BANGLADESH HEALTHCARE CORRUPTION AND WORKFORCE VULNERABILITY AMIDST THE COVID-19 PANDEMIC
Rolin G. MAINUDDIN (ORCID iD : https://orcid.org/0000-0002-3362-8246)
Analele Universității din București. Științe Politice [Annals of the University of Bucharest. Political Science series]
Vol. XXIII, Issue 2, pp.225-243
Amidst the pandemic resulting in a global health crisis, Bangladesh was unnerved by the fake COVID-19 test result certificates issued by the private Regent Hospital in Dhaka. The healthcare corruption was exposed when Il Messaggero (The Messenger) daily newspaper in Rome reported that infected Bangladeshi migrants were moving undetected throughout the city and were thus a potential health risk. What is the impact of healthcare corruption during a pandemic for the vulnerable people of a developing country in a globalized economy? This article assesses the plight of the Bangladeshi migrant labor force and the ready-made garment sector domestic work force within the framework of vulnerability interdependence, discussing the democratic consolidation context, the environment that led to the issuance of fake healthcare certificates and the potential implications for tackling corruption.
Keywords: Bangladesh, corruption, COVID-19, democratization, garment export, healthcare, migrant labour force
The US Secretary of State Henry Kissinger once famously labelled Bangladesh as the “bottomless basket” for being heavily dependent on foreign aid to navigate its economic and financial woes. However, during the last decades the country has achieved laudable economic success, especially in connection to garment exports, remittances, and agricultural production, achievements reflected also in the Millennium Development Goals. Currently, Bangladesh is the second largest apparel exporter in the world and the fifth largest recipient of remittances. With women accounting for 75% of the employees, the garment sector is the biggest economic contributor for the country (Masud 2018). In fact, the ready-made garment (RMG) sector accounts for 80% of Bangladesh’s merchandise exports, as well as for 13% of the country’s GDP. The major export destinations are the US, the UK, Germany, France, and Italy (Mohiuddin 2020, 5; World Bank 2021, 26). In short, complementing manpower export to the oil-rich GCC countries, the garment industry in Bangladesh has done well in the globalized market under the neoliberal framework. However, both garment and manpower sectors in Bangladesh have fallen victim to the COVID-19 pandemic, which was aggravated by the endemic corruption in the society.
COVID-19 was first reported in Bangladesh on the 8th of March 2020. The World Health Organization (WHO) declared it a pandemic three days later (Islam et al. 2021, 116; Maswood 2021; Al-Zaman 2020, 1). The COVID-19 epidemic in Bangladesh reached a peak in July 2020. However, the national coronavirus vaccination campaign began only in February 2021, after receiving an initial shipment of 30 million doses from India (World Bank 2021, 1). During the summer, China sent seven million vaccine doses of its own production ([The Daily Star] 2021a) and, under the COVAX arrangement, Bangladesh received also from Japan a total of three million AstraZeneca vaccine doses ([The Daily Star] 2021b).
The unprecedented global health crisis exposed the vulnerability of the Bangladesh workforce in a globalized economy. The pandemic had devasting impact for both the migrant labour force abroad and garment workers at home. It was within this context that Bangladesh faced the exposure of a case of corruption involving a considerable number of fake healthcare certificates issued by the private Regent Hospital in Dhaka. CCharging $59 per report, and $100 for expatriates, the hospital issued over 10,000 certificates. However, significant numbers were fake and did not relate to any actual coronavirus test (Gettleman & Yasir 2020; Anik 2020; Sullivan 2020). The issue gained traction when Il Messaggero (The Messenger) daily newspaper in Rome reported that at least 600 Bangladeshis infected with the SARS-CoV-2 virus were moving about undetected in Rome and elsewhere in Italy (Gettleman & Yasir 2020; Anik 2020).
This article explores the impact of healthcare corruption on the vulnerable people of a developing country during a pandemic, using the particular case of Bangladesh, with a focus on the Bangladeshi labour and garment exports within a globalized market. For this purpose, it also asks what socio-political context may explain the unconscionable fake certificates issued by the Regent Hospital. Not least, it introduces the puzzle of whether leadership weakness may aggravate an already challenging situation.
