Posted by Jambo
One mother who sued Pumwani Maternity Hospital after doctors “forgot” a pair of medical scissors inside her womb for nine days, is too traumatised to visit health facilities, even though she has a life-threatening health condition.
After the ‘successful’ cesarean operation, Margaret Anyoso, 38, was also illegally detained at the hospital for one week because she was unable to clear her bills.
She now suffers bouts of debilitating cramps in her lower abdomen every time she bends to cook.
“I get frequent stomach aches and every time I try to bend, I feel like my stomach is bursting. I also have to visit the bathroom every five minutes,” she says.
In most operating rooms, a nurse keeps a manual count of the sponges and tools the surgeon uses during a procedure. However, this is not always the case especially in busy and chaotic environments where miscounts occur. Often, it is a sponge that gets left behind.
Margaret was on her way out of the hospital unaware of the scissors still inside her. But a security guard at the gate – with no medical training – realised her life was in danger because she was looking haggard, and was still bleeding.
She underwent an emergency operation to remove the scissors and stayed at Pumwani for a further four days. That was 15 years ago.
“At that time I didn’t know that I should have taken immediate legal action by suing the hospital. I always blamed myself for having no money,” she says.
In September 2010, she returned to Pumwani to deliver another child, but doctors failed to realise her baby was in a breech position. She says they “left her unattended and bleeding on a bench for more than two hours before performing a cesarean, which caused her to suffer a ruptured bladder.” The hospital detained Margaret again – this time for six days over a Sh6,300 balance. She had only managed to clear part of the total amount billed of Sh12,300. Margaret – who now has five children – says staff taunted her for ‘being stupid’, not knowing her pregnancy was a result of rape.
Pumwani Hospital is the oldest maternity facility in the city, established in 1926 by the now defunct Nairobi City Council. This is same place where President Uhuru Kenyatta was born in 1961. It currently handles about 3,000 normal deliveries every month and less than 300 cesarean sections each month.
Margaret’s daughter delivered in 2010, appears to have developed a complication. “My daughter has persistent colds and nosebleeds a lot. So I constantly have to buy medicine for her. But I cannot stand the sight of a hospital,” she says.
Counsellors believe Margaret suffers nosocomephobia-the fear of hospitals, and tomophobia – a fear of surgery or surgical operations.
In 2012, Margaret and Maimuna Awuor, a mother of six who was detained for 24 days at Pumwani Hospital in 2010, sued the hospital, the Attorney General, Minister for Local Government, City Council of Nairobi and Minister for Medical Services, for human rights violations.
The case was filed on their behalf by Nairobi-based Centre for Reproductive Rights. It ended successfully in September last year when High Court Judge Mumbi Ngugi, ordered the Nairobi County government to pay Margaret Sh500,000 and Maimuna Sh1.5 million for their suffering, in addition to footing costs of the suit. The court also directed the government to take necessary measures to eliminate the practice of detaining patients who cannot pay their medical bills.
Maimuna, 45, a casual worker in Majengo, developed chronic flu during her ordeal and might require lifelong intervention. The mother of five, who could not raise the Sh3,600 bill, was forced to shared beds with other patients. She was eventually forced to sleep on a cold floor next to a flooding toilet, and developed pneumonia as a result.
Maimuna says the health of one of her children deteriorated because there was no one to look after them during her time in detention.
Lady Justice Ngugi found that apart from being illegally detained, Maimuna and Margaret were subjected to “cruel, inhuman, and degrading treatment.”
She said the two were discriminated on the basis of their socio-economic status and gender, and that some of their human rights were violated, including their right to liberty and dignity.
The ruling follows a similar one in 2012 by Justice David Majanja who found it illegal to hold anyone hostage until they pay their bill. He made his ruling in the case of Sonia Kwamboka Rasugu v Sandalwood Hotel & Resort Limited , in which he stated, “it is illegal for an establishment hold a customer hostage for the non-payment of a bill.”
The two women detained at Pumwani, are devastated that the county government plans to challenge the ruling.
Margaret makes a living washing clothes in Majengo area in Eastlands, Nairobi. She had planned to use the compensation to get counselling, before attempting to seek medical help.
About 5,000 babies are born daily across Kenya and at any given time, Pumwani and Kenyatta National Hospital have some new mothers detained for unpaid bills.
Evelyne Opondo, regional director for Africa at the Centre for Reproductive Rights, says the case has emboldened pregnant women to seek basic maternal health care, even if they are poor and broke.
“Denying essential maternal care and illegally detaining those who seek but cannot afford it, is a human rights violation that is
especially harmful to women living under harsh economic circumstances,” she says.
About 8,000 Kenyan women die from pregnancy-related complications each year, mostly because they cannot afford medical care or reach health facilities in time.
In June 2013, as the case of the two women was pending in court, President Uhuru Kenyatta issued a directive abolishing all maternity service costs in Kenyan public hospitals.
“It’s time the national and county governments immediately improve the oversight of Kenyan hospitals and ensure all women get quality maternal health care that President Kenyatta promised,” Opondo says.
The Kenya National Commission on Human Rights says hospital infrastructure and staffing cannot support the additional number of women who seek free maternal health care because of the President’s declaration.
“A matron at Pumwani Maternity Hospital, for example, noted that while the hospital used to charge Sh5,000 for normal deliveries and Sh10,000 for a cesarean, the government was reimbursing them at a flat rate of Sh5,000 per delivery, creating a critical financial gap,” says the 2013 KNCHR report,Implementing Free Maternal Health Care in Kenya.
“As documented in other countries that have implemented free delivery services, such as Ghana, these funding and implementation gaps can create serious friction between communities and health staff and between facility managers and higher levels of the health system,” the report adds.
The CRR welcomes the waiver of maternity feels but says the quality of services is wanting.
The organisation also brought the case of Josephine Majani, who was physically and verbally abused and repeatedly denied quality maternal care at Bungoma District Hospital. The case is still pending in the High Court.
The centre questions why the ministry of Health withdrew its “Standards and Guidelines for Reducing Morbidity and Mortality from Unsafe Abortion in Kenya”.
“The deaths and injuries of these women can be prevented and must be prevented. Medical professionals in Kenya must be trained and given clear standards and guidelines on providing women who qualify for services and need to end a pregnancy, with safe, legal care,” says Opondo.
Unsafe abortion contributes about 20 per cent of all maternal deaths in Kenya, according to the ministry.
“Denying a woman access to the critical health care she needs, can lead to devastating consequences in her life, her family, her community, and Kenyan society as a whole,” Opondo says.
Margaret nowadays, finds washing clothes for a living as risky as a pregnancy, because of the abdominal pains.
“At 38 I am still young, but I let my children do all the work for me,” she says.
-the-star.co.ke
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