Two Burundian refugee women have died at Dowa district hospital, amidst allegations from several refugees of discriminatory practices and financial barriers to healthcare. Refugees claim they are subjected to unofficial fees for treatment, unlike Malawian citizens who receive free care. "In this hospital, citizens are treated for free, but for refugees, an unrecognised sum, which varies according to the severity of the illness, is paid to nurses to receive a good welcome. This is inadmissible. We should be subject to the same treatment regime," several refugees stated. They further alleged that "at least two refugees die each month" and that the hospital treats "the lives of refugees lightly."
Refugee Accounts of Care Barriers
A witness reported that the situation for the two women worsened after they were unable to pay a sum described as a "deposit." The witness stated, "C’est alors que les infirmiers ne leur ont plus accordé une attention particulière" (It was then that the nurses no longer paid special attention to them), characterizing this as "criminalité extrême" (extreme criminality). Refugees said they had used all their savings to purchase fuel for an ambulance intended to transport them to the hospital. A witness added, "Elles avaient utilisé toutes leurs économies pour acheter du carburant pour l’ambulance qui devait les amener à l’hôpital. Cette situation est vraiment catastrophique et alarmante. Comment un réfugié démuni peut-il se retrouver dans une situation aussi chaotique ? Nous méritons mieux que ça" (They had used all their savings to buy fuel for the ambulance that was supposed to take them to the hospital. This situation is truly catastrophic and alarming. How can a destitute refugee find themselves in such a chaotic situation? We deserve better than that). Refugees accuse the hospital of treating "à la légère la vie des réfugiés" (the lives of refugees lightly).
Overcrowding and Strain at Dzaleka Camp
The women had been transferred urgently to the Dowa reference hospital due to complications related to their pregnancy and childbirth. This incident notes the significant strain on resources, particularly within the Dzaleka refugee camp. The camp, originally designed to accommodate approximately 12,000 people, now houses over 50,000 refugees. Among these residents, over 11,000 are Burundian. The overcrowding exacerbates existing challenges in accessing essential services, including healthcare. Refugees in the camp have previously accused the hospital of treating "à la légère la vie des réfugiés" (the lives of refugees lightly), an allegation that shows concerns about the adequacy of care.
Official Response and Ongoing Concerns
Refugees have denounced financial difficulties in accessing medical care at Dowa Hospital. Several refugees interviewed stated that the two recent deaths are not isolated cases, claiming "au moins deux réfugiés meurent chaque mois" (at least two refugees die each month) at Dowa Hospital due to their inability to pay certain medical fees. They further alleged, "Dans cet hôpital, les citoyens sont soignés gratuitement, mais pour les réfugiés, une somme non reconnue et qui varie selon la gravité de la maladie est versée aux infirmiers pour bénéficier d’un bon accueil. C’est inadmissible. Nous devrions être soumis au même régime de traitement" (In this hospital, citizens are treated for free, but for refugees, an unrecognised sum, which varies according to the severity of the illness, is paid to nurses to receive a good welcome. This is inadmissible. We should be subject to the same treatment regime). Refugees accuse the hospital of treating "à la légère la vie des réfugiés" (the lives of refugees lightly). The administrative authorities of the Dzaleka camp and the Haut-Commissariat des Nations unies pour les réfugiés (HCR) have reportedly promised to seek a solution to the problem, particularly concerning healthcare access.