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Doctors at Nairobi’s Kenyatta National Hospital have told Robert Wanyonyi there’s nothing more they can do for him. Yet more than a year after he first arrived, shot and paralyzed in a robbery, the ex-shopkeeper remains trapped in the hospital.
Because Wanyonyi cannot pay his bill of nearly 4 million Kenyan shillings ($39,570), administrators are refusing to let him leave his fourth-floor bed.
At Kenyatta National Hospital and at an astonishing number of hospitals around the world, if you don’t pay up, you don’t go home.
The hospitals often illegally detain patients long after they should be medically discharged, using armed guards, locked doors and even chains to hold those who have not settled their accounts. Even death does not guarantee release: Kenyan hospitals and morgues are holding hundreds of bodies until families can pay their loved ones’ bills, government officials say.
An Associated Press investigation has found evidence of hospital imprisonments in more than 30 countries worldwide, according to hospital records, patient lists and interviews with dozens of doctors, nurses, health academics, patients and administrators. The detentions were found in countries including the Philippines, India, China, Thailand, Lithuania, Bulgaria, Bolivia and Iran. Of more than 20 hospitals visited by the AP in Congo, only one did not detain patients.
Millions possibly affected
“What’s striking about this issue is that the more we look for this, the more we find it,” said Dr. Ashish Jha, director of the Harvard Global Health Institute. “It’s probably hundreds of thousands, if not millions of people that this affects worldwide.”
During several August visits to Kenyatta National Hospital — a major medical institution designated a Center of Excellence by the U.S. Centers for Disease Control and Prevention — the AP witnessed armed guards in military fatigues standing watch over patients. Detainees slept on bedsheets on the floor in cordoned-off rooms. Guards prevented one worried father from seeing his detained toddler.
Kenya’s ministry of health and Kenyatta canceled several scheduled interviews with the AP and declined to respond to repeated requests for comment.
Health experts decry hospital imprisonment as a human rights violation. Yet the United Nations, U.S. and international health agencies, donors and charities have all remained silent while pumping billions of dollars into these countries to support their splintered health systems or to fight outbreaks of diseases including AIDS and malaria.
“People know patients are being held prisoner, but they probably think they have bigger battles in public health to fight, so they just have to let this go,” said Sophie Harman, a global health expert at Queen Mary University of London.
Hospitals often acknowledge detaining patients isn’t profitable, but many say it can sometimes result in a partial payment and serves as a deterrent.
‘A way to conduct business’
Festus Njuguna, an oncologist at the Moi Teaching and Referral Hospital in Eldoret, about 300 kilometers northwest of Nairobi, said the institution regularly detains children with cancer who have finished their treatment, but whose parents cannot pay.
“It’s not a very good feeling for the doctors and nurses who have treated these patients, to see them kept like this,” Njuguna said.
Still, many officials openly 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.”
Global health agencies and companies that operate where patients are held hostage often have very little to say about it.
The CDC provides about $1.5 million every year to Kenyatta National Hospital and Pumwani Maternity Hospital, helping to cover treatment costs for patients with HIV and tuberculosis, among other programs. The CDC declined to comment on whether it was aware that patients were regularly detained at the two hospitals or if it condones the practice.
Dr. Agnes Soucat of the World Health Organization said it does not support patient detentions, but has been unable to document where it happens. And while the WHO has issued hundreds of health recommendations on issues from AIDS to Zika virus, the agency has never published any guidance advising countries not to imprison people in their hospitals.
‘Cruel, inhuman and degrading’
Many Kenyan human rights advocates lament that hospitals continue to hold patients despite what was seen as a landmark judgment in 2015.
Back then, the High Court ruled that the detention of two women at Pumwani who couldn’t pay their delivery fees — Maimuna Omuya and Margaret Oliele — was “cruel, inhuman and degrading.” Omuya and her newborn were held for almost a month next to a flooded toilet while Oliele was handcuffed to her bed after trying to escape.
Earlier this month, the High Court ruled again that imprisoning patients “is not one of the acceptable avenues [for hospitals] to recover debt.”
Omuya said she is still psychologically scarred by her detention at Pumwani, especially after another recent run-in with a Nairobi hospital.
Several months ago, her youngest brother was treated for a suspected poisoning. When Omuya and her family were unable to pay the bill, the situation took a familiar but unwelcome turn: he was imprisoned. Her brother was only freed after his doctor intervened.
