In Honduras, where 60 per cent live in poverty and 5 million people are completely dependent on public health facilities, corruption in the health industry has serious repercussions for people in need. That's why, in 2013, when a state-controlled medical warehouse was accused of corruption, immediate action was crucial.
The warehouse in question handled around US$24 million worth of drugs yearly that are bought by the government and is supposed to service the public hospitals and health centres in Honduras. According to reports, however, corruption in the purchase, sales and distribution of pharmaceuticals was endangering the lives of untold numbers of Hondurans.
Responding to the allegations, our partner in Honduras, Asociación por una Sociedad más Justa (ASJ), started an investigation.
They found proof that millions of dollars' worth of medicine were being siphoned off from the state-controlled warehouse, possibly to be sold on the black market. Beyond the missing drugs, counterfeit and expired drugs were making their way to hospitals undetected due to little control on medication entering the depot.
One week after we presented the report and formal complaint, the Minister of Health ordered a raid on the warehouse, which was put under military control. This measure was taken to prevent employees of the warehouse or other actors from removing or destroying evidence.
The raids were swiftly followed by thorough investigation of the case and resulted in the arrest of six people, including warehouse employees, pharmaceutical suppliers and civil servants. As part of the investigation, one state pharmaceutical supplier was found to be hiding 200 boxes of stolen medicine stashed away in her home.
One year on, five people await trial for corruption and one person has already been sentenced to five years in prison.
Perhaps even more importantly, the system itself has changed. Thanks to ASJ's efforts, the president announced that civil servants would no longer be in charge of buying and distributing medicines in Honduras. From now on there will be an independent trust responsible for the buying and distribution of pharmaceuticals to state-run hospitals, and ASJ is one of three civil society organisations tasked with keeping watch over the trust's work.
The work of ASJ and its coalition partners on this case required a great deal of persistence, meticulous investigative skills and a strong ability to work with reform-minded actors for change.
But above all it required a great deal of courage to speak out in a country as violent as Honduras. The results, however – new laws, criminal convictions and lives saved – are real and immeasurable.
Image: Creative Commons, Flickr / Jesse Moore
Kamal's* anxiety increased with the heat of the day. His 11-year-old daughter, who is partially blind, had injured her head and urgently needed a brain scan. It was a hot, sticky day in Casablanca, and they sat uncomfortably in the hospital, waiting for the doctor to arrive.
Eventually, the nurse in charge of brain scans spoke to them. He told Kamal that it would be several months before they would be able to find an appointment for his daughter. If he wanted her to be seen sooner, Kamal should return early the next morning with 500 dirhams (US$60), on top of the standard 200-dirham (US$24) scan fee.
For Kamal, who is a vendor at a local market, paying the nurse would mean finding around a third of his monthly income overnight.
It's a dilemma that regularly faces too many parents around the world – pay an illegal backhander, or risk the health of your child. Fortunately, Kamal knew of an alternative. Calling our anti-corruption helpline, he reported what had happened to him. When our advisors recommended that he file a complaint directly to the Attorney General's Office, he quickly agreed, and presented the complaint in person that day.
As a result, he wasn't alone when he arrived at the hospital the next morning. Unnoticed by the nurse, the two men who arrived with Kamal were undercover police officers. When the nurse arrived and asked for his money, the officers arrested him on the spot. After a fast-moving court case, the nurse was imprisoned for two months. In the meantime, Kamal's daughter received the scan she so urgently needed – free from any excess charge.
With help, more citizens could follow this example. "All Moroccans are legally entitled to call for police assistance when faced with bribery, but most people don't know about this right," says Ali Lahlou, coordinator of the legal advice centre who helped Kamal on his case.
"In addition, others are reluctant to act on it because they think the judiciary will simply ask for more bribes. They also fear retaliation by the authorities against which they file complaints."
Kamal agrees. "We need to make sure there is real protection and support for people who speak out," he says, "then more people in situations like mine can come forward and take action against corruption."
*Name has been changed
Image: Creative Commons, Flickr / enki22
Around 200 kilometres from the Zimbabwean capital Harare lies the region of Hurungwe. Drought is common here, and back in 2011, minimal rainfall left crops devastated. Families had no surplus food to sell, and no money to buy grain. Nationally, an estimated one in three children suffered from malnutrition that year. Hurungwe was among the worst hit.
Help should have come from a state grain scheme that allocated seeds, grain and fertilisers to impoverished farmers, helping them survive through the next harvest. Yet when our legal advice centre visited the region, people told a very different story.
"Everyone kept mentioning one particular official", says Danai, an officer from our advice centre. "They claimed he had been abusing his position for more than 10 years. Instead of giving out the supplies for free, he'd charge extortionate amounts from desperate farmers, making as much as US$1,000 a day in profits. The only people who got the grain without paying were members of the ruling party. If depot staff tried to leak the information to the public, they were threatened and dismissed."
Taking on the case, Danai contacted the grain marketing board, asking to meet with them.
