Volume 4, Issue 5, May – 2019
ISSN No:-2456-2165
Medical Detention of Patients in Nigerian Hospitals:
Relief or Punishment?
1
Hosea Nakina Martins, 2Demas Sams Sarki, 3Joy Isaiah Tonga
Department of Christian Religious Studies
Taraba State University
Jalingo, PMB1167, Taraba State Nigeria
Abstract:- The practice of detaining patients especially in
clinics, maternities and hospitals for non payment or
completion of their medical bills or just to hike their bill
is a very clear omen that raises the concern of many to see
the act as purely motivated and encouraged as total
punishment and not a relief . The patient is believed to go
to these medical health centers with the hope that his/her
deteriorated healthy condition would be revitalized. In
this work, primary and secondary sources were used to
accessed the information that build the research work.
This excerpts examined the very reasons behind the
practice of medical detention of patients in Nigerian
medical health centres which are do to lack of money or
total refusal or non availability of resources to settle for
such a bill or just to hike medical bills of patients or just
to restore the health of patients from deterioting. The
paper also seeks to examine the root causes of patient’
detention in Nigerian hospitals, clinics, maternities which
is been on the other way round as punishment, it also
examine some of the resultant consequences of such
practice and even some of the benefits of medical
detentions to both patients and doctors or nurses. The
work also discovered that if there is a better working
relationship among patients and medical personnels, it
will go along way in resolving the crises occurring
between medical personnels and patients. It is the hope of
this paper to proffer better ways of tackling or
eliminating such a term “ punishment” as it is been
caused by both patients and medical personnels, which is
an un healthy human treatment called medical “detention
”or popularly referred to as punishment by patients.
This punishment is either caused by the patients
themselves or out of sheer inhuman sympathy resulting
from an abuse of the vocation to save life by the nurses
and doctors themselves. However, this is not a right for
one not to settle his / her own bills or a right to detain
the patients.However,when such is done, it facilitate in
deteriorating the health conditions of patients and
sometimes they even die out of frustration. The paper
profered some recommendations like, let there be mutual
trust between patients and medical personnels, patients
shouldn’t to redeem or cleared their medical bills, well
and meaningful individuals should assist patients who
cannot afford to pay for their medical bills, and also,
patients should be ready to cooperate with medical
personnels so as to reap the better benefits of the duo
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International Journal of Innovative Science and Research Technology
relationship. If such are adhered by patients and medical
personels,it will help in fostering a better doctor to
patients relationships in the medical institutions, which
would be seen as a relief and not punishment on the other
way round.
Keywords:- Medical, Detention, Patients, Relief and
Punishment.
I. INTRODUCTION
All human societies have belief system that people turn
to in order to identify disease and effect a cure(Lehmann and
Meyers,2001:150). Good wellbeing is what every body desire
to have at all cost. Every body tries to see a doctor when ever
he or she is sick.The doctor is the intermediary between the
sick and the ultimate healer. There are various Health centers
or hospitals or clinics which are springing up daily in Nigeria
as a result of high demand for physical well being by
patients. Patients sought for medical attention from hospitals,
clinics or maternities in order for them to be well and go
about their normal daily activities. However, prior to the
coming of Christian missionaries to Nigeria, there have been
in existence herbal medicine men ,who treat patients of
various illnesses and charged them for some money ,animal
or food stuff in compensation for their services.
However, with the coming of orthodox medicine,
highly facilitated medical centers are been established with
highly trained professionals to address the health challenges
of people around. Medicine proffers a wholistic approach to
the problem of ill-health and diseases
(Shishima,2014:100).There is high improvement on medical
diagnosis of patients, which are sprinking up daily in
favourable places, where they can serve the needs of the
people.Many patients today go for their medication in these
health centers; clinics, hospitals and maternities ranging from
child delivery, physiological and psychological.
