THE FOREIGN SERVICE JOURNAL | DECEMBER 2017 41 contract, and include compensation for the nationalization in the management fee. Mobutu would be in compliance with interna- tional law by paying compensation, but he would not lose credibil- ity with his own people. We pitched this idea directly to Mobutu, and he agreed without hesitation. It was a solution worked out by the diplomats at our embassy—Washington was not involved. It’s all in a day’s work. Ambassador (ret.) Herman J. Cohen is a veteran of 38 years in the For- eign Service. He served at five U.S. embassies in Africa, as well as in the Bureau of African Affairs at the State Department and as Africa director at the National Security Council under President Ronald Reagan. His last assignment before retiring in 1993 was as assistant Secretary of State for Africa under President George H.W. Bush. Saving Lives Defending a U.S. Business Guatemala 2015 By Nicole DeSilvis and Aileen Nandi The past few years in Guatemala have seen a revolving door of senior government officials and rampant gang and narcotics violence, as well as the corruption that plagues this region. Guate- mala is an enormously challenging market, but our embassy team works together to foster success. It’s not very often that Commerce Department officials get involved in humanitarian issues the way other agencies at post do. But when a crisis concerning U.S. medi- cal services provider Baxter Healthcare came across our desk, we knew we needed to pitch in. In 2013 Baxter was the service provider for peritoneal dialysis treatment for some 500 patients in Guatemala. But in 2014 the Guatemalan Social Security Institute (IGSS) issued a tender for a new contract. The tender contained several irregularities and was clearly biased in terms of the qualification process and require- ments. Baxter Healthcare sought guidance from and worked with the Foreign Commercial Service and economic section regarding a variety of allegedly corrupt tendering processes within IGSS. In December 2014 Baxter was informed by the government of Guatemala that it had lost the tender for peritoneal dialysis for patients who had been under their care for the past six years—to a Mexican firm. This firm had no experience in peritoneal dialysis in Guatemala, lacked the required clinic infrastructure, mysteriously received the environmental study of their facility in two days and quoted the government of Guatemala a higher price than Baxter. In 2015, 530 patients were transferred to the new provider. Soon after, patients began reporting infections, some of which unfortunately resulted in death (of 198 infected, 42 died). This placed the issue on the national agenda, reinforcing the impor- tance of transparency during the tender processes and making the well-being of the patient a priority. Under the direction of Ambassador Todd Robinson and with guidance fromDeputy Chief of Mission Charisse Phillips, our embassy developed a strategy for engagement with relevant stake- holders to demand transparency in the tender process and to pri- oritize patients’ interests. We met with private- and public-sector stakeholders who could help bring visibility to the anomalies in the process. Embassy involvement prompted a serious investiga- tion, which resulted in the arrest of 17 representatives from IGSS, and the Mexican company was charged with corruption. IGSS reversed its decision, and the health ministry asked Baxter to resume treatment of dialysis patients, saving hundreds of lives. On June 1, 2015, Baxter sent a letter to Ambassador Robinson: “Your team’s active engagement and perseverance, advocating for transparency and for the safety of patients, made this possible. Specifically, Nicole DeSilvis, Antonio Prieto and Jennifer Nehez have worked closely with our team in Guatemala to raise concerns for the way these tender processes had been carried out and its potential impact on the health of Guatemalan renal patients. Thanks to the outstanding work of your team, Baxter and the Gua- temalan patients are in a better and safer environment.” Baxter said that the embassy team provided important support guiding them through this complex situation, analyzing current events, facilitating meetings and serving as observers at tender proposals to promote integrity and transparency. This was a huge win. Not only did the reversal of IGSS tender practices save lives, but embassy engagement at the highest levels helped resolve Baxter’s dispute with IGSS and leveled the playing field for other U.S. companies competing for Guatemalan govern- ment tenders. Baxter earned $40 million for the equipment and services it delivered in Guatemala; the company’s $2 billion in total sales in Latin America support 861 employees. The experience became a case study at Baxter’s headquarters in Deerfield, Illinois, called “the power of compliance,” and its best practices have been shared in several forums and workshops as an example of the importance of behaving ethically in complex situa- tions and the rewards that compliance can bring. Nicole DeSilvis is a senior commercial officer at the U.S. embassy in Guatemala. Aileen Nandi is currently the commercial counselor in New Delhi.