Poland's lively trade in the dead

THE BALTIMORE SUN

LODZ, Poland - What began as well-intended entrepreneurship, mixed with a communist-era mentality and the economic poverty of the free market era, has led to a macabre scandal here that has become known across Poland as the "skin trade."

Ambulance crews are being accused of taking bribes from funeral homes to deliver bodies to them instead of to competitors, and the practice became so lucrative that some doctors might have murdered seriously ill patients.

And ambulance drivers are accused of delaying their arrival in hopes of hastening a death.

Residents of this city - once a hub for textiles and filmmaking - are furious. People have threatened to attack rescue crews. Doctors, fearing for their own safety, are reluctant to go out on calls.

And for a few days just after the scandal broke, almost no one here called for an ambulance.

"The problem is a lack of supervision," Health Minister Mariusz Lapinski said in interview. "As everywhere, you have good people and bad people. We have to get rid of the black sheep."

In a country of modest circumstances, the funeral industry is one field where there are profits to be made. Twelve years after the collapse of communism, the median income in Poland is about 2,200 zloty, or $525, a month.

But a government that can no longer offer the cradle-to-grave subsidies the communist system sought provides one final benefit: an allotment of twice the average monthly income - about $1,050 - to the next of kin for funeral aid.

After surviving the economic reversals of past years, Poles have one thing to look forward to: a nice funeral, a fine coffin, flowers and a decent burial.

This has provided grieving families some emotional comfort in a Catholic country where a respectful funeral is the most important ceremony of a person's life. The afterlife, says Konstanty Gebert, a columnist for Gazeta Wyborcza, is supremely important to most people.

"The Catholic teaching is that this is all prep school and the real life begins after death," Gebert says. "It's also a moral status symbol: 'I wasn't stingy on Dad's goodbye.'"

But this religious devotion and moral obligation have also provided an opportunity for the unscrupulous to make money.

It started in the early 1990s, when one ambulance worker noticed a niche that needed to be filled. Ambulances could only take living people to a hospital; there was no prompt method for taking bodies away to a morgue or funeral home. So Woldzimierz Sumera got a car and began his own business.

He started out by giving his ambulance buddies some vodka or cognac whenever they called to let him know there was a body that could be taken away. There was money in it because the one thing a family could afford was the cost of death, thanks to the government's funeral aid.

Business grew. Others started taking bodies, too. Then funeral homes started offering incentives for drivers to bring bodies to them. Inevitably, money began changing hands and a bidding process emerged, according to Gazeta Wyborcza, the country's largest circulation daily, which has been investigating the scandal. The business took off.

By 1995, ambulance crews were getting 500 zloty for a body, according to the reports. Today they can get 1,800 zloty, nearly $430, and one newspaper headline has dubbed the scandal "coffingate."

Prosecutors from the justice ministry's organized crime division launched a nationwide probe into allegations that morticians paid ambulance crews hundreds of dollars in kickbacks for each body they received for interment.

Fifteen people here - including doctors, undertakers, dispatchers and an orderly - are facing bribery and corruption charges. All but three of them are in detention, including one man who was arrested last fall. He is suspected of offering an undercover police officer a 25,000 zloty ($6,000) down payment to kill a city councilman who also operates one of the largest funeral homes in Lodz, 80 miles southwest of Warsaw.

No murder charges have been filed, but they have not been ruled out, according to various reports, which suggest that some doctors might even have decided to kill seriously ill patients so they could turn them over more quickly to ambulance drivers and funeral homes.

Here in Lodz, Poland's second-largest city with about 800,000 people, 20 investigators from the police department's organized crime unit are currently targeting about 50 suspects, according to police spokesman Jaroslaw Berger.

Some police are also suspected of being in on the scheme.

"Whoever is involved, it will come out," Berger says. "Whoever committed a crime, he'll be stopped."

Depending on the death rate - and there are some wildly conflicting numbers - the grimly named "skin trade" could be a $5 million-a-year business in Lodz alone.

"It is the result of many years of doctors being paid like they didn't finish primary school," one official says. "If a doctor makes $400 a month, that's a lot."

Police are investigating suspicions that some doctors administered lethal injections to patients, using a muscle relaxant called Pavulon. Berger says the use of other drugs is also being investigated.

In addition, ambulance drivers are being accused of responding slowly to urgent calls as a way of producing bodies to sell. One allegedly stopped off at a McDonald's for a hamburger before answering a call.

The so-called "skin hunters," as they've come to be known, carried such pseudonyms as "Dr. Potassium," "Dr. Mengele" and "the Angel of Death." Only one of the doctors has been detained, according to a source familiar with the investigation.

To date, he has been charged only with the relatively minor offense of selling confidential information. It's a crime punishable by eight years in prison, according to Malgorzata Wilkosz-Sliwa, a prosecutor and a spokeswoman at the justice ministry.

But simply arresting those who committed crimes might not be enough, if, as appears likely, the problems are institutionalized in the ambulance services, hospitals and funeral homes.

Slawomir Selder, 32, an orderly who has been detained, is also the regional head of the country's trade union of medical rescue workers.

Besides allegedly killing some patients, doctors are also suspected of blackmailing the families of the deceased. Before signing a death certificate, the doctor has to determine whether foul play was involved or if it was a natural death. The latter means that the body can immediately be taken to the mortuary.

But if the doctor decides it was a suspicious death, the police will be called to investigate, the body will be cut open for an autopsy and the funeral will be delayed.

This is usually too much trauma for a grieving family, and so they agree to the funeral home selected by the doctor. Lapinski's remedy is to have the family's general practitioner sign the death certificates.

The minister also wants to undo the health care reforms of the previous right-of-center government, even though he readily admits that the "skin trade" crisis predates those reforms by many years.

That reform program included decentralizing the system. Now the socialist-led government wants to reassert the ministry's direct authority over the country's ambulance services.

The investigation and prosecutions could take another decade. When it will end, Wilkosz-Sliwa, from the justice ministry says, "Only God knows."

Under communism, when services and supplies were sorely lacking, it was commonplace to offer almost anyone in position of authority a token gift to get what was needed. The payoffs were usually little more than bottles of liquor, and people didn't consider it bribery, or otherwise inappropriate.

Today, many public workers are still poorly paid, and old habits die hard. Corruption remains a serious problem across Eastern Europe, according to the non-governmental organization Transparency International. It lists Poland as the 44th most corrupt country on a list of 91.

"That is a very bad place to be," says Berger, the police spokesman.

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