Two days ago on the web, BackChannels listened to the pleas of a young man in Morocco for relief from lowest-wage labor and daily uncertain employment ($7 per day if it could be found) and exposure to illness and injury and related distress without access to local basic health services. The acquaintance told the story of friends, two among five who for sleep shared a room in a house. One had been stricken with severe stomach pain and the other with a leg injured in a fall, and there followed the story of getting to a hospital, being initially refused emergency care, and persisting in insisting on being seen.
Being seen — eventually the two were, the one with the leg injury being sent home, and the other with severe stomach pain remained in the hospital.
Being made visible – that’s why this post is here.
With online research, it doesn’t take long to connect the absence of simple human decency in the distribution of Moroccan health care in its public facet to the social cancer of pervasive corruption. In fact, corruption appears to BackChannels the chief impediment to the firm establishment and distribution of basic medical services in the state.
There appears in numerous reports the petite corruption of patients bribing the doctors to rush the que.
How rude!
However, of greater concern may be the business to privileged business way of doing business, i.e., what is referred to as institutional or “grand corruption”, and that appears suppressed: nonetheless, one picks up from the literature notes associated with bribery, nepotism, profiteering, skimming, and stealing — all the many possibilities available to the feudal and ruthless.
Who diverted money budgeted for facilities maintenance and how was it really spent?
Who took the medicine or failed to protect it in storage?
Equipment or medicine damaged or stolen would seem the same thing — i.e., useless — to doctors and their patients.
Where is the money going?
Who is getting it?
What are they doing with it?
BackChannels has no idea although reading Gulain P. Denoeux’s 1999 or 2000 report may raise awareness of the tension between a feudal systems of absolute power — and lenience and patronage — and a modern rule-of-law system engaged in independent investigation, administrative and judicial oversight, and associated regulation with corrective measures and penalties specified.
This blogger’s impression, which could change with the next reference piece, is that both external forces and internal pressures have made corruption a major theme in Moroccan governance, and while related policies and laws have been developed to address issues, they have yet to be vigorously implemented by King Mohammed VI who needs must balance the legacy relationships of powerful families and institutions in situ with the state and its quest for a political modernity that cares for, enfranchises, and empowers a broadening swath of the less visible Moroccan population.
In the manner of kings, Mohammed VI this past summer shifted culpability for the death of a fishmonger trying to recover a swordfish — caught out of season — from the garbage truck (in which police had by implication thrown it) to local political authority while pressuring the same to do their work:
“If the King of Morocco is not convinced by the way political activity is conducted and if he does not trust a number of politicians, what are the citizens left with?” Mohammed VI said during a televised speech commemorating the 18th anniversary of his ascension to the throne.
“To all those concerned I say: ‘Enough is enough!’ Fear God in what you are perpetrating against your homeland. Either carry out your duties fully or withdraw from public life.”
Often in the feudal mode, appearance may be made to suffice for performance.
In the modern world, that’s not enough: the conditions of things, the states of affairs come out in open observation and statistics, and today that observation is global.
To get public health distributed as needed — as deserved and as befits the humanity and image of the state — Morocco needs greater economic development supported by rule of law and capable of sustaining revenues within the state and seeing a greater part of that confidently distributed in the public interest.
One may paint the hospital’s new oncology wing to avoid a king’s ire while also making him look good, but one may not paint over the misery of suffering alone in pain and uncertainty without recourse to accessible basic clinic services staffed by personnel educated and trained for the purpose.
Reference
Alami, Aida. “Morocco’s Health Care System in Distress.” The New York Times, March 27, 2013:
It was a makeover fit for a king, Mohammed VI, whose visit, to inaugurate a new oncology wing, was later broadcast on national television. But it did not do much to mask the reality of health care in Morocco, where even Health Minister Houssaine Louardi has conceded that standards of care for the country’s 33 million people are far from adequate.
Public hospitals are decrepit and lack doctors, equipment and medicine, and fewer than 30 percent of Moroccans have health insurance coverage.
Al Jazeera. “Moroccan king pardons more than 1,000 protesters.” July 29, 2017:
The Rif, a predominantly Berber region where al-Hoceima is located, has been gripped by months of unrest.
Protests erupted last October after a fishmonger was crushed to death in a rubbish truck as he tried to retrieve a swordfish confiscated for being caught out of season.
