Hospital sieges & drug ambulances… sinister tactics of modern Mafia & how they’re learning from terror groups like Hamas
DRUG trafficking has propped up Mafia organisations for decades – but now it seems cunning mob bosses are finding new lucrative revenue streams.
A mob expert has told The Sun that criminal groups are “acting more like CEOs” by targeting lower-risk businesses and are even “learning from terrorists” to increase profits further.
His claims follow shocking details emerging last month about how the Contini clan – a powerful group within Italy’s Camorra family – took over San Giovanni Bosco Hospital, in Naples.
They used the building as a hub to make cash – including dealing drugs from hospital wards and ambulances, running accident insurance scams and offering quicker treatment to those who paid.
Additionally, medical supplies were raided to make ‘murder kits’ for hitmen – which included gloves, surgical robes and a gel that stopped killers from shedding hair at murder scenes.
One magistrate said the mafia had created an “anti-state” and a clan turncoat told investigators “90 per cent of the hospital was corrupt”.
Mafia expert Dr Chris Allen, director of Criminis Training and Consultancy Services, warns that actions like this suggest the mob are “learning from terrorists” like Hamas, in Gaza, and using it to increase profits.
He tells us: “Even for Italy, which historically has mafia connections deep in its society, 90 per cent of a hospital to be corrupt is a huge, huge issue.
“Certainly this is where there are potential similarities between organised crime groups and terrorists.
“Terrorist groups use hospitals as bases because they know, generally speaking, if they have hostages people won’t try to come or, for example, bomb the hospital because there are innocent people recovering there.
“So this is a classic case, I suspect, of organised crime groups looking at the playbook of terrorists and learning from it, they know they can use hospitals as cover.
“In Syria, it’s the same. Insurgent groups all over the country use places like hospitals or schools, because they know that the good guys will think twice about storming a school or hospital.”
The true scale of the Mafia’s operation at the 156-bed hospital was revealed in a 481-page arrest warrant after 11 arrests last month. It followed 126 people being taken into custody by police in 2019.
The mob had taken advantage of an Italian law to get former criminals jobs in the health service and flooded the wards with crooks over several decades.
Among those hired was Paolo di Mauro, the head of the Contini clan, who was “given the nickname ‘the Nurse’” due to his influence in the hospital, according to MP Francesco Emilio Borrelli.
“He never actually showed up for work, but drew a salary… When he died [in 2018], posters mourning him went up at the hospital,” said Mr Borrelli.
The mob was said to have exploited “every possible activity at the hospital for financial gain” according to The Times, and mobster Gennaro Manetta, 45, was at the heart of it.
Manetta, listed as a cleaner in the radiology department, dealt drugs from the hospital entrance and masterminded an industrial-scale accident fraud scheme.
Hospital employees were forced to write up reports of fake car accident injuries and sent mob lawyers x-rays of other people’s broken bones to make claims.
Additionally, to back up those fraudulent reports, a storeroom worker – who previously worked as a mechanic – was hired to damage vehicles for photographic ‘evidence’ of the crashes.
An investigator claimed the scheme milked insurers of thousands and is now “the reason car insurance is so expensive in Naples“.
The Mafia also held meetings in intensive care and gynaecology wards and offered faster treatment in exchange for payment.
Ambulances were filled with cocaine for deliveries – often with a patient with a fake injury inside to make it more convincing when they put the sirens on – and as a taxi service, including for singers and TikTok stars linked to Manetta.
It’s not the Godfather sat with a glass of wine – bosses are thinking on a strategic business level, thinking like CEOs, to maximise profit with minimal risk of jail time.
Dr Chris Allen
Dr Chris tells us: “There are several key innovations, such as fake ambulances, something we’ve seen over the last decade, and the use of the hospital as a meeting place, which is also incredibly smart.
“Lots of people coming and going, multiple entries and exits, and also the potential of a large amount of lower-paid workers who may be willing to look the other way for some extra cash.
