Sierra Leone’s Health Care System Becomes The Latest Example of Charity Fraud

by Gary Snyder

In spite of the world’s worst rates of maternal and infant mortality, investigators have found nurses illegally selling drugs to patients in the free care program and doctors charging for services that were, according to the donor terms, supposed to be free.

Last month, the country’s 29 top health officials found themselves indicted by Sierra Leone’s anticorruption agency on charges of misappropriating a half-million dollars in grants from a global vaccine provider, GAVI Alliance, started by the Bill & Melinda Gates Foundation. The amount may not seem huge in some places, but in Sierra Leone, one of the least developed nations in the world, it looms particularly large, and the list of suspects is stunning.

The country’s top doctor — the chief medical officer, Dr. Kizito Daoh — was among those indicted. So were the director of primary health care at the Health Ministry, the permanent secretary at the Health Ministry and the ministry’s program manager for reproductive health. Much of the ministry’s leadership, the key agency in tackling some of the continent’s worst health outcomes, now finds itself charged with wrongdoing, including eight doctors.

The vaccine alliance first noticed problems in an internal review. And last week i t released an audit report that found tens of thousands of dollars in unjustified uses of finances and cash withdrawals, ambulances for which the Health Ministry paid almost twice as much as it should, and over a dozen motorcycles improperly distributed. The audit showed “very high exposure of this grant to misuse,” the report concluded.

The charges against the country’s top physicians have also shocked the public in Sierra Leone.

“There’s a perception that doctors are meant to heal wounds, not bleed them,” Mr. Kamara said.

His predecessor obtained a corruption conviction against the former health minister, Sheiku Koroma. Health care “is an area that has long been corrupt,” said Abdul Tejan-Cole, the former anticorruption commissioner, who resigned three years ago after receiving threats.

Top doctors, including at the Health Ministry, “refuse to go to the hospital” because “it’s much more lucrative to manage a donor project,” Mr. Tejan-Cole said. “Across the board in public-sector funds, a lot is going wrong. There’s a lot of misappropriation and abuse.” (NYT)

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