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Hospitals Worldwide Detain Patients If They Cant Pay The Bill

Earlier this month, the High Court ruled again that imprisoning patients “is not one of the acceptable avenues [for hospitals] to recover debt.

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Margaret Oliele, a former detained patient, poses for a portrait in her home in Nairobi, Kenya. VOA

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.

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A relative adjusts the oxygen mask of a tuberculosis patient at a TB hospital on World Tuberculosis Day in Hyderabad, India. VOA

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.

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Detained patients lie on beds in the Kenyatta National Hospital in Nairobi, Kenya. VOA

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.”

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FILE – A Yemeni woman suspected of being infected with cholera receives treatment at a hospital in the capital Sanaa. VOA

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.

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A doctor gestures outside a hospital in the Algerian town of Boufarik, as the country faces a cholera outbreak. VOA

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.

Also Read: Kenya’s First Breast Milk Bank to Combat Newborn Mortality

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)

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What Is So Special About the African Jungle Safari?

Once you are in the middle of several wild animals experiencing an African jungle safari, you'll know why they call this a once-in-a-lifetime experience

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There are specific areas in Africa where you can take an African jungle Safari and view a natural ecosystem that is constantly in motion. Pixabay

It’s not surprising that Africa is one of the top spots to travel to when you want to experience something unusual in your life as it is known for its large mammals and massive bird population. By visiting the continent, you can experience breathtaking views of wild animals in their natural environment. Whether you’re traveling by night, on a walking African jungle safari or viewing the area by plane, you’ll probably feel like this is a once-in-a-lifetime experience after visiting certain areas of Africa.

What Is Special About an African Jungle Safari?

There are specific areas in Africa where you can take an African jungle Safari and view a natural ecosystem that is constantly in motion. You can see animals that range from elephants and giraffes to lions and zebra. Certain areas offer a viewpoint of amazing wildlife throughout the year with certain times highlighting special events such as the annual wildebeest migration where close to 1.5 million wildebeest, 300,000 gazelles and 200,000 zebra trek across the dusty plains in search of greener pastures.

Get in Touch With Nature

Going on an African jungle safari allows you to get in touch with nature. You can hear hyenas cackling as they look for food or watch elephants trample across trails that are hundreds of years old. You’ll also see rhinos, hippos and cheetahs sitting in the sun or refreshing themselves in one of the flowing rivers. Not mention, there is magnificent scenery to see just about everywhere.

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During Safari, You can see animals that range from elephants and giraffes to lions and zebra. Certain areas offer a viewpoint of amazing wildlife throughout the year with certain times highlighting special events. Pixabay

Wide Range of Accommodations Are Available

If you’re looking for a place to stay when you visit Africa, you’ll find everything from luxury lodges to public campsites. The Central Serengeti region hosts the largest variety of accommodations to choose from. It’s important to book your accommodations well in advance of your trip, especially if you’re going to be traveling during peak season. If you decide to stay in public campsites, you usually won’t need to make a reservation in advance. The cost for these campsites typically ranges between about $30-$50 for an adult, but if you’re on your trip and run short of cash, you can have a relative or friend send money to Africa to tide you over during your trip.

ALSO READ: Here are 4 Travel Destinations for Couples

Once in a Lifetime Experience

Once you are in the middle of several wild animals experiencing an African jungle safari, you’ll know why they call this a once-in-a-lifetime experience. At any given time you might see giraffes loping along or monkeys shuffling around in trees. If you get a chance, try and go when The Great Migration is occurring as it can be a truly spectacular sight to see. When it’s the wet season in the Serengeti, the animals will be traveling towards the south, which is from December to June. After temperatures rise and dry out the area, the migration will move towards greener pastures. Most African jungle Safari guides will know where the animals are located. It’s also possible to travel through the area and see the animals by driving your own vehicle.