“Then the fact that Di Mauro drew a salary and never showed up just shows how deep the corruption went, because there clearly wasn’t anybody chasing him from the HR or hospital administration.
“This is a fascinating case and a win for law enforcement in the battle against the Mafia. The deeper you dig into organized criminality, the more sophisticated it gets.”
‘Thinking like CEOs’
In recent years the Mafia appears to have turned away from their bloodthirsty ways, like racketeering and violence, in favour of white-collar crime.
In 2022, just 17 people were killed by the mob in Italy compared with more than 700 back in 1991.
That hasn’t prevented some vicious killings though. In 2017, an uncle and nephew, both named Carlo Nappello, who were linked to the Lo Russo clan, part of the Camorra mafia group, were gunned down while riding a scooter in Naples.
But it’s clear, there is a change among the Mafia when it comes to their business – including the decision to take over the hospital in Naples.
Chris explains that this is just one example of how Mafia groups are “thinking like CEOs” in modern times – and while “drugs remain their favourite” revenue stream, they continue to exploit other illegal money-spinning options.
“It’s not the Godfather sat with a glass of wine – bosses are thinking on a strategic business level, thinking like CEOs, to maximise profit with minimal risk of jail time,” he adds.
They include trafficking illegal cigarettes between US states that have different tax rates, which in 2012 reportedly cost the US £4billion.
Previously it was reported that one truckload could translate to more than a million in cash after being sold on the black market.
The boss just needed to call a farmer to steal his land. Often, feared by the mere name of the mobster, the farmer gave up his land without even trying to rebel, for fear of retaliation.
Court documents
As of 2024, Missouri had the lowest tax on cigarettes with 17 cents (13p) charged per 20 pack, compared with $5.35 (£4.20) in New York, the highest, meaning huge profit margins when its between the states and flogged.
Chris says: “Drugs are always a favourite because the demand always remains high but they will move anything that they can make a profit that is most risk-averse as possible.
“The penalties for smuggling cigarettes are six months in jail, whereas if you’re caught with 10kilos of coke you’re looking at 20 years to life.
“They realised they could make the same amount of profit on cigarettes as they were supplying cocaine.”
Fake olive oil
Within the last decade, agricultural industries have increasingly targetted and accounted for 15 per cent of Mafia turnover, according to a 2018 Financial Times report.
Chris Vansteenkiste, from Europol, told the publication: “The falsification of food products is now the second-most profitable enterprise in the EU after drug trafficking.
“Food is where the profit is. Women buy a handbag every few months but you have to eat every day.”
The so-called ‘agromafia’ industry grows 10 per cent per year according to Observatory, and generated more than £18.6billion in 2018 – nearly double the amount made seven years earlier.
One of the biggest money-spinners within that industry was the production of fake olive oil, which has profit margins as high as 700 per cent.
It’s done by switching the olive oil for sunflower, soy, rapeseed or canola oils, and then colouring the product using chlorophyll.
Previously, The Guardian reported that 50 per cent of olive oil on supermarket shelves in Italy were fake, as were 69 per cent of those exported to Europe.
In 2017, 12 people with links to the ‘Ndrangheta – a mafia group from Calabria, near Sicily – were arrested as part of an operation that saw at least 10 tonnes of counterfeit olive oil sent to the US.
The line between illegitimate and legitimate businesses is incredibly thin when it comes to these guys.
Dr Chris Allen
Two years later, Europol arrested 20 individuals from Germany and Italy, with links to the Mafia. They found 150,000 litres of fake oil and claimed the groups made £6.7million per year.
‘Ghost farms’
Alongside this, Mafia groups have turned their attention to fraudulently claiming EU farming subsidies and made millions in the process.
In 2022, 91 people were convicted in connection with a scheme that saw the bloc defrauded of £4.3million – between 2010 and 2017 – including funds for so-called ‘ghost’ farmland.
The term refers to land that was nonexistent, taken from farmers by threat or owned by the Italian state or regional government.