The worrisome issue in this article pertains to the
Nigerian medical centres, having a sour relationship with
patients due to some factors which culminate in detaining the
sick, who are supposed to be cared but later maltreated,
frustrated and subjected to mental trauma and abuse because
of their in ability to pay or settle their outstanding medical
bills. This palaver is not only in Nigeria that is obtainable
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but, also in African medical health centres, where detention
of patients by hospital management are necessitated out of
pure reason to hike fee. Some patients failed to settled their
medication bills, and they are being detained and not
discharged or even given complete dose of their medication
until they settled their bills. This ugly experience subject the
patients to what could be termed as punishment .The practice
contribute in deteriorating the health conditions of those who
are supposed to be cared for( Punarimang, 2018).These are
compounded issues which are going to be taken into
cognizance as the essay tries to delved into examining
medical detention of patients in Nigeria hospital as a
punishment or relief?, which has left good and bad image on
the patients and the medical personnels. The paper seeks to
profered solutions to the lingering crises rocking patients in
the medical health on issues of medication with medical
personnels .
II. DEFINITION OF TERMS
 Medication
Connected with illness and injury and their treatment
(Hornby,2001: 733).
 Detention
The State of being kept in a place, especially a prison,
and prevented from leaving (Hornby,2001:317). “It is also
refers to the non release of patients after medical treatment a
deceased body”(dailypost.ng 2018,Dec.17).
 Patients
Patients are, or believe themselves to be in need of care
and attention by pulling themselves in the hand of doctor or
hospitals, they voluntarily subject themselves to other in the
belief that by so doing, they will benefit (Duncan and
Welbourn, 1997:323).
III. HOSPITAL MANAGEMENT
The Hospital Management is one of the essential social
and medical organizations whose essence of existence is to
provide and the running of such a health care institutions. It
is also for the population complete health care, both curative
and preventive and whose out patients’ service reach out to
the family and its home environment. The hospital
management sets the apparatus for the center for the training
of health workers and for biosocial research. The
management is charged with the act of equipping the
hospital, clinics and maternities with drugs and hospital
equipment. It also charged with the employment of highly
placed personnels to manage the affairs of the hospital in all
strata. Hospital management is a great task shouldered on the
entire management team, who ensures all that is needed for
the proper functioning of the hospital is put in place.
IJISRT19MY139 www.ijisrt.com
International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
A. Doctors and Patients’ Relationship
This is a kind of connection between two or more
individuals; between a physician and the sick. The doctor is
therefore for the sick person, and the sick person is there for
the doctor to take to care of him or them. Both patients and
doctors need the cordiality of one another. To compliment
doctor and patients’ relationship, it is done in every cordial
manner of trust and love, which facilitate smooth mediating
administration and relationship.
Doctors and patients’ relationship is very important
aspect in patients’ diagnosis or treatment. Thus, patients must
have confidence in the physician, and the physician must
give hope to the patient. For most physicians, establishing a
good rapport with the patients is very important aspect of
diagnosis.According Holmboe and Durning, “most
physicians, the establishment of good rapport emphasizes the
physician-patient relationship more than others such as in
psychiatry and family medicine” (23).
Doctor-patient’ relationship is one of the special trust
and confidences that is required by the duo. The standard of
expertise and professional conduct among the medical
professionals should ideally be such that patients believe that
the treatment they will get is the best suited for their own
interest (not necessarily on the interest of society at large;
since no patient would like to think that his or her doctor
might sacrifice him to the general good (Duncan and
Dunstan,1997: 323). Most universities teach students from
the beginning, even before they set foot in hospital, to
maintain a professional rapport with patients, uphold patients
dignity and respect their privacy. The quality of doctor-
patients relationship is important to both patients. This
relationship is built in terms of mutual respect, tender
hearted, knowledge, trust and assistance. The doctor and
patients value and perspectives about diseases, life and time
available play good role in fostering this relationship
(Holmboe and Durning, 9). When people are ill, they are
inclined to regard their doctors as good-like and able to work
miracles, and to be regarded on the doctors side the very
person relationship with the patients credence to good
medical diagnosis and recovery from treatable diseases.
