Since Sudan introduced a health insurance system in 1994, the public health sector has witnessed a deterioration and decline that has led to the emergence of corrupt practices. An investigative report on petty corruption in Sudan points to a number of factors for the decline, including the increase in the number patients without a parallel increase in facilities.
Other factors are equipment and access, a decrease in the number of qualified medical staff, low motivation of hospital employees due to poor salaries, and the complicated and ineffective health insurance system that does not cover patients’ needs, the activist Sudan Democracy First Group (SDFG) reported.
Examples of corrupt instances include surgery waiting lists. Because of limited capacity, public hospitals have established waiting lists for patients who need surgery. Given the high number of such patients, the waiting period can take months, hence patients’ families can seek backdoor openings to move their family members to the top of the list. The most common technique is to bribe the medical staff in charge of the surgery waiting list.
Another corrupt activity is the referral to specialist private clinics. Senior medical specialists in public hospitals frequently refrain from seeing all patients, or only see few, and instead refer the remaining to junior medical officers. In such a situation, patients who have been waiting to be seen by the specialists are left with little choice other than to schedule an appointment and pay high consultation fees to see the same specialist at his/her private clinic.
Hygiene in public hospitals causes another corrupt practice. Most public hospitals are unhygienic environments caused by neglect and irregular cleaning routines in general wards, public areas, clinics and the surroundings. Leftover food and medicine litter the place, the fixtures and furniture – including patients’ beds – are old and dirty, and cats and dogs roam the surroundings. The situation in these hospitals has become so unbearable that patients are eager to be discharged or transferred to private rooms. However, private rooms in public hospitals cost a substantial amount of money and are not easy to secure because of high demand.
'These instances in public hospitals indicate that such practices thrive as long as the degradation and deterioration of services in the health sector continue unabated. Moreover, those who benefit from such practices, the hospital administrations, medical specialists and medical staff and workers, are part of the problem,' SDFG said.
To address these illicit practices in public hospitals, the government should adopt a policy to raise the salaries of the health sector employees and increase their fringe benefits, the activists conclude.