Demands for justice later snowballed into a wider social movement named Al-Hirak al-Shaabi, calling for jobs, development and an end to corruption.
Council of Europe Portal. “Anti-corruption digest, Morocco”.
Euromed Rights. “Morocco / Western Sahara”.
A broadly worded article in the Moroccan penal code criminalizes receiving support from foreign organizations with the purpose of “harming the integrity, sovereignty or independence of the Kingdom, or shaking the loyalty that citizens owe to the state.” This article can be used to penalize a wide range of legitimate forms of expression and association and to curtail the right of Moroccan civil society to seek funding freely as guaranteed by the international human rights conventions to which Morocco is party
Export.gov. “Morocco – Corruption”. September 21, 2016.
France 24. “The grimy reality of Morocco’s public hospitals.” The Observer, March 31, 2015:
Blocked pipes, mouldy walls, wet blankets and a shortage of supplies: this is what users of Morocco’s public health system have to deal with. Dozens of photos published on Facebook have shed light on the grime reality of the country’s public hospitals. According to our Observer, it reveals a disastrous state of affairs that the government’s privatisation plan won’t be able to fix.
Friedman, Thomas L. “The Globalutionaries”. The New York Times, July 24, 1997.
The Suharto regime allows no space for a democratic opposition to emerge. So what the pro-democracy, pro-clean-government forces are relying on is not a revolution from below, not a revolution from above, but a revolution from beyond.
Their strategy is to do everything they can to integrate Indonesia into the global economy on the conviction that the more Indonesia is tied into the global system, the more its government will be exposed to the rules, standards, laws, pressures, scrutiny and regulations of global institutions, and the less arbitrary, corrupt and autocratic it will be able to be.
GAN Business Anti-Corruption Portal. “Morocco Corruption Report.” October 2016.
Snapshot
Corruption represents a problem for businesses in Morocco. Almost all sectors suffer from rampant corruption. Cultures of patronage, nepotism and wasta (the use of connections) exist, and inefficient government bureaucracy and excessive red tape deter investors. The legal framework concerning corruption, transparency and integrity is in place, and the regulatory system is becoming increasingly transparent. Under the Moroccan Criminal Code, active and passive bribery, extortion, influence peddling and abuse of office are illegal. Anti-corruption laws are reportedly not enforced effectively by the government. Prosecutions of corruption cases have been accused of targeting only petty corruption, and, allegedly, companies owned by highly influential persons are rarely disciplined. Facilitation payments and giving and receiving gifts are criminalized under Moroccan law, but businesses indicate the likelihood of encountering these practices is high.
The report goes on to comment on Morocco’s judicial system, police, public services, land administration, tax administration, customs administration, public procurement, natural resources, legislation, and civil society.
Global Integrity. “Morocco – Country Findings Summary.” Africa Integrity Indicators. 2016.
Partnership for Transparency – Health Services.
Transparency International. “Moroccan Honoured for Taking on Health Corruption”. February 3, 2014.
What are Morocco’s expectations for the 6th session of the UNCAC Conference of States Parties (COSP)?
It’s a UN process. All UN processes are slow because you need consensus and you cannot force governments to agree to anything. Still it’s worth noting that more and more countries accept evaluation, country visits, publication of full review reports. It’s less and less comfortable for the countries that oppose transparency. Morocco will work to help to make progress in the review process at the next COSP session, although I remain sceptical about reaching quick achievements
What is Morocco’s position on holding a discussion of grand corruption at the UNCAC Conference of States Parties (COSP)?
I think the UNCAC COSP can discuss grand corruption. Transparency International should elaborate instruments for this. The Corruption Perceptions Index is biased towards petty corruption—it does not point out grand corruption or institutionalised corruption.
Wikipedia. “Health in Morocco”.
Wikipedia. “Mohammed VI of Morocco”.
World Health Organization. “Country Cooperation Strategy at a Glance”.
Posted to YouTube April 24, 2015.
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BackChannels 
Having spent childhood on foreign soil I can attest to healthcare deficiencies. The poor must purchase intravenous fluids from a local pharmacy. This manner of business also applies to antibiotics, wound dressings – practically everything. The saddest of memories is the small child who died after cranial surgery in a filthy ward with her final hours spent lying on a dirty mattress without a sheet. My mother bathed and dressed this small human being after her demise. This act – still haunts her.
The world outside of the U.S. can be composed of islands of wealth surrounded by oceans of misery.
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