Tackling Envelope Bribery in Latvia

Changing the “token of gratitude” culture

Indra Mangule_220x220Indra Mangule

Policy Analyst, PROVIDUS

The Project

In Latvia, the corruption in health sector remains wide-spread to this day. Even though it is an issue people are aware of, due to the fact that it is not encountered by the general public on day-to-day basis, it is discussed sporadically with only occasional attempts to tackle it.

In many cases, bribes are given by the patients as a “token of gratitude”, in which case it can be expressed via financial means or material means, such as flowers or sweets. More often than not however, bribe-giving occurs prior the actual service is given. The doctor/the nurse would receive an envelope with a certain sum of money to either receive a consultation more speedily or to increase the overall quality of the service. Whilst being problematic in itself, this practice of course puts strain on the state budget, but, more importantly, on those patients who have no means to bribe their doctors and nurses to ensure decent level of healthcare.

It is therefore crucial that the general public of Latvia is reminded that the problem exists and is also provided an insight into why the practice is damaging. It is especially important since for many in Latvia the practice of ‘envelope bribery’ is not perceived as inappropriate or damaging necessarily. In addition, it is also important that the medical institutions who do not wish to be associated with corruption to take a firm stance and are encouraged to stand against it, letting the public know that there can be another way of working with patients.

Project Activities

To make the first step in tacking this issue, here is what this project aims to do – firstly, it will raise awareness of the health sector bribery. It will do so by presenting statistical data regarding bribery in health sector (research will be conducted to compile the existing data on the issue) and it will also illuminate the overall negative consequences of bribery in the health sector (using the attained data to ‘paint the bigger picture’ in a straightforward manner). Secondly, the project will strive to establish a good practice example with a medical institution willing to state their stance towards corruption publicly. This will be done by piloting a PR campaign with one medical institution/hospital and one doctor’s association organisation, setting a case example for the rest of the hospitals in Riga. Finally, the project will empower medical staff and doctors to be ethically responsible and take an active stance in fight against corruption and will mobilize media and general public to discuss the issue of bribery (30 media representatives from leading media channels in Riga will be participating in the launch event of the project).

Game Changing Factor

Provided the cooperation with partners develops smoothly and successfully, the project could catch on, so to speak, and have far reaching impact on medical institutions and Latvian society. First, it addresses the habit of “not talking about it”, where the practice continues uninterruptedly, since most cases of bribery take place in silence – it is not discussed openly. It is therefore particularly difficult to have an approximation of overall amount of money paid in bribes to doctors and other medical staff in Latvia.

Second of all, the project would create the very first case of a whole institution not only addressing the issue, but openly stating their disapproval the bribery practice in public. This would in turn encourage other institutions to follow, creating a mass campaign in the whole city and eventually across Latvia.

Why I Fight Corruption

One of the most terrifying experiences of my life was being exposed to a situation where it was pretty clear that unless an envelope is passed on, so to speak, a beloved member of my family wouldn’t receive the medical services of adequate quality that she required to save her life. To me, the realization that this sort of thing can happen to a person was so appalling, that I have never managed to forget it since. Today, I am happy to have a chance to do something about it and if I can contribute with at least making a small step towards eradicating this awful practice, I am determined to go ahead and do my best to make it happen.