Given the fact that Bangladesh reached the status of lower-middle-income country in 2015 (World Bank 2021, 25), PM Sheikh Hasina counts the Vision 2021 governmental strategy as a success (Kamal 2020). However, Bangladesh continues to be one of the eight least developed countries (LDCs) in Asia (UNCTAD 2020, ix). With 21.8% of the population living under the poverty line and a deep urban-rural divide, its healthcare system is significantly deficient in “reliability, responsiveness, and empathy” (Al-Zaman 2020, 1). What the COVID-19 pandemic put in the spotlight are three structural fissures in the country: poor governance and high level of corruption, inadequate facilities, and weak public health communication (Ibid.). Within this context, this study is placed within a framework at the intersection of three theoretical and conceptual insights: vulnerability interdependence, democratization trajectory (or lack thereof), and public goods.
In the era of interdependence there is an associated cost for exercising power (Young 1982, 73). In transaction costs this is reflected in the two dimensions of interdependence: sensitivity and vulnerability. Sensitivity interdependence refers to a situation in which policy adjustments to changes in external environment are easy to accomplish. In contrast, vulnerability interdependence relates to a context where policy adjustments to changes in external circumstances are difficult to accomplish. Given the higher costs of change for the relatively more dependent party, vulnerability interdependence is crucial in revealing the structure of that asymmetrical relationship. As noted above, this vulnerability arises for the weaker party in policy adjustment difficulties from changes in external relationships (Keohane & Nye 2001, 10-15). In this article, the plight of the Bangladeshi workforce (both the migrant international labour force and the domestic garment workers) is assessed within the liberal school framework of vulnerability interdependence. Without alternative markets for labour and garment exports, a developing country like Bangladesh is vulnerable to the volatility of the global market. On the one hand, the Bangladeshi labour force abroad has been negatively impacted by the COVID-19 pandemic and the fake negative test certificates scandal. On the other hand, facing their own liquidity challenges from sales disruption, cancellation of purchasing contracts by Western retailers negatively affected the factory owners and workers of the Bangladeshi garment industry.
At the same time, one must consider the challenging democratic consolidation process in Bangladesh, which sustained the environment that led to the issuance of fake healthcare certificates. For this purpose, one may take an institutional approach to democratization (actually, the lack thereof) for fathoming corruption. This approach usually emphasizes the lack of robust political parties during a period of rapid increase in political participation (Huntington 1970, 495, 499-500), but in matters regarding corruption there is also a broader debate between ineffective institutions versus democratization itself (Robinson 1998, 2). Democratization can proceed at one of three levels: transition, consolidation, and perfection (Denk & Silander 2012, 26). Democratic transition from an authoritarian regime - or upon independence - can happen through one of three processes: collapse (breakdown), extrication (weakening), and transaction (negotiation) (Share & Mainwaring 1986, 178-179; Baaklini et al. 1999, 29; Baloyra 1986, 9-12; Monclaire 2006, 64). In hop-skipping a strongly grounded democratic transition, Bangladesh has fallen short in democratic consolidation (Johnston 2004, 139, 144; Monclaire 2006, 63, 69; De Oliveira 2006, 127-128, 142-143) despite several national elections since the country’s independence in 1971 (Akhter 2001, 25, 178). Most significantly, democracy in Bangladesh did not go through the expected transition process involving a political pact, national dialogue, and legislative autonomy (Baaklini et al. 1999, 33-43) and this had significant implications for governance as manifested in the endemic institutional and societal corruption.
