Hospitals in Romania have been using substandard disinfectants to clean equipment, operating theatres and floors, an investigation has found, raising alarm across the country that patients in need of critical healthcare are being thrust into unsafe environments.
The investigation, by Romanian journalist Catalin Tolontan, found that pharmaceutical company Hexi Pharma has been diluting a line of at least 10 products, with some containing as little as 10 percent of the active substance on the label.
In the days after the investigation went public earlier this month, the pharmaceutical company – which distributed products to more than 350 hospitals in at least 40 districts – filed for insolvency. The company was indicted on Friday.
Samples tested this week revealed that the disinfectants for surfaces and hands were at times ten times weaker than stated, the Institute for Research and Development in Chemistry and Petrochemistry said.
Meanwhile, health minister Patriciu Achimas Cadariu resigned as Prime Minister Dacian Ciolos took on the post for an interim period.
On Friday, further revelations alleged that in neighbouring Bulgaria, the same diluted disinfectants were being used at 24 blood donation centres in more than 10 cities.
The investigation came as Tolontan's exploration into the deaths of 64 people in a nightclub fire last year took a turn when a doctor told him that half of the victims died because of infections originating in hospitals, as opposed to succumbing to their burn injuries.
When a biologist with Hexi Pharma provided evidence of the dilution, Tolontan's team independently sourced drums of the products and tested them in April.
"After a five-month investigation, we proved that not once over the past 10 years has the Romanian state checked the concentration of any disinfectants," Tolontan told Al Jazeera on Saturday.
"When we realised the authorities had failed to protect the citizens, we decided to 'go after the system', not the company."
The investigation also found that private laboratories linked to the company were checking off products that did not match their labels.
"[Since 2006], 140 epidemiological doctors, 350 hospital executives, thousands of doctors and hundreds of hospital inspectors working for the health ministry were unable to mentally draw the line between hospital infections and the quality of the disinfectants used," he said.
"This is all the more shocking when you consider the fact that Romania has the most aggressive bacteria in the whole of Europe, over four times the average in the rest of EU.
"According to doctors, what has actually happened, because we used diluted products, is that they administered shots to bacteria, making them even stronger, with mutations that are still unknown."
The government has verified the claims made in Tolontan's investigation. Faced with the crisis, the government has promised a "strong approach".
Dan Suciu, a spokesman at the prime minister's office, promised to tighten controls going ahead, as he tried to reassure the public that substandard products had been removed from hospitals.
"It's the priority of our government now …The state has to answer to this," he told Al Jazeera. "It's not just a matter of empathy. It's a matter of responsibility.
"I don't make an emotional approach to this. Our duty is an institutional approach."
When asked on which grounds a new health minister would be chosen, Suciu said independence was key.
"He or she should know the system very well, and they should not be part of the system if you understand what I mean," he said.
Despite its reassurances, anger has intensified towards the state.
Public discontent and distrust was already high after the 64 people died in the Colectiv nightclub fire in October 2015. Following days of mass protests calling for the government to step down, Prime Minister Victor Ponts led his ministers out the door. After the latest disinfectants scandal, protests have re-emerged on the streets of Bucharest.
"The risks are very hard to quantify but it is easy to imagine the effect of this lack of standards can have on the healthcare system," Marina Popescu, director of the Median Research Centre in Bucharest, told Al Jazeera.
"What they have found out was that the Romanian state did not have procedures to check – even randomly – if any substance was approved … It's quite shocking in terms of an institutional failure."
The think-tank director has researched parliamentary sessions to discover a large number of complaints and questions from various constituents about hospital conditions.
"They [the government] had signals over time," she said. "It really took this chemical evidence to show that all the substance, all that stock, was actually wrong."
Looking ahead, Popescu said she expects more examples of substandard products to emerge, though not on the same scale as the Hexi Pharma scandal.
She also hoped that the current interim government would act responsibly in providing a carefully considered response, especially given it is an election year.
Like many other Romanians, she was disappointed the state had not launched an investigation into the hospitals in the immediate aftermath of the fire at Colectiv, as there were indications that healthcare professionals and institutions had difficulty in coping.
"It's really quite concerning," she said. "Anyone who would have sold on this market would have no need to comply … Clearly this particular company had an incentive to behave this way – there was nothing to stop them."
Published on Al Jazeera on 14th May, 2016