By Maris Sellah
More women seeking maternal health services continue to be detained in hospitals due to their inability to clear their medical bills.
This year alone, more than 10 women have been detained in facilities, despite the 2015 High Court ruling that declared detention and abuse of women who are unable to pay for maternity services in Kenyan Public hospitals as arbitrary, unlawful, and in violation of Kenyan constitutional and international human rights standards.
The High Court asserted that detention and abuse of women who are unable to pay for maternity services constituted discrimination on the basis of gender and socio-economic status, because only women require health care services for pregnancy and childbirth, but also only poor women will be detained.
Judith Amoit, a 27 years old police woman, is among those detained this year. Judith was detained in a City Hospital for failure to raise the close to Sh3Million medical bill, which had accrued since her admission to the hospital for delivery in July 28.
The administration of the hospital refused to free Ms Amoit due to the pending bill after she had delivered her twin daughters who unfortunately passed away. Judith visited the hospital after she developed sharp back pains. At seven month of pregnancy, Judith delivered premature twins who were kept in an incubator, where they later developed an infection and passed on.
The two bodies were also detained in the hospital’s morgue. Veronica Nyangai had also been detained in the same city hospital over Sh600, 000 medical bill early this year. “Besides Nairobi West Hospital, there was also detention in Mercy Light Hospital in Kiambu County, where a young mother was detained for six months after delivery.
“Yet this is just the tip of the iceberg because there are several cases in other facilities that go unreported,” says Evelyne Opondo, the senior regional director for Africa at the Centre for Reproductive Rights (CRR). In 2013, the government issued a directive that all women would now access free maternity services including delivery in public health facilities.
However, this directive has not been successfully implemented. According to Ms Opondo, the government has failed to allocate sufficient additional resources to implement the directive which has resulted in suspension and interruption of the free maternity services in some facilities.
Other than detention, women seeking maternity services also encounter both verbal and physical abuse in some facilities. Recently, Centre for Reproductive Rights filed a case on behalf of a woman in Western Kenya who was slapped and verbally abused by nurses in a health facility where she had gone to deliver.
The woman was left to deliver on the floor of the hospital for lack of sufficient delivery beds. According to Ms Opondo, in most of health facilities, such treatments go unpunished.
This is because there lack clear complaint mechanisms within those facilities and hence most women do not know where to lodge their complaints. In addition, most women do not know their rights and thus do not challenge these kind of practices.
“Health care providers who physically and verbally abuse patients or who treat them disrespectfully and in abusive ways should be held accountable for their actions,” she said.
For many women, the decision whether to go to a health facility for specialized care will be dependent on how they are treated in those facilities. Ms Opondo added: “It’s important that we treat women respectfully, even as the government undertakes its campaigns for more women to go to health facilities for skilled health care delivery”.
Detention and abuse of women seeking maternal health services deprives women of their dignity and violate women’s rights to fundamental freedom from cruel, inhuman and degrading treatments and their right to health.
According to Ms Opondo, both health care providers and patients need to be conversant of patient’s rights and challenge their violations, the health facilities, both private and public, should desist from detaining women who cannot pay their bills after delivery and seek other means of collecting that debt as is done with other civil debts.