The corruption usually takes the form of bribe demands from doctors and other medical staff. Patients are often told that unless they pony up “gift money” for the health-care practitioners, they will not be treated.

Those living in former Soviet countries are supposed to be guaranteed free public health care, but the reality is different because of the bribe demands.

Some doctors actually refuse to treat a patient who is in a life-threatening situation unless they are paid up-front.

Just one example of the tens of thousands of medical-care bribe demands made across the former Soviet Union each year is the case of Karen Papiyants of St. Petersburg, Russia.

A few years ago the truck driver was taken to a hospital after losing his leg in a traffic accident.

Doctors demanded a bribe of $4,500 for treating him — money he did not have. As his family tried to come up with the money, the hospital staff gave him a taste of what would might befall him if he failed to raise it.

He writhed in pain through the night, unattended. Finally his screams of agony led to the staff administering painkillers.

In Moldova, a 72-year-old woman with a thrombosis condition lay in a hospital bed untreated for three days until her son said his family finally “incentivized the doctor financially.”

But it was too late. She died.

A 36-year-old woman in Moldova’s capital of Chisinau said she went to seven health-care facilities before she found one that would remove her tonsils without a bribe. Doctors at the other facilities had demanded $360 — more than a month’s pay — which she did not have.

Although doctor bribe demands are at the heart of health-care corruption in the former Soviet Union, the graft takes many forms. One is drug and medical-equipment companies paying bribes to have care facilities buy their products, even when the products are inferior.

Armenian news organizations raised a fuss recently about the country’s plan to continue administering an Indian-made drug to diabetics after ordering a better French-made drug.

The Indian drug, DiaZon MR, has side effects such as nausea and dizziness that the French drug, Diabeton MR, does not.

But many Armenian diabetic patients continue to get the Indian drug.

News stories about the situation hinted that money was changing hands to keep the Indian drug in circulation, although the Health Ministry had said it would be discontinued once current supplies run out.

Journalists pointed to two facts to suggest something underhanded was occurring in the continuing use of the Indian drug.

One was that Armenia ordered additional supplies of the Indian drug after signing a contract to import the French drug.

Another was that the new Indian-drug order occurred even though the cost of the drug had jumped by 70 percent.

Armenian news organizations have suggested that medical-care corruption — or at the very least, negligence — was involved in the recent snake-bite death of 55-year-old Karineh Haroutyunyan. The snake bit her in the leg as she was working in her garden in the village of Surenevan in the Ararat area.

Gagik Tadevosyan said he got his mother to the Ararat Medical Center just 15 minutes after the bite.

He said she lay untreated in the hospital for seven hours with only an ice pack on the bite. He was with her, he said, and that the only time an attending physician showed up was immediately after she arrived and at the end of the seven hours. “Her situation had worsened” considerably by then, he said.

She died after being transferred to the Erebouni Medical Center.

The Health Ministry, smarting from bad publicity about the case, has contended that Haroutyunyan did not arrive at the medical center until 12 hours after the bite, according to Tadevosyan.

That is an outrageous claim, he said. He expressed doubt that she had even received the anti-venom shot that the Ararat Center Center insisted it had administered.

The fact that Haroutyunyan lay untreated for so long raised the question of whether medical-care staff were angling for a bribe before treating her.

It could be that this was a case of neglect rather than corruption. But with health-care bribe demands so rife across the former Soviet Union, it is understandable why many Armenians wonder if corruption was the real cause of Haroutyunyan’s death.

Armine Sahakyan is a human rights activist based in Armenia.