Reuters Pakistani doctor Shakil Afridi talks with people in Pakistan in file footage released May 23, 2012.

PESHAWAR, PAKISTAN For more than a year Pakistan and the United States have found little they can agree upon. From the efficacy of drones and NATO supply routes to who, exactly, is to blame for a cross border NATO attack from Afghanistan that ended with 24 Pakistani soldiers dead last November, each side is convinced its view is the correct one. The story of Shakil Afridi, the Pakistani doctor credited with helping track down Osama bin Laden, is no exception. Heralded in the United States as a hero, he has been lambasted at home, where his service to a foreign intelligence agency—no matter the end result—has been denounced as treasonous.

But while policy makers on both sides of the divide debate Afridi’s fate—he has been sentenced to 33 years in jail on unrelated terror charges that many assume to be trumped up—longstanding and horrific accusations of grievous malpractice, sexual harassment, fraud and theft cast dark shadows on his record. Afridi’s murky past, as revealed by former colleagues, poses the question: is a hero born of circumstance, or is he built over a lifetime of choices? “As far as I am concerned, getting rid of bin Laden was a service to mankind,” says Tariq Hayat, who supervised the district where Afridi worked up until 2008. “But it doesn’t make up for everything else [Afridi] did wrong.”

(READ: Is the doctor who helped get bin Laden now in danger?)

After finishing medical school, Afridi moved into Pakistan’s public health sector, where he worked his way up to supervisory positions in regional government-run hospitals in what was then called the North West Frontier Province (now known as Khyber-Pakhtunkhwa). Government health work, while poorly paid, is a sought after job in Pakistan as it comes with a pension and near-guarantee of lifetime employment. As a sprawling bureaucracy with limited oversight, it also offers plenty of opportunities for graft. The temptation was simply too much, says a former colleague who worked with Afridi in a regional hospital, who asked not to be identified for fear of retaliation. “He was a greedy person, and wanted to earn money any way he could. Unfortunately corruption is easy to do here.” Throughout the early 90s, Afridi’s superiors were besieged with complaints that he was docking subordinates’ pay; that he was selling the hospital’s donated medicines on the open market, and was taking kickback from suppliers, according to his former colleague. Those accusations have been backed up by a 2002 Pakistani Health Department document seen by Reuters. The complaints went unheeded, says his former colleague. Finally, in 1994, one exasperated hospital administrator suggested that Afridi be promoted away from the hospital, as long as he stayed in a well-supervised position, according to his colleague, who now holds a prominent position at one of Peshawar’s biggest hospitals. Nonetheless, he was soon given his own projects to run. His former colleague chalks up Afridi’s rise to an uncanny charisma, hard work and a genius for reading people. “He could reach every influential person to seek support, he made links and through that he protected himself.”

Afridi, of course, is in jail, and could not be reached for comment. His brother, Jamil Afridi, dismisses the allegations as “totally fabricated. He was a good administrator, a good surgeon, but due to professional jealousy, some doctors have said bad things against him.” They say that the allegations, which have been amplified by a Pakistani media hungry for scandal and eager to paint Afridi as an unmitigated villain, are part of a carefully managed character assassination campaign. Afridi is not the first public figure to have faced a concerted smear campaign in the Pakistani media—such propaganda has been used as a potent tool against politicians and judges as well. Still, those accusations, and worse, continued to dog his career. Most predate his role in the capture of bin Laden. In a country where medical malpractice, corruption and cronyism are rampant, it is unlikely that Afridi’s crimes would have ever come to the surface had he not also been implicated in the American raid that shamed Pakistan in the eyes of the world. Hayat, who stands by the government’s charges against Afridi, agrees that the doctor would most likely have gone unnoticed had his role in the bin Laden case never been revealed. “He is a man who has violated every norm of citizenship of his motherland [by spying for the Americans], for money. This is revenge.”

When Afridi moved to his new post, as health supervisor to the impoverished and insurgency-wracked Khyber Agency district of Bara, a populace desperate for medical attention enthusiastically welcomed him, says brother Jamil Afridi. “Before he came, the hospital where he was posted was not serviceable at all. No one had conducted surgery in the operation theater in 33 years. He was the one who brought care to the village.”

Government doctors often supplement their meager incomes with work in private clinics, and soon Afridi was doing the same. But the system is open to abuse. In many ways, Afridi’s privately run clinic, which he built and ran with a business partner and fellow doctor, was better than the government-run hospital. Soon he was suggesting to patients at the government hospital that they might do better at his private clinic, where he had better and more modern equipment, say Bara residents. His former colleague from the previous job says that Afridi had utilized a lucrative scam in which he prescribed unnecessary medical tests—malaria, dengue, hepatitis or HIV— at specific diagnostic centers where he was rewarded with generous “referral” fees. In Bara, he took the scam a step further, says the colleague. Patients who came to Afridi with fever or pain were often falsely diagnosed with severe medical emergencies, and told they needed surgery immediately. “You would say ‘I have a pain in the flank,’ and he would take an X-ray, and say you have kidney stones, and that he will remove them with surgery.” Then he would put the patient under, make a superficial cut, and stitch it back up. “You wake up thinking you had surgery,” says the colleague. Afridi’s fees were moderate even for Pakistan—anywhere from $80 to $120—but for an impoverished community they represented a lifetime of savings.

