By ALISON MUTLER and VADIM GHIRDA
BUCHAREST, Romania (AP) - Dr. Catalin Cirstoveanu runs a cardio unit with state-of-the-art equipment at a Bucharest children's hospital. But not a single child has been treated in the year-and-a-half since it opened.
Medical staff he needs to bring in to run the machinery would have expected bribes.
So Cirstoveanu has launched a lonely crusade to save babies who come to him for care: He flies them to western Europe on budget flights so they can be treated by doctors who don't demand kickbacks.
That's what Cirstoveanu did last week for 13-day-old Catalin, who needed heart surgery. Cirstoveanu packed a small bag, slipped emergency breathing equipment into the baby carrier and caught a cheap flight to Italy, where doctors were waiting to perform the surgery.
The operation was successful. Two days later, though, a 3-week-old baby that Cirstoveanu whisked away to the same clinic in northwestern Italy _ with tubes piercing her tiny frame _ died before she was able to have lymph gland surgery.
"I was very worried it wouldn't work," said Cirstoveanu. "But in Romania, she would have died anyway."
The soft-spoken Cirstoveanu is fighting an exhausting and largely solitary battle against a culture of corruption that's so embedded in Romania that surgeons demand bribes to save infants' lives and it's even necessary to slip cash to a nurse to get your sheets changed.
It's one of the reasons why the country's infant mortality rate is more than double the European Union average, with one in 100 children not reaching their first birthday.
"To be honest, it's so deeply rooted into our system that it's really difficult to eliminate," Health Minister Ladislau Ritli said in an interview with The Associated Press.
Officially, the new cardio unit that Cirstoveanu runs at the Marie Curie children's hospital isn't functioning because jobs have not been filled. The real reason appears to be that Cirstoveanu has banned staff from taking bribes. That means that high-tech machinery lies idle because qualified experts do not bother to apply for jobs, as they know they cannot supplement their incomes with bribes.
The zero-tolerance policy to corruption makes for a grueling work schedule for Cirstoveanu, who needs to shuttle babies abroad for surgery _ and take care of them on the flight. During the two-hour flight with the girl who died, Cirstoveanu fixed tubes, sedated her and hand-pumped oxygen to keep her alive.
In the less than 24 hours Cirstoveanu had in Bucharest between returning from Catalin's trip and departing with the little girl, he even squeezed in a shift at the Marie Curie clinic.
Patients in Romania routinely discuss the "stock market" rate for bribes. Surgeons can get hundreds of euros (dollars) and upward for an operation, while anesthetists get roughly a third of that, depending also on what a patient can afford. Nurses receive a few euros (dollars) from patients each time they administer medications or put in drips. Getting a certificate stamped to have an operation abroad can easily cost hundreds, if not thousands of euros (dollars) if you ask the wrong doctor.
While the Romanian state appears unwilling to do anything, it often ends up footing the bill.
At the Marie Curie unit, Catalin's operation would have cost (EURO)2,000 to (EURO)3,000 ($2,700 to $4,000) without bribes. Romanian state health insurance is paying 10 times that for his operation in Italy _ a small fortune in a country where the average monthly salary is 350 euros after tax.
Many disillusioned doctors have abandoned the country, which spends just 4 percent of its gross domestic product in health care _ about half of the percentage of GDP spent by Western European countries.
Last year, some 2,800 Romanian doctors _ discouraged by the antiquated and corrupt health system and low wages _ left to work in western Europe, according to the Romanian College of Doctors.
"Ideally, we would have decent salaries and nobody would be tempted to accept informal payments," said the Ritli, the health minister. "And the population would be educated so people would believe that this is not the only way to get proper health care."
Bribes across Romania accounted for some $1 million a day in 2005, according to a World Bank report; more recent estimates are not available. The culture of bribes _ or "informal payments" as they're commonly known _ is tacitly accepted.
But anger is rising. One of Marie Curie's donors, Procter & Gamble, has several times gone back to the hospital and the Health Ministry to ask questions about when the unit will start functioning.