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Vadim Ghirda / AP
Doctor Catalin Cirstoveanu, right, checks a newborn baby before transport to Italy for heart surgery from the intensive care unit of the Marie Curie children's hospital, on March 22, 2012, in Bucharest, Romania.
Dr. Catalin Cirstoveanu runs a cardio unit with state-of-the-art equipment at a Bucharest children's hospital. But not a single child has been treated in the year-and-a-half since it opened.
The reason?
Medical staff he needs to bring in to run the machinery would have expected bribes.
So Cirstoveanu has launched a lonely crusade to save babies who come to him for care: He flies them to Western Europe on budget flights so they can be treated by doctors who don't demand kickbacks.
That's what Cirstoveanu did last week for 13-day-old Catalin, who needed heart surgery. Cirstoveanu packed a small bag, slipped emergency breathing equipment into the baby carrier and caught a cheap flight to Italy, where doctors were waiting to perform the surgery.
The operation was successful. Two days later, though, a 3-week-old baby that Cirstoveanu whisked away to the same clinic in northwestern Italy — with tubes piercing her tiny frame — died before she was able to have lymph gland surgery.
"I was very worried it wouldn't work," said Cirstoveanu. "But in Romania, she would have died anyway."
The soft-spoken Cirstoveanu is fighting an exhausting and largely solitary battle against a culture of corruption that's so embedded in Romania that surgeons demand bribes to save infants' lives and it's even necessary to slip cash to a nurse to get your sheets changed.
It's one of the reasons why the country's infant mortality rate is more than double the European Union average, with one in 100 children not reaching their first birthday.
"To be honest, it's so deeply rooted into our system that it's really difficult to eliminate," Health Minister Ladislau Ritli said in an interview with The Associated Press.
Officially, the new cardio unit that Cirstoveanu runs at the Marie Curie children's hospital isn't functioning because jobs have not been filled. The real reason appears to be that Cirstoveanu has banned staff from taking bribes. That means that high-tech machinery lies idle because qualified experts do not bother to apply for jobs, as they know they cannot supplement their incomes with bribes.
The zero-tolerance policy to corruption makes for a grueling work schedule for Cirstoveanu, who needs to shuttle babies abroad for surgery — and take care of them on the flight. During the two-hour flight with the girl who died, Cirstoveanu fixed tubes, sedated her and hand-pumped oxygen to keep her alive.
In the less than 24 hours Cirstoveanu had in Bucharest between returning from Catalin's trip and departing with the little girl, he even squeezed in a shift at the Marie Curie clinic.
Endemic corruption
Patients in Romania routinely discuss the "stock market" rate for bribes. Surgeons can get hundreds of dollars and upward for an operation, while anesthetists get roughly a third of that, depending also on what a patient can afford. Nurses receive a few dollars from patients each time they administer medications or put in drips. Getting a certificate stamped to have an operation abroad can easily cost hundreds, if not thousands of dollars if you ask the wrong doctor.
While the Romanian state appears unwilling to do anything, it often ends up footing the bill.
At the Marie Curie unit, Catalin's operation would have cost $2,700 to $4,000 without bribes. Romanian state health insurance is paying 10 times that for his operation in Italy — a small fortune in a country where the average monthly salary is about $460 after tax.
Many disillusioned doctors have abandoned the country, which spends just 4 percent of its gross domestic product in health care — about half of the percentage of GDP spent by Western European countries.
Last year, some 2,800 Romanian doctors — discouraged by the antiquated and corrupt health system and low wages — left to work in Western Europe, according to the Romanian College of Doctors.
"Ideally, we would have decent salaries and nobody would be tempted to accept informal payments," said the Ritli, the health minister. "And the population would be educated so people would believe that this is not the only way to get proper health care."
Bribes across Romania accounted for some $1 million a day in 2005, according to a World Bank report; more recent estimates are not available. The culture of bribes — or "informal payments" as they're commonly known — is tacitly accepted.
But anger is rising. One of Marie Curie's donors, Procter & Gamble, has several times gone back to the hospital and the Health Ministry to ask questions about when the unit will start functioning.
The tragic plight of Romanian children is nothing new.
