistics to professional services, and contribute to skills development and training initiatives within the local workforce. This model of tech-related collaboration between businesses in small towns and research institutions can be highly beneficial as it leverages academic knowledge, ideas, or patents, applies them locally to create new products, and ultimately, accelerates the pace of innovation and job creation.

Conclusion – the way forward is to replicate those stories 

These examples show us that even in the EU’s poorest region, technology can successfully impact elderly care, employment, healthcare, and education. No recipe for the revival of a region can be universal, but one ingredient can be universally applied – technology. From Pleven to Vidin, the stories of each town underscore the pivotal role that technology plays in reshaping the region’s trajectory. Yet, revitalizing the entire Northwest region through technological means demands further effort and dedication. The effort should be aimed at replicating and scaling more stories such as these. Monitoring the health of not just 700, but 20,000 individuals through IoT. Leveraging technology transfer to generate not merely 50, but 5000 employment opportunities. 

The endeavor to achieve this should come from various stakeholders – municipalities, the central government, businesses, libraries, educational institutions, and communities themselves. Moreover, it requires a shift in mindset from viewing technologies such as IoT, EVs, robots, and many more as something obscure to embracing them as an enabler of regional progress. The stories of the Bulgarian towns in the Northwest region can guide us as in a rapidly evolving global landscape multiple regions have difficulties in providing jobs, quality healthcare, and education. The bigger takeaway is that technology serves not only to introduce small improvements in multiple areas but also to emerge as a beacon of hope in small towns and underdeveloped regions.

References used:

Eurostat – Regional gross domestic product by NUTS 2 regions – million EUR

Eurostat – EU life expectancy at birth 80.6 years in 2022

Eurostat – Digital society statistics at regional level

Bulgarian Red Cross – Innovative Community Care Models in Favor of People with Chronic Diseases and Permanent Disabilities Project

European structural and investment funds information portal – Vratsa, Montana and Vidin with a control and communication center unique of its kind in the country

Medical University of Pleven – Robotic Surgery

Euronews – Robots treating patients in Bulgaria ‘revolutionary for society’ 

Bulgarian Cardiac Institute – Only within one month in ‘Heart and Brain’ Pleven 14 robotic abdominal surgeries were performed

Bulgarian News Agency – The Vidin library received an electric library bus

DECIBEL – Research and development

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