B. Types of Medical Detention
As far as detention is concerned in any health care
institution and among patients, it has been clearly categorized
into two forms according to this paper, namely:
 Long Term Detention:
This is the kind of detention where by patients are
detained or not allowed to leave the hospital for a very long
period of time, or until they are able to settled their debts or
hospital or medical bills. However, these patients are kept in
a long duration pending when their bill are settled. According
to Hickey: “Many patients need expert medical advice or
operation or long term hospital stay (87).
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 Short Term Detention:
In the short term detention, patients are detained for a
very short while. They do not exceed longer days or weeks,
depending on the period needed or when soon they settled
their bills or discharged.
C. Resultant Causes of Detention of Patients
Many people often think that patients should not be
detained due to their ill-health condition. While the resultant
causes of detention of some patients are been attributed to a
lot of factors been put into consideration, and some are below
examined:
According to Hamuel, a patient interviewed says:
“Some patients are not just serious or their family
members are not serious to clear or settled the medical
bills of their sons, daughters, fathers, mothers or
relations. They keep pleading and pleading and this has
pushed many physicians to attend to them in an
incomplete manner of medication, and such worsened
their health condition ” (2018).
There is lack of seriousness on the part of the patients
or their kinsmen to put things in place, and this protracts or
leads to detention of such patients under medical personnels’
custody. There is total refusal and stubbornness on the part of
the patients to pay or buy certain medical requirements like
drugs, syringe and host of others or to settled hospital charges
like bed fee and many others. Some of the patients stubbornly
refused to adhered to instructions, which they failed, and out
of their own charges, which often led to their detention by the
hospital management until they settled the bills accrued, or
their conditions are certified before they are discharged.
Kuku reiterated a similar incident thus:
“My sisters was hospitalized in one of the clinics, and was
diagnosed of some related illness ,and was told to pay for
additional drips, which she has the money to pay but
stubbornly refused, and was detained for so many days
before I went home and looked for the remaining money,
which I brought before the treatment was concluded and
she was discharged” (2018).
A similar incident was reported thus:
A sickle cell patient Onyiye Ezeanyika died in a mission
hospital in Onitsha after being detained by the hospital
management over unpaid accumulated bill. She was
detained for one year and six month by the hospital after
she and her family were unable to pay bill of #1.2 Million
given by the hospital, and she died while she was held
hostage by the management ( dailypost.ng 17 Dec 2018).
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International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Some patients exhibits very high sense of stubbornness
and refusal to settle certain bills of their
medication.However, despite the fact that their money is
incomplete , they are pitied and given the drugs or
medication on ground of, “if you get the remaining money,
you can bring it”. However, many patients failed to redeem
the pledge as stated, even if they get the money, and this has
been one of causes of their detention in hospitals or clinics,
and maternities today.
There is also the high rate of ignorance coming from
some of the patients, who are ignorant of some medical rules
guiding the existence and running of such medical institution,
and this ignorance let to their being detained by the hospital
management( Vahme,2019). Ignorance is a diseases, many
patients appeared in such a state and lack full knowledge of
the running of the medical institution. There is lack of
assistance coming from meaningful individuals to assist
patients who don’t money to settled for their medication. It is
pathetic when I met a young man in his early 30’s in one of
the dines around, who has been bitten by sick but tried and
brought himself to the hospital, paid more than half of the
required bill, but was impeded for lack of Two Thousand
Naira Only (N2,000) to complete his medical bill and
discharged. He said “I have exhausted my reach, I don’t have
any body here, and I have refused been discharged because of
Two Thousand Naira Only. I thank God , a good Samaritan
came and cleared my medical bill and left, and I was later
told by one of the nurses that you are lucky, some one had
cleared your bill and I left happily”( Anonymous,2018).
Many sick people today lack assistance to pay or
complete their medical bills, and such is an ugly scenario
which led them to be detained by the hospital management.
