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Listen to Oliver Bullough's story about endemic corruption in Ukraine
Last Online: 17 Nov, Last Online: 31 min ago. Last Online: 38 min ago. Last Online: 51 min ago. Roan Birkin. Danny Castillos. Lucas Westt. Last Online: 60 min ago. Kiev has a grand opera house, cathedrals, chain stores, sweeping central avenues, a metro, everything required to make a place look European. But it resembles a modern European capital city only in the way the Cancer Institute resembles a hospital.
In the latest ranking, it fell behind Nigeria. Since , officials, members of parliament and businessmen have created complex and highly lucrative schemes to plunder the state budget. The theft has crippled Ukraine.
Ordinary Ukrainians have seen their living standards stagnate, while a handful of oligarchs have become billionaires. Public fury has fuelled two revolutions. In , street protests helped Viktor Yushchenko defeat an attempt by the then prime minister Viktor Yanukovych to rig the presidential election.
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During his five years in power, however, Yushchenko failed to dislodge the networks of patronage. Amid widespread disillusionment, he lost the election to Yanukovych, who was in turn driven out in February , after corruption mutated into still more virulent forms. This behaviour has infected all sectors of Ukrainian society.
President Yanukovych lived in a vast palace on the edge of Kiev. After he fled, protesters found millions of dollars worth of paintings, icons, books and ceramics stacked in his garage.
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The protesters camping out on the Maidan in central Kiev last winter wanted to prevent a repeat of , when the old networks of corruption simply absorbed the new officials. Among those protesters was Andrei Semivolos, a pale, slim, dark-haired surgeon from the Cancer Institute with a mauve birthmark on his right temple.
He had volunteered as a medic during the protests on the Maidan, patching up protesters beaten by police. He had returned to the institute determined to help change his workplace as he had helped change the government. Shchepotin, the chief oncologist, stood by his side, beaming. To him, it sounded like Shchepotin was trying to ingratiate himself with the new order. Facebook had played an important role in catalysing the protests that swelled into revolution over the winter. Ukrainians knew how such posts could go viral and quickly energise mass protests.
Managers control attendance, however, meaning they can keep a tight grip on proceedings. Here are your colleagues and they are looking you in the eyes and saying what they think of you. Those present voted unanimously to condemn Semivolos and to declare his opinion of Shchepotin false.
Among a crowd of colleagues, he looked pale and alone. In April, Semivolos responded by setting up a trade union with a dozen or so like-minded colleagues.
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He organised two protests outside the health ministry to demand an investigation into the hospital, to ask — among other questions — why no action had been taken after a probe suggested evidence of corruption there. But his chances of success looked slim. Semivolos and his friends were fighting a hardened bureaucracy that was reasserting itself. There might have been a revolution on the Maidan, but here in the institute, it seemed that everything would proceed as normal. After Yanukovych fled last February, the new administration — headed by the speaker of parliament, who became acting president — gave control of most ministries to insiders and veteran politicians.
This led to much muttering about how the old elite had clung on to power. Three new ministers, however, came from the Maidan protesters, and one of them was Oleg Musy. Slim and tanned, with a slight, grey beard, he looks like a s musician — perhaps a member of the Police — on a comeback tour. In February, he became the new health minister, and embarked on an ambitious reform programme. He wanted to transform Ukrainian healthcare along European lines, and to clean up the process whereby the state buys drugs and equipment. Traditionally, Ukrainian officials have had wide discretion over which companies to approve and which to exclude, which, it is claimed, gives them the chance to make insider deals, inflate prices and steal with impunity.
Musy wanted to end this practice and to dismiss anyone found to be involved in these deals. This was a dangerous undertaking. In , Yushchenko had commissioned a security operative, who specialised in organised crime, to lead an internal report into healthcare corruption. The report exposed how businessmen use offshore shell companies to conspire with corrupt officials, rig state tenders and jack up prices. Within weeks of the report being completed, an assailant threw a grenade at the operative who had written it, as he got out of his car on Tatarska Street in central Kiev.
Shrapnel shredded his car, and scarred the nearby buildings. The man survived but only after extensive surgery at a specialist unit in Israel. His report was never officially published — although it was leaked online — and the assailant was never found. Musy was not deterred, however, and began work on his reforms as soon as he took up his position. When I met him in August, he was startlingly open about the problems he faced.
The Ukrainian government was allocating only 3. Naturally, around the same amount is coming from somewhere else. Musy said a key front in his campaign for reform was the Cancer Institute. On June 26, he announced the results of an investigation into the hospital, detailing 43 alleged violations of the law. Among them were claims that patients had been forced to buy expensive medicines, even though those medicines had already been paid for by the state, and that equipment costing around UAH 42 million, bought in , was gathering dust in a store cupboard, never used, with the warranty expired.
He said the details had been passed to police, who would interview Shchepotin in his capacity as head of the institute. He believed that the suspicion alone was grounds to sack Shchepotin, although that could not happen just yet, because Shchepotin had gone on sick leave. Under Ukrainian law, that meant he could not be dismissed for four months, not until October.
He refused to comment on further questions about widespread corruption at the institute. Shchepotin repeatedly refused to talk to him, unless he produced a search warrant. Most patients come to the Cancer Institute via regional hospitals, so relatives caring for them need to find accommodation in Kiev. A charity called Zaporuka , which helps children with cancer, provides rooms for six families, in a large, detached house on a winding suburban street not far from the institute. Natalia Onipko, who heads Zaporuka, is slight, with her blonde hair in a bob that falls onto her shoulders.
In a decade of working with parents, almost all of whom had paid bribes so their children could be treated, Onipko had never known anyone make an official complaint. Do you understand what that would mean? Doctors have total discretion over which patients to admit or discharge, so it is not surprising that parents are anxious to keep them happy: giving them gifts, paying the amounts suggested, never speaking out.
There are more cancer patients than there are beds — being sent back home would be a death sentence. We walked through to the kitchen, where six women sat around the table, chatting over tea as if they were old friends rather than strangers brought together by the awful coincidence of their children having cancer. At first, when I spoke to them, it seemed the mothers were reluctant to admit to breaking the law.
No signs, and the ones that were there were the truck signs. Musy said a key front in his campaign for reform was the Cancer Institute. Jacket Jeans Overalls. He took us to an amazing hotel. And what about the Cancer Institute?
It soon turned out they were simply struggling to understand what I was asking. Bribes were so ordinary that it seemed bizarre someone would have come all the way from Britain to ask questions about them.
That meant dollars. But actually he was catching my attention.
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Then he held out two fingers. They were not only struggling to support their children through a terrible illness, but also trying to navigate a health system apparently determined to exploit their desperation for financial gain. I heard the same stories throughout the institute: there was little money for maintenance, medicine or salaries, little interest in the patients, or in the medics doing the work of keeping people alive.
Apart from some microscopes — given by donors eight years ago — the equipment in the department had not changed for two decades, according to one person who worked there. These slides are crucial for diagnosing cancer.
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Examples have to be stored in case the patient suffers a relapse. To prepare the biopsies, the lab workers drip purple dye onto slides suspended over an enamelled basin, which was once white but, after decades of use, is now dark purple.