In a 2013 speech, the then World Bank President Jim Yong Kim famously declared corruption “public enemy no. 1” in the developing world. Bribery, profit maximization, and favouritism are the three main instruments of corruption (Heidenheimer 1970, 4-6; Rothstein & Varraich 2017, 12). This ensues when policymakers abandon public interest for private interest. Transforming public goods into private greed degenerates the political system itself (Rothstein & Varraich 2017, 13-15; Rothstein 2011, 12). There are three ways of dealing with corruption: repression (penalty), integrity (trustee), and prevention (Lambsdorff 2007, 225-227; Mungiu-Pippidi 2015, 80-82). Inept political leadership does not help the control of corruption. Whereas the Roman (Cicero) legacy focuses on the individual or private goods and equality of citizens, the Greek (Aristotle) tradition stresses the collective or public goods and morality of citizens (Rothstein & Varraich 2017, 35-36, 40-41; Rothstein 2005, 203-204; Mungiu-Pippidi 2015, 58). When corruption becomes a way of life, as is the case in Bangladesh, procedural “impartiality” (Rothstein 2021, 3-6, 14-15, 114, 151; Rothstein 2011, 14; Rothstein & Varraich 2017, 97) does not overcome the substantive lack of principled principals. Leadership matters for social capital (Putnam & Goss 2002, 17; Rothstein 2021, 4), and so does integrity for effective leadership. Singapore and Hong Kong are exemplary for corruption control (Uslaner 2008, 204). In Bangladesh corruption has degenerated from the limited elite stage to a pervasive rampant reality (Alatas 1999, 17-20; Rothstein & Varraich 2017, 26-27). At the same time, when it comes to both garment and manpower exports, Bangladesh is in a relationship of vulnerability interdependence with the more developed economies.
Accounting for 80% of total export earnings (World Bank 2021, 26) and an annual price tag of US$7 billion, the RMG sector holds the highest share of exports for Bangladesh. The European Union imports 75% of its textile from Bangladesh. In the United States, the Walmart Corporation is also a major importer of RMG from Bangladesh (Singh 2007, 10, 13, 15). International orders are generally placed three months ahead of delivery and finished products are paid for only after receiving them. Job loss for the workers during the pandemic not only denied future income, but also unpaid back wages. During the COVID-19 pandemic Western retailers exercised their contractual rights to cancel existing orders that were “already completed” (emphasis in original) or “already shipped.” Furthermore, 91.3% of the name brand giant retailers that cancelled their orders with Bangladeshi factories disavowed to pay the suppliers. Consequently, about 58% of the factories in Bangladesh were partially or completely forced to close, which resulted in unemployment for more than a million garment workers. In violation of a Bangladeshi law that requires payment of partial wages for furloughed employees, 98% of the international buyers refused to contribute. That resulted in 72% of the workers being sent home without pay (Pham 2020, 317-319).
After losing about US$3 billion because of the pandemic, the RMG sector anticipated a total loss of US$6 billion. As it is, 47% of the RMG laborers were already not getting their wages. Within this context, it should be emphasized that the RMG sector sustains also a US$6 billion backward-linkage industry. This includes yarn fabrication, texture creation, and colouring-printing. In employing 7.8 million people, the RMG sector provides livelihood for 31.2 million people (Islam et al. 2021, 120-122). In the 2020 fiscal year, apparel production dropped by 16.8% because of supply-chain disruptions and suspension of international orders. Although there have been significant job losses in the RMG sector, they were partially overcome by reinstated international orders and resiliency in remittance inflows (World Bank 2021, 3-4, 26-27).
Given the unemployment challenge and the importance of remittances for the state treasury, manpower exports are crucial for the economic viability (and political stability) of Bangladesh. Adding to the earlier market presence in the Gulf Cooperation Council (GCC) countries, Bangladeshi labour migration to Southeast Asia and to Europe developed significantly during the last decade. Currently, most of the Bangladeshi migrant workers are in the Middle East (GCC) and Southeast Asia (Malaysia). Many others are also in the United States and the United Kingdom (Mohiuddin 2020). According to the Central Bank of Bangladesh, the estimated 12 million Bangladeshi migrant workers sent back about $19 billion in remittances ([Deutsche Welle] 2020; Sullivan 2020), with expatriates from Saudi Arabia sending the most, i.e. over US$3 billion in the 2020 fiscal year (World Bank 2021, 11). Around the same time, about 35,000 Bangladeshi expatriates were diagnosed with COVID-19, with almost half of them (i.e. 16,000) being located in Singapore, and more than 800 deaths from SARS-CoV-2 infection being reported within the Bangladeshi expatriate community (Mohiuddin 2020).
