Body of Evidence

In the industrial town of Lodz in central Poland, they are known as skins. Theyre some of the hottest items on the black market. Prices are high, with buyers paying hundreds of dollars just to get one. Competition for skins is so fierce that some may have even resorted to murder to secure their supply.

The skins in question are, in fact, human corpses, and the determined buyers are Polish undertakers, who are alleged to have paid up to $450 to the countrys paramedics for timely tip-offs of imminent deaths. Alerted to a fatality, representatives from the funeral home rush to the emergency ward to offer their services to the recently bereaved. According to an investigation by Polands leading daily, Gazeta Wyborcza, some paramedics may have deliberately killed patients to collect the kickbacks. Reports of the macabre trade have shocked the nation and further undermined public confidence in a health-care system dogged by poor pay and corruption.

According to police sources, it is relatively common for undertakers to offer money to medical staff in exchange for information about the recently deceased. In Silesia in southern Poland, funeral-parlor operators are believed to have paid around $300 a corpse and supplied paramedics with mobile phones to call in tips. Such payoffs are obviously attractive to medical workers with average monthly incomes of around $250.

The Gazeta Wyborcza investigation detailed these practices, but also provided fresh revelations that some ambulance crews delayed arrival at accident scenes or administered muscle relaxants to increase the chances that a seriously ill or injured patient would die. The newspaper pointed out the suspiciously high use of Pavulon, a relaxant drug, in Lodz, where over 200 ampoules were used by emergency units last year. In Warsaw, which has about twice the population of Lodz, only 90 ampoules were used over the same period. Pavulon is widely employed to obtain muscle relaxation during surgery, mechanical ventilation or general anesthesia but can cause asphyxiation if artifical respiration is not administered.

State authorities were quick to respond to the Gazeta Wyborcza investigation, banning the use of Pavulon by emergency medical crews and ordering a country-wide review of past users of the substance. But it was too little too late for horrified Poles. Some people hurled stones at passing ambulances, while others refused emergency treatment. Calls from relatives suspecting foul play in the deaths of loved ones have flooded police phone lines across the country. “I can only apologize to the families of the deceased,” said Deputy Health Minister Aleksander Naumann. President Aleksander Kwasniewski called the alleged practices “paralyzing,” adding, “It is difficult to speak about a crime here. One has to speak about degeneracy, deviation from all ethical principles and humanity.”

Law-enforcement officials have so far arrested seven suspects — including two Lodz doctors and two funeral parlor owners — all charged with bribery and facing up to 10 years in prison. But there are signs that the number of arrests will grow as investigations open up across the country. “Nobody has yet been charged with murder,” says Jolanta Badziak, spokeswoman for the Lodz public prosecutors office, “but we are investigating.”

Prosecutors and police are considering the exhumation of dozens of bodies in Lodz alone to check for traces of the drug. The government has also pledged to improve oversight of the funeral industry and to ban the practice of funeral home-representatives pitching their services directly in hospitals. Some firms even run the morgues.

Without better pay for medical staff, however, such measures are unlikely to eliminate corruption. The Polish economy is only sputtering along, which may prevent the government from addressing the sectors financing soon. Health care, at least in theory, should come at little extra cost to patients as it is largely insurance-based or state-financed. Yet, a World Bank report published last year concluded that almost one-third of Poles routinely make “informal payments” — bribes. A recent poll carried out by public opinion research center OBOP ranked doctors as the most corrupt professionals in Poland. Not exactly something to inspire confidence.