…as groups link detention to rising maternal mortality rate
By Josephine Agbonkhese
When earlier this year a campaign tagged “Not Again” was launched by notable women human rights group, Women Advocates Research & Documentation Centre, WARDC, calling for concerted efforts towards ending the increasing number of Nigerian women who die at childbirth, not many understood the need for more of such campaigns in Nigeria until a couple of weeks ago when another needless maternal death dramatically occurred.
That death this time around resulted from the alleged detention of a mother of four at the Lagos University Teaching Hospital, LUTH, in Lagos, over her inability to completely settle a bill of N1,382,700. The victim gave up the ghost 43 days into detention, leaving behind four little children, the youngest being 4-month-old.
Illness during custody
The deceased, 35-year-old Mrs.Folake Oduyoye who was a fashion designer residing at Ijesa-tedo in Lagos, was said to have been admitted at LUTH on 7th September, 2014, following complications arising from her delivery at a private hospital on 30th August, 2014. She was discharged by the hospital on 31st October 2014, but allegedly prevented from going home for failure to settle her hospital bill.
Her husband, Mr Adeyemi Oduyoye, a printer, had paid N300,000 leaving a balance of 1,082,700. Adeyemi was said to have written a letter dated 11th November, 2014, to the Chief Medical Director of LUTH, appealing for a waiver and structured payment to offset the balance monthly. That letter reportedly yielded no reaction from the management.
The deceased later died in detention on 13th December, 2014, from a cough-related illness for which she allegedly received no care and treatment while in LUTH’s custody and was also prevented from seeking treatment anywhere else.
This case, according to women human rights groups, raises a number of issues that border on the violation of fundamental human rights of women and children which are guaranteed in international and regional instruments which Nigeria is party to, as well as in national frameworks.
Call for independent post-mortem, compensation
In a petition to the management of LUTH, the two groups handling the case, WARDC and the Women Consortium of Nigeria (WOCON), are asking the management to conduct an independent post-mortem examination to ascertain the cause of death of Late Mrs. Oduyoye, as well as compensate the Oduyoyes or risk legal action.
Also condemning strongly the practice of illegal detention after birth for women who cannot afford the cost of treatment for pregnancy and child birth related issues, they asserted that the penalty for non-payment of hospital fees for maternal health care should not be false imprisonment.
Debt not criminal
“Section 35 (1) of the 1999 Nigeria Constitution provides that “no person shall be deprived of their liberty save in cases such as in execution of the sentence or order of a court in respect of a criminal offence of which he has been found guilty”.
Article 9 of the International Covenant on Civil and Political Right which Nigeria is party to provides that “everyone has the right to liberty and security of person and no one shall be subjected to arbitrary arrest or detention except on such grounds and in accordance with such procedure as are established by law”.
The matter of not being able to pay up the balance is a civil matter and not a criminal one. Hence, the management of LUTH should have taken the option of going to court to compel the couple to pay their balance instead of detaining anyone,” Dr (Mrs) Abiola Akiyode-Afolabi and Chief(Mrs)Bisi Olateru-Olagbegi, Executive Directors of WARDC and WOCON respectively, said.
In a swift reaction, Acting Chief Medical Director of LUTH, Prof. Chris Bode, at a press briefing penultimate Saturday in Lagos, however said that the death of Mrs.Oduyoye was regrettable as it occurred despite the hospital management’s efforts and ‘not because of negligence.’
“Our healthcare team had kept her alive in spite of the ongoing health workers’ strike. This lady came into LUTH in critical condition, unconscious and infected from a caesarean section performed in another hospital. She underwent a major operation at which plenty of pus was evacuated from her abdomen.
“She underwent a tracheostomy, creating a hole on her neck to enable her breath and stay alive. She was admitted into the Intensive Care Unit, with multiple organ failure, and for one month she was on ventilator, a machine which was breathing for her. She also developed two episodes of cardiac arrest from which she was rescued. She also developed renal failure for which she underwent four sessions of haemodialysis.”
“The multiple surgeries, specialised tests, interventions, dialysis, drugs and consumables cost N1.5 million. The family paid a total of N300, 000 and requested that a total bill of N1.2 million be waived. The husband requested to pay in installments of N15, 000 per month and this was accepted, but he could not bring anyone to stand as guarantor. The conditions of Oduyoye became suddenly poor and she died of pulmonic complications on Dec.13,” Prof Bode said.
‘Abolish detention of mothers at LUTH’
Dr.Abiola-Akiyode and Chief Olateru, at a press briefing last week in Lagos, however insisted that an investigation and abolishment process should immediately begin on the practice of detention after birth for women at LUTH. The groups are also demanding the immediate release of every woman held presently in such manner at the hospital.
“According to information gathered, a large number of women are being prevented from going home after discharge from LUTH for their inability to offset huge bills relating to pregnancy and child birth. Yet further treatment is withdrawn from these women and they are not free to seek treatment in other hospitals. According to Mr. Oduyoye who was with his wife most times at the hospital, several women have died due to failure of the hospital management to attend to them and several are still being detained for failure to make up the fees. Thus this case is of great concern to us because if nothing is done immediately, more women would likely suffer the same fate as the Late Mrs. Oduyoye,” they said.
Detention and maternal deaths
Giving reasons why the case of the Oduyoyes should provoke a renewed efforts by government over maternal-child mortality, Mrs.Akiyode said , “Nigeria has the second highest number of maternal deaths in the world, accounting for more than 10% of maternal deaths worldwide. As shown by recent studies conducted by Lancet Studies, WARDC and Centre for Reproductive Rights (CRR) maternal deaths have increased by 56% while hospital deliveries fell by 46% after user fees were introduced. Most women don’t want to go to hospital because they know that when they give birth and cannot afford the bill, they will be detained. This is one of the detentions and this is the result.”