Collective Reveals Deficiencies In Romanian Healthcare System And Reflects International Healthcare Concerns

On October 30th, 2015, a fire in the Colectiv nightclub in Bucharest, Romania, immediately killed 27 people. Romanian citizens took to the streets, furious that the nightclub’s lack of fire exits did not meet fire safety regulations, but also because victims who had a good chance of survival were dying in hospitals. Collective, a film that was nominated for this year’s Academy Awards for best documentary, follows a team of investigative journalists from the sports newspaper Gazetta as they discover that the reason behind these hospital deaths was the use of watered down disinfectant. Hexi Pharma, the company that produced it, had offshore companies and was bribing hospital managers to buy its product. Reports on the situation had been sent to State Security Services starting in 2008, but the government did nothing to respond to the issue. The subsequent protests against corruption forced the Social Democratic prime minister to resign, and a government of technocrats was put in place for a one-year term.

Catalin Tolonton, the journalist in the film who led the investigative team, commented on why his sports newspaper took on the investigation: “People ask us why did we [do] the investigation. Journalists from all over the world feel a lot of pressure, hate speech, xenophobia against them, but we as sports journalists are trained to resist this type of pressure. Everyone is unhappy when they read your chronicle of a game. The second explanation is that you need an outside man to tell the truth here in this city. And you need an outsider from the health system to write about the health system.”

Six years after Gazetta revealed corruption in Romanian healthcare, there have been several changes to the system. Doctors’ salaries have been raised two to three times, now averaging 3,000-5,000 euros per month. “This [salary] is not a huge amount, but for a Communist country, it means a lot,” Tolontan said. But he added that there are also many problems, like doctors moving out of Romania to work in other European countries and a new lack of trust in healthcare: “Growing up in a Communist country, doctors were like gods. After the Colectiv fire, everything has changed. If people don’t trust the healthcare system, they don’t go to the hospital. [This results in] a huge death rate in the country.” In the film, hospital managers were charged for corruption, and there were four cases that went to court. However, even after six years, there has not been any verdict for the people convicted and bribery among the hospital staff remains to be proven. 

COVID-19 has further strained healthcare in the country, and within the past year, two preventable fires occurred in Romanian hospitals. In November, a fire in a COVID-19 intensive care unit in the town of Piatra Neamț killed 10 people. Two months later, in late January, a fire in another COVID-19 ward in Bucharest’s Matei Balş hospital―one of Romania’s largest and best-funded hospitals, according to Euronews―killed 12 people. “Piatra Neamț [is] an old hospital,” Răzvan Luţac, another journalist for Gazetta said. “This hospital doesn’t have a system of getting fresh air in.”

The other hospital, Matei Balş, was built in 1953. There is very low government spending on hospital infrastructure (5.2% of GDP, compared to the EU average of 10%), according to Euronews. Since communism ended 31 years ago, only one state hospital has been built in Romania. During the pandemic, hospital-borne infections were still a problem but were not being reported: “Last year, a few months after the start of the pandemic, we asked the health minister how many infections were reported from COVID,” Luţac remarked. “And they reported zero. But we spoke with people in Romania and there were people who died from infections. Six years after the Colectiv [fire], they still don’t declare the infections.”

In a world that is recovering from the coronavirus, corruption within the healthcare system has international relevance. Alexander Nanau, the director of Collective told The New York Times, “the situation was so appalling that basically it should have been a big scandal in the whole of Europe.” During the pandemic, parallel situations could be seen in China, where government officials did not publicize information about the virus outbreak, or even in the U.S., where Donald Trump also kept the initial outbreak quiet and suggested ineffective treatment strategies. In Mongolia, a woman was moved from a non-COVID hospital to a COVID hospital with her baby in freezing cold weather. The incident became a scandal and people in Mongolia claimed they needed to question their authorities, citing Collective. “COVID was timed with when [the film] was supposed to be released,” said George Cragg, the film’s editor. “What happened was that people were watching a lot of stuff, because [they] were stuck in their houses. People started thinking about healthcare and all of these things, and the importance of a national healthcare system that was capable of handling crises. It was good timing for the film. I think the film was well-received but wouldn’t reach as big of an audience if at a different time.”

One of the main take-aways from the film is the power of journalism and a free press in holding institutions accountable. “I hope that what [audiences] can take-away is that no one should become complacent about what is going on in their healthcare system. People have to be extremely vigilant and demand to get rid of corruption, and [also] demand accountability and transparency and value the journalists that are trying to achieve that,” Cragg stated. A free press in Romania could pressure the government to allocate funding into building new hospitals, the private sector to fund public infrastructure, and for there to be control procedures that regulate hospital managers’ behavior. Luţac added that people should start to speak up outside of traditional media outlets: “Normal people not involved in the health system [need] to speak when there is a problem, not only to the press. We had a lot of courageous people in the movie [speak] and they have to be an example for everyone who has a problem. Some courageous people wanted to find the truth.”

People who protested government corruption in the streets after the Colectiv fire led to the resignation of the prime minister, and later, the existing health minister. “After the Colectiv fire, everything changed. After that, [people did their duty] as citizens. They protested, they changed the law. [I’m not talking] about revolution. Collective is not about revolution. It’s about being together and putting pressure on authorities and politicians to make things better,” Tolontan said. He pointed out that when other countries see movies like Spotlight or The Newsroom, they think the media can only bring down corruption in countries like the U.S. When they see Collective, however, they have hope that the press in their countries can do the same thing.

The biggest counter to corruption around the world, in both developing and developed countries, is free press and free speech. Media outlets can prioritize whistleblowing, instead of tailoring and censoring their content. Unfortunately, many governments around the world still do not respect the human right of free speech. International human rights organizations can promote protection of international journalists and call for laws restricting freedom of speech to be lifted. They can also work to give people in countries that censor free speech access to online outlets, where people can express their points of view. It is up to the international community to hold these governments accountable for not prosecuting people who do express their opinions.  

“A young person from Canada told me when Collective ran at Toronto International Film Festival, it’s like a Marvel movie but without superheroes,” Tolontan reflected. “You feel a lot of problems that came in the film and we need superheroes to solve the problems. When we watched the movie, you saw normal people, with weaknesses and vulnerability.” Even despite the slow progress towards concrete change in Romania, the film has sparked international discourse in a time when good healthcare is extremely important. “I don’t know if there’s been any real changes in Romania because of the film,” Cragg said. “There’s been a lot of debate, but I don’t know if there is anything you can identify as concrete change. The world is full of these types of situations, so it is good that this film exists, and it gives a platform to people who are fighting the good fight. I think it does give hope to people, that change is possible.”

Change is possible when people speak up, not only when a crisis occurs, but also continually afterwards. The power of free press and freedom of expression was demonstrated in the film and resonates internationally.

Dayna Li


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