The aforementioned reasons are responsible for the detention
of most patients today in Nigerian hospitals, maternities,
clinics both by government and private today in
Nigeria(Aliyu, 2019). Some patients failed to redeem the
pledges as promised the management, and when treated and
discharged, they no longer return to clear their outstanding
bill, until when they fall sick again and brought to same
hospital that they are been detained for their outstanding
bills. Some patients are left to die and un- attended because
they failed to redeem their pledges . This act of ungodliness
has pushed the doctors and nurses to detain such patients,
and their health conditions worsened.
D. Patients and Detention Palaver: Punishment or Reliefs?
Detention of patients in Nigerian hospitals, clinics or
maternities is no longer strange news on the ears of the
victims. Patients are been detained simply because some of
them are unable to settle their hospitals bills (Brikci and
Philips, 33). This practice of detaining patients in hospitals/
clinics/maternities is found to feature predominantly in public
and private health centers. There seems to be wide society
acceptance in certain areas, where level of education is very
low, and it is assumed that the rights to these patients are
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exposed to being imprisoned and made vulnerable in such
ways, which is been regarded as total punishment and not a
relief. Patients detained, expect to be treated freely without
being asked to pay for such services received, this won’t be
condone by both private and public hospitals, clinic and
maternities. Even though the essence of detention is to help
improve the health situation of the patients, but today it is
done on negative ground of exploitation and punishment
instead of offering relieve to the patients. Medical detention
in this work shall be examine on the negative aspects of its
existence and impacts on the patients.
It has indeed become a punishment detaining patients
in Nigerian hospitals, clinics or maternities. Patients on no
moral reason are kept hostage for some intentional and
delayed hours, days or months for not able to pay settled their
bills for treatment received or to hike their medicals bills so
as to there’s ten them if they failed to setttled, they are
detained which is regarded as punishment. This practice as
observed, happens most in public and private health centres,
and has been the concern among health watchers and the
populace. Medical detention of patients is a punishment
which traumatizes the patients, prolonged their ill health,
frustrate their emotional stability and even aggravate their
health conditions if done in the interest of trying to raise
more funds for the hospital, it is the patient that suffers at the
end. My niece was detained in one of the hospitals because
of incomplete bed fee, which we later realized and went and
settled. But the management still detained her, and additional
fee was paid, but after some days from the release, we lost
the girl(Bondi,2018). In some instances, “we patients are the
remote causes of such detention. We refused to pay or
cooperate with the management and that is why we were
meted with the punishment of detention” (Nzaala,2019).
Patients are detained on no justifiable ground just for them to
pay extra money to the management not such a hospital or
clinic, or maternities.
According to a news published by Vanguard. Com “
Hospital detention of patient is a punishment I quote “I was
admitted on 8th April, 2017 and discharged on the 27th
August, 2017. But prevented from going home due to my
failure to pay up the balance of my bill of about 313, 900”.
Therefore, hospital detention in the case of Nigeria is purely
an abuse and a punishment. I was detained in Zing General
Hospital for many hours when I accidentally cut one of my
right big toes. My money was remaining N 1,200 even
though, I called a friend after I might have spent more than
the hours to be discharged, but refused until my friend send
someone, who came and settled the remaining balance before
I was discharged(Aaron,2018). My experience was very
traumatizing indeed, and there are many, who are victims of
such an experience today.
Similarly, Ganja, said “I was detained for two days in a
maternity clinic in Yola even after my medical bill was
settled, they still add some days for me so as to increase to
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International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
their bed fee which accrued and I was not able to complete,
until my uncle went and settled for the bill before I was
discharged after detaining me for additional two days”
(2019) . patients been detained by medical personnel in
various health centres across the country today. Some
patients are the resultant causes of the problem; they expect
father Christmas from an institution that is being run by
funds which is very rare today. Medical detention are purely
done not on ground of medical improvement of the health of
the patients but to subject them into untold hardship known
as “punishment”
E. Consequences of Medical Detention of Patients
There are resulted consequences of medical detention
of patients in Nigerian hospitals, clinics, maternities and
some of these consequences are thus examined:
 Due to detention of some of the patients, it has created a
low esteem for the patients, who are been relegated as the
worst people beyond recognition or
respect(Danjuma,2018).
