At the outset of 2021, an Iranian-born doctor in a remote corner of Bulgaria became the unexpected center of a media storm. Dr. Abdullah Zargar-Shabestari, the director of Isperih General Hospital, a once-struggling municipal health facility close to the Romanian border, had been forced to resign after six years at the helm.
It came about because of a change to the Law on Public Enterprises, which barred non-Bulgarian citizens from occupying managerial posts at public institutions. Dr. Zargar-Shabestari had applied for citizenship in the country back in 2015 but had been unsuccessful.
Locals were horrified and launched a petition calling for the head of the hospital to be granted citizenship. It was signed by 1,000 people in the first week, and 7,000 by the time it was received by the authorities on January 29. Between 10,000 and 15,000 more Bulgarians added their names in the aftermath.
Politicians of all stripes were convinced, in a staggering and rare display of unity. Just five days later, Vice-President Iliana Iotova signed a decree conferring Bulgarian citizenship on the 52-year-old surgeon from East Azerbaijan. Then on February 7, Dr. Zargar-Shabestari received his citizenship at a ceremony in Sofia in the presence of the Bulgarian Ministers of Justice and Health.
The deluge of media coverage put a small Bulgarian town in the spotlight, together with its hospital: a once-dilapidated building burdened with debts and a doctor exodus that had turned itself around to become an exemplary facility under Dr. Zargar-Shabestari’s leadership. But it also shed light on the remarkable story of an Iranian doctor whose only wish had been to travel and help people – no matter where they lived.
From Selling Gold to Saving Lives
Abdullah Zargar-Shabestari was born in the city of Shabestar, East Azerbaijan in 1969 to a family of Azeri jewellery shop owners. Looking back, he says, this mercantile upbringing may have had something to do with his success in his role as hospital director.
“My family are all businesspeople,” he says, “I’m good at business, despite the fact that I don’t like it. It’s in my genes. Half of the job of a good chief executive is being a good businessman.”
At the age of about 18 the young Abdullah was fired from managing one of the stores himself because of being over-generous with the amount of gold he gave to customers: “I often gave customers a bit extra,” he says.
Having previously considered becoming a veterinary surgeon or a dentist, he decided to pursue a career in medicine after completing military service. “I always wanted to do something useful in my life,” he tells IranWire. “I like helping people and giving relief to people. And I wanted to travel and see the world.”
He studied Russian in Baku, Azerbaijan, which was then part of the Soviet Union, before moving to Moscow to train as a doctor at the Medical Academy. From there, he moved to Germany in 1994. “At the time,” he says, “as an Iranian, there was no chance for me to specialize. So I came to England but again, it was difficult for me to get hired. I decided to go to Bulgaria for a PhD.”
Dr. Zargar-Shabestari first travelled to Bulgaria in 2004 and worked for a long spell as an orthopedic surgeon in Varna. In 2012 he briefly returned to the UK and registered with the General Medical Council, but again found it hard to secure a long-term contract. He didn’t experience discrimination per se, he says, but to compete as “Abdullah from Iran” against specialists from Germany or France was difficult. Finally, he was offered a position at an English hospital.
In 2013, an acquaintance of his working as a spinal surgeon in Germany came forward with an unusual proposition: a hospital in Bulgaria that was “nearly bankrupt” was in need of a new director.
“He said nobody would take the chief executive role,” Dr. Zargar-Shabestari remembers, “because it was getting worse and worse there. I didn’t know whether to sign the contract, or to drive down and see what was happening. But I went – and I saw a disaster. I don’t know how to explain it. I thought to myself, ‘This may be a lifetime chance to do something nobody else wants to do.’”
Rebuilding a Municipal Hospital From the Ground Up
Isperih General Hospital had been struggling for years. The building was dilapidated, the facility had mounting debts, and medical staff were leaving in droves. At the time, this shabby hospital, the only acute facility in a 40- to 50km radius, only had the capacity for around 80 patients and no facilities to carry out even the most basic operations. “I saw that the people were suffering,” Dr. Zargar-Shabestari says.
With the blessing of the then-governor of Razgrad province, he put himself forward for the top role. In Bulgaria such appointments need to be approved by the city council and when it came to the vote, he remembers, “some of them were laughing at me. They said, ‘There’s no doctor we will find [for this position] from Iran.’ They thought it was funny. But they didn’t have any choice.
“Since then, all of them have become friends with me. Now I feel that this is my home.”
