[afro-nets] Hundreds of Insolvent Patients Detained

[Claudio Schuftan <claudio@hcmc.netnam.vn>]

Burundi: Hospital Officials Detain Hundreds of Insolvent
Patients
--------------------------------------------------------
From: Kevin Burns <kdburns@gmail.com>

The full report is at http://www.hrw.org

I have just spent two months in Burundi, and very glad to see
this report come out. It is one of the only and most
comprehensive documentation of this type of human rights
violation, even though anecdotally I have heard many people
mention similar situations occurring in different parts of the
world.

The role of the World Bank/IMF/donors comes through in this
report. My thoughts are that the situation is primarily the
outcome of cost recovery/cost effective/efficiency schemes
applied to one of the poorest countries - while it is working to
recover from 13 years of civil war, and a longer history of
ethic violence.

The report mentions the implementation of a cost recovery system
in 2002 (p.5).

"According to the chef de cabinet, the responsibility for the
non-payment lay not with her Ministry, but with the Crédit de
Relance Economique, a World Bank- financed fund for
reconstruction activities" (p. 48)


--
Kevin Burns http://www.amsa.org/global

Burundi: Hospital Officials Detain Hundreds of Insolvent
Patients

(Bujumbura, September 7, 2006) ­ Burundian state hospitals
routinely detain patients who are unable to pay their hospital
bills, Human Rights Watch and the Burundian Association for the
Protection of Human Rights and Detained Persons said in a new
report released today. The patients can be detained for weeks or
even months in abysmal conditions.

This practice highlights broader problems of the health system
in Burundi, where patients have to pay for their own treatment,
the two organizations said. Both organizations called on the
Burundian government to end the detentions and to make access to
health care for all Burundians a central part of its new Poverty
Reduction Strategy Paper.

?Detaining poor patients because they can?t pay a bill punishes
the poor and violates international human rights law,? said
Juliane Kippenberg, NGO Liaison of the Africa division of Human
Rights Watch. ?It?s an abuse that the Burundian authorities must
end.?

The 75-page report, ?A High Price To Pay: The Detention of Poor
Patients in Hospitals,? documents how Burundian hospitals in
2005 detained hundreds of indigent patients, sometimes in
inhumane conditions. Many of those detained were women giving
birth who unexpectedly needed caesarian deliveries. In some
cases, hospital authorities refused further medical care to
those who could not pay their bills and forced them to vacate
their beds for wealthier incoming patients.

Patients who could not pay their bills were kept under guard and
prohibited from leaving the hospital grounds, often for weeks or
months, but in one case for more than a year. Some detainees
sold their farm animals or land to settle accounts in order to
leave hospitals. Others escaped or were rescued by benefactors
who paid their bills. Burundi?s government continues to detain
indigent patients and hundreds are currently in detention in the
country?s state hospitals.

In Burundi, one of the world?s poorest nations, patients
commonly have little money to pay medical expenses. The most
vulnerable are supposed to have part of their medical expenses
paid by the government, but the system of assistance does not
work in practice. Moreover, the Burundian health sector is
plagued by massive funding shortfalls and by fraud and
corruption.

?With authorities working on poverty-reduction strategies, it is
clearly past time for them to address the basic right of all
Burundians to health care,? said Jean-Baptiste Sahokwasama of
APRODH.

On May 1, 2006, the government took a positive step of ordering
that maternal and child health care be provided free of charge.
Hospitals have since allowed mothers and small children to leave
hospitals without paying their bills. However, the measure was
ill-prepared for and resulted in an influx of pregnant women and
sick children, severely straining hospital resources. The
measure did not provide relief for other indigent patients who
continue to be detained.

?Donors will soon be making major decisions about debt relief
and aid to Burundi,? said Sahokwasama. ?Funds from debt relief
and international assistance should be urgently directed toward
health care so hospitals and doctors can focus on providing
health care to all those in need.?