The Kenyatta National Hospital is east Africa's biggest medical institution, home to more than a dozen donor-funded projects with international partners - a "Center of Excellence," says the US Centers for Disease Control and Prevention.
The hospital's website proudly proclaims its motto -- "We Listen ... We Care" -- along with photos of smiling doctors, a vaccination campaign and staffers holding aloft a gold trophy at an awards ceremony.
But there are no pictures of Robert Wanyonyi, shot and paralyzed in a robbery more than a year ago. Kenyatta will not allow him to leave the hospital because he cannot pay his bill of nearly 4 million Kenyan shillings (USD 39,570). He is trapped in his fourth-floor bed, unable to go to India, where he believes doctors might help him.
At Kenyatta National Hospital and at an astonishing number of other hospitals around the world, if you don't pay up, you don't go home.
The hospitals often illegally detain patients long after they should be medically discharged, using armed guards, locked doors and even chains to hold those who have not settled their accounts. Mothers and babies are sometimes separated. Even death does not guarantee release: Kenyan hospitals and morgues are holding hundreds of bodies until families can pay their loved ones' bills, government officials say.
Dozens of doctors, nurses, health experts, patients and administrators told The Associated Press of imprisonments in hospitals in at least 30 other countries, including Nigeria and Congo, China and Thailand, Lithuania and Bulgaria, and others in Latin America and the Middle East.
The AP investigation built on a report last year by the British think-tank Chatham House; its experts found more than 60 press reports of patient detention in 14 countries in Asia and sub-Saharan Africa.
"What's striking about this issue is that the more we look for this, the more we find it," said Dr. Ashish Jha, director of the Harvard Global Health Institute, who was not involved in the British research.
"It's probably hundreds of thousands if not millions of people that this affects worldwide. It is not something that is only happening in a small number of countries, but the problem is that nobody is looking at this and it is way off the public health radar."
Some examples:
"People know patients are being held prisoner, but they probably think they have bigger battles in public health to fight, so they just have to let this go."
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