(READ: U.S. Senate cuts Pakistani aid over Afridi conviction.)

“When you are with faced with human life, you don’t care about the money,” says retired Bara policeman Ayub Afridi. (They are not related. The Afridi tribe is one of the largest in Khyber agency, and most members take the tribe’s name as their own). When Ayub Afridi’s sister came down with fever he took her to see Dr. Afridi, who promptly diagnosed her with appendicitis, and charged 7000 rupees (about $87) to have her appendix removed. But she didn’t get better. She started complaining of debilitating pains in her side, and her health rapidly declined.

At this point, Ayub Afridi had started hearing complaints from other residents about the doctor. Even the local militant group leader, a self-styled Robin Hood by the name of Mangal Bagh, took notice. According to Ayub Afridi, Mangal Bagh convened a jirga, or meeting of elders, in which he accused Dr. Afridi of medical malpractice, and demanded that he pay a fine of 1,000,000 rupees or $12,500, that he then promised to distribute to the doctor’s victims. When the doctor refused, he was taken hostage.

Jamil Afridi, the doctor’s brother, corroborates the story even as he denies his brother was performing unnecessary surgeries as charged. He sold his car, and his sister-in-law sold her jewelry, to raise the necessary cash, and Dr. Afridi was released. But Mangal Bagh wasn’t the only one who had taken notice of the mounting complaints. Hayat, Khyber Agency’s Political Agent, who serves as a kind of president-appointed governor, says he was besieged with weekly accounts of Dr. Afridi’s medical malfeasance. He was also alarmed by reports that Dr. Afridi was treating Mangal Bagh’s militants when they came back wounded from fights with the Pakistani military. And then there was a local nurse who registered a rape case against the doctor, though she later dropped the case, citing fears that it would hurt future employment, says Hayat. “He was an all around lousy character, a mercenary who would do anything for money, whether it was treating enemies of the state, or defrauding simple tribesmen.” In June 2008, he says, he requested that Dr. Afridi be transferred out of his district. Afridi, already spooked by his run in with Mangal Bagh, quickly packed up. When the doctor’s replacement arrived at the district hospital, he reported that the EKG machine was missing. It was found in Afridi’s private clinic, according to Hayat. “Doctors the world over take the Hippocratic Oath. And he was in direct violation of that oath,” says Hayat. “Here was a man who stole equipment from a public hospital, so he could treat paying patients in his private clinic.”

Lawyer Samiullah Afridi (also not a relation), who is now defending Shakil Afridi for his upcoming appeal on June 21, says that these accusations have been concocted in order to justify slamming him in jail. Had Afridi actually been tried for treason, on the basis of working for a foreign intelligence agency, it’s unclear that he would have been convicted, and it most likely would have caused even greater friction with the United States. It also might have raised uncomfortable questions about bin Laden’s long term presence in Pakistan. Instead, says the lawyer, he has been accused of supporting terror, largely based upon the fine he paid to Mangal Bagh. Charging Afridi with providing material support to a terrorist group will also make it more difficult for US officials to challenge Afridi’s case. “A ransom is not support,” Afridi fumes. “When a man comes to your clinic asking for medical assistance, you don’t ask first if he belongs to a terror group.”

But as far as Ayub Afridi is concerned, you also don’t offer unnecessary medical procedures, especially when you know your patients can’t get a second opinion. When his sister didn’t get better, and when he heard the complaints about Dr. Afridi’s care, he took her to the hospital in the provincial capital of Peshawar. When the doctors examined her there, he says, they found that not only had her appendix been crudely removed, but that her surrounding organs had been damaged as well. There was little they could do. He says his sister today is neither dead nor alive—she exists in a semi-vegetative state and requires constant care. It’s ironic, he says, that Dr. Afridi has been accused of treason and charged with supporting terrorists, when his real crimes go unnoticed. “Everyone from here to Landi Kotal [a town on the other side of Khyber Agency] will say they want to kill Shakil Afridi, but it has nothing to do with Abbotabad and bin Laden. It is because he made them suffer, he killed and hurt and robbed them. He is no hero.”

Aryn Baker is TIME’s Middle East Bureau Chief, based in Beirut. Find her on Twitter at @arynebaker. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIMEWorld.