Catholic Medical Quarterly Volume 70(3) August 2020

A killer virus in the developing world: CORRUPTION

Fr. James McTavish

FR McTavishA short reflection on corruption involving the health care sector in the developing world setting.

Background of author:
The author, Fr. James McTavish, is a Scottish Catholic priest with the Verbum Dei missionaries. He has been working in the Philippines for 17 years. Prior to entering religious life, he worked as a medical doctor (MB, BChir, Cambridge University1992) and later in surgery (Fellowship of the Royal College of Surgeons of Edinburgh 1997). Upon entering religious life in 1999, he did further studies in Moral theology and Bioethics. Part of his current priestly ministry involves giving formations on medical ethics to healthcare workers in the Philippines, as well as spiritual accompaniment (prayer with the Word of God and the celebration of the Eucharist) to nourish their life of faith.

It was with much frustration that I read the latest corruption scandal hitting the Philippines. I say frustration because corruption is endemic here already, but the recent scandal involves corruption in the health care sector. This is especially deplorable in the midst of the coronavirus pandemic where the health care systems in each country need all the help they can get.

The latest scandal here involved the organization called “PhilHealth,” the National Health Insurance Program of the Philippines. Their own website describes their official mandate: “The National Health Insurance Program was established to provide health insurance coverage and ensure affordable, acceptable, available and accessible health care services for all citizens of the Philippines.”[1] In 2019, investigative reporters from national newspaper groups revealed that the PhilHealth organization lost approximately PHP 154 billion Filipino pesos (equivalent to GBP 2.3 billion British pounds) to fraud, which is an astronomical amount in the developing world context.

Fraud cases include the “ghost” dialysis scheme, where PhilHealth was billed for non-existent kidney dialysis treatments. The breaking news now concerns fraudulent projects and fictitious claims in the PhilHealth budgeting, principally in the area of IT (information technology). Billions of mismanaged funds are at stake, but what particularly irked the auditors was the fake billing for Adobe software for the healthcare system. Each unit should have cost PHP 168,000 per unit (GBP 2,600 British pounds), but were being billed at PHP 21 million (GBP 330,000 British pounds). In the face of such blatant dishonesty and mismanagement of funds, the official anti-fraud officer of PhilHealth, the lawyer Thorrsson Montes Keith, has just quit citing “widespread corruption” and now says he is receiving death threats.

Commentary

It is a sad, but well-known fact, that a major killer in the developing world, is not only coronavirus but the deadly virus of corruption. It is estimated that corruption robs the world’s developing countries of more than a trillion dollars every year. If this money was actually invested in health, it could prevent 3.6 million deaths. [2]

Already in 2015 in his visit to the Philippines, Pope Francis himself commented on the situation when he mentioned “a society burdened by poverty and corruption” and invited the crowds to “reject every form of corruption which diverts resources from the poor.” [3] A year later, in his encyclical Amoris Laetitia, he had some strong words for those involved in corruption stating that it is a “festering wound,” “a grave sin,” “an evil,” “a sinful hardening of the heart,” and “a work of darkness.” [4]

Often corruption starts small. Once I was in a taxi in Manila and the driver was complaining about the corruption in the country. He was really irritated. When I got into the taxi, he changed the meter from PHP 40 (about 60 pence) pick-up fee, to PHP 80 (around GBP 1.20). On the journey, he asked my work. I told him I was a Catholic missionary priest. He was so shocked that he stopped the taxi in the middle of busy traffic and said “Bless me Father for I have sinned.” He then told me what he had done, bowed his head and asked for forgiveness! The traffic behind us was blowing their horns but the driver would not move until he received forgiveness! He then told me the ride was totally free. I found out on the journey he had a wife and 3 children to support so I gave him the fare and asked that he not be dishonest anymore. He promised me never again! Widespread corruption begins on a small scale. So, if a person is corrupt in small things, later it may worsen.

How can we respond?

In seeking an adequate response, Pope Francis said that “if we want to drive it out from personal and social life, we need prudence, vigilance, loyalty, transparency, together with the courage to denounce any wrongdoing. If it is not combated openly, sooner or later everyone will become an accomplice to it, and it will end up destroying our very existence.” [5]

Always a first response can be an examination of my own life, following the dictum of many Saints, “Change yourself, and you change the world.” Each one of us can personally examine our own conscience to ensure we are living with integrity, and without corruption, especially in small details. The Catholic Magisterium reassures us that our little good efforts can give life to the whole Body of Christ, as the teaching of Pope Pius XII succinctly taught us: we will never meditate enough on how the salvation of many, depends on the prayer and sacrifice of the few. [6]

Life givers in the Body of Christ

Revered Father Jaime Bonet, founder of the Verbum Dei community, used the image of an injection in the vein of the arm which brings healing to the entire body being comparable to the beneficial effect of our good actions in the whole Body of Christ: “This is very important because it means our lives greatly influence the whole Body of Christ because applying Life to some people, it also gives life to the entire Body. I would say that it is something similar to what happens in the human body when an injection is put into a vein, or a certain part of the body. Maybe the person has a sore, a microbe, a disease in a part of the body and the injection is given at a distant site in the body. However, the result is that it heals the sick part and achieves the health of that damaged part. The intention is to heal the diseased part. The effect affects the whole body. Thus, in an analogous way, it happens in the Body of Christ.”[7]

So we should never get discouraged in doing good as St Paul also reminds us: “We must never get tired of doing good because if we don't give up the struggle we shall get our harvest at the proper time.”[8]

A Catholic concern for all

And as we become more aware of the plight of many poor in the developed world, especially as the majority of them lack access to good quality healthcare, we might not complain about the NHS so much! As Catholics, if we are true to our identity, all of us should really be concerned about “universal” health care for all. William May reminded us, “we the people have a strict obligation in justice to see to it that the health care needs of the poor in our society are met. In addition, since we are obligated to honor the universal common good, we need to think of the health care needs of the millions of poor throughout the world. Although we are not obligated to do the impossible, and although we simply cannot do everything, we must seek to do something to bring to people in other societies a decent minimum in health care.”[9]

Fr. James McTavish MA, FRCSEd, STL, FMVD, Provincial, Verbum Dei Manila, Philippines

References

  1. PhilHealth official website. “Mandate.” See https://www.philhealth.gov.ph/about_us/mandate.html#gsc.tab=0
  2. ONE. 2014. “The Trillion Dollar Scandal.”
    See https://s3.amazonaws.com/one.org/pdfs/Trillion_Dollar_Scandal_report_EN.pdf
  3. Pope Francis. 2015. Pope’s homily at mass with Filipino bishops, priests, religious. January 16. http://www.zenit.org/en/articles/pope-s-homily-at-mass-with-filipino-bishops-priests-religious .
  4. Pope Francis. 2016. Amoris Laetitia, n. 16.
  5. Pope Francis. 2015. Misericordiae Vultus, n. 19.
  6. Paraphrasing Pope Pius XII. 1943. Mystici Corporis Christi, n. 44.
  7. Rev. Fr. Jaime Bonet. 1999. “Familiares de Dios.” Spiritual Exercises given to Married Couples, Spain, p. 544.
  8. Galatians 6:9-10.
  9. William May. 1989. “Health care and the poor.” National Catholic Bioethics Center, Philadelphia, USA. Ethics & Medics 14 (12) December.