In Italy, there are over 100,000 Bangladeshis legally residing in the country, and about 30,000 of them live in Rome. There are also about 45,000 Bangladeshi illegal immigrants in the country. The migrants work in tourism, catering, and the agriculture sector. Others are enrolled in educational institutions ([Deutsche Welle] 2020). The continuous reporting of Italian newspapers about a surge of COVID-19 cases among the Bangladeshi community in that country brought the Regent Hospital case and the Bangladeshi healthcare corruption to both local and international attention. For instance, Giuseppe Mazzara, a spokesman from the Lazio region (which includes Rome), stated that among the more than 6,000 coronavirus tests in June 2020 for travellers from Bangladesh, 191 tested positive (Anik 2020; Gettleman & Yasir 2020). And when Alessio D’Amato, an Italian health official in Lazio, called the July 6 flight from Dhaka a “veritable viral ‘bomb’ that we’ve defused,” the Bangladeshi community in Rome became stigmatized as “viral bombs” ([Deutsche Welle] 2020).
Most significantly, after 37 passengers in Rome tested positive for SARS-CoV-2, Roberto Speranza, the Italian Health Minister, ordered the suspension of all flights from Bangladesh. Pierpaolo Sileri, the Italian Deputy Health Minister, estimated that at least 600 Bangladeshis living in Italy were infected with SARS-CoV-2 (Anik 2020). In early July 2020 Italian authorities sent back 168 Bangladeshis arriving at Rome and Milan airports. Another 377 passengers were refused entry upon arrival in Rome. While noting that some 1,600 Bangladeshis travelled to Italy without the COVID-19 fake certificates, the Bangladesh Foreign Ministry regretted that some compatriots failed to practice mandatory quarantine upon reaching their destination. At the same time, a number of Bangladeshis returning to Japan and South Korea, and carrying false negative test certificates for COVID-19, tested positive. Consequently, these two East Asian countries also suspended flights from Bangladesh (Anik 2020; Gettleman & Yasir 2020; Bin Habib & Adhikary 2020).
The COVID-19 pandemic had already disrupted both the garment exports and labour migration, the two major foreign currency earning sectors of the Bangladeshi economy. Within this context, a healthcare scandal involving fake certificates for COVID-19 tests had a devastating effect. Former Bangladeshi Ambassador Humayun Kabir remarked that the Regent Hospital COVID-19 corruption hurt Bangladeshi expatriates abroad, tarnishing the image of the country of their origin. Furthermore, this case of corruption would increase the risk of COVID-19 transmission, cautioned at that time Muzaherul Huq, former Southeast Asia regional advisor for WHO (Bin Habib & Adhikary 2020). This socio-political environment in Bangladesh is the result of half a century of failures in democratic consolidation.
In Bangladesh, the democratization process left unsolved the foundational national identity puzzle. The country has yet to resolve the contestation between co-ethnic (cross-border) linguistic, secular Bangali nationalism, and geographical (transnational) territorial, religious Bangladeshi nationalism (Akhter 2001, 57). Uncivil recriminations have become poor substitutes for a national dialogue among the three major political parties - Awami League (AL), the Bangladesh Nationalist Party (BNP), and the Jatiya Party (JP-Ershad). Despite multiparty elections and parliamentary seats, majoritarian domination of the prevailing ruling majority political party - notwithstanding the party in power - has jettisoned any thought of legislative autonomy vis-à-vis the executive branch. In practical terms, what all these mean for Bangladesh, especially when compared for instance with the similar long and convoluted democratization in post-independence Brazil (Share & Mainwaring 1986, 177; Balorya 1986, 50), is that after half a century of independence the political landscape in the country is on a never-ending path of democratic transition process.
This process includes a substantial authoritarian interlude. The first phase of the democratization was a parliamentary democracy under the AL rule. This was followed by military dictatorship disguised as presidential democracy, then parliamentary democracy was reinstated in the third and current phase of this meandering road of Bangladeshi democratization. More specifically, shortly after the 1971 independence, Bangladesh started to slide from a parliamentary democracy to a one-party political system – Baksal (Bangladesh Krishok Sromik Awami League; krishok = agricultural worker, sromik = labourer or factory worker). That came to a halt following the 1975 assassination in a military coup of Sheikh Mujibur Rahman, the founding figure of the new state. The consequent civil-military relations resulted in two successive military regimes (i.e. of Ziaur Rahman, assassinated in 1981, and of Hussain Muhammad Ershad) disguised under a presidential system (Akhter 2001, 118, 137-138, 178). Thereafter, since 1991, in providing party leadership by virtue of family association – “politics of kinship” (Idem, 221) – Khaleda Zia (widow of Ziaur Rahman) and Sheikh Hasina Wazed (daughter of Sheikh Mujibur Rahman) served as prime ministers in a reverted parliamentary system under the Twelfth Amendment (Hossain 2015, 7).
