Women are routinely detained after they give birth at Harare Central Hospital (HCH) if they are unable to pay their hospital bills. The matter has been widely discussed in the press and online, raising public disgust.
New mothers and their babies are not permitted to leave and are ‘prisoners’ in the hospital until they pay up. Most of the women Harare News spoke to say that in these instances they are given insufficient food and only allowed to sleep on the floor. If there are no free beds available, the babies sometimes have to sleep on the floor with their mothers. The women also complained about ill-treatment by hospital staff immediately after giving birth and also of being deprived of the birth records of their babies until fees are paid.
Margaret Muropa, who spent two days at the institution last year, described her ordeal. “First the food is meagre and there are no proper washing facilities. The moment you give birth, they treat you as an outcast. The nurses will tell you to get out of the bed because someone else needs it. You are viewed as outcast and you begin to think that having a baby is a crime! Even after finally paying the hospital fees their attitude was dehumanising,” said Muropa.
Another mother, Shoriwe Mhanda, said she spent a day at the hospital before her husband came to take her home. “I was in a lot of pain because I had a C-section. I did not have enough dressing and I was bleeding profusely from the wound. The nurses told me to get out of the bed because someone else needed to use it. When I told the nurses that I was in pain, I was told, ‘Hatichakwanisa kukubatsirai takatoita zvinoenderana memari yenyu’ (we can’t help you any further, we have helped you as much as the money you paid allows),” said Mhanda.
Acting CEO Doctor George Vera dismissed the allegations by the women as untrue. “It is not true that we detain women who have given birth. The incidences described by the mothers are when we discharge them. We normally ask them to wait for their husbands or next of kin. The institution policy is that we don’t discharge without declaring your bills, and without someone coming to take you home. Most of our mothers will be in a fragile state, hence we ask someone to come and take them home,” said Dr Vera.
Dr Vera blamed the husbands and relatives of the women for not coming in time or reneging on their hospital bills when they are called by the hospital to come and pay.
Harare News journalist, Lovemore Lubinda, whose wife went through the same ordeal a year ago contradicted the doctor’s claims.
“I was told to come to the hospital and settle the bill in order for my wife to be released to go home in spite of the fact that I had paid her fees at a city clinic where she had registered to deliver. When my wife was transferred to HCH, I was never told that I had to pay extra costs,” said Lubinda.
The World Health Organisation says that the post-natal period –the days and weeks following childbirth – is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time. Post-natal care involves getting proper rest, nutrition, and vaginal care. This is not happening at Harare Hospital.
Experts in Zimbabwe believe high user fees are leading to higher rates of maternal mortality. A normal delivery costs on average $100. Should a C-section be necessary, patients fork out another $168 and up to $600 in some cases. The average Zimbabwean woman earns less than $250 and therefore cannot afford the fees charged by clinics and hospitals. Medical aid is also often unaffordable.
Health activists continue to campaign for accessible and affordable health care for pregnant women. They describe the practice of detaining women as wrong and as an abuse of women’s reproductive rights. Sally Dura, national coordinator of the Women Coalition of Zimbabwe says, “This kind of treatment is traumatising and punishing to women. Many women will shy away from health delivery facilities and die because these fees discourage them from seeking medical attention,” said Dura.
In contradiction to all reports, the Government maintains that maternity services are free. Public relations officer for the Ministry of Health and Child Care, Donald Mujiri, said the Maternal and Child Health policy which came into effect in 2013, pledges that free maternal health for mothers is a “highest priority” and that this is government policy which should be respected.
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