By Sonnie Ekwowusi

Last week I found myself in a certain big hospital in Lagos (name withheld) trying to assist a terminally-ill patient who had been detained by the hospital for non-payment of hospital bills. That was not the first time I was encountering such a patient being maltreated by a hospital. Over the years I have been encountering patients who had been detained by hospitals for non-payment of bills. Increasingly hospital managers in Nigeria are detaining their patients for their inability to pay hospital bills. As far as the managers of these hospitals are concerned, the most effective way of compelling poor patients to pay their hospital bills is to detain them at the hospital immediately after treatment or midway during treatment. Que barbaridad!

The dying patient who solicited my assistance last week underwent a major surgery at the hospital. Prior to the surgery, the patient, with the assistance of many charities and generous public donors, paid the hospital in question a gargantuan sum of N17.5 million. The sum covered all pre-surgical and surgical expenses. But unfortunately the surgery was unsuccessful. Before he was wheeled into the hospital operating room he wasn’t experiencing any severe pains in his stomach. But since he underwent surgery he had in the last one month been writhing in great pain. As at last week, the patient could hardly eat, let alone sleep at night due to the intense pain. Not even his wife, children, brother and friends frequenting the hospital to accompany him could console him or cheer him up. The pain seems unbearable. The pathetic aspect is that the hospital is unsure of the time the patient would be relieved from the intolerable pain. To add insult to injury, the hospital had slammed additional N6.2 million post-surgery bills on the patient. To avoid incurring more hospital bills and expenses, the family and friends of the patient had applied last week to the hospital to temporarily discharge the patient from the hospital so that he could go home and be attending hospital from home. The hospital turned down the application. Instead of acceding to the application, the hospital insisted that the patient must pay at least 50% of the N6.2 million additional post-surgery bills. Before I left the hospital last week the patient was still being detained despite all pleadings. I even had a meeting with the hospital management wherein I pleaded with them to allow the dying patient to go home. As we struggle to live with multiple perceptions of the truth, we should aim at building one world rooted in common humanity in which care for the sick occupies a primordial place. The sick are always with us and we cannot afford to remain in our respective cocoons unmindful of their plight.

Clearly the detention of the patient by the hospital is unconstitutional and illegal. By placing the patient under a false imprisonment for non-payment of bills, the hospital had flagrantly violated his right to freedom of movement and right to human dignity as enshrined in our 1999 Constitution and African Charter on People’s and Human Rights. Secondly, by acting as the offended party, complainant, accuser, prosecutor and the judge in their own case, the hospital had violated the rule of natural justice expressed in the well-known Latin maxim Nemo judex in causa sua.

You see, two wrongs cannot make a right. If the hospital was aggrieved that the patient had not settled his hospital bills before applying to leave the hospital, all it could have done was to request the patient or his relatives to enter into a written undertaking agreeing to the mode of and precise date of settling the bills. Subjecting the patient, who had earlier paid the hospital a whopping sum of N17.5 million, to psychological torture and humiliation simply because he was unable to pay his post-surgery bills is, in my humble view, inhumane. More importantly, recourse to force and self-help in settling disputes is a recipe for chaos and anarchy. A hospital not governed by the rule of law poses great danger to society. This probably explains why the law court has been vested with the jurisdiction to determine or settle all matters relating to the civil rights and obligations of the citizens.

Consequently, Nigerian hospitals should stop detaining patients for non-payment of bills. Aggrieved patients should approach the law court to seek remedy. Nigeria and Cameroun, I gather, are holding the world record as countries with hospitals where patients are routinely detained for non-payment of hospital bills. Why is Nigeria always featuring bad things? I also gather that some Nigerian pregnant women who had been detained in some hospitals for non-payment of hospital bills had died. Remember Mrs. Folake Oduyoye, a pregnant lady who was detained at the Lagos University Teaching Hospital (LUTH) for non-payment of her hospital bills despite the entreaties of her husband that the bills would be paid in due course? Sad to say, Mrs. Oduyoye eventually died at LUTH on December 13, 2014 while still in detention.

It is high time Nigerian governments understood that access to affordable health care is no longer a privilege: it is a human right of the citizenry. Nigeria’s greatest challenge over the years is making basic primary health care accessible to her citizenry. Come to think of it, provision of basic primary health care is no rocket science. All it takes the government to achieve that laudable goal is for it to get its priorities right. For example, instead of wasting $2 billion in constructing a railway line from Kano to Niger Republic, the Buhari administration should have spent the aforesaid amount in re-equipping public hospitals in Nigeria or providing affordable public health Insurance for Nigerian citizens. After assuming power in 2015 President Buhari promised that he would ensure that many Nigerians had unimpeded access to primary health care services. In one speech, President Buhari said: “Our goal of revitalizing the Primary Health care Centres is to ensure that quality basic health care services are delivered to the majority of Nigerians irrespective of their location in the country”. Till date, the President has not fulfilled this promise and other promises.

Beyond the government, the citizens cannot turn their back on their fellow citizens who are sick. To achieve this goal, it is imperative that we establish a broader consensus about the meaning of humanitarianism, and about its role in the promotion of human welfare. We need to identify common values from which to erect an ethical framework for human solidarity. In identifying this ethical framework, the pitiable situation of the sick particularly merits top priority. The citizens should build a strong solidarity for the welfare of the sick. We must set out in earnest to set up formidable blocks of social institutions to alleviate the sufferings of the sick in our midst. No man is an island unto himself. We cannot live in our little cocoons unmindful of the plight of the sick in our midst.

Ekwowusi writes that the detention of patients by hospitals is wrong

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