Brazil, a Sad Tale of Government Failure

"Every shift it was like that [a lack of ventilators forcing doctors to choose who might survive and whose condition was so dire they might not, to decide who would get the ventilator and the opportunity to survive COVID-19]."

"Sometimes, I would give them [seriously ill patients] sedatives just so that they didn't suffer. Eventually, they would pass away." 

"It's very difficult to accept things you know are wrong."

Dr.Pedro Archer, surgeon, municipal hospital, Rio de Janeiro

"It ended up creating a perfect storm for corruption."

"The pandemic allowed governments to spend significant resources very quickly while internal controls were relaxed due to the emergency."

Guilherme France, research director, Transparency International, Brazil

The Maracana campaign hospital is seen next to the Maracana stadium amid the coronavirus disease (COVID-19) outbreak in Rio de Janeiro, Brazil September 16, 2020. REUTERS/Pilar Olivares

 

 

In Brazil the public health system was quickly flooded with COVID-19 patients, where people struggling to breathe were mentally divided into two groups; the health-impaired elderly who might not survive even if heroic efforts were made on their behalf, and the others who were though ill with the virus, in superior physical shape who were more likely to survive with the use of a ventilator. Ventilators in such short supply that doctors had little option but to quickly gauge such situations and come to a reluctant determination that some would live and others would not.

This is a scenario that played out elsewhere, not just in hard-hit Brazil. Italy and Spain too were overwhelmed by COVID cases, their hospitals stretched to their limits and beyond. Ventilators were in short supply everywhere. Even in Canada where the first wave of COVID cases failed to inundate hospitals as expected with more patients than they could care for, those very same scenarios of choosing who would survive played out beforehand as a potential scene that thankfully failed to materialize.

The deaths in Brazil are now viewed as entirely avoidable in theory though practise and reality made it otherwise. Federal and state prosecutors allege top officials in the country were more fixated on enriching themselves personally than planning for legitimate, trustworthy contracts to provide the badly needed health supplies and personal protection equipment, which resulted in the critical shortage of medical devices to face the emergency of respiratory distress due to COVID.

Top officials in the country saw $72.2 million ending up in their bank accounts thanks to corrupt schemes to steer inflated state contracts to allies in self-serving plots to defraud the country and deny it the equipment to leverage control over the virus and save Brazilian lives, according to prosecutors. Three contracts for a thousand ventilators, claim the prosecutors, were signed with the intention of favouring corrupt officials' bank accounts, and in the event most of the ventilators were never received.

In July, Rio state Health Secretary Edmar Santos was arrested, charged with corruption related to those contracts. Rio state Governor Wilson Witzel was suspended from office in August, reflecting concern he could interfere with the investigations, even while he is facing impeachment proceedings over alleged graft. Even as Latin America as a whole has been stunned by the ferocity of the pandemic, with 8.9 million cases by September 24, over 139,000 COVID deaths have been registered in Brazil alone.

Bolsonaro greets supporters upon arrival at Planalto Palace in Brasilia, on May 24, 2020, amid the COVID-19 coronavirus pandemic.

 

Over ten thousand people have perished from COVID-19 in the city of Rio itself; 18,000 in the state of Rio de Janeiro. Poverty and crowded urban conditions are partially to blame for the situation. And it has been anything but helpful that Brazil's President Jair Bolsonaro has minimized the severity of the epidemic; infamously he has compared the disease to a common cold. Perhaps he feels differently now that he has the experience of recovering from the virus.

Brazilian prosecutors have zeroed in on what they describe as a series of interrelated criminal enterprises where contracts for masks, coronavirus tests and hand gel sanitizers have all been rigged, expressing the opportunistic corruption so irresistible to those in authority who feel they will be able to mask their corrupt plans for enriching themselves, robbing the population of the necessary safety equipment to see them safely through the pandemic.

 

As Latin American countries cope with the pandemic, investigators are probing whether funds to pay for protective equipment, medicine and other essentials are being misused © AFP via Getty Images

 

The state called for seven field hospitals to be built for the treatment of COVID-19 patients, where the state health ministry -- SES -- awarded contracts to the value of $151 million to a non-profit health group, IABAS was directed to construct the structures to open by the end of April. Of the seven, two were opened to date, one in May, the other June, long after the first surge of COVID-19. These contracts are seen to comprise a portion of a kickback racket managed by a local entrepreneur.

That man, Mario Peixoto, had been arrested in May on charges of defrauding the Rio state health system, federal court documents describing a complex scheme where Peixoto's associates arranged for bribes routed to government officials in the interests of securing public health contracts, among them for the field hospitals. IABAS had drafted its winning proposal prior to the SES having solicited offers. Four of the seven field hospitals were incomplete in early June when Rio state cancelled the contract with IABAS and took control of all project sites.

A little-known company, Arc Fontoura, was awarded a contract worth $12.3 million  for 400 ventilators to be delivered immediately, toward the end of March. The health ministry, according to state auditors, paid close to a 200 percent markup from the market price for the ventilators, only a small batch of which had been received from the company, leaving hospital workers complaining the machines that were delivered were lacking key components.

Two additional firms were awarded contracts to the value of $20.9 million to supply 300 ventilators each. According to court documents, these shady enterprises submitted their proposals less than an hour after SES opened the tender, though it hadn't been advertised beforehand; clearly indicating the companies had inside knowledge, according to prosecutors. Of the one thousand ventilators Rio's state health department had ordered, a mere 52 had been delivered, all from the original firm.

Leading the SES to cancel its contract with one of the companies reflecting "the company's inability to deliver" the ventilators. Dr.Archer, the surgeon in Rio de Janeiro, is beyond bitter over his experience leaving him helpless to give needed medical assistance to patients during the peak of the pandemic in April and May when as many as 30 of his patients were left waiting for the arrival of the machines. Many of those patients too unstable to move to hospitals elsewhere and who ended up dying.

"It gives you a feeling of impotence and anger to know that you could have saved more lives and helped more people if resources were not diverted, if supplies were not overpriced,."

"The pandemic comes to expose all these dirty politics and its schemes -- and we are the ones who are the frontline suffering from their actions."

Micaella Melo de Paula, respiratory physiotherapist in a Rio de Janeiro public hospital

Military police walk outside the official residence of Rio de Janeiro Gov. Wilson Witzel on May 26 after a raid by Federal Police as part of an investigation into the alleged embezzlement of public resources.