In Romania, bribery is a health problem

By Dan Bilefsky, International Herald Tribune, 13/02/2009

BUCHAREST: Alina Lungu, 30, says she did everything necessary to ensure a healthy pregnancy in Romania: She ate organic food, swam daily and bribed her gynecologist with an extra €200 in cash, paid in monthly increments of €25 handed over discreetly in white envelopes.

Another bribe of €25, or about $32, went to a nurse to guarantee an epidural. Even the orderly reaped an extra €10 to make sure he didn't drop her from the stretcher.

But on the day of her delivery, she says, her gynecologist never arrived. Twelve hours into labor, she was left alone in her room for an hour. When a doctor appeared, the umbilical cord was wrapped twice around her baby's head and had nearly suffocated him. He was blind and deaf and had suffered severe brain damage.

Now, Alina and her husband, Ionut, despair that if they had paid a larger bribe to the doctor, then Sebastian would perhaps be a healthy baby. "Doctors are so used to getting bribes in Romania that you now have to pay more in order to even get their attention," she said.

Romania, a poor Balkan country of 22 million that joined the European Union two years ago, is struggling to shed a culture of corruption honed during decades of communism - and stretching back beyond that. The European Commission, the EU's executive body, published a damning report Thursday criticizing Romania for backtracking on key judicial changes necessary to fight corruption. Sanctions could follow, including losing some of the €32 billion in EU aid it is due to receive between 2007 and 2013.

Transparency International, the Berlin-based anti-corruption watchdog, last year ranked Romania as the second most corrupt country in the 27-member bloc behind neighboring Bulgaria. Those who have faced corruption allegations have included a former prime minister, more than 1,100 doctors and teachers, 170 police officers and 3 generals, according to Romanian anti-corruption investigators.

While alarm grows in Brussels that the EU's newest entrants are undermining the bloc's rule of law, Romanians complain that everyday graft and bribery blight their lives. One patient here recently offered his doctor a free shopping trip to Dubai. The doctor politely declined.

Dr. Vasile Astarastoae, a biomedical ethicist who is president of the Romanian College of Physicians, representing 47,000 doctors, blamed the black healthcare economy on a pitifully low average monthly wage of €400 for doctors, which he said was forcing them to rely on supplementary income.

"Patients don't want to go to a doctor who is distracted thinking, 'How will I feed my kids or pay the rent?"' Astarastoae said. "So there is a conspiracy between the doctor and the patient to pay a bribe."

"If salaries were higher, then the practice would disappear," he said.

A study conducted by the World Bank for the Romanian Ministry of Health concluded that so-called informal payments amounted to $360 million annually. When an illness requires hospitalization, the Romanian patient typically pays three or four bribes equivalent to three-quarters of a family's monthly income, the study showed.

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