- Associated Press - Monday, August 23, 2010

BUCHAREST, ROMANIA (AP) - No sutures and other basics; a dire shortage of staff; catastrophic hygiene; then this _ a hospital blaze that killed five premature babies. Romania’s hospital system is on the ropes.

The Aug. 16 fire that broke out in an intensive care unit killing five premature babies and leaving six others in critical condition is the most compelling example of a health sector reminiscent more of a developing nation than an EU member country.

Romania’s hospitals were a nightmare under communism which ended in 1989. But more than two decades after communist rule was toppled and almost four years after it joined the EU, Romania remains one of Europe’s poorest countries _ and the sorry state of its hospitals reflect that status.

In a revelation sure to add to the controversy, Bucharest Mayor Sorin Oprescu told reporters Monday that only three of Bucharest’s 21 hospitals have a fire alarm system. It was unclear whether any have sprinkler systems, but Giulesti hospital _ one of the capital’s best, where the tragedy occurred _ did not.

A massive shortage of medical staff, bribes to doctors and nurses to ensure better treatment, and chronic underfunding or high debts run by hospitals are everyday obstacles that patients need to negotiate. Supply shortages mean that operations sometimes do not get performed if patients do not supply their own bandages, syringes, surgical thread and antibiotics.

In recession-battered Romania, the government in 2009 spent just 3.7 percent of national GDP, or euro4 billion, on health. That is less than half in percentage terms of the European Union average.

And over 90 percent of those interviewed by the Association for Implementing Democracy this year in Romania, said corruption in the health system was “a critical issue which directly impacts the patients.”

The European Commission’s annual report on Romania said last month that “two-thirds of respondents said they have offered money to medical personnel, with 81 percent saying that they believe such payments played an extremely influential role in how they were treated.”

It’s mostly a matter of money _ or lack of it.

In neighboring Bulgaria, another poor EU member which spends just 4.2 percent of its GDP on health, patients also often pay for medical supplies and medicines _ and preferential treatment.

“Typical forms of corruption in hospitals are bribes to secure hospital admission, purchase of medical supplies and medicines, soliciting official donations to the hospital, extra charges for treatments and operations,” says Konstantin Pashev from the Center for the Study of Democracy.

Romanian leaders regularly go abroad for treatment of serious medical conditions. The less fortunate have grim stories to tell.

“My sister had an ovarian cyst which was operated on two years ago,” says accountant Agnes Sekely, from the western Romanian city of Cluj. “She saved as much money as she could to give to the doctor (but) a month later, when she went for a checkup, the doctor said to her: ‘You owe me something.’

“My cousin … has a kidney stone and she was told that without 1,000 euros she should not bother to go to hospital for the operation.”

Standards are inconsistent. Costel Rotaru, 55, says he had to buy bandages when he was recently hospitalized with a hand infection. But Mihaela Stroe, 40, who gave birth this week in another Bucharest hospital, said that hospital provided everything.

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