At many hospitals worldwide, you don’t pay, you can’t leave

Doctors at Nairobi’s Kenyatta National Hospital have told Robert Wanyonyi there’s nothing more they can do for him. Yet more than a year after he first arrived, shot and paralyzed in a robbery, the ex-shopkeeper remains trapped in the hospital.

Because Wanyonyi cannot pay his bill of nearly 4 million Kenyan shillings ($39,570), administrators are refusing to let him leave his fourth-floor bed.

At Kenyatta National Hospital and at an astonishing number of hospitals around the world, if you don’t pay up, you don’t go home.

The hospitals often illegally detain patients long after they should be medically discharged, using armed guards, locked doors and even chains to hold those who have not settled their accounts. Even death does not guarantee release: Kenyan hospitals and morgues are holding hundreds of bodies until families can pay their loved ones’ bills, government officials say.

An Associated Press investigation has found evidence of hospital imprisonments in more than 30 countries worldwide, according to hospital records, patient lists and interviews with dozens of doctors, nurses, health academics, patients and administrators. The detentions were found in countries including the Philippines, India, China, Thailand, Lithuania, Bulgaria, Bolivia and Iran. Of more than 20 hospitals visited by the AP in Congo, only one did not detain patients.

“What’s striking about this issue is that the more we look for this, the more we find it,” said Dr. Ashish Jha, director of the Harvard Global Health Institute. “It’s probably hundreds of thousands, if not millions of people, that this affects worldwide.”

During several August visits to Kenyatta National Hospital — a major medical institution designated a Center of Excellence by the U.S. Centers for Disease Control and Prevention — the AP witnessed armed guards in military fatigues standing watch over patients. Detainees slept on bedsheets on the floor in cordoned-off rooms. Guards prevented one worried father from seeing his detained toddler.

Kenya’s ministry of health and Kenyatta canceled several scheduled interviews with the AP and declined to respond to repeated requests for comment.

Health experts decry hospital imprisonment as a human rights violation. Yet the United Nations, U.S. and international health agencies, donors and charities have all remained silent while pumping billions of dollars into these countries to support their splintered health systems or to fight outbreaks of diseases including AIDS and malaria.

“People know patients are being held prisoner, but they probably think they have bigger battles in public health to fight, so they just have to let this go,” said Sophie Harman, a global health expert at Queen Mary University of London.

Hospitals often acknowledge detaining patients isn’t profitable, but many say it can sometimes result in a partial payment and serves as a deterrent.

Festus Njuguna, an oncologist at the Moi Teaching and Referral Hospital in Eldoret, about 300 kilometres northwest of Nairobi, said the institution regularly detains children with cancer who have finished their treatment, but whose parents cannot pay.

“It’s not a very good feeling for the doctors and nurses who have treated these patients, to see them kept like this,” Njuguna said.

Still, many officials openly defend the practice.

“We can’t just let people leave if they don’t pay,” said Leedy Nyembo-Mugalu, administrator of Congo’s Katuba Reference Hospital. He said holding patients wasn’t an issue of human rights, but simply a way to conduct business: “No one ever comes back to pay their bill a month or two later.”

Global health agencies and companies that operate where patients are held hostage often have very little to say about it.

The CDC provides about $1.5 million every year to Kenyatta National Hospital and Pumwani Maternity Hospital, helping to cover treatment costs for patients with HIV and tuberculosis, among other programs. The CDC declined to comment on whether it was aware that patients were regularly detained at the two hospitals or if it condones the practice.

Dr. Agnes Soucat of the World Health Organization said it does not support patient detentions, but has been unable to document where it happens. And while WHO has issued hundreds of health recommendations on issues from AIDS to Zika virus, the agency has never published any guidance advising countries not to imprison people in their hospitals.

Many Kenyan human rights advocates lament that hospitals continue to hold patients despite what was seen as a landmark judgment in 2015.

Back then, the High Court ruled that the detention of two women at Pumwani who couldn’t pay their delivery fees — Maimuna Omuya and Margaret Oliele — was “cruel, inhuman and degrading.” Omuya and her newborn were held for almost a month next to a flooded toilet while Oliele was handcuffed to her bed after trying to escape.

Earlier this month, the High Court ruled again that imprisoning patients “is not one of the acceptable avenues (for hospitals) to recover debt.”

Omuya said she is still psychologically scarred by her detention at Pumwani, especially after another recent run-in with a Nairobi hospital.

Several months ago, her youngest brother was treated for a suspected poisoning. When Omuya and her family were unable to pay the bill, the situation took a familiar but unwelcome turn: he was imprisoned. Her brother was only freed after his doctor intervened.

