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Years of political clientelism and cronyism affect Romania’s response during the COVID-19 pandemic

By Ionut Chiruta

Lessons from the past should be learned, or so the historians keep saying. But no, at least not in the case of Romania, and not in 2020.

Romania’s response during the COVID-19 pandemic is proof that a gloomy history may repeat itself just because the past events were neglected. Here is how the thread of history is knitted and cut by the three sages. The antagonists in this story are political clientelism, cronyism, and corruption, whereas the protagonists are the Romanian health sector and its patients.

Building the tension

In 2015, the Colectiv fire resulted in 64 people being killed. The investigations of the authorities resulted in negligence for both granting permissions for the establishment that did not meet the safety criteria and for the hospitals that could not cope with the burned victims. Corruption and political clientelism that grasped the Romanian health system killed people.

Despite mass protests, which lead to the resignation of the then Victor Ponta’s cabinet in 2015, the history will soon repeat itself in 2016, when journalistic investigations revealed that the Romanian health system was widely using diluted disinfectants, which do not meet medical standards. Naturally, a government, when facing two consecutive health crises, which resulted in victims by negligence, ought to react and set the course of the boat to address the problem. Well, not in this case! In 2016, when the Social Democrat Party (PSD) won the parliamentary elections, it pledged it would build eight regional hospitals. By 2019, when the PSD administration was removed via a no-confidence vote, no hospitals were built. Romania’s health system, the EU’s worst and the lowest spending on health care, is feeling the effects of how clientelist networks, persistent corruption, cronyism, and political neglect is taking a toll on Romanian citizens during the COVID-19 pandemic.

Now, this brings me to the introduction into the scene of its antagonists and protagonists.

Who are the antagonists?

Romania’s health system is a deeply politicized environment. The reasons of this meander fault are financial gains, which in the hospital sector are enormous. Leading parties like the Social Democrat Party (PSD) and the National Liberal Party (PNL) have for years on squabbled and then decided, via a carefully designed political logic, how the leadership of the hospitals will be divided to their political cliques. Thus, hospital managers can be party members after the Romanian government tacitly adopted in 2016 the emergency ordinance 79/2016. For years, the managers of hospitals have been named because of their party affiliation, and not professional criteria. As the Romanian medical system became politically encroached, and it felt the lack of reforms, the exodus of medical practitioners to Western countries grew to more than 10.000 in recent years.

To address the ticking bomb from the health system, in 2018, the then Social Democrat administration under Viorica Dancila adopted the ordinance OUG nr. 91/2017, which increased the salaries of medics and nurses (the rest of hospital personnel being left outside until 2022). The socialist government focused on combating the exodus of physicians and nurses, without considering concrete strategies to modernize hospitals in need or to provide up-to-date equipment. Despite increased salaries for medics and nurses, reports of bribes in Romanian hospitals continued in 2019. Such systems develop only under the protection of hospital managers, as the trajectories of the bribes lead to the top of the pyramid in most cases. This year, on February 29, the former socialist health minister Sorina Pintea, the general manager of the county emergency hospital from Baia Mare (north-western Romania), was arrested for taking bribe. Contrarywise, other hospitals adopted anti-bribe publicity campaigns that try to dissuade people from offering enticements in hospitals.

Not much has changed since Colectiv in Romanian hospitals. The costs of such decisions are hitting hard in the medical sector during the Coronavirus outbreak. Ironically, the opposition, spearheaded by the Social Democrat Party, is sitting in its corner and tacitly supporting the current administration’s efforts to fight the pandemic. No sooner the epidemic comes to an end, that the opposition will try to capitalize on the many faults committed by the liberals during this crisis.

These are the protagonists

Currently, at the time of this writing, the officials reckon 4417 people with COVID-19, 460 people recovered, and 205 of victims. However, the tallies are expected to increase, as Romania has not reached its peak. Comparing countries with similar numbers of infections and deaths (e.g., Poland 4848 – 129; Czechia 5017 – 88), Romania has a high number of per capita deaths compared to the number of infections. Already in a shortage of health workers, the health system may collapse if facing a more significant amount of infections, which will result in higher scores of deaths. Romania’s infected numbers were initially due to an influx of Romanians coming from the diaspora, especially from red-zone designated countries, such as Italy and Spain, where more than two million people live and work. Shortly thereafter, the causes of infections moved to hospitals, mainly because these facilities lack equipment and operational leadership.

The authorities should do more to protect health workers. They should avoid situations like that from the Suceava county hospital where the whole facility is under military supervision, who tries to rectify the malpractice of the previous manager. This situation escalated after the manager decided to call on all the hospital employees to be examined for COVID-19 after other workers were declared positive. The decree of the manager resulted in more than 50% of the hospital workers being infected. The manager and his aides are currently facing criminal charges.

At the time of this writing, almost 700 people infected are hospital workers, while more than 50% of the infections are taken from hospitals. In most of these facilities, health workers are treating patients without protective gear. Some health workers quit their job because of the exposure to the virus in Romanian hospitals. The call to arms of the health minister, to bring in the first-line medical practitioners and volunteers have been met with deaf ears, in most of the cases, as almost no one wants to work in hospitals that lack essential equipment. Each day, accounts of health workers who speak to media under anonymity, because of administrative repercussions, are snowballing. The workers denounce the lack of equipment and the absence of robust strategies. Each of these cry outs is dismissed by managers, who are unlikely to take responsibility for their actions.

Despite Romania’s potential to manufacture medical protective gear, and thus stimulate the national industry and economy, during this pandemic, the current administration prefers to import medical paraphernalia at exorbitant prices from abroad. The reasons for these ludicrous decisions are because party-affiliated contractors have a monopoly on these agreements, being much easier for them to make extra money buying from abroad than stimulating the national economy. The liberal government can inject much-needed hope by emitting an emergency ordinance that would circumvent the notorious and sluggish Romanian bureaucracy and grant leeway to local entrepreneurs to produce medical equipment. As the numbers of infections and victims from COVID-19 are growing each day, so does societal anxieties. Before the COVID-19 pandemic unfolds in Romania, the Liberal government was considering having snap local elections in May. These evaluations soon changed course, as the elections were postponed for later this year. The political logic of rescheduling the local election makes sense, as all the current administration will face scrutiny before their citizens sooner or later. Recently, journalists reported that Romanian authorities decreased the number of tests to lower the daily tallies that made people aware of the authorities’ incapacity to deal with the current situation. For sure, the current political decisions will be measured by the public in the coming months. To the victors belong the spoils, but what will be in store for the losers?

In the case of Romania, if there is a lesson to be learned from this critical situation, is that the health system needs to be reformed from its foundations. Perhaps, the third time will make lawmakers reconsider keeping political clientelism outside hospitals for the simple reason that life counts more than anything.