 The health conditions of some patients deteriorated, there
by leading to their death especially when they needed
adequate and urgent attention before any thing money
comes into play.
 There is creation of misunderstanding between patients,
relations and management of those hospitals or clinics.
Cordial doctor to patients’ relationship is being affected
and turn sour.
 The prestige of such hospitals, clinics or maternities is
tarnished beyond any recognizable doubt, leading to loss
of patronage and collapse of some of the hospitals, clinics
or maternities due to lack of constant patronage by
patients (Ardo, 2019).
 These hospital, clinics or maternities often stand the
chance of been closed down because, they are been
impeded for lack of capital to pay the staff and even run
the institution. It created hitch due to lacks money
realised to pay for any revenue to Government.
 Human life is the first thing any medical personnel
should save. But money has been given most priority to
salvaging human life, which has led to lost of lives daily
and contributed a lot in affecting the quality of lives of
patients and economic and religious growth families and
nation.
F. Benefits of Medical Detention of Patients
Medical detention of patients has a lot of benefits,
which some of them are outlined below:
 It helps the hospital management to run the hospital very
well by not running at deficit, which result in the collapse
of the institution for lack of capital to run it.
 The detention of patients helped the doctors to know and
study the health progress of the patients, thereby giving
them adequate care.
 It also helps the patient’s relations to know that,
medication administered on patients needs to be paid,
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because without payment of their bills, they are left to
suffer.
 Medical detention helps in punishing stingy patients, who
have the money to pay for their medical bills but refused
to, and there is need to pay for such bills before they are
discharged from such a clinic or hospital.
 Medical detention also helps the hospital management to
make huge profit by detaining patients for some days,
which increases their profit making(Aaron, 2019).
 Medical detention benefits patients by attracting
sympathizers to assist them in some facets areas of needs
while in the hospitals.
 It helps in creating lasting familiarity and strong friendly
affiliation with doctors and nurses and patients.
 Patients while on detention, devise means on how to
sustain themselves or learn skill work. For example, in
ECWA Evangel Hospital Jos, patients are taught various
skills acquisition to enable them help themselves in life,
and many will for longer stay there in order to acquire
skills.
 Many relations of patients and doctors find hospitals or
clinics avenue as a place for doing business especially on
fruits, food stuff or other related goods. These goods are
sold at these places because of the number of sick and the
attendants ( patients relations, doctors or nurses.
 Medical detentions of patients help both doctors and
patients to study and improve on the medication of the
patients. This is done on delayed study so as to determine
the real causes of such illness and ensure the patients
receive the best and completed medication before being
discharged. So such a detention should be seen on good
ground and not on the negative.
IV. CONCLUSION
There are wide range of reports of experiences passed
through as a result of medical detention. This could be shown
seen or heard of the ordeal such people detained by medical
personnels in various hospitals, clinics and maternities faced
today. However, such experience is quite pathetic and
horrific due lack of completing or paying their medical bills.
However, some of the patients been detained, are detained
intentionally so that their bed charges would accrue. Well,
sometimes, some patients have the money but refused to
settle for the drugs or bed charges. Health workers altitudes
towards patients, and patients attitudes towards medical staff
and medication is a very pathetic experience in Nigeria
today. The duo parties need complementarity so as to be of
great help to each other. Health is money, and sick persons
and their relations must try and cooperate with hospital
management so as to avoid been detained for short and long
term periods. The fact that a patient is not able to settled
his/her medical bills, he /she shouldn't be subjected to such a
horrific experience. Patients too, should not pushed the
doctors or nurses into acting in an un cordial manner, that
will lead to frustrating the hospital management or collapse
of the institution. Respect and cordial relationship between
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International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
patients and doctors should be a stand watch word in
medical institutions which comprised of doctors, nurses and
patients. Patients and medical personnels should work hand
in hand, so that there will be a suitable and better cordial
human relationship between the duos in the medical
institutions. Detention that is done with the honesty of
ensuring the betterment of the patients’ health conditions
should not be seen as punishment but a relief.