“Detentions still go on because there are no rights here,” Omuya said. “What I suffered, I want no one else to suffer.”

Doctors at Nairobi’s Kenyatta National Hospital have told Robert Wanyonyi there’s nothing more they can do for him. Yet more than a year . . .

Follow Us On Google News | Get Our Newsletter



Trending News on PVDN

  • Where do foreigners come from and where do they live in MexicoMexico City Protest on July 5 Challenges Gentrification and Airbnb’s Impact on Housing Residents of Roma and Condesa will gather at Parque México on July 5 to protest gentrification, rising rents, and Airbnb’s effect on local housing. This Saturday, July 5, Mexico City will witness its first organized citizen protest against gentrification—a peaceful but urgent gathering taking place at 3:30 p.m. at the Lindbergh Forum in Parque México,…
  • protests3Mexico City Protests: There is a fine line between anti-gentrification and xenophobia The line between anti-gentrification and racism is clear if you choose to see it: genuine activism targets policy and practice, not nationality or ethnicity. I have lived in Mexico for two decades, and I have never witnessed the level of anti-American sentiment that exists today. All of it is tied to the buzzword "gentrification," a…
  • puerto vallarta lettersPuerto Vallarta needs a new image to create meaningful reasons for travelers to visit Business leaders at Jalisco Tourism Secretariat forums stressed the need for renewing Puerto Vallarta image and diversifying attractions to appeal to national and international markets. Local business leaders and tourism specialists agreed this week that Puerto Vallarta needs a fresh look and a broader range of attractions to compete at home and abroad. In a…
  • puerto-vallarta-police-chase-bahia-de-banderasPuerto Vallarta police chase ends in deadly collision in Bahía de Banderas A Puerto Vallarta police chase along Highway 200 ended in a deadly collision in Bahía de Banderas, leaving two people dead. A high-speed chase that began in Puerto Vallarta, Jalisco, and ended in Bahía de Banderas, Nayarit, left at least two people dead and raised new questions about police engagement and road safety in the…
  • puerto-vallarta-rainfall-hurricane-flossie-july-2025Puerto Vallarta braces for torrential rains as Hurricane Flossie gains strength Puerto Vallarta faces a high risk of flooding as Hurricane Flossie intensifies in the Pacific. Torrential rains and overwhelmed drainage systems pose major challenges for the city. Puerto Vallarta, a city wedged between the Sierra Madre mountains and the Pacific Ocean, is no stranger to dramatic weather shifts—but this summer, the skies are testing the…
  • protestProtest graffiti and smashed windows mars anti-gentrification rally in Mexico City Residents and activists joined an anti-gentrification rally in Mexico Park, but the anti-gentrification rally Mexico Park turned destructive as masked youths defaced local shops and broke windows. A rally against gentrification held yesterday in Mexico City’s Parque México drew residents from Juárez, Roma, Condesa and Hipódromo alongside local activists. Organizers billed it as the city’s…
  • mexico city real estateGentrification in Mexico City is not the reason for the high cost of housing City housing shortage, not gentrification, drives prices skyward as planning lags behind demand and foreigner influence remains minimal. High real estate costs in Mexico City stem from a deep and persistent housing shortage—exacerbated by land constraints, tangled regulations and speculative investment—rather than by the presence of foreign residents. Despite headlines blaming “gentrification,” foreign-born residents make…
  • Body with signs of crocodile attack found in Ameca River, a leg was found last monthPurple Flag Warns Beachgoers after Crocodile at Los Muertos Beach Authorities raised a purple flag after a crocodile at Los Muertos Beach was spotted swimming near shore, advising visitors to avoid entering the water until safety checks ended. Local authorities recorded a crocodile swimming in the vicinity of Los Muertos Beach, one of Puerto Vallarta’s busiest tourist spots. Lifeguards spotted the reptile in shallow water…
  • José Luis Velázquez RodríguezSEAPAL Official Reported Missing in Puerto Vallarta Authorities in Puerto Vallarta have launched a search for José Luis Velázquez Rodríguez, SEAPAL's head of transparency, who has been missing since June 30. Family and officials are urging the public to report any information. Local authorities and civil protection units have launched a search operation for José Luis Velázquez Rodríguez, head of the Transparency…
  • puerto vallarta loses three blue flag beachesPuerto Vallarta retains four Blue Flag Beaches, down from eight Puerto Vallarta will enter the 2025–2026 season with four international Blue Flag distinctions in Puerto Vallarta, even after tourism-driven environmental damage cost it half of its previous honors. The Foundation for Environmental Education (FEE) in Mexico confirmed that three resort flags will be revalidated at Marriott Puerto Vallarta Resort & Spa, The Westin Resort &…
Scroll to Top