News reports examine patients unable to pay health bills in Kenya's "cash starved" hospitals; "bad shape" of Uganda's facilities

Jun 30 2009

The Los Angeles Times examines several stories of patients too poor to pay their hospital bills in Kenya that were held in a "makeshift patients' prison," until they escape or settle their debt. "Tragically, healthcare horror stories are common in Africa, where developing countries rarely have medical safety nets for the poor. But an increase in cases of cash-starved public hospitals and mortuaries detaining patients and even corpses over unpaid bills is spurring outrage in Kenya," writes the newspaper.

It has been two decades since the government cut funding to hospitals and implemented "cost-sharing" measures for patients, Kenyatta National Hospital spokesman George Ojuondo said. Now, he added, the government covers hospital workers' salaries but facilities must charge patients for drugs and other supplies. "The only way we can run the hospital is by charging patients," he said. "If people walk in and don't pay, how are we going to pay for the next patient?"

Kenyan lawmaker Njoroge Baiya said of the hospitals, "They know very well these people can never pay those bills. A more humane policy should be developed." But according to the Los Angeles Times, "many AIDS and cancer patients are pressured by their families to take public buses back to their hometowns, saving the burden of hospital bills, postmortem transportation and ensuring a decent burial. There, some face a painful, lingering death with little more than family members or traditional healers to comfort them" (Sanders, Los Angeles Times, 6/27).

Uganda Hospitals "In Bad Shape" 

According to IRIN News, "most Ugandan hospitals are in bad shape, something pointed out in a recent parliamentary committee report which looked at the performance of the health sector in 16 districts in the first few months of 2009."  Rapid population growth has put pressure on the country's hospitals and most of the facilities are dilapidated and in need of renovation. Several Uganda officials told IRIN News that "matters will get better this year" with plans to borrow money from the World Bank for hospital renovations, efforts to improve health care infrastructure and drug access, and efforts to retain Uganda health care workers (IRIN News, 6/25).