I live in Bulgaria and can say it is exactly the same in Eastern Europe - I asked the same questions you ask, Maya.

Eastern Europe and the countries from the former USSR are a vast population of mothers needing skilled lactation support. Unfortunately the situation here is the situation you in the USA and Western Europe had in the 70's and 80's. Requirements for the exam are changing as changes in the western countries progress and that's understandable when you look at the statistics for the LC's around the globe. But we from the former communist block can't make it at that pace. Not that we can't educate ourselves and be that good LC's - but we can't change our own countries, medical programs and hospitals in some short years to match the situation in the USA and Western Europe. So it would be good if someone (IBCLE) would think about it, if it has the ambition to be a truly international certifying body and show respect and understanding to the individual situations in the other countries around the globe. This would honor the roots of the IBCLC credential too...

Other organizations show this understanding at many levels. I am a language teacher and all the international seminars and programs have special conditions for the Eastern block because of these differences - not that there is less required form us at the actual program, but just for the way to get there. So that would not be something uncommon and never done before. I would think allowing us to certify under the new or old requirements by choice for another 10 years would be wise if anyone wants us to be able to catch up.

The differences are very deep on many levels. It is really absolutely not possible to just take the college courses you want if you are not enrolled in a whole medical education program. 

There is an after graduate program in my country for something like a lactation nurse/midwife which gives the right to call yourself LC in my country (nothing internationally recognized and this education focuses too much on nutrition in general and about one third is bf basics - I know because I have studied the materials and the program). But, of course, it is only for medical professionals and the cost is insane (that's why there is noone willing to make it). And although there are absolutely no candidates for this program in the 5 years since it exists, nobody is willing to make it for non-medical professionals who would be willing.

I still get practice in a hospital, which is very rare and not at all the norm here. The only reason I and my colleagues have access to the hospital and the pp floor is the fact that the only lactation clinic in the coutry is situated in the hospital and there is just no way to not allow us in. Still our being there depends entirely on the good mood of the hospital personel, which is not always good, of course. And we are allowed only under specific conditions and if the doctor supervising us is there. Although we are barely tolerated and always looked upon with great distrust - it is the only way to have a hospital experience and we are fortunate to have this opportunity.

Another big problem is that I am still not sure if anyone would be willing to see my education from our local peer councellor program as a valid  prerequisite for taking the exam. I don't want to go the LLL-route - I did half my application some years ago and can honestly say it is not for me, although I enjoy the meetings and have a great admiration for the organization. It would be mean to just use LLL as a source for getting to the IBCLC-exam when my heart is not there - and I truly do not wish to take this route.

There are no IBCLC's in my country - the doctor I am working with would be willing to certify just so she can make route 3 available for us, but that would take another 10 years at least until she is able to function as a mentor and she is not that young.

So I really do not see a way to get to the credentials at all now. The situation with the new requrements for our countries is really simple now - those who are willing, are not able. Those who are able (medical professionals), are not willing. 

Christina Yaneva, feeling sad and depressed
BF Peer Councellor
Bulgaria


      

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