Communist legacy
In a misguided effort to boost Romania's then-population of 23 million, Communist dictator Nicolae Ceausescu banned birth control and abortion, which led to thousands of infants being left in orphanages in harrowing conditions broadcast around the world after his execution in 1989.
Nearly a quarter-century later, the country's shortcomings are again being seen through the gaze of children and powerless parents trapped in a web of corruption.
For those whose children die shortly after birth, grief is magnified when they do not receive a birth certificate or even see their babies alive. Angela Vasile, whose baby daughter, Cristina, only lived one day, saw her infant just once after she'd died, lying on a metal table.
She was then put in a ward of nursing mothers, adding to her anguish.
Bianca Brad, a Romanian celebrity, spoke out publicly about the pain of losing her baby at birth — calling the situation "criminal." She founded the "EMMA Association" to help grieving parents, offering support for those who do not receive psychological counseling and remain locked in years of grief.
Yet remarkable things are happening at the Marie Curie Hospital. Cirstoveanu is personally overseeing the survival of Baby Andrei, an 8-month-old Roma baby born to underage parents. His intestines are almost nonexistent.
The tiny infant who weighs about 4.4 pounds with limbs that look like gnarled twigs was given only days to live. His bright eyes, alert gaze and lively personality have endeared him to all staff who comfort him in their arms as much as they can outside of his incubator.
Andrei can only have lifesaving surgery in the United States — and a fee of hundreds of thousands of dollars is proving prohibitive. Nurses are so fond of the bright boy that they are playing the state lottery in an attempt to raise funds for his surgery.
Even in this grim setting, there are signs that doctors are mobilizing in a bid to make things better.
Anca Mandache, a child heart surgeon, left her career in France to offer her services to the Marie Curie hospital, taking a salary one tenth of what she would have earned there. Others also are expressing an interest in working at the clinic
Cirstoveanu, who also flies sick babies to Germany and Austria, says he feels "ashamed" that he has to go to the lengths he does to save children, but talks with pride of the moment he sees the joy of relieved parents whose babies survive.
They are in awe of his dedication.
"Cirstoveanu is more than a hero — he is a god for us and the children," said Gheorghe Meliusoiu, Catalin's 28-year-old woodcutter father. "If there were more like him, many lives would be saved."
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Leave a Comment:
You sure hear often enough about Romanians doing pretty terrible things to women and children. They must be born without consciences.
I think the prevailing theory is that we are all born without consciences.
I would tell those wanting bribes: The cost to hire someone to break you legs is cheaper. Now save my baby.
to make such a broad statement about an entire country is sheer stupidity. There are many good people who live in Romania. Blame the officials who refuse to do anything about it.. not the people.. they are the victims.
I'm not sure I understand the concept of a 'bribe' in this context. So, if they don't get the money they want (obviously more than the salary) they go elsewhere. So, if they don't need the job and can get work elsewhere, is this any different than anyone in America turning down a job because of too low a salary, benefits, etc.? Is demanding extra money from each person you serve any different than going on strike or worse yet the dreaded union action "Work-To-Rule"? Why are salaries so low there then? Are they artificially set salaries by the government? If he can't fill jobs because the salary is too low, shouldn't he just raise the salaries until he gets qualified employees interested? Sounds like a free market economy should work there.
I'm not saying that the process here is a good thing, but I think the reasons behind it are not well understood by the author.
@ PADUKI : I don't know where you're getting your information from but I agree with Woodlan and rrobeson, thank you guys! I am a Romanian living in America and donating money every month for American kids who go through the same hardship as that described in the article. Don't forget America is a country where you cannot afford to get sick because you have to pay monthly "bribes" to the insurance companies who dictate the doctors what they could or could not prescribe to their patients and where a mother who just gave birth is thrown out of the hospital before even her colostrum started and the baby was properly checked, because a hospital bed costs $1000.00 a night or more. I totally agree with rrobeson and would go even farther, saying that the author is presenting some hearsay information that is not totally accurate. If there is no staff to use the "state of the art" cardio unit equipment, where are the nurses who try to raise money for Andrei's surgery coming from? Are they the same who request money to change the bed sheets? And who bought the equipment for the hospital (which by the way is just one of the many pediatric hospitals in Bucharest)? There is definitely more to the story than meets the eye. Romanians are very decent and loving people and I am very proud of my heritage and education. I am however ashamed of the level of understanding and lack of basic human decency (not to mention spelling skills) that I perceive in some of the comments I just read.
