Millicent Awuor Omuya and Margaret Anyoso Oliele v. The Attorney General & 4 Others [2015], Petition No. 562 of 2012

Nature of the Case

Two women who were detained by a public maternity hospital for non-payment of their hospital delivery bills sued the government and hospital alleging violations of their and their children’s constitutional rights and rights under various regional and international human rights instruments.  Both petitioners had originally sought affordable clinics due the low delivery prices, but both were unexpectedly referred to Pumwani Maternity Hospital, where they delivered but the prices were much higher than they were able to pay. As a result, they were detained.

Enforcement of the Decision and Outcomes

The Court ordered the government of Kenya to take the necessary steps, which include enacting laws and policies to protect patients from arbitrary detention in health care facilities. It further issued a directive to the Kenyan government and the Pumwani Maternity Hospital to develop clear guidelines and procedures for implementing the fee waiver system in all public hospitals and to take all necessary administrative, legislative, and policy measures to eradicate the practice of detaining patients who are unable to pay medical bills. The Court further awarded Ms. Awuor 1.5 million Kshs in damages, Ms. Oliele 500,000 Kshs, and awarded both of them legal fees.

Significance of the Case

Pregnancy-related complications take the lives of approximately 8,000 Kenyan women each year. Despite the steps that the Kenyan government has pledged to provide free maternity services, user fees and poor service delivery continue to present obstacles, particularly for women experiencing poverty. This case emphasizes the government’s obligation to fulfill the right to reproductive health services, including in the face of resource constraints. It also sends a strong message that the government has the obligation to ensure that health care workers do not discriminate against and mistreat indigent patients. Indeed, this case was the precursor to J.M. v. Attorney General, where in 2018 the court also found violations of the right to health as well as the right to dignity and to freedom from cruel, inhuman, and degrading treatment.

For their contributions, special thanks to ESCR-Net member: the Program on Human Rights and the Global Economy (PHRGE) at Northeastern University.