A severe dispute over unpaid medical bills and unresolved death claims has ignited a massive operational crisis at the Coast General Teaching and Referral Hospital, leaving hundreds of patients stranded and desperate.

The largest public healthcare facility in Kenya's coastal region has been plunged into unprecedented chaos as administrative disputes over patient billing and mortality documentation reach a boiling point.

The Coast General Teaching and Referral Hospital in Mombasa is currently navigating a catastrophic administrative breakdown. Families of deceased patients are locked in bitter confrontations with hospital management over exorbitant accumulated bills, while critical healthcare services for new admissions face severe disruption. This systemic failure highlights the fragile state of public healthcare financing across East Africa.

The Anatomy of a Healthcare Collapse

The crisis at Coast General is not an isolated incident but rather the culmination of years of underfunding and structural inefficiencies. The transition from the National Hospital Insurance Fund (NHIF) to the new Social Health Insurance Fund (SHIF) has created massive bureaucratic bottlenecks. Families grieving the loss of their loved ones are arriving at the facility only to be met with demands for cash payments ranging from KES 50,000 to upwards of KES 500,000 before bodies can be released for burial.

Hospital administrators, facing massive funding deficits from the national treasury, argue that the facility cannot sustain daily operations without recovering these operational costs. However, this hardline stance has resulted in mortuary overcrowding and escalating public outrage. For the residents of Mombasa and the broader coastal region who rely exclusively on this referral hospital, the situation has rapidly evolved from an administrative dispute into a dire humanitarian emergency.

Systemic Failures and the Kenyan Context

The ongoing standoff at Coast General serves as a microcosm of the broader healthcare challenges plaguing Kenya. Despite significant investments in medical infrastructure by county governments, the operational budget required to maintain referral hospitals remains grossly inadequate. The inability of the national insurance apparatus to process claims swiftly has forced hospitals to transfer the financial burden directly onto deeply impoverished citizens.

• Massive delays in the processing of national health insurance claims causing operational cash flow crises.
• Severe overcrowding in hospital mortuaries due to bodies being detained over unpaid medical bills.
• Significant disruption of essential outpatient and emergency services as administrative staff manage the ongoing protests.
• A growing deficit in public trust regarding the transition to the new Social Health Insurance Fund.

Human rights organizations operating within the coastal region have strongly condemned the practice of detaining bodies, labeling it a violation of fundamental human dignity. The legal framework surrounding medical debt collection in Kenya remains highly contentious, with previous court rulings declaring the detention of patients or bodies over unpaid bills unconstitutional. Yet, the practice persists unabated due to the sheer financial desperation of public health facilities.

A Blueprint for Sustainable Healthcare Recovery

Resolving the crisis at Coast General requires immediate and decisive intervention from both the Mombasa County Government and the Ministry of Health in Nairobi. Short-term relief must include an emergency financial bailout to clear the backlog of detained bodies and allow grieving families closure. However, the long-term solution demands a fundamental restructuring of how referral hospitals are financed in Kenya.

There must be a seamless, highly efficient mechanism for processing health insurance claims that ensures hospitals receive timely reimbursements. Furthermore, the implementation of a robust indigent fund—specifically designed to cover the medical expenses of citizens living below the poverty line—is absolutely critical to prevent public hospitals from resorting to draconian debt collection methods.

"We cannot build a healthy nation when our largest public hospitals operate like aggressive debt collection agencies; healthcare is a fundamental right, not a conditional privilege," declared a Mombasa-based civil rights advocate, demanding immediate governmental intervention.