In Bangladesh, political corruption is significantly manifested in electoral corruption.This leads to the breach of constitutional principles and unscrupulous practices, including election rigging. For instance, 13 of the 22 elections in the first three decades since the 1971 independence were under authoritarian rule. In fact, the country experienced electoral corruption for 16 years under military or military in civilian clothes from August 1975 to December 1990. Party politics has thereafter continued to be contested over election integrity in an atmosphere of distrust and incivility (Akhter 2001, 14, 17, 19, 25, 29, 224-228). Incorporated into the constitution of Bangladesh under the 1996 Thirteenth Amendment (Hossain 2015, 7-8), the institution of the non-party caretaker government (NCG) had to be invoked to be part of the political process for the transfer of electoral power (Akhter 2001, 178-179, 224, 227-228). A 2003 amendment by the then ruling party BNP to increase the retirement age from 65 to 67 years for Supreme Court judges (who can be part of NCG) did not go well. In installing himself as the chief advisor and ignoring the council of advisors, the president further muddled the waters. After BNP holding off any offer of negotiation for more than a year, the proposed dialogue between AL and BNP proved to be futile. This was followed by a dispute over the voter list for the 2007 general elections, for which the Supreme Court eventually intervened. This made Kanti Bajpai, an Indian academic, to observe that both AL and BNP have devalued democracy (Singh 2007, 1-3, 15). The NCG was once again brought into the spotlight in 2021 in connection with the upcoming elections in the country ([DBC News] 2021). Not least, in addition to illiteracy and poverty, which favour vote buying, patron-client relationship is also a significant factor for electoral corruption. Political instability, socio-economic pitfalls, and weak democratic values have entrapped the society into a highly problematic electoral culture that has hindered democratic consolidation (Akhter 2001, 224-228).
In May 2020, the Bangladeshi government proactively announced a US$14.6 billion COVID-19 response program, which represented 4.5% of the country’s estimated GDP for the 2020 fiscal year. The program included a 100% reimbursement for workers in export industries. US$11 billion was allocated for the social security sector; US$2.4 billion loans went to the Cottage, Micro, Small, and Medium Enterprises (World Bank 2021, ii, 15; Lata 2020). However, lower prices and lockdown created a crisis in rural areas, especially for dairy farmers, vegetable producers, and poultry farmers. Furthermore, since social programs had been directed at reducing rural poverty, the urban poor found themselves in dire circumstances without the benefit of savings and social safety nets (Lata 2020; Sarwar et al. 2020, 19). Nevertheless, in late April and mid-May 2020 the government provided food relief and cash payments to the country’s floating population, including street vendors and those engaged in manual labours. Local administrators and elected representatives were solicited to identify these beneficiaries. The process lacked transparency, accountability, and integrity. Reflecting the prevailing corruption practices of political favouritism and nepotism, some middle-class people affiliated with the ruling AL also usurped that government largesse (Lata 2020).
In the corruption scandal of fake COVID-19 certificates, along with the Regent Group Chairman Mohammad Shahed and Managing Director Masud Parvez, fifteen other staff members were accused (Rabbi 2020). Ariful Chowdhury, Chief Executive Officer of JKG Health Care, and his wife Dr. Sabrina Sharmin Hussain, JKG Health Care Chairperson (although she denied being the chairperson and claimed she only did consultancy work) were also arrested, and the latter, a medical doctor at the public National Heart Institute and Hospital, was suspended by the Health Ministry from her position at the hospital (Bin Habib & Adhikary 2020; Tipu 2020; [The Daily Star] 2020). The COVID-19 corruption syndicate included medical doctors, hospital staff, pathology technicians, graphic designers, and information technology specialists. After unscrupulously obtaining a few original certificates, these were then scanned to prepare fake documents. On the 6th of July 2020, the police seized about 10,500 COVID-19 samples from the private Regent Hospital at its Uttara and Mirpur branches. Among these samples about 60% proved not to have been tested. The police also recovered 40 forged COVID-19 certificates with fake logos. Those who demanded COVID-19 negative certificates included workers returning to garment factories. Ironically, public servants were acquiring COVID-19 positive certificates for accessing special facilities offered to such patients, as well as taking leave from office (Anik 2020; Sullivan 2020).