One of the first tasks was to secure funding to make the necessary improvements. Against a tight deadline of December 2013, Dr. Zargar-Shabestari managed to secure a 2 million-euro grant from the European Union to spend over the next year and a half. “It was a critical time,” he says. “In the small area of Bulgaria where I live, that’s a lot of money.”
They spent the money on sanitation and a full range of equipment including CT scanners, endoscopy equipment and ultrasound scanners. Within the year, the hospital was then able to re-secure subsidies from the Bulgarian government. “The first time I went to the Ministry of Health to apply,” Dr. Zargar-Shabestari recalls, “they mistook us for a big hospital in Romania because they didn’t even know the name!”
In time, Isperih built its first fully-equipped intensive care unit. Coaxing specialist doctors into moving to Razgrad province was hard, but luckily, Dr. Zargar-Shabestari says, “I found and encouraged some people who had the internal motivation for it.”
Another important factor was changing the culture at the hospital. “Patients were coming here because they had no choice. A lot of them don’t have the income to go to another town. I told staff, ‘We can’t shout at the patients or have behavior issues. We have to help them.’”
Today, Isperih General Hospital is a thriving institution, described as exemplary by many Bulgarian media outlets. It now has a capacity of 110 and offers such services as diagnostics, pulmonary surgery, cardiology and gastroenterology, pediatrics and physical therapy and rehabilitation.
The improvements have also kept coming: in 2018 the hospital received a donation of beds, physiotherapy baths and other equipment from colleagues in Germany, and in 2019 it installed a range of new devices including ventilators, ultrasound scanners and a new set of cribs for the children’s ward. “Our task is very difficult,” read the hospital’s publicity statement at the time, “but not impossible, when the limited resources of the hospital are adequately and effectively managed.”
In 2020, like thousands of secondary care facilities all over the world, Isperih General Hospital had to reorganize itself to treat patients with Covid-19. Bulgaria was comparatively lightly-touched by the “first wave” of the pandemic in Europe, but began to record large numbers of coronavirus infections in October and November. According to statistics reported to the World Health Organization, the Balkan country has now recorded more than 10,500 Covid-19 deaths.
“We had to change many things,” Dr. Zargar-Shabestari says. “As the only hospital in the area, for many people we were the last station: if they couldn’t get treatment here, there was nowhere else. At one time Covid-19 accounted for about 70 percent of capacity; at first we had no extra funds for treating them, but we never stopped. We had a tough time. After two months the Ministry of Health awarded us some funding because we were even taking patients from the bigger hospitals.”
The Whirlwind of Obtaining Bulgarian Citizenship
Planned changes to the Law on Public Enterprise had first been announced by the Bulgarian government in late 2019. It was not until late 2020 that Dr. Zargar-Shabestari and his colleagues realized it would apply to him, too: after the grace period expired in February 2021, he would be forced to step down from the role.
For his part, the doctor says, he was resigned to his fate. He felt he had achieved his goals and wanted to concentrate on his work as a physician. “I felt it would be handier for them to have me as an orthopedic surgeon rather than chief executive,” he says. “I’ve traveled to many villages and found pathologies in people, and been able to cure them with small treatments.”
But locals were having none of it. The formal petition launched in January went from strength to strength, bolstered not just by people in Isperih, where Abdullah Zargar-Shabestari was by now a household name, but by residents and patients all over Razgrad province and sympathetic parties across the rest of the country.
Like most European states, the process of naturalizing in Bulgaria is an arduous one – perhaps particularly so, as any application requires the assent of the Bulgarian Ministry of Health, the Ministry of Justice, and a cross-party group of Bulgarian politicians who do not usually see eye-to-eye, before finally going before the presidency. The fact that this Iranian doctor’s case was advanced and signed off in just five days was a minor miracle.
“I never expected it to happen in five days,” Dr. Zargar-Shabestari says. “I felt very grateful to everyone; it’s a great honor, but also a great responsibility that I’ll have to compensate for. I never had anywhere in the world do this for me.”
There are, he points out, many other doctors in Bulgaria still waiting for citizenship who did not have the support of TV coverage and an adoring local populace. Among them, scattered across Europe and further afield, are countless other Iranian-born doctors and nurses.
Dr. Zargar-Shabestari says that based on conversations with colleagues, he believes most Iranian émigré physicians didn’t leave in search of a better salary – a specialist in Iran, he says, could earn “two to three times more” relative to the cost of living – but rather, because of “the social aspect”.
For his part, Dr. Zargar-Shabestari says he is content for now to remain where he is. “Everybody knows the hospital in Bulgaria now. It was a wave, and we managed to catch it. I can help more people in this position. Nothing compares to it.”