First published Sunday Standard, October 1, 2017. Kindly reproduced here with permission from the Standard Group
Ten years ago, reports of mothers detained without dignity in hospitals were alarmingly commonplace. Despite new laws, policies and 47 County Governments, it seems holding mothers’ hostage until they can pay their hospital bills is on the rise again.
Last week, police officer Judith Amoit finally returned home after her bill was settled by the National Police Service. Nairobi West Hospital had detained Judith with her dead twins for over a month when she couldn’t pay her bill. Judith’s case is the second known case at the Nairobi West Hospital this year. Veronicah Nyangai sued the hospital earlier in the year for detaining her for two months after losing her baby in unexplained circumstances.
Their horrific accounts are repeated in twelve other known cases this year alone. They include the four mothers of Embu who were locked in the basement of the County Medical Centre over Kshs 400,000 in January. One month later, six Bungoma mothers were stripped of their IDs, forced to share beds and then neglected with their new-borns. In August, a mother born with premature triplets was detained by the Pandya Hospital in Mombasa. This month, Christa Marianne Hospital in Kisii detained a class 8 student mother until her family could pay her bills.
Pregnancy, child-birth and aftercare carries great risks. Every single day, twenty women die giving birth in Kenya. Fifteen counties are responsible for 98.7% of these deaths. Mandera alone, is responsible for 50% of the deaths. With existing technology and medical knowledge, most of these deaths are completely preventable. That women should risk their lives giving birth and then suffer imprisonment, abuse and neglect in our hospitals must alarm us all.
Kenya is signatory to both the African Union Maputo Protocol on the Rights of Women and the Charter on the Rights of the Child. Article 43 of our Constitution (2010), the Patients Charter (2013) and the new Health Act (2017) affirm our right to the highest standard of health, including reproductive health. Holding mothers and their babies as hostages should offend our moral compass.
When it happened to Margaret Oliele and Maimuna Awuor, they weren’t just offended by it, they sought justice. In September 2015, they were compensated Kshs 2 million by the Constitutional court who found their post-delivery detention by Pumwani Maternity Hospital was unlawful and unconstitutional. In so doing, they and the Centre for Reproductive Rights breathed life into our constitution.
Government policy has been driven from the top. In 2013, President Kenyatta re-affirmed an important 2007 directive to abolish all costs of maternity services in public hospitals. This time, funding shortfalls left public hospitals unable to cope with the additional demand for services. It was this that prompted First Lady Margaret Kenyatta, or as I like to call her the Fast Lady, to rally Kenyans to run and raise funds to boost County maternity services. Last year, National Health Insurance Fund guaranteed expectant mothers free check-ups and immunizations for their children.
So why are we seeing a resumption of these cases and what can be done? Public health financing is still woefully inadequate overall. Tenderpreneur cartels walk much too confidently in our Government corridors. Yet without patient’s rights education, most patients still have much less confidence. 4/5 Kenyans are not yet registered with the NHIF and women’s organisations have not rallied effectively to protect mothers’ rights. The line between care and captivity is now so thin it discourages those who need maternity health-care services most.
In 1991, mothers of political prisoners led by Wangari Maathai fasted and chained themselves in Uhuru Park to protest their imprisonment. Perhaps it is time for families to join detained mothers in hospitals until they are released.
This coming Thursday October 5th, concerned citizens are meeting in the Kenya Cultural Centre to discuss what they can do about the quality of maternal health care. As County Governors attend their own orientation this week, let them declare a ban on detentions and generate innovative financing strategies. Let them also resolve the crippling nurses strike and pre-empt growing disputes among other cadres of health-workers.
It is time for 47 Beyond Zero campaigns, localized and ran from the counties. The scale of the challenge faced by our mothers cannot rely on a few passionate advocates in power. To make a difference, we must make this a cause, the public can rally around.
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