KENYA—The Nairobi Women’s Hospital, a for-profit hospital in Kenya, has been called out by Oxfam’s Sick Development report for allegedly receiving aid from international development partners to subside costs but still offering services at an exorbitant cost.
The report by the development charity looked at a pattern of behavior by private hospital chains and other for-profit healthcare corporations in the developing world misplaced utilization of the funding from global development partners.
The sick development report also ponders on how these patterns by rich-country government and World Bank funding to for-profit private hospitals could be causing harm, and why it should be stopped.
The charity presented its findings during a British parliamentary hearing held by the International Development Committee that is investigating the British International Investment (BII) overseas health investments.
Moreover, every year hundreds of millions of pounds are taken from the UK aid budget and invested into foreign businesses and programs in poor countries via the BII which is owned and managed by the UK’s Foreign Office, Direct Foreign Investment Department (DFI)
The report findings note that the hospitals named failed to subsidize the cost of health services but instead engage in what the report term as glaring human rights violations and financial extortion of patients.
The Oxfam report first identified that the hospital group had indirectly received funding from the BII’s overseas health investments.
Anna Marriott, Oxfam’s health policy manager, told MPs at Westminster during the parliamentary session that the “alleged and confirmed human rights abuses” associated with the Nairobi Women’s Hospital group require immediate investigation.
Marriot stated that the case of Nairobi Women’s Hospital is illustrative of the dangerous inadequacy of due diligence, oversight, and monitoring mechanisms for DFI investments.
Oxfam’s Nairobi Women’s Hospital’s disturbing revelations in depth
The Nairobi Women’s Hospital’s biggest stakeholder Abraaj Growth Health Markets Fund (AGHF) has received funding from Germany’s DEG, France’s Proparco, and the World Bank’s IFC.
Other investors were the Norwegian DFI Norfund, the African Development Bank (AfDB), the Southern African Development Bank, and the Bill & Melinda Gates Foundation.
In 2016, Proparco, the British International Investment, and IFC invested US$10 million and US$75 million respectively in the Abraaj Growth Health Markets Fund (AGHF), which in 2017 bought a 75 percent stake in Nairobi Women’s Hospital.
Nairobi Women’s Hospital shareholder TPG told Oxfam, ‘These events appear to have occurred before our ownership period’.
Despite these investments, the report highlighted some alleged or confirmed human rights abuses against patients by Nairobi Women’s Hospital since 2017.
In one of the cases referenced by Oxfam, a newborn baby was detained by the Nairobi Women’s Hospital group for three months after his twin died during childbirth.
Additionally, the child’s grieving mother couldn’t afford the bill and was forced to commute daily to the hospital to breastfeed him.
In another case, a secondary school boy was detained for 11 months over an unpaid bill of around US$26,000 according to Oxfam.
Oxfam also reported that a patient’s deceased body was held at the hospital over non-payment of US$9,700.
The Nairobi Women’s Hospital’s Response to the Oxfam report
In a press release published on their social media pages, The Nairobi Women’s Hospital Founder and CEO, Dr. Sam Thenya, reassured the public that allegations made by the report were untrue.
The hospital insisted that it subscribes to policies that advocate against detaining patients, aligning with a High Court ruling that vehemently condemned such actions.
“The Nairobi Women’s Hospital does not detain patients for any reason at any of our hospitals as alleged. We have fully complied with the ruling by the High Court of Kenya, Constitutional and Human Rights Division – Petition No. 242 of 2018 and have aligned our policies and practices,” its statement read in part.
Back in October 2018, a court ruled that Nairobi Women’s Hospital had acted unlawfully and in violation of the Kenyan Constitution.
Nairobi Women’s Hospital CEO Dr. Sam Thenya says the institution revised its policy in 2018 and again in 2021 to comply with the court ruling.
However, according to the Oxfam report cases of detention of patients were being recorded well into 2019.
The statement also read, “The Nairobi Women’s Hospital has never received any grants from the said Direct Foreign Investments (DFIs) for subsidizing patients’ medical bills. The Nairobi Women’s Hospital has never received any funds from the said DFIs, whatsoever.”
“Our mission is to provide quality, accessible and affordable healthcare in a sustainable way to the lower and middle class, which we have successfully done over the last 22 years,” the hospital maintained.
Oxfam maps out the extent of the rot, elsewhere
Marriot while testifying in front of the British parliament said, “If I’ve been able to find these 32 cases of patient detention, how is it that this multi-billion-pound government-owned institution, with responsibility for due diligence, upholding human rights, and doing no harm, has either failed to identify these well-reported crimes or ignored them.”
Marriott also said, “There should be an immediate freeze of all future [BII] investments in healthcare provision.”
She argued that British taxpayers’ money was being spent on services that are exacerbating poverty and health inequality in the world’s poorest countries.
The government says that the BII’s investments are intended to create economic opportunity for local communities, tackle poverty, promote gender equality, and bring a financial return for the British taxpayer.
In another example of misspending, the charity said the BII had indirectly invested in hospitals across Burkina Faso, Uganda, and Zimbabwe, three of the world’s poorest countries, which were charging women between US$650 to US$1300 for ‘normal deliveries’.
In Nigeria, where nine in 10 of the poorest women go without any skilled birth attendance, the delivery prices at one hospital funded by BII, via the EverCare Health Fund, start at US$1650 which is equivalent to 12 years of pay for the bottom 20 percent of earners in the country.
Elsewhere in Uganda, the fees for childbirth at one hospital have increased by 60 percent since BII first invested in it four years ago, the charity said on Tuesday.
“Rather than helping to tackle maternal mortality, BII is investing in hospitals that are simply out of reach for the majority of women,” Marriott added.
Since 2015, more than US$ 5.1 billion has been directed away from the UK’s aid budget to the BII and invested in foreign businesses and markets, according to the Catholic Agency for Overseas Development.
A BII spokesperson said, “Anna Marriott of Oxfam was part of a group that raised different allegations about our healthcare portfolio over a year ago. We investigated these and found them to be inaccurate.”
“The list of unsubstantiated allegations made by Oxfam at today’s parliamentary session was not brought to our attention through any of our reporting channels. We are not able to provide further comment without conducting our own investigation,” the spokesperson added.
The Oxfam report has now raised concern about whether concrete and systematic scrutiny of investments will be put in place to prevent such cases from happening again in other investments.
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