PS In Romania diabetics don't have to pay for their insulin and all children in public schools are getting free breakfast, every day. Education is free (including superior education, which is based on merit). Maybe it's just their inborn lack of conscience that they need to propagate ...
Dr. Cirstoveanu is a true hero.
Yes. He's not the one who should be ashamed.
I wonder if there's a fund we can donate to for baby Andrei?
Unfortunatly same thing is in Bosnia too. If you are poor and don't have money you will die in hospital. There is also some cases like good doctor over here but they are exeption to the rule.
I am Romanian and I hate the new Romania. Sadly to say, is nothing as I remember it. Bribes everywhere, men steal and con anything they can, women sell sex for any little gain. None can be trusted. Sadly its even accepted and their famous : asta este (this is how it is)
This is so despicable. Pay to live because you are nothing more than crop to be harvested.
Another sore spot in our pathetic human existence.
Not sure what you mean by the "new Romania". I trust that you do not feel communism was better.
Woodlan-
The difference between the new and old Romania is very simple. Once the old government collapsed, the new could not provide sufficiently, without anyone to govern, people will resort to anything, just to earn some money. The same happened in Russia, Ukraine, Belarus, and many other formerly USSR countries. Communism may not have been the ideal, but at least there was some kind of order.
The older generation that lived to see both scenarios, frequently expresses disdain and disappointment in the direction which many countries went after the collapse.
I have nothing but admiration for this doctor. One man's tireless effort and genuine goodness. Great to see there are still compassion and goodness in this world. Great story!
If Romania doesnt improve itself, it deserves to die away like the babies it cares so little for today.
Sounds like where the U. S. is going. If you have money you can get healthy.
It is from numberless diverse acts of courage and belief that human history is shaped. Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope.
~ Robert Francis Kennedy ~
I wish there was also some information in the article where donations can be accepted.
Think the republican candidates need to read this article and be forced to spend some quality time working with this Dr. (who happens to be a wonderful example of compassion). "In a misguided effort to boost Romania's then-population of 23 million, Communist dictator Nicolae Ceausescu banned birth control and abortion, which led to thousands of infants being left in orphanages in harrowing conditions broadcast around the world after his execution in 1989." The desire of the republican party to destroy Medicare, repeal Obamacare, to deny American women of birth control, and their intent to destroy Social Security are going to get a very similar type of result. Absolutely disgusting and incredibly immoral public policies are on the way if these sleezeballs are given any more power then they already have. May any these disgustingly selfish so called 'public servant' supporters of the 1% (at the expense of the majority of the general population) all burn in hell.
glimmmerr_
As an American living in Romania, it seems to me that Obamacare is actually going to take the US in the direction of a health care system like the one Romania struggles with now - as described in the article. There are many similarities. Everyone here is required to have state issued health insurance, too. And they still have to make the "informal payments" to get cared for. Also, abortion rates are probably the highest in the world in Romania: 34% of pregnancies end in abortion (fortunately there has been a downward trend in the last 20 years of "freedom" since the 75% rate in the early 90's after communism ended). Watch who you wish to "burn in hell".
Oh really, you're living in Romania?
Do you know the biggest failing of Newsvine? It doesn't show post history or join date by the name of the poster. If you click on G in Romania's name, you'll see that this post is his only post and that his account was made in "3/2012". Which means March, 2012, day omitted. But we can guess what day that is...
This account was made today to respond in a way that sounds more credible, never to be used again, by a paid astroturfer.
This is the kind of dishonest lengths that the opponents of "Obamacare" are willing to go to spread misinformation. Consider yourself warned!
