Observers

The main hospital in the capital of Cameroon detained about a dozen mothers and their newborns in a small room for about a month because they were unable to pay the hospital fees for the birth by Caesarean section. The detention of patients is common in Cameroon, where there is no universal healthcare system.

In late July, when the women had already been detained for several weeks at Yaoundé’s main hospital, a few of them managed to send friends and relatives photos of the room where they were being held. These photos quickly found their way to activist Paul Chouta, who posted them to Facebook on August 2. Chouta said that the new mothers and their babies had been subjected to “inhuman treatment” all because they had been unable to pay the “exorbitant fees” for a Caesarean section.

The photos show at least 11 women holding their babies and sitting on the floor in a small hospital room.


Tweet translated from French: “DENUNCIATION - 13 WOMEN AND 11 BABIES LOCKED IN A ROOM IN THE MAIN HOSPITAL IN YAOUNDÉ FOR SEVERAL MONTHS LIKE PRISONERS”
 

The FRANCE 24 Observers team also received photos showing the new mothers eating a meal from plates set on the floor.
 

The women share a meal. (Photo sent by a woman who was detained in this room in the main hospital in Yaoundé for over a month.)

“To leave the hospital you need a document authorizing your release, which you can only get if you pay. We were really trapped.”

Julie (not her real name) arrived in the main hospital on June 22 and wasn’t able to leave until late July, when she managed to sneak out. She shared her story:
 

When I got to the hospital to give birth, I only had enough money to pay for a traditional birth, which costs about 55,000 CFA francs CFA [around €83]. But, in the end, I had to have a Caesarean. I stayed in the hospital and was under observation for seven days. They then asked me to leave my room and pay.

My bill was for around 200,000 CFA francs [around €305]. I didn’t have the money to pay. My family, who live back in our village, couldn’t come to town. Moreover, they didn’t have the money. So the hospital put me in Room A35, where I was supposed to wait until I could pay.

To leave the hospital, you have to show one of the guards a document authorizing your release, which you have to pay for.

We were really trapped. The only thing that we could do was walk up and down the hospital corridors. We shared three beds, which meant that some of us were sleeping on the floor. We did our best to wash clothes in the bathroom sinks. The hospital brought us food in the morning and at noon. Sometimes, we asked people who could leave to bring us and our children things to eat.

In the end, a few of us tricked the guards and left. I was finally able to go home and see my family.


On August 2, the day that the photos were posted online, the women were allowed to leave the hospital. Our team spoke to a few of the women. Some believed that a representative from a charitable foundation had paid their bills. Others thought that the hospital let them go to avoid a scandal.
 

A woman sleeps on the floor with her newborn baby. Photos sent by a woman who was trapped for a month in the main hospital in Yaoundé. (Photo blurred by at her request.)

"We begged for food from other patients"


Jocelyne (not her real name) was one of the women who were freed on August 2. She says she stayed for over a month in the small room that she nicknamed "Kosovo". After the first group of women managed to escape, she says that the hospital enacted new restrictions:
 

After the first group of women left, hiding their babies in their bags, we were no longer given food. We went from room to room, begging for food from other patients.

I have a motor disability and I thought that my disability card would equal a reduction in my fees. Not at all! And, because of my disability, I couldn’t escape. My two other children were waiting for me at my parents’ house and I couldn’t go get them. My parents didn’t want to help me. They said that it was my husband’s job but he couldn’t gather enough money. I finally left the hospital when they freed us on August 2.

Two women nurse their babies while another one washes her newborn using a glove and a bucket of water. (Photo sent by a woman who was detained for over a month in the main hospital in Yaoundé. Photo blurred by at her request.)


On August 3, the hospital director, Pierre Joseph Fouda, organised a press conference to deny allegations that the women had been “trapped” in his establishment. He claimed that the story had been manipulated. On the hospital website, however, it says that “sick people who don’t pay” are “forced to prolong their stay at the hospital”.

In a statement published in the local media, Fouda said that, in 2017, the hospital had lost more than 32 million CFA francs [Editor’s note: around €49,000] in fees relating to Caesarean sections (including hospitalisation, medical imaging, anaesthesia, medicine, surgery) and that this figure could get worse in 2018.

While he said that the hospital believed in caring for all women who come so that none of them “die while giving life”, he criticised families who “refuse” to pay.

"Everyone knows the only solution: to put in place universal healthcare”

However, the situation doesn’t seem so simple for our Observer Marcus (not his real name). He is a doctor in a hospital in Cameroon and chose to remain anonymous.

These photos aren’t surprising. Because there is no universal healthcare system, hospital management constantly faces dilemmas – patients are cared for after they arrive and are expected to pay when they leave, but many of them don’t have enough money.

In Cameroon, only about 1 to 2% of the population has private health insurance to help pay for medical fees. Each year, many people fail to pay their fees, leaving a huge hole in hospital finances.

To prevent people from taking advantage of the system, some hospitals do have detention rooms like those shown in the photos. It is a common problem, especially because some families genuinely don’t have bad intentions – they just don’t have the money to pay. Other women are abandoned after they give birth. Everyone knows the only solution – to establish universal health care.


The director of the hospital did not respond to our interview request. We will update this page if we do receive a response.

In 2016, there was a massive scandal when a woman who was pregnant with twins died after being turned away from a Douala hospital because she didn’t have the money to pay for all of the hospital fees.

>> READ ON THE OBSERVERS: Pregnant woman’s shock death puts Cameroon’s healthcare under spotlight

 

This article was written by Maëva Poulet (@maevaplt).