Risk Areas

3.7 Provision of healthcare

Explanation of risk area

Perhaps due to a widespread perception of healthcare as a universal good, it is often seen as a sector immune from corruption. The complexity of healthcare-related issues, the power imbalance between practitioner and patient, and the multitude of stakeholders involved are only some of the factors that make healthcare susceptible to corruption risks, especially in fragile and conflict-affected environments where the needs are greater and capacities, especially for oversight, lower.

Consequences for the mission

Greater casualties

Morale depletion

Waste of resources

Overall lower effectiveness of partner forces


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Dawood National Military Hospital, Afghanistan

At the Dawood National Military Hospital in Afghanistan – a US-funded and overseen project in Kabul – corrupt personnel embezzled funds, extorted bribes from families of Afghan military officers, and suppressed complaints and whistleblower reports; one high-ranking Afghan officer embezzled almost $20 million in US funds. The price of corruption was paid in human suffering as care for the wounded was compromised and some patients became malnourished. US officers responsible for running the hospital suppressed reports of wrongdoing and attempted to stonewall investigations demanded by healthcare personnel.

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Deployed medics in Afghanistan

Deployed medic experience indicates that low wages and dangerous postings for Afghan National Army medics meant that many attempted to supplement their income through parallel, better-paid jobs which would take them away from the field. The practice was recognised and condoned by senior officers, but it meant that ANA units would need to do without medics for extended period of time in combat. As NATO increasingly drew down the mission and there were fewer international officers and medics to fill in, casualties rose: the ANA suffered over 5000 killed and 14,000 wounded many of them in Helmand during the ISAF draw-down

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Indicators & Warnings

Witness and whistleblower reports of corruption in healthcare systems

Lack of medication that has been paid for or supplied

Personnel shortages and absences

Inadequate provision of care

Unexplained wealth among healthcare providers