HOSPITAL LOCKUP
NAIROBI, Kenya — The Kenyatta National Hospital is east Africa’s biggest medical institution, home to more than a dozen donor-funded projects with international partners — a “Center of Excellence,” says the U.S. Centers for Disease Control and Prevention.
The hospital’s website proudly proclaims its motto — “We Listen We Care” — along with photos of smiling doctors, a vaccination campaign and staffers holding aloft a gold trophy at an awards ceremony.
But there are no pictures of Robert Wanyonyi, shot and paralyzed in a robbery more than a year ago. Kenyatta will not allow him to leave the hospital because he cannot pay his bill of nearly $40,000. He is trapped in his fourthfloor bed, unable to go to India, where he believes doctors might help him. All despite a court ruling years ago that found the detentions were illegal.
Health experts decry hospital imprisonment as a human rights violation. Yet the United Nations, U.S. and international health agencies, donors and charities all have remained silent while pumping billions of dollars into these countries to support splintered health systems or to fight outbreaks of diseases including AIDS and malaria.
“It’s the dirty underbelly of global health that nobody wants to talk about,” said Sophie Harman, a health academic at Queen Mary University of London. “They probably think they have bigger battles in public health to fight.” these patients to see them kept like this,” Njuguna said.
Still, some officials defend the practice.
“We can’t just let people leave if they don’t pay,” said Leedy Nyembo-Mugalu, administrator of Congo’s Katuba Reference Hospital. He said holding patients wasn’t an issue of human rights, but simply a way to conduct business: “No one ever comes back to pay their bill a month or two later.”
At many Kenyan hospitals, including Kenyatta, officials armed with rifles patrol the hallways and guard the hospital’s gates. Patients must show hospital guards a discharge form to prove they’re allowed to leave and even visitors must sometimes surrender their identification cards before seeing patients.
In its 2016 financial report, Kenyatta’s auditor-general said the hospital lost more than $470,000 in fees from patients who “absconded” without paying. That year, the hospital reported total revenue of more than $115 million.
Kenya’s ministry of health and Kenyatta canceled several interviews with the AP and declined to respond to repeated requests for comment.
After she was elected to Kenya’s Parliament, Esther Passaris visited Kenyatta last December to check on supporters who were injured in election violence. She was stunned to find that patients were incarcerated.
“There was one lady I met in the corridor and she was crying, ‘Please let me go home,’ ” Passaris said. The woman had hurt her back and hip. She had been medically cleared to leave but wasn’t allowed to go home because she hadn’t paid her bill. “I just thought, ‘Oh my goodness, it’s almost Christmas, how can these people not go back to their families?’ ”
Passaris started an online campaign to have the patients released. Just before the holidays, Kenyatta let more than 450 leave — a victory, Passaris says, though the problem remains. like pharmaceuticals or federal agencies like the CDC become aware that their partners engage in such a fundamental violation of human rights, that they hold them accountable and work to end these practices.”
The CDC provides about $1.5 million every year to Kenyatta and Pumwani Maternity Hospital, via funding from the President’s Emergency Plan for AIDS Relief, or PEPFAR.
At Kenyatta, the CDC covers treatment costs for patients with HIV and tuberculosis, trains health workers and helps with HIV testing, among other programs. The agency declined to comment on whether it was aware that patients were regularly detained or if the agency condones the practice.
Dr. Agnes Soucat of WHO said the U.N. agency was aware of hospital detentions and confirmed they happened “quite frequently.”
“We do not support this in any way, but the problem has been documenting where it happens,” said Soucat, director of WHO’s department of health systems, financing and governance. To date, WHO has made no attempt to collect data on hospital detentions and says such information is hard to find. The AP obtained patient lists, records and bills from about a dozen hospitals in Congo detailing imprisonment practices.
And though WHO has issued hundreds of health recommendations — from treating AIDS to Zika — the agency has never published any guidance advising countries not to imprison people in their hospitals.
Soucat said WHO officials in more than a dozen countries had expressed their concerns about detained patients to ministers of health, but that those discussions were private.