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. Last Updated: 07/27/2016

How to Handle the Kickback Culture

"The art of bribe-taking opens up to us a direct route to happiness," wrote Erast Pertsov, an obscure 19th-century Russian writer and a friend of Alexander Pushkin.

Pertsov's satire divided bribes into gifts, surprises, dinners and money, "preferably banknotes because they change hands without much hue and cry."

Two hundred years later, the question of what constitutes a tip, a gratuity or an outright bribe is still hotly debated in Russia, and everyday services are affected as much as official services or business.

If you don't grease it, you don't get it, and this means that even the most cosseted foreigners are unlikely to avoid negotiating the unofficial-fee terrain at some point during their time in Russia.

"[Corruption] is everywhere in some form or other, but in Russia it's so upfront it turns foreigners off," said a German businessman who had firsthand experience in dealing with Russian officials while on a stint at a factory in the Moscow region.

For foreigners looking to do business here, there are at least some sources of guidance through the kickback maze.

Yelena Panfilova, president of Transparency International Russia, said foreign businesses operating in Russia approached the watchdog group frequently for advice. Last month, a manual titled "Russian Customs for Finns," published by the Finnish-Russian Chamber of Commerce, caused a stir when it offered advice on bribery to Finns doing business in Russia.

While according to Vladimir Rimsky, a sociologist with the Indem think tank, "no sphere is free of corruption," the areas most rife with bribery and gratuities are schools and hospitals.

In such situations, foreigners have to rely on intuition or the advice of Russian friends when confronted by the gratuity-bribery dilemma. Most embassies prefer not to meddle, leaving expats on their own when dealing with the day-to-day extortion at local hospitals, in schools or on the roads.

"A person should use common sense when dealing with the situation," said a spokesperson for the U.S. Embassy.

Corruption in the medical sphere is so deep-seated that people are often comfortable with paying unofficially even before they are asked to do so, experts said.

"If you don't pay, nobody will notice you," said Anna Cheltsova, patient service manager and chief nurse at the International SOS Clinic in Moscow.

While Cheltsova said patients at her Western-style clinic were billed according to official price lists, at state-run hospitals or emergency rooms, a simple procedure may require unofficial fees "from 200 to 300 rubles, and something serious may require $1,000 to $2,000."

"Many of my acquaintances give a bribe upfront, for example, to a doctor accompanying an ambulance so that he'll take them to a good hospital," she said.

Indem has recently put together an anti-corruption policy textbook that is aimed at teaching students about anti-corruption strategies. However, the book has yet to be introduced at universities, which can themselves be hotbeds of corruption. "We don't have that" is a common reaction of universities in answer to accusations of receipt of unofficial fees, Rimsky said.

But while at higher-education institutions the academic environment does not always make for an open discussion of kickbacks, directors of secondary schools and kindergartens can be much more upfront, parents said.

"You'd be expected to make a donation," a kindergarten director told an American mother of three interested in giving her children the chance to learn Russian quickly by enrolling them in a Moscow detsky sad. On top of the official 250 rubles ($9) per child per month and a 200 ruble fee for round-the-clock security, the mother was asked to sponsor some IKEA furniture for the kindergarten. "I see it as a public-private partnership between me and the detsky sad," she said.

The mother said her experience was "pleasant," as the kindergarten provided her children with three meals a day; they didn't have to pay the teachers directly, as many do at other kindergartens; and she even got a receipt for her purchase. Such "donations" are meant to be yearly contributions of around $1,500, the mother said, adding that the British School's annual fees are $10,000 while the Anglo-American School charges $19,000 yearly.

Opinions of the anti-corruption strategists are divided over what should be the proper reaction to advances by extortionists.

"Foreigners quickly accept the rules of the game," said Kirill Kabanov, the acting director of the National Anti-Corruption Committee, a watchdog set up six years ago to monitor corruption. But "the strong should resist the system."

"It would be more correct for everybody to fight corruption," Rimsky said. "But the rational strategy of the average man is to adapt to the system."