"They said no at first, but I persisted until they responded to me," she says. "A few weeks after we first spoke, they got back to me. They said they had investigated, and while they did not have enough evidence to dismiss the official, they had decided to move him closer to the head office so he could be kept under surveillance."
She remembers the response from the community when they heard the news. "The women living there called me," she says, "they were so happy that after 10 years someone had managed to get the manager removed from the depot."
Today, Danai and her team are checking to ensure the villagers receive their subsidies. The bigger solution, though, is greater public scrutiny. "The grain initiative is so important, but there's a lack of transparency in how it's administered. If we want to stop this kind of abuse happening again, this needs to change."
Image: Creative Commons, Flickr / sidewalk flying
Save our school
When a group of students in Indonesia suspected corruption in the financial management of their school, they refused to stay silent. Starting the "Save our School" campaign, they succeeded in holding those responsible to account.
The students first suspected corruption in the financing of new multimedia centre. On paper the centre was listed as completed, and the funds had been spent. Yet in reality the room did not exist.
They started digging deeper, comparing the records of different school renovations with the site itself. Quickly other discrepancies emerged.
Bringing students from the school together, the group refused to give in to warnings or intimidation.
"The risks that I was going to face were worth it," says student organiser Darmawan Bakrie, whose parents tried to stop him speaking out for fear he would be failed in exams. "I was sure that when everything came out in the open, the changes we hoped for would come."
As news of their campaign appeared repeatedly in the media for more than three months, the local mayor took action. He ordered that 750 million Indonesian rupiah (US$66,000) be repaid to the school. The head teacher of the school was demoted and transferred. Other school officials were also demoted or removed from their positions.
Transparency International Indonesia captured the "Save our School" story on film as part of a project which promotes youth integrity in Indonesia. Today, the group have graduated from high school, but they are continuing their fight against corruption.
Speaking in the film, student campaigner Rio called on others to follow their example. "If not us, then who?" he asks. "If not our generation, then whose generation?"
Image: Copyright, iStockphoto / jjayo
Upholding the law
Unhošť is a small, sleepy town about 20 kilometres from Prague's city centre – home to around 3,500 inhabitants. Normally, this is a peaceful place, but a controversy a few years ago has taken its toll on the community.
It all began when a newly elected politician decided to look into the town's finances. He soon discovered some questionable spending, but speaking out about it and getting authorities to take action proved an uphill battle.
Raising the alarm
The politician, Karel Kopp, first approached us in 2011. Back then, he was a newly elected representative for the municipality. Upon entering political office, he was keen to make sure the town's funds were being spent responsibly. While he was looking through procurement records, his suspicion was raised when he found irregularities in how money was spent on a certain construction project. In fact, it seemed the work done was in violation of the law. Yet, when he tried to raise the alarm internally, he was blocked by certain colleagues, including the mayor. This led him to our doors.
Officials above the law?
The case concerned a decision by municipal leaders to demolish an old leisure facility and build a new one. To outsource the work, they invited several local construction companies to submit tenders for the contract.
The problem, Kopp said, was that no-one checked if the winning price for the demolishment of the old leisure facility actually provided good value. Despite a law stipulating that they needed to compare the price against market-related prices, none of the politicians seemed concerned to check whether public money was being wasted on inflated bids.
If this seems like a small matter, it's worth remembering the bigger context. More than 50 per cent of citizens in Czech Republic think that business is corrupt, and almost three-quarters think the same about government officials and politicians. If no-one's checking the real value of contracts between business and officials, there's the risk of ramped-up pricing and kick-backs. The business wins, so does the official – but the public loses out.
In the case of the leisure centre, it seemed the costs were well above their actual worth. Kopp claimed that, as a result of this negligence, as much as 4.5 million Czech Koruna (€160,000) had been wasted during the demolishment work – money that could have been used to improve daily life for the people of Unhošť.
Kopp even sought an opinion from an expert advisory company from the construction field, which supported his claims, yet some of his other colleagues still refused to support him in initiating an internal investigation. That's when he came to us for help.
Fighting for change
We took the case on immediately, and started working to secure an investigation. We gathered photographic documentation of the case, spoke with experts, and shared our concerns with the Ministry of Finance.
Like Kopp, we faced obstacles in the town. First, we had to battle against officials who were demanding extortionate fees in return for releasing public information. Then, after we successfully lodged a criminal complaint against the former mayor for neglecting his duties, we received news that the investigation had been suspended by the police.
But we did not give up our struggle. We took our complaint to the Supreme Prosecutor, who after reviewing the case decided to reopen criminal investigations. He also said he was willing to be involved in ongoing discussions with us about wider procurement issues, indicating real interest in change.
The fight to uphold the law is not over yet, but we're getting closer. This case has revealed worrying gaps in the enforcement of legislation that controls public spending. With public money being limited, it's vital that procurement law is respected so that funds are spent responsibly and benefit the projects for which they are intended.
Image: Courtesy, Transparency International Czech Republic