A High Price to Pay: Detention of Poor Patients in Burundian Hospitals

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A High Price to Pay
Detention of Poor Patients in Burundian Hospitals

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Summary and Recommendations
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Acronyms

Map of Burundi

I. Summary

II. Recommendations

III. Methodology

IV. Background: Health, Poverty and Conflict

Political and socio-economic situation in Burundi: Moving from conflict to post-conflict

The health sector in Burundi

Availability and access to health care

Hospital detentions in Africa

V. Detention in Public Hospitals for Lack of Payment

Numbers of hospital detainees

Medical problems leading to detention

Surgery

Patients suffering from long-term or chronic diseases, including HIV/AIDS

Maternal health problems before May 1, 2006

Infant and child health problems

“Since you have not paid, we will imprison you”: Experiences of patients

Surveillance

Prince Louis Rwagasore Clinic: Detention in a lock-up

Size of bills

Conditions of detention

Lack of medical treatment

Lack of food

Losing the bed

Children in hospital detention

Mohamed S.

Noah B.

Félix M.

Adèle A.

Refusal to release dead bodies

VI. Consequences of Hospital Detention

Economic pressure

Fear to seek access to health care

VII. The Government Response

VIII. Government Measures Aimed to Improve Access to Health Care

The failure of health insurance

The failure of the exemption system for the poor

The indigence card

The voucher for displaced people

Alternatives to hospital detention

Free care for women giving birth and small children: The May 1 presidential directive

An increased burden on the health system

Impact on hospital detentions

Further government plans for health reform

IX. Government Failure to Address Other Structural Problems of the Health System

Starving the hospitals: The downside of hospital autonomy

Lack of transparency in health sector finance

X. Keeping the System Alive: The Dilemma of Being a Benefactor

XI. The Role of the International Community in the Health Sector

Donor aid

Debt relief

XII. Human Rights Standards

Detention

Health

XIII. Acknowledgements

September 2006 Volume 18, No. 8(A)

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