Some Ugandan Hospitals Allegedly Requiring COVID Patients to Pay Deposit Before Admission

Some Ugandan hospitals having been accused of demanding cash deposits before admission of COVID-19 patients, the Associated Press reported.

Others have accused hospitals of demanding security items in lieu of cash, such as title deeds. This drew the attention of an anti-corruption investigator who said her office had received over 200 complaints.

One hospital was even accused of refusing to hand over a dead body to the family, holding out for $9,000 in unpaid medical bills. The body was finally handed over after a lawsuit, but the hospital refused to provide a postmortem report.

For more reporting from the Associated Press, see below:

Uganda Hospitals Demand Cash Deposits
Some hospitals in Uganda are accused of demanding cash deposits up front before admission for COVID-19 care. Above, workers load oxygen tanks to be distributed to hospitals in the country on June 29. Badru Katumba/Getty Images

Tofa Tamale said he tried to reason with hospital managers, hoping for an arrangement that would preserve his mother's dignity.

"The hospital didn't give us a single piece of documentation," said Tamale, who believes his mother had COVID-19 before she suffered a stroke.

The case, one of two publicly known as this East African country sees a surge in COVID-19 infections, has shocked many in a socially conservative society where bereavement customs are strictly observed.

"You can't say you're holding on to a dead body in order for you to get your fee. That's repugnant," said Joseph Luzige, an attorney who represented Tamale.

Uganda has confirmed a total of 84,554 COVID-19 cases, including 1,995 deaths as of Wednesday. Authorities are reporting dozens of deaths a day.

As in many other African countries, the actual number of infections and deaths are believed to be much higher because testing is not widely available. And now "the speed and scale of Africa's third wave is like nothing we've seen before," the World Health Organization's Africa director, Matshidiso Moeti, said last week.

The highly infectious delta variant is fueling Africa's new surge in cases, a worrying situation on a continent where just over 1 percent of the continent's 1.3 billion people are fully vaccinated.

In Uganda, where less than 1 percent of the country's 44 million people have received even one shot of the AstraZeneca vaccine, hundreds of new cases daily are overwhelming public health centers and creating more business for private facilities, which traditionally accept cash.

Some hospitals with COVID-19 wards have charged nearly $1,500 in daily treatment fees, a prohibitive sum for most Ugandans. Many are now self-medicating within their homes, experimenting with everything from traditional medicine to new herbal remedies.

"There are many Ugandans who are dying in their homes simply because they fear to face high-deposit hospital fees," Colonel Edith Nakalema, leader of an anti-corruption unit under the presidency, said in a series of Twitter posts. "If you have not yet suffered this personally remember that you might suffer it soon."

Grace Kiwanuka, executive director of an association of private health groups, said hospitals are caught "between a rock and a hard place" as they balance their obligations to patients and business concerns in an unprecedented pandemic.

"The market is dictating certain prices we have to pay," she said, citing complicated COVID-19 cases of patients with kidney failure who stay in intensive care units for several days.

Some die, leaving hefty bills that hospital directors have to account for, she said. "I feel for these people. I really do. But the fact is, this is medicine."

The fear of detaining patients—dead or alive—over medical bills is a source of frustration, said Sarah Mirembe, who recently accused a hospital director of not honoring his word to waive certain fees.

Although her grandmother recovered from COVID-19, Mirembe said, the experience left her upset after the family had to sanitize the "filthy" room she was given. After threatening to take her grandmother elsewhere, she was able to negotiate the daily rate down to $170 from $714.

The total bill was $4,000, she said. "What if I didn't have this money?" she asked.

Some Ugandan Hospitals Demand Cash Deposit
Some hospitals with COVID-19 wards are charging prohibitive sums for most Ugandans, and many people are self-medicating at home. Above, a woman reacts after covering herself to inhale steam from an infusion made from local herbs, which she believes will prevent and treat COVID-19 symptoms, in Kampala on Tuesday. Nicholas Bamulanzeki/Associated Press