RECOMMENDATIONS
 Patients should try and redeem or settle their debts
(medical bill) so to avoid been detained by hospital
management, and which constitute in worsening their
health conditions.
 Patients should as a matter of urgency put in their best to
respect medical conditions and rules governing the
running of medical institutions for effective health
service delivery. They should try as much to settled their
bills so as to avoid been detained by any health centres
They should try to pay off their medical bills so that there
would be better patients to doctors’ relationship, which
would enhanced effectiveness of the medical profession.
 The dignity of patients should be respected so as to usher
a new sense of hope for the patients and doctors
relationship.
 Human right watch should keep a brace with the latest
happenings in hospitals, clinics or maternities and try to
ensure that the right of patients are protected first before
monetary attachment is brought in to consideration.
 Medical personnels should respect medical ethics that
governs their profession. As people, who are meant to
salvage the lives of patients, they should not to allow it
deteriorate.
 Government, traditional rulers, religious leaders or
meaningful individuals should assist the less privilege
ones so as to avoid unforeseen humiliation of the human
persons by medical detainers, who detain patients on
grounds earlier stated.
 Medical detention should be done with utmost respect so
as not subject the patients to feel very dehumanized or
traumatised as treated by the medical personnels. It
should be done with good intention of the patients and not
at their own detriment because of financial hike interest.
 Government as well as Non Governmental Organizations
(NGO’s) should try and compliment or give assistance to
patients who are very poor to settle their bill, or subsidies
of their medical expensis should be reimbursed so as to
give relief or succour to such patients.
 Hospital management should try and adhere strictly to
tackling exploitation of patients by any of their staff
under the pretense of detention to complete medication.
If any found, he or she should be sanctioned.
 Management of hospitals, clinics and maternities should
make provision of basic facilities so as not to give room
for the staff to bring their own dubious and exploitative
tendencies on the patients by detaining or punishing them.
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ISSN No:-2456-2165
The essence of establishing any health care center is to [4]. Hornby,A.S (ed). Oxford Advanced
save lives and not to punish patients by any dubious Learners’Dictionary,6th edition. Oxford: Oxford
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 Human right abuse is a serious crime against humanity; [5]. Holmboe and Durning. “Applied Health Economics and
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bodies should be carried out by organizing seminars, [6]. Hickey, Raymond.History of the Diocese of Yola.nd.
symposiums, debates, quiz on the need for people to [7]. Lehmann, Arthur and Meyers, James E. Magic,
know their fundamental human rights and respect them in Witchcraft, and Religion Fifth Edition.
wherever they found themselves. USA:McGraw-Higher Education,2001.
[8]. Shishima,D.Sarwuan.African Religion: A Bird’ Eye
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[3]. dailypost.ng “Girl Dies After Being Detained by
Hospital over unpaid Medical Bill” 17th December,
2018.

LIST OF INFORMANTS

SR. NAME SEX AGE PLACE DATE OCCUPATION

No.
1 Aaron,Nyanbon. Male 39 Numan 4/11/18 Driver
2 Ardo,Umaru. Male 53 Serti 22/12/19 Herdsman
3 Anonymous Male 43 Mubi 22/8/18 Teacher
4 Bondi,Salamatu Female 42 J/Yola 28/12/18 Housewife
5 Hamuel, Apollos Male 51 Zing 14/4/18 Student
6 Kuku, Christiana Female 47 Iware 17/8/18 Farmer
7 Danjuma, Sarah Female 42 Sunkani 14/8/18 House wife
8 Yopoh, Wuzang Female 31 Lankaviri 3/9/19 Farmer
9 Vahme, Regina Female 43 Nukkai, Jalingo 1/3/19 Farmer
10 Aliyu, Zanti Male 27 Serti 13/1/19 Civil Servant
11 Punarimang, Idi Female 35 Mayo-Belwa 18/4/18 Farmer
12 Ganja, Pius Male 46 Rd Block, Jalingo 4/5/19 Farmer
13 Nzaala,Godfrey Male 32 Nyabun Kaka 5/4/19 Student

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