Three weeks after giving birth to twins, 16-year-old Annaelle felt like a hostage: the hospital would not let her leave until she’d paid her medical bills, but she had no money.
Her mother was doing shifts there as a cleaner to stump up the cash.
Then a woman Annaelle had never met called Grace Mbongi Umek entered the maternity ward at Bethesda clinic in Congo’s capital Kinshasa and handed doctors a wad of bank notes – $130 to cover Annaelle’s caesarean section, and more for two other women who had also been forced to stay.
Like most countries in sub-Saharan Africa, Democratic Republic of Congo has no universal health coverage, and most cannot afford what limited care there is. Hospitals, also cash-strapped, are forced to make patients stay until they have paid in full.
Some stay weeks in already overstretched facilities while relatives scramble for solutions.
“I want it to stop,” said Umek, a businesswoman who owns shares in several security companies and in 2017 set up a foundation to help mothers with unpaid medical bills.
The mother of four, who first heard about the problem during an encounter with a United Nations official, said she donates up to $3,500 a month.
“I want women in my country to give birth in good conditions and not be held hostage because they cannot pay.”
President Felix Tshisekedi’s government is ratifying a law to make health services free for the vulnerable.
But the minimum of $40 required to give birth in a health facility is steep in a country where according to the World Bank over 60% of the population lives on less than $2.15 a day.
Bethesda’s head doctor Emmanuel Mpumpa, whose sister died in labour a few years ago because she could not afford hospital care, said keeping patients in was regrettable but necessary.
“Bills ensure the facility’s operations, pay for salaries and supplies,” he said.
Annaelle had become accustomed to staring at the hospital ceiling as her healthy girls dosed by her side in matching red beanies. Two other young women in the room were in the same situation.
“We bought a few of the prescribed medicines but could not afford the doctors and hospital,” said Annaelle’s mother, Yvette Kalongo.
When Umek paid, the ordeal was over. The young mothers uttered their thanks, wrapped their babies in blankets and made their way home through the neighbourhood bustle.
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