DETAINING PATIENTS, BODIES

Kenya's healthcare horror story

The universal health coverage seems a mirage as Kenyans continue drowning in the medical debt ocean.

In Summary

• Pumwani Maternity at one time had detained 60 women next to an overflowing toilet

• The moral quandary is whether healthcare facilities should enforce medical debts collection by any means necessary or write off such as bad debts.

Pumwani Maternity Hospital.
SWAPPING BABIES: Pumwani Maternity Hospital.
Image: FILE

Tuesday, March 3, the family of Robert Mureithi rode on the streets of Nyeri on a donkey-drawn cart with an empty coffin.

The caravan was fundraising to clear the pending hospital bill and subsequently get their father's body for his burial. Robert passed on after a battle with cancer on January 11, 2020. That marked the beginning of the nightmare for the family from Gitathiini village in Nyeri Town.

The body was detained by the hospital and taken to Umash Mortuary where it continues to incur daily fees, putting the total bill at Sh1.3 million as of Tuesday.  

 

This is not the only case.

In August 2017, one Chege Kiarie committed suicide after being detained at the Kenyatta National Hospital over an unpaid medical bill. Kiarie, who had been admitted on August 9 got discharged on August 5but the bill he had accumulated for the five days was beyond his means.

He jumped from the seventh floor of the casualty wing. A life that was supposed to have been saved ended this way. 

Pumwani Maternity at one time had detained 60 women next to an overflowing toilet where nurses would verbally harass them with one woman, a rape victim, being told she was an idiot for not knowing she was pregnant after the rape.

 
 

It is a common practice for hospital guards too be paid special commissions to ensure detained patients don’t sneak out.

Cases of patients and bodies being detained due to their inability to clear their bills have become the norm.

A study published by Chatham House on Global Health Security had Kenya at the top position, a slot we share with Zimbabwe, Uganda, Liberia, Nigeria, DRC and Ghana.

The red flagging of Kenya is a shame coming at the backdrop of the country regaining its top position from Ethiopia as the region’s biggest economy. What seems to escape the nation’s leadership is the fact that the real wealth of the nation is its people. It is the cardinal duty of a government to ensure its citizens lead a long enjoyable productive life.

President Uhuru Kenyatta resolved to restore the nation’s dignity through the Big Four agenda, with affordable healthcare being one of the four pillars. The president sought to scale up the intake of the NHIF to ensure universal health coverage. When NHIF was transformed into a state corporation in 1998, its mission as a social medical insurance cover was to keep the Kenyan workforce healthy, ensuring there is minimal premature death and most definitely ensure a dignified life for all. The impetus by the President to enhance subscription to the fund seemed well thought and related well with Kenyans.

Now, reports indicate NHIF on the verge of collapse. A report by a Health Financing Reforms Expert Panel, which was established by immediate former Heath CS Sicily Kariuki to transform and reposition the NHIF task force, has expressed concern that if all factors remain constant, the insurer’s financial sustainability will be compromised.

The universal health coverage thus seems a mirage as Kenyans continue drowning in the medical debt ocean. Unlike other debts, medical ones are unique as they are rarely taken voluntarily. Most of these cases involve patients being admitted for emergency treatment. In fact, for most detainees, the debt is acquired with the debtor unconscious. This is not to challenge the golden rule in the credit ecosystem that dictates that giving of debts, medical or otherwise is a privilege on the consumer and not a right.

The moral quandary is whether healthcare facilities should enforce medical debts collection by any means necessary or write off such as bad debts.

Jointly, Nyando MP, Jared Okello and his Nyali counterpart have separately sort to address this quagmire through legislative efforts (Health Laws Amendment).

They are seeking to have health facilities forfeit bills and outlaw detaining of bodies or patients or risk a Sh5 million fine and/ or a jail term of up to five years. The Judiciary has also on several occasions ruled in favour of detained patients. They have termed detention of either patients or bodies as inhumane, cruel and degrading. Moreover, the law considers detention an affront to international human rights standards, including the right to access medical care and false imprisonment of a debtor.

The government should not allow medical bills to take precedence over humanity. Studies have proved detention hampers the consumption of healthcare and enhances medical impoverishment.

The government should thus invest more in the healthcare sector to an upward of at least 10 per cent the GDP. Address the grey areas within the governance systems that allow the detention of patients and bodies. After all, medical debts just like other debts, if the patient or the deceased estates are proved insolvent the law has the respective creditors write off such debts.

“The health of nations is more important than the wealth of nations”

 

Wambugu is a youth leader