In Uttar Pradesh, India’s largest state, corruption of the health care system kills, directly and indirectly. The New York Times, which deserves some applause for stepping up its India coverage despite tight budgets, has the story:
The first doctor to die, a senior government health administrator, was shot on his morning walk last October by two men on a motorbike. Six months later, his successor, a cardiologist, was shot to death while out on a predawn stroll. A third government doctor, accused of conspiring to murder the first two, was found dead in jail in June, lying in a pool of blood with deep cuts all over his body.The one thing the doctors had in common? All three had at one point been in charge of spending this city’s portion of the nearly $2 billion that has flowed to Uttar Pradesh, India’s most populous state, as part of a nationwide push to improve the health of India’s poorest citizens.
Predictably, evidence of graft followed:
Only after the doctors were killed did a review by the central government’s investigators find that contracts worth millions of dollars were granted without competitive bidding, and millions more was paid in full to contractors who did not complete the work they were required to do, leaving health centers in ruins and without vital equipment.
Healthcare for Uttar Pradesh’s poorest citizens is abysmal. The story reports that some of the region’s hospitals stand half-constructed or have too few beds and medical workers are lacking the most basic supplies “like oral rehydration salts for children with diarrhea”:
“We sometimes don’t even have soap for our hands,” said P. N. Tiwari, the center’s vaccination officer. “Meanwhile, they are looting like monkeys,” a reference, he said, to politicians, bureaucrats and contractors.Half a dozen babies are born in the clinic daily, but the water tank is broken, so deliveries are performed without running water. The center has an ambulance, but it, too, is broken. Repairs would cost only about $30, but there is no cash to pay for it.
In India, only a fraction of money allocated for the public good makes it through the miasma of greedy bureaucrats and crony-capitalists. Many of these corrupt officials and businessmen may not realize how disruptive their actions are. A small bribe to them is just business as usual. They believe they are only taking one bite, but by the time the money reaches the people who actually need it (and for whom it was allocated in the first place) little or nothing is left.India’s middle class is growing weary of graft and is campaigning to root it out, but corruption is more complex than many reformers are inclined to admit. Whoever said that corruption is the mother’s milk of politics could have had India in mind; from government ministers and members of parliament down to low-level bureaucrats in backwater towns, corruption and cronyism are intrinsic to the way Indian governance works. Creating new government agencies to combat corruption will also create more places where corruption can flourish — bureaucrats watching bureaucrats are ripe clients for bribery.Yet the human victims of the corrupt bureaucrats cry out for justice — and India cannot continue to modernize without addressing this holdover from past times. Outsiders can’t do much one way or the other about the battle, but studying the problem and watching India’s attempts to overcome it is one of those things that geopoliticians in the 21st century will have to learn to do.