Mohammad Shahed, the owner of the private Regent Hospital in Dhaka, had his employees print fake COVID-19 results, while billing the government for treatment and care of coronavirus patients. It is noteworthy that the Director General of the Health Services (DGHS) signed a contract with the Regent Hospital, which had not renewed its license for the past six years, allowing it to operate as a designated facility to handle COVID-19 cases (Rabbi 2020). In the context of the scandal, the DGHS issued a statement that the agreement with the Regent Hospital for treating COVID-19 patients was signed upon orders from “higher-ups” in the Health Ministry (Hasan 2020). The media reported that traders of garments, auto parts, and electronics secured lucrative deals from DGHS for delivering medical supplies. Along with irregularities regarding N95 masks, money was siphoned off in shady deals among medical and business elites. The failure to develop testing capacity and infrastructures for isolating infected individuals resulted in patients being denied admission to designated COVID-19 treatment hospitals. Administrative mismanagement and the apathy of the medical staff have led patients to die at home rather than go to the hospital (Maswood 2021). In short, the case illustrates how mismanagement and corruption spreads throughout all sectors and every level of the society in Bangladesh. These are reflective of the administrative practices and political leadership in the country.
A World Bank (2021, 29) update on Bangladesh observed that “fragmented governance” undermined coordination and efficiency, fostering siloed development. In neglecting services for the people, patchwork regulations and administrative dysfunction fail to deliver public goods. Multiple ministries and numerous government agencies create bureaucratic redundancies, confusion, and red tape. With corrupt businessmen stockpiling coronavirus testing kits, private medical facilities have been charging inflated prices per test (i.e. US$50-60), prohibitive for most of the population. At the same time, on the 5th of August 2020 a government edict restricted law enforcement investigations into hospital malpractices. The healthcare sector in Bangladesh was so disorganized that in June 2020 a team of visiting Chinese physicians expressed concern about incompetence in the healthcare administration (Al-Zaman 2020, 1-2).
For the very crucial garment industry, better wages and improved working conditions are likely to avoid periodic unrests from protests by the work force (Singh 2007, 11-13). In this context, professional law enforcement measures in stopping fake medical documents are also essential for saving the migrant labour force and domestic garment workers from job insecurity and wage loss. Yet, unless enforcement mechanisms are adhered to against corruption, and not just limited to lateral transfer to another post, resource allocation and utilization will suffer. More tests need to be administered to identify, quarantine, and treat infected people. Hospitals should have the necessary equipment and medical supplies. Medical professionals and staff must be protected from infection. Educational information about proper hygiene and social distancing needs to be periodically disseminated using multiple channels (Al-Zaman 2020, 2). Given the importance of foreign direct investment for the economy, expedited government decisions and better services in the transportation sector are expected to make the investment climate more attractive (World Bank 2021, 27-28, 31; Singh 2007, 11) .
However, as both internal and outside observers have acknowledged to different degrees, endemic corruption remains a particularly difficult challenge. For instance, Ambassador Humayun Kabir regretted that the Regent Hospital healthcare corruption reflected “domestic governance problems” (Bin Habib & Adhikary 2020). Muzaherul Huq, former regional advisor for WHO, scathingly remarked that COVID-19 exposed the “muddled, weak and corrupt” healthcare system in the country, while Iftekhar Zaman, executive director of Transparency International Bangladesh, found it resentful that some people engaged in illegal and quick money-making ventures during the COVID-19 pandemic (Maswood 2021). In the middle of all these, the May 2020 arrest of Rozina Islam, a female journalist for the Prothom Alo (First Light) Bangla language daily newspaper, for investigating COVID-19 related government corruption further embarrassed the Bangladesh Foreign Minister A.K. Abdul Momen (Zaman 2021).
