Awa Fadiga, 23, was a model. She was attacked on Sunday evening and subsequently dropped off at the emergency room at the University Hospital Centre of Cocody in Abidjan. Just over 36 hours later, she died there. Her relatives claim that she spent the night without any care because she couldn’t pay for it on the spot. Our Observer, a doctor in Abidjan, is not surprised by this allegation.
Her relatives are trying to raise public awareness about this incident on social networks. According to them, the young woman was the victim of the hospital staff’s negligence. Awa was attacked by a taxi driver and thrown out of the car into the road. She was found lying in a pool of blood by the police, who dropped her off at the hospital around 11pm.
From this point onward, her relatives’ version of events diverges from the hospital’s. One of her friends told FRANCE 24 that she rushed to the hospital the next day at 1pm with Awa’s parents, who had been alerted by the police. She says Awa was lying on the ground, bleeding, and a janitor, who told her she had cleaned up the young woman, had covered her body with a sheet. Awa’s friend and parents immediately paid for the young woman to receive the appropriate medication. They also paid for the ambulance trip needed for her to get scans at a private clinic. Several hours later, she was transferred back to the hospital’s intensive care unit, where she died at 7am in the morning.
A list of the medications paid for by Awa’s family. Photo uploaded to the Facebook page dedicated to the young woman.
When contacted by FRANCE 24, the hospital’s spokespeople explained that the young woman received care as soon as she arrived, based on the hospital’s admissions ledger. In a statement, the minister of health explains that “she received the first aid that her condition required, including intravenous treatment, as well as cleaning and bodily care from assistants with soapy water and antiseptic”. He further added that the young victim died “following a terrible and unforgivable attack for which the hospital staff are not responsible”.
Awa’s death has sent shockwaves rippling across Ivory Coast. A Facebook page in honour of the young woman has been set up under the name “Awa Fadiga, Stop, Never Again”. And a petition “so that hospitals stop being just places people go to die” was created on March 26, to be sent to the Ministry of Health.
Cocody’s university hospital centre.

“If you’re alone in the hospital and unconscious, the system is such that you probably won’t receive care in time”

Michel X has been a doctor in Abidjan’s hospitals for over ten years.
I don’t know the specific details of this story, but the allegations do not surprise me. There are problems at all levels of the ER. Often, it starts with the first responders, who are poorly equipped and lack the proper training, which means the victim will arrive in an even worse state. Hospital procedure requires the patient to be first checked out by a doctor, during which time relatives must fill out administrative documents. Afterwards, the doctor gives a prescription to the nurse, who passes it on to the family. At this point, the family must pay to obtain the medication, blood pouches, radiology procedures, and the associated equipment [gloves, cotton swabs, etc.] needed to care for the patient. Often, families are unable to pay, and sometimes there is a shortage of medication.
In this young woman’s case, it’s very likely that the personnel saw that she had no relatives present to pay for her care. They probably put her to the side as a result. If you’re alone in the hospital and unconscious, the system is such that you probably won’t receive care in time because you will not be able to pay for it. This is particularly the case when you’ve just been attacked, because you probably don’t have any money on your person anymore.
There is no social security in Côte d’Ivoire. Hospitals are organisations that must generate revenue. It’s hard to admit, but since the ER is always overflowing, doctors must make decisions based on which patients are likely to be able to pay for their care.
“Doctors aren’t the ones that should be condemned; it’s the system as a whole that needs to be overhauled”
The president [Alassane Ouattara] had enacted a policy of free healthcare after the post-electoral crisis. However, he reneged on his commitment and instead introduced “targeted free care” [outlined in more detail here, this policy covers the first 48 hours in medico-surgical emergency rooms]. But hospitals aren’t following suit. There aren’t enough emergency doctors, there isn’t enough training in this speciality, and the ERs are under-equipped. Just think — there is only one functional MRI machine in the entire country!
Another important point to keep in mind is that specialties are not accounted for in salaries: ER doctors that work at night and generalists that only work day shifts both get paid the exact same salary. And the budgets are so tight that very often, the staff isn’t paid at the end of the month. In this context, even though the staff wants to save lives, they inevitably lose much of their motivation.
When a woman in Awa’s state is dropped off at the ER, people expect her to be treated, but the state of Ivorian hospitals is such that her care cannot be ensured. Doctors aren’t the ones that should be condemned; it’s the system as a whole that needs to be overhauled.
Cocody university hospital centre. Photo posted in 2009.