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From
the October 2001 issue of World Press Review
Corruption and Albania's Hospitals
You’ve Got to Pay to Pee
Olsi Kolami, Shekulli (centrist),
Tirana, Albania, July 1, 2001.
“It is not enough that we are sick,” a patient from the
district of Librazhd says. “The cleaning staff is making life
even more difficult for us.” He counts his coins while a cleaner
waits for him to hand them over. Says another patient, “I have
a kidney infection, and I have to use the bathroom several times a
day. I have to pay 200 lek [US$1.34] each time I go in.”
The phenomenon: Bathrooms in public hospitals have suddenly become
private property. Usually the cleaning staff manages the restrooms.
They say they do not get paid enough, so they follow people down the
hall to collect what they think is owed them.
Their daily bread: Individuals have claimed public restrooms
as their private property. They say that their children would starve
if not for this business. “I have been working here for the past
three years. Two of my sons do the cleaning, while my wife and I collect
the money,” says an owner of a public restroom in the capital.
Most restrooms charge between 200 and 300 lek [$1.34-$2] per use,
and if you need toilet paper, you will have to pay an additional 100
lek [67 cents].
Corruption of the white coats: There is a lot of talk about
dishonest doctors. In fact, this is how most doctors are perceived
by the public. Doctors, however, think differently: “We do not
accept bribes; we accept only gifts. Why is there so much talk about
a mere 2,000 lek [$13.46] that patients give to doctors when they
pay as much for a good lunch? We should not forget that doctors are
duty-bound to save lives, not to rob people,” says Dr. Ahmet
Duraku of Hospital No. 1. Were it not for these gifts, he says, Albanian
hospitals would be staffed only by cleaning people, so meager are
the salaries of doctors.
The cause: A pediatrician recounts: “True, we do accept
small amounts of money, but they are barely enough for coffee. It
is not right to criticize doctors for this. What we accept is minimal
compared to what we give.” Dr. Duraku continues: “Our salaries
are very low. We cannot make ends meet with 12,000 lek [$80.80] a
month. We spend more than half that amount on utilities and plain
bread.”
A demand: With time, what doctors call a gift or a tip
becomes a demand. Patients tell stories of doctors asking them
for a precise amount of cash. The patients may not be able to
afford it, but they do not hesitate to pay. “He asked me
for 8,000 lek [$53.87] before going into surgery. And I gave
it to him because I did not want to die on the operating table,”
says Islam S. from the district of Peshkopi. Nurses and anesthesiologists
charge their own fees, establishing a whole hierarchy of fees.
“I thought I was done,” the same patient continues.
“But I noticed that they were delaying the anesthesia.
One of the nurses told me to give 2,000 lek to the anesthesiologist
if I did not want to wait forever. So it was only after I paid
the 2,000 lek and another 1,000 to the nurse that surgery began.” 
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