Bangladesh has achieved economic success with earnings from apparel exports and remittances from manpower supplies. The RMG sector has secured lucrative contracts from retailers in the United States and the European Union. Migrant work force has found substantive salaries from employment in the Middle East, Southeast Asia, and Western Europe. Despite accomplishing notable achievements within the Millennium Development Goals framework and being considered by some accounts a middle-income country, UNCTAD still lists Bangladesh among the least developed countries in the world. The common thread for Bangladesh in these two export sectors is the cheap labour resulting from an exponential population explosion. Very closely tied to fluctuations in global markets, the ripple effects of COVID-19 pandemic have shown the vulnerability interdependence of Bangladesh with the industrialized economies of the West and the rentier economies of the oil-exporting sheikhdoms of the Middle East.
Three days before the WHO declared the spread of the SARS-CoV-2 virus a pandemic, Bangladesh reported its first COVID-19 case. The vulnerability of the health sector was quickly visible, within the context of a profound lack of resources and funding. The government had to wait for external donations to start the coronavirus vaccination campaign, months after richer countries initiated their vaccination programs and about a year from the first case of infection confirmed in the country. The vulnerability of Bangladesh was further revealed with the devastating revelation of the fake COVID-19 certificates issued by the Regent Hospital in Dhaka. The Bangladeshi migrant community in Italy was stigmatized and the migrant work force faced financial jeopardy in being barred re-entry. Flights between Bangladesh and Italy, and then those connecting Bangladesh with Japan and South Korea were cancelled for fear of spreading the SARS-CoV-2 virus. Though shocking due to its size and impact, the COVID-19 fake certificate scandal was not surprising in a country where corruption is rampant and pervasive.
The socio-political context that sustains this degree of corruption has roots in the authoritarian back sliding of the first civilian government and the subsequently transformed civil-military relations. With the multiparty political system jettisoned for a single-party rule, two successive military regimes usurped power and further derailed the democratic experiment. The cosmetic democratic trajectory has been on a never-ending transition. The process did not promote national dialogue and negotiations for a political pact. Legislative autonomy has not been a reality throughout the meandering democracy of parliamentary and presidential electoral systems. While Bangladesh is a democracy by virtue of holding periodic elections, there have been recriminations of voter list manipulation and vote rigging. The atmosphere of distrust and incivility surrounding election integrity has forced the two major political parties to seek impartiality in the institution of the non-party caretaker government. Entrapped into a highly problematic electoral culture, the corruption of the political parties has left its mark on other institutions in the country.
The COVID-19 fake certificates syndicate case revealed a more complex corruption puzzle that includes multifarious players. The Health Services concocted lucrative shady deals with various stakeholders in the business sector. The state of health administration is even more troubling when one considers that the Regent Hospital operated without renewing its license for six years prior to the scandal but, at the same time, it was issued a contract by the Health Services as a designated COVID-19 treatment facility. Fragmented governance facilitated corrupt practices by those shrewdly cultivating social connections with the power elite. Within this context, leadership integrity is paramount for good governance and generating public goods.
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All links were verified by the editors and found to be functioning before the publication of this text in December 2021.
Rolin G. MAINUDDIN, PhD (ORCID iD: https://orcid.org/0000-0002-3362-8246) is an Independent scholar based in the USA. rolinmainuddin@gmail.com
An earlier version of this article was presented at the 7th international interdisciplinary conference of political research SCOPE: Science of Politics (University of Bucharest, 20-24 September 2021, virtual), as well as the 3rd Research Methods School on Corruption and Corruption Control Analysis (CORAN) (University of Lisbon, Portugal, 27-30 September 2021, virtual). The author would like to thank Julia Gracia, Luis de Sousa, Luciana Alexandra Ghica, Georgeta Ghebrea, and the two anonymous reviewers for helpful comments.
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MAINUDDIN, Rolin. 2021. Bangladesh healthcare corruption and workforce vulnerability amidst the COVID-19 pandemic. Analele Universității din București. Științe Politice [Annals of the University of Bucharest. Political Science series] XXIII (2): 225-243. https://doi.org/10.54885/TXMS6637