Considering that the Affordable Healthcare Act was based on the many good ideas of Republicans (sounds like an oxymoron, I know), I find it hypocritical that they now call the individual mandate an attack on our "freedom". During H.W. Bush's reign, Senators John Chafee and Senator Don Nickels wrote healthcare bills that included the individual mandate, and they had bi-partisan support - imagine that! Even back in the early 1990's, both the dems and repubs knew that the healthcare industry needed changed.
G in Romania - your a liar ----this story will be what the US healthcare system will be like if the Affordable Healthcare Act is struck down by those supposedly "non-political" justices. Another oxymoron, I know.
One can only hope that sort of thing doesn't happen here. That said, considering the current state of our country, it's not very promising.
It does happen here..You just don't know it Yet!...I do mean Yet!Just look at these "Pill Mill" clinics..Thats "Corruption" at its Finest..
Good point.
What about coming to Canada for medical assistance instead?
Actually, if we must blame someone/thing??, then blame the international monetary system,,Creating and keeping! a "money" that is always sub par is one of the worst problems with developing countries and especially their people!!,..false manipulations based on air, no reality there at all,, except greed and ignorence,..and this is what we get,,, kids dying, women being abused, corruption running rampant and drugs and the drug trade!! running the country and not the elected officials,,same story, different country,, so very! often,,,I say, set up and use!! a "world buck"$ type of financial system,,everyone uses the same currency, it trades at par, everywhere!, and then we will finally see the end of this unholy alliance between money and the true evils of our world,..sad story,, my docs must be having fits!!,..and as another human, one of the teeming billions?, this makes me sick to my stomach,,world buck,, just think about it, please?...enourmous advantages, very little if any real disadvantages, far more effective law enforcement, drug trade will crash and burn,,slave trade? ditto!...so many real usefull tools,,,and yet,, whats the deal here? am I the ONLY ONE! who see,s and cares about these things??. methinks not,..solutions!,, they are there, but ya gotta look people,, they wont come to you,, you have to go to them,,and, for the now??. get some doctor/intern rotation deal going in Romania, people from developed countries learning! from adversity,,, isnt that what medicine is all about?? "adversity"??..the kids die, but the "officials" eat cake,,,Not my! kind of world at all, at all!, never will be either,..We put "world buck" out there in 09, got Canada to do it too,,and while some went off the rails[greedy buggers!!].. many did not,,and since then,,many more have seen that this is a real!! solution to many many of our problems,,as we can see, "bank-sters" can not be trusted to put people above profits,and they kill millions with their criminal scams,, quietly,in secret,, but they do die, you bet!!...think about something better,, try and talk to others about it,, who knows,, we may get a real solution in play someday soon??..btw, this would also crash and burn!! "cyberwars"..and that is good for us all,.. no??,and since there is no longer a gold standard at all,, this can!! be done,,should be done,, and WTH is going down it is/has not been even spoken of! before??. did the bank-sters kill all those who spoke of it??. since they are, for the most part,, OC central,, this would not surprise me one bit,, not at all at all!!..if every!! one made a decent wage,regardless,, we would have zero!! corruption,,no??.food for some grey cells to chomp on for a wee bit,..
setting up a real work "buck type"$ system where everyone uses the same system now has the same reality as raising a skyscraper without drilling for a foundation on bedrock. Are you aware that the catholic pope and and his goonies spent the last two decade plus on beating up americans and making them spend time in church? That's because the catholic pope as a business retard believes money is made for stolen, and so does his flock..
Hmmmm, what do you call it when all the Medicare and secondary payments have been made and here comes a bill from the doctor? You call for an explanation, and are told the insurance "just didn't cover the doctor's bill." I have had to pay as much as $150 over a doctor's call.
My son is in Med school in our former Communist country. **AT SCHOOL**, they are taught, "If you don't have an overflowing liquor cabinet [gifts from patients], you're not doing your job well."
I've NEVER paid anything extra to a doctor here in 21+ years, and I never will. During my first year, I was told by a colleague, "When I needed to get a crown from the dentist, the dentist asked for a bride so I would get my crown quicker. I paid the bribe, and the crown still arrived in the normal time."