“Detentions still go on because there are no rights here,” Omuya said. “What I suffered, I want no one else to suffer.” (VOA)
Super model and actress Hailey Bieber said she is lucky to have a husband like Justin Bieber, refuting rumours of the ace singer not treating her properly. Hailey was speaking at singer Demi Lovato's podcast '4D With Demi Lovato', dailymail.co.uk reported.
Talking about her popstar husband and rumours around their marriage, Hailey said: "I think one of the biggest things is you have to know what the truth is behind everything. You know, there's so many narratives that float around about me, about him, about us together." She addressed the rumours point blank as she said: "There's one big fat narrative that goes around that's like, 'Justin is not nice to her, and that he mistreats her', and I'm just like, it's so far from the truth, and it's the complete and utter opposite."
Hailey went on to set the record straight about Justin, who she married in 2018. She said: "I really am lucky to say I'm with someone who is extremely respectful of me, who makes me feel special every single day. So when I see the opposite of that, I'm just like, 'Huh?' And everybody around who knows us personally would say the same thing." (IANS/ MBI)
Keywords: Hailey Bieber, Justin Bieber, husband, respectful, truth, married
Among the Tamil epics written during the Sangam age, only a few survived to this day. Manimegalai is one such. It is written as a sequel to the Sillapadikaram, taking the story forward of Kovalan and Madhavi's daughter, Manimegalai. The Sillapadikaram is about the injustice of the Madurai kingdom in the execution of Kovalan, which turned Kannagi, his wife into a goddess seeking vengeance for her husband's death. Kovalan, before his death, has an affair with a court dancer, Madhavi, and his daughter, Manimegalai, is said to begin a different tradition among the Tamils.
The epic, written by Sattanar, introduces Buddhism to Dravidian culture, something that has been alien to them for years. Manimegalai is the protagonist, who flees constantly from the pursuit of Chola prince Udhayakumara, and tries to lead an ascetic life. Throughout the plot, Buddhist tenets are used to avoid the culmination of a love-story. Manimegalai is believed to be the anti-love story sequel to the Sillapadikaram.
A complete work of Tamil epic written by hand on leaves Image source: wikimedia commons
The Sillapadikaram was written by a Jain monk, Illango Adigal, and Sattanar, uses the sequel to question Jainism. It is almost a political battle between two new religions competing for a place in a predominantly Hindu society. Parts of Manimegalai even go to the extent of opening ridiculing Jain practices and beliefs.
Critics of Tamil literature have stated that while the Tamil epics have great poetic significance, they are inferior to other world epics when it comes to clearly portraying religious affiliations. In fact, they refer to the newer religions with an infant's perspective. Some scholars have found that Sillapadikaram has more ethical substance than its sequel, but in and of itself, despite being written by a Jain monk, reads like Hindu poetry (Subhramanya Aiyar, 1906).
Keywords: Manimegalai, Sillapadikaram, Tamil Epic, Sattanar, Ilango Adigal, Chola kingdom, Sangam Age, Buddhism
The Covid-19 pandemic could act as an inflection point to shift India's growth model from being consumption driven to investments-led. In its Ecoscope report, Motilal Oswal Financial Services, said: "With Covid-19 hurting India's 'Household' (HH) and 'Government' sectors adversely, the continuity of strong consumption growth is in question."
"On the contrary, with listed companies' financial positions improving and an uptick in household investments in the Real Estate sector (called physical savings), the narrative of investment-led recovery is gaining momentum." The report prescribed that various economic participants - households, governments, listed companies, and unlisted corporates -- to increase their fixed asset investments in the immediate future based on their financial position.
The Covid-19 pandemic could act as an inflection point to shift India's growth model from being consumption driven to investments-led. | Photo by Fusion Medical Animation on Unsplash
At present, the listed and unlisted corporate sector accounts for only about half of total investments in India. The 'HH' sector including unincorporated enterprises accounts for 35-40 per cent in India's investments, while the remaining 12-13 per cent is contributed by centre and states governments. Besides, the report cited that demand environment is expected to remain subdued due to weak financial position of 'HH' and government sector.
"Despite household investments picking up strongly in 2HFY21, given that Indian households bore the maximum brunt of Covid-led losses in CY20 (and CY21), we believe household spending would remain subdued over the next few years." It further pointed out that unless 'HH', 'Unlisted Corporate', and government sectors can improve their financial positions -- leading to a demand uptick -- a strong revival in investments seems challenging. (IANS/ MBI)
Keywords: India, covid, pandemic, growth, household, government, investment