The Batanesi clan – alongside the Bontempo Scavo and Tortorici – were said to have headed up the fraud, which was alleged to have involved 150 companies.
It’s claimed they were able to corrupt “white-collar workers” to navigate their way to obtain EU funding and rented large amounts of land in Nebrodi Regional Park to claim subsidies.
To do this, they rented thousands of hectares of land from the government for as little as £30 a hectare per year and claimed up £1,100 from the EU per annum.
Much of the land was rarely farmed upon and the lack of activity was not clamped down on due to some officials, who assigned the funds, being corrupted by the groups.
The Mafia also threatened farm owners to give up their land or take part in the fraud, which would earn more than £1million per 1,000 hectares.
“The boss just needed to call over the phone a farmer to steal his land,” a magistrate wrote in a court file for the case.
“Often, feared by the mere name of the mobster, the farmer gave up his land without even trying to rebel, for fear of retaliation.”
Those convicted were found guilty of a range of crimes including fraud against the EU, extortion and mafia association.
Among them was Katia Crasci, who claimed a subsidy for land to rear buffalo when in reality the site was being used to host US Navy satellite communications.
The line between illegitimate and legitimate businesses is incredibly thin when it comes to these guys.
Dr Chris Allen
In February this year, a further 37 people were arrested after testimonies from former members of the Batanesi mafia group.
EU robbery
Efforts to create more green energy have also been corrupted by the Mafia – especially wind farms, according to Europol.
They explained that the scam worked on various levels including infiltrating regional agencies that awarded the subsidies and contracts, as well as intimidating farm owners to use their land as sites.
A Europol report found: “The Italian Mafia is investing more and more in renewable energy, especially in wind farms, to profit from generous
“European grants paid for by member states which allow them to mix dirty money with legitimate economic activities.”
Dr Chris added: “The line between illegitimate and legitimate businesses is incredibly thin when it comes to these guys.
“Ultimately they need legitimate businesses to launder the money they’re making from the drugs, because it’s not like 1990 when you could go and buy a house in cash.
“They need all of these companies to move money earned from drugs into some form of bank account where they can spend it like a normal person.”
One of the biggest wind farm busts happened in 2013, when assets worth more than £1.1billion were confiscated from Sicilian businessman Vito Nicastri after he was deemed to be a ‘front man’ for the ‘Ndrangheta.
How did the Mafia begin?
WHILE the Mafia is known for its violence and drug smuggling today, in the past it was formed for a very different reason.
Its origins trace back centuries to when Sicily was regularly invaded and ruled by foreign powers including the Romans, Arabs, French and Spanish.
To fight back against their often-hostile occupiers, residents formed small groups – known as ‘clans’ or ‘families’ – to protect themselves.
According to Selwyn Raab, an author of books about the mob, the term ‘mafia’ stems from a Sicilian-Arabic slang word that means “acting as a protector against the arrogance of the powerful”.
The writer noted that the word ‘mafioso’ – a member of the Mafia – referred to someone who was suspicious of authorities until the 19th Century when it all changed.
From that point onward it was used to described someone involved in criminal activity after small groups of clans former private armies that would extort businesses and land owners for protection money.
They would go on to form what is know as the Sicilian Mafia.
Investigators found the 57-year-old – dubbed ‘Lord of the Wind’ due to his vast renewables investments – had “high-level” contacts with the mob and had invested money from criminal activities.
Nicastri had 43 wind and solar energy companies, some of which were found to have laundered mafia money.
Dr Chris explains that cracking down on these types of mafia is a complicated task, which involves building up intelligence and ensuring there is “due diligence” and “integrity” from investigators looking through financial records.
He also says resisting a mob takeover is in-part down to people living within the areas afflicted by criminality.
“If there are areas where the economy isn’t performing strongly, people need money and the government doesn’t provide support or funding then people will look for money elsewhere,” Dr Chris said.
“That’s where tackling organised crime is a priority. It doesn’t matter whether it’s Colombia, Afghanistan, Italy or the UK, if people can’t survive legitimately then they may look at other options.”