Hospital detention practices


In recent years, for example during the cooperation with the partner hospitals in Kenya and Indonesia, we were confronted several times with the underexposed phenomenon of Hospital Detention Practices.


Hospital Detention Practices (HDP) can be defined as: ‘Refusing to release living patients or release the bodies of deceased patients when their families are unable to pay the hospital bill.’ Each day in hospital detention, the hospital bill continues to build up, becoming increasingly difficult for the families involved to pay the bill for the patients taken hostage. Not only adults but also children are imprisoned. Patients are regularly held in hospitals or morgues for months.

HDP have numerous negative consequences for healthcare: the fear of being imprisoned in hospitals means that patients do not attend the hospital or attend late. When patients do eventually seek conventional medical care, their disease is often advanced and can no longer be cured. Unnecessary mortality is the result. HDP also cause overcrowded wards, which increases the risk of infection. HDP also have a major psychological impact and are described by the victims as a traumatic experience.

HDP violate Universal Human Rights, such as the right not to be imprisoned as debtors, the right to access medical care, and the right of children not to be forcibly separated from their parents.


Recent research led by our physician-researcher Dr. Saskia Mostert shows that HDP occur in at least 46 countries, including Africa, Asia, South America, Europe and North America. According to the study, HDP are significantly more common in countries with more corruption, higher out-of-pocket health care costs, and lower Universal Health Coverage.


Based on their analysis, the researchers make recommendations to have HDP structurally addressed by international financial institutions, donor countries, the United Nations and the World Health Organization (WHO). The WHO has invited Saskia Mostert as a speaker at one of the upcoming congresses to jointly draw more attention to this problem.