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Third World feels staggering bite of petty corruption
By Celia W. Dugger
The New York Times
TUESDAY, AUGUST 30, 2005
BANGALORE, India: Just as the painful ordeal of
childbirth finally ended and Nesam Velankanni waited
for a nurse to lay her squalling newborn on her chest,
the maternity hospital's ritual of extortion began.
Before she even glimpsed her baby, she said, a nurse
whisked the infant away and an attendant demanded a
bribe. If you want to see your child, families are
told, the price is $12 for a boy and $7 for a girl, a
lot of money for slum dwellers scraping by on a dollar
a day. The practice is common here in the city,
surveys confirm.
Velankanni was penniless, and her mother-in-law had to
pawn gold earrings that had been a precious marriage
gift so she could give the money to the attendant, or
ayah. Velankanni wept in frustration.
"The ayah told my mother-in-law to pay up fast because
the night duty doctor was leaving at 8 a.m. and wanted
a share," she said.
The grand thefts of rulers may be more infamous, but
the bitter experience of petty corruption, less
apparent but no less invidious, is an everyday trial
for millions of poor people across Asia, Africa and
Latin America. Increasingly, it is being recognized as
a major obstacle to economic development, robbing the
impoverished of already measly incomes and corroding
the public services they desperately need.
The bribes vary from place to place and in the
services affected, but stretch from cradle to grave,
according to surveys and anticorruption investigators.
People pay to give birth, and to collect their loved
one's bodies from mortuaries, and for things in
between: garbage collection, clean water, medicines,
admission to public schools. Police officers double as
shakedown artists.
Such petty bribery acts as a hidden regressive tax,
according to the World Bank Institute, the bank's
research arm.
In Zambia, for example, poor people paid 17 percent of
their incomes in bribes for medical care, while the
middle class paid only 3 percent. The comparable
figures for Paraguay were 7 percent for the poor and
only 1 percent for the middle class.
"The poor not only are paying much more of their
incomes to get the same medical services as the middle
and richer classes, but they are also discouraged from
seeking basic medical care because they can't afford
it," said Daniel Kaufmann, director of global programs
at
the institute.
When low-level officials pick the pockets of the poor,
it is also often a reliable indicator of greater
corruption higher up the bureaucratic and political
hierarchy.
Here in Bangalore, a city of 6.5 million known for its
booming high-technology industry, pleasant climate and
good private schools, local health managers commonly
pay bribes to senior bureaucrats or elected officials
to get good jobs, say investigators, civic leaders and
senior civil servants. The health professionals then
exact payments from subordinates and patients.
"Most of the district health officers have to pay
bribes to get promotions and postings, and they in
turn collect bribes from their staff and patients,"
said Hanumappa Sudarshan, an official in Karnataka
state.
"It's a vicious cycle," said Sudarshan, the state's
vigilance director for health and education.
Sudarshan's boss, Nanjegowda Venkatachala, who heads
the agency, put it bluntly: "The greed of politicians
is ruining the country."
No matter where the corruption starts, it moves down
through the ranks and finally to the poor, for whom it
is an inescapable burden.
In the narrow lanes of the slums and working-class
neighborhoods around the 30-bed Austin Town maternity
hospital, families with babies and toddlers described
their personal experiences with bribery.
Shobha Rani, the doctor in charge, emphatically
disputed such accounts in an interview earlier this
year. "I've not come across even one patient who's
come here and said I've been charged for anything,"
she said. "So many times, I've spoken to patients
without the knowledge of my staff. I say: 'Tell me the
truth. What did you face?' They always give me a good
report."
But people who have used the hospital tell a different
story. Nagaratna Hanumanthu, 23, and her husband,
Hanumanthu, 28, a sugar cane juice vendor, who has a
single name, lost their first baby to a raging fever
just two days after he was born. Their anxieties were
high last November when their daughter was born at
Austin Town.
The moment the baby emerged, the nurses took her away
and demanded $7, the parents said. But Hanumanthu, a
tall, imposing man, said he pretended he knew
important people and threatened to complain. The
nurses backed down, he said.
But then his fears grew that the staff might hurt the
baby. "We had already lost one child, and we were
worried we would lose this child, too," he said.
Hanumanthu, who earns about $1 a day, turned to his
mother, who makes $11 a month sweeping floors and
washing dishes. She gave him money for the bribe.
It was far from the first bribe he had paid, he said,
and certainly not the last.
Every month, he said, he must pay off city workers who
threaten to confiscate his pushcart. He has no choice,
he said. How else would he make a living?
Last summer, he saw what happened to a vendor who
refused to move when the city workers told him to.
They overturned the man's cart, cracking the engine.
He was out of work for three months.
"I try to earn a decent living," he said bitterly,
"but because of all the demands, I'm tempted to rob
and steal to make money fast. I'm fed up with life."
A growing number of surveys of poor households are
documenting the problems of corruption and poor public
services, arming advocates who are fighting corruption
with information and providing voters with data that
helps them hold elected officials accountable.
The Public Affairs Center pioneered the use of
consumer surveys in Bangalore to measure the extent
and effects of bribery and to give citizens a
collective, credible voice about their experience of
public services. The approach was the brainstorm of
Samuel Paul, who formerly led one of India's premier
business schools.
In the last decade, the center has released report
cards that have generated splashy coverage in local
newspapers. "There was power in the information," Paul
said.
The idea has been widely copied. Today report cards
are used in Ethiopia, Uganda. Zanzibar, Ukraine,
Bangladesh, the Philippines and Vietnam.
Bangalore's success in fighting corruption has
enhanced the appeal of report cards.
The center's latest survey, done in 2003, found that
bribery had fallen sharply since 1999 and satisfaction
with public services had risen, although bribes
persisted at shockingly high levels in maternity
hospitals.
Bangalore substantially reduced corruption in property
tax assessments by setting simple rules so citizens
could estimate their own property values, cutting out
inspectors who had demanded payoffs. Property tax
collections rose sharply.
Cleaning up the city's 30 maternity hospitals, which
mainly serve the poor, has proved tougher, however.
A 1999 survey by the center found that 9 of 10
families whose relatives gave birth in the hospitals
reported paying a bribe, usually to see the baby. The
average amount paid has since dropped to $7 from about
$16. But 8 in 10 women still reported paying bribes in
2003 - to have their baby delivered, to see the child
after birth, to get their newborn immunized.
At the center's urging, the city set up boards of
volunteers to monitor hospitals and posted charters in
maternity hospitals stating that bribery was
prohibited.
Margaret, a 50-year-old grandmother, who uses only one
name, said she had paid to see her 19-year-old
daughter's baby the day he was born. She earns only
$10 a month as a maid and said that she was determined
to pay no more than $7 - and that she did not.
"Though I felt bad and a little angry, a private
hospital would have cost at least 2,500 rupees," or
about $60, she said. The bribe was still costly but,
by the calculus of poverty, a relative bargain.
Copyright © 2005 The International Herald Tribune |
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