Americans just don't understand bribes; they really are fee for service. These medical professionals are not being paid by the government because the government is not working so this is how they get paid. They are no more evil than being denied service here in the US when you have no money and no insurance. Too bad everyone cannot afford the medical services but it is the same here in the US. No money, no service...
Is the doctor's first name the same as the child he flew to Italy for the operation?
Former Russian satellite, complete with everything that made communist Russia a despicable, earthly entity, unworthy of being called part of our global community. The hammer does not fall far from the sickle. Perhaps North Korea can lend a supportive, humanitarian hand!
was not a Russian satellite:-) check your history
There is a simple cure. Raise salaries.
I knew a surgeon in another eastern EU nation who gave it up to drive a taxi and perform as a musician. He couldn't afford his own rent, to say nothing of ever getting married and having a family.
Here in the USA we have gone crazy the other way. Physicians here make far too much. A starting salary is double to triple what an average person makes. That's equally wrong.
I'll respectfully disagree with that. People give up years of their lives for education that they must pay back. Medical education isn't cheap and that's just for your basic doc. Specialists go longer - some a lot longer depending on their chosen field. Residents and fellows in hospitals are put through a great deal of abuse in terms of long hours and patient overload and when it's broken down to an hourly salary, it doesn't even work out to minimum wage.
I will agree with
from the angle of what celebs / actors / atheletes / rock stars make.
What is more important - saving lives or being entertained??? Personally, I don't think that docs, nurses, medics and aides make enough for what they do and while they're saving lives, many times their own lives are at risk. How??? Patient violence against providers is a lot more common than the media lets us know and that could be in part because it is seldom reported to authorities. Infectious diseases are no bargain (think TB or hepatitis) and sometimes in an emergency situation, there just isn't time to use universal precautions. Sometimes accidents happen.
Don't forget about continuing education. Wouldn't you want to know that your providers have been updated on the latest technologies and safety issues???
All this for saving lives. (Condensed version.)
oh really? Physicians here pay excessive malpractice insurance rates because of our sue-happy society. The cost of medical school is outrageous. No one seems to complain that sports figures make multi-millions for playing games, but someone with the knowledge to save a human life is unworthy of higher compensation? Take your left-over pittance from your little job and buy a jersey or some play-off tickets, keep feeding that ridiculous machine, but when you have your coronary from your lousy diet and your lucky enough to survive, you'll think that all the money in the world won't be enough to compensate the Dr. that saves your life.
So in Romania, we have a Doctor Catalin Cirstoveanu flying babies elsewhere out of the country for treatment instead of his state of the art facility because his staff wanted to do some bribing?
In Christianity, a martyrdom can move the people to change. That's one versus the many that can not survice a trip elsewhere. Doctor Catalin Cirstoveanu needs to goto church and learn from the catholic Pope.
Let me clarify something: this is not Romania, this is stinky Bucharest city and culture. Transylvania (currently part of Romania) used to be like a different country. The real soul of the Roman and Dacic civilization, with influences from the Austro-Hungarian empire, can still be found north of the Carpathians. But it is slowly engulfed by the Bucharest cancer that has grabbed Romania.
sounds like an Obama plan
As an ER nurse in the USA, I have taken care of patient's from all over the world. I have had a few patients try to give me money after they have asked for something, even something simple like a blanket or a pillow. I had one woman try to give me money after I explained her child's condition to her using a translator. I will never forget the look of shock on her face when I explained to her (through the translator) that I'm not allowed to accept money or gifts from my patient's or patient's family and that I could loose my job if I did. I explained to her that I take care of all of my patient's the way I would want my family to be taken care of.
My hospital only allows us to accept gifts that can be shared by everyone in the unit, something like cookies or candy, etc. Cards and letters are fine. I can't imagine how anyone in the medical field would REQUIRE a bribe to ease a persons suffering or save a life.
Great post.
To all the idiots who have to say something against Obama regardless of the topic being discussed: you can bark as much as you can. There is absolutely no quality candidate coming from the Republican party in recent elections. The Republican party has lost its vision in recent years, and no one intelligent enough will vote for any of those Republican monkeys. Obama is an excellent president, he has done a couple of mistakes, but he has fixed the mess. This is coming from a neutral Romanian.