Birth row: Bosnia's pregnant women report rampant hospital corruption

Many mothers in Bosnia and Herzegovina, where corruption is high, know that in order to have a sound birth, they must give money to the doctor who assists at birth.

One mother was so traumatic that she chose to give birth to her fourth child at home and later indicted the state at the highest court in Europe.

Magdalena gave birth to two children at the same state hospital in Sarajevo, and in both cases, the 38-year-old gave the doctor envelopes.

Inside the envelope was money worth 150 euros. Even though public health care is meant to cover all expenses, Magdalena, who has asked not to make her last name public, gave her the money because she wanted “to provide better treatment during birth”.

According to Magdalena, the doctor told her that she did not need money but took it anyway.

The money, however, had its effect.

The doctor was present at both births, not the midwife. I'm so glad I got a full anesthesia during the sewing”, Magdalena said.

I had a baby, [the doctor] brought me his cell phone to call my family. They treated me differently from other mothers. I'm not sorry for what I did and I'd do it again,” Magdalena added, saying she's not the only one.

According to Magdalena, such payments, or bribes, are normal in Bosnia. A form of security for better care.

And at least one survey supports what Magdalena says.

About 1m euros of bribery were awarded to maternity departments in Bosnia and Herzegovina last year, according to a survey by Baby Stepes, an NGO in Bosnia struggling to end “corruption in the birth of children”.

The survey of 2713 mothers from around the country found that 50 percent had given him money or a gift to the medical staff. The average payment was about 70 euros.

The survey shows widespread corruption in maternityities throughout Bosnia, with one in every second in the east, said Amila Tatarviq, chairman of Baby Steps.

The staff of some maternity wards has actually made it clear that such payments should be made, while on other occasions families have handed in the envelopes without such suggestions, afraid of stories and rumors they had heard if they were not to, Tatetarviq explained Radio Free Europe.

The survey results were shared with Health Ministry officials at the national and regional level, as well as the maternity departments, Tatarviq said, adding that the answer was not impressive.

“We received some answers [from officials], most said there have been no reports of corruption in the last 10 years. So we have 15,000 births related to corruption and there's absolutely no reporting on it. This in itself shows how big the problem is”, Tatarvic continued.

In general, corruption, if not rampant, is widespread throughout Bosnia. With a score of 35, the country is on the decline in the region, dropping seven points since 2012 in Transparency International's 2020 Transparency International index of global corruption.

Free Europe Radio contacted the General Hospital, “Dr. Abdulah Nakas” in Sarajevo to ask for possible bribery in his maternity ward. The hospital said there were no such reports, but added it was taking measures to prevent it.

A anti-corruption team has been formed in the hospital. Anti-corruption material is located at eight locations in the hospital, along with forms for reporting corruption and detailed instructions on how and to whom corruption is reported at hospital”, the hospital reported in response to Radio Free Europe.

The Srbija hospital, located in eastern Sarajevo in Republika Srpska, the Serb-dominated entity in Bosnia and Herzegovina, said patients had not complained of bribery in its maternity department.

“Therefore, there is no need to take steps. In corruption cases, the hospital will take all necessary steps to initiate disciplinary procedures”, the hospital told Radio Free Europe.

Not addressing allegations of corruption, some health officials stressed that a uniform system for reporting corruption had been adopted in October when the directors of health centres had gathered.

Research of the NGO “Baby StepS” shows that many mothers in Bosnia are so traumatic during their first birth that they are discouraged to have more children.

Vesna, who did not want her last name to be used, gave birth to three children in the same maternity ward in Sarajevo as Magdalena. After experiencing what she described as a “traumatic experience” with her first child, she was made sure to pay a bribe for her two other children.

The only time I didn't give the doctors money, I got into trouble. When a doctor is scheduled to help during birth, he must be paid [the bribes] in advance. I didn't know that, and I think I was suffering because of my lack of money. It was a disaster”, confessed Vesna, 38 years old for Radio Free Europe.

I was not told why I was going to a forced birth and what drugs were using. I was terrified. The doctor entered several times during birth and finally sewed me without anesthesia”, continued Vesna.

For the next two births, Vesna decided to pay 200 euros to the doctor and nurse who cared for her.

On average, people in Bosnia pay the equivalent of 60 euros a month for state health insurance. This is not a small quantity for most people. The average monthly gross salary totals 500 euros.

Like other mothers who spoke of Radio Free Europe, 32-year-old Sanja from East Sarajevo, who refused to give her last name or specify the name of the hospital, also handed an envelope to the medical staff when she was born four years ago.

Technically, it was her husband who gave the money. The sum was the equivalent of 100 euros paid for the doctor who treated him.

Everybody's waiting for that envelope. We live where we live, and we must be aware of that. The doctor who managed my pregnancy was not on duty at the time. I paid because I wanted her to help me east. She wasn't. She wasn't on time that day, but she came for my birth. She didn't ask for (money), but I think that's self-aware because in the opposite it wouldn't have entered”, Sanja explained.

Senad Sariq, a specialist in gynecology and reproductive medicine, has worked for years at a hospital in Mostar, a town in southern Bosnia.

Saric is currently working in a private administration and says he has never seen direct corruption in a maternity ward, though he acknowledges this practice is widespread in the state.

I've been working for years and never took [money]. This, however, is not always what happens here. There is a custom that is symbolically honored, but it is a small thing and here in Mostar has never been widespread”, Sariq explained.

“As far as maternity power is concerned in Sarajevo, I know there are voices about paying for a cesarean operation and other things. This is incomprehensible to me. Whoever does this should shoulder criminal responsibility”, Saric said.

The Bosnian Health Ministry did not respond to requests for comments by Radio Europe Free on bribery charges in maternity wards.

The experience of three births in state hospitals caused Amira Qerigiq to have her fourth child at home, definitely something extraordinary in Bosnia.

The “is indefinite in Bosnia. [Homes] are a grey area. I went through the formal process of looking for hospitals for this opportunity, but I knew prematurely that [my request] would be rejected. It's not banned, but you can't find medical staff, nor is this option available,” explained Qerimalic, now a volunteer at Baby Steps.

I was finally born home and midwife, so husband, <x1baba”, as I call it, was from the European Union and lives in Slovenia”, she relates.

Frustrated by her problem of having the right to be born at home, Qerimaci appealed to the Constitutional Court of Bosnia, claiming that its human rights were violated.

After the country's highest court rejected its case, Qerigiq addressed the Strasbourg-based European Court of Human Rights. This request is now under consideration.

Meanwhile, Baby Steps has launched an online petition “for birth without fear and cost”. Thousands are said to have it Sign Already.

The organisation says that all mothers deserve professional and dedicated staff and a dignified birth without “to additional”.

Corruption threatens basic human rights because it creates inequality in the treatment of mothers. Taking bribes is a crime to be known, discouraged, and sanctioned”, said Baby Steps.