Tales from the Crypt: Angola’s Hidden Hospital Horrors

Morgue Tax

“Sick people don’t have to pay.  Only the dead.”

At face value, this remark from one of the administrators of the Regional Hospital in Cafunfo, in the province of Lunda Norte seems to make no sense.  Then clarity emerges: the town does not have electricity. The living have to put up with no electricity.  But the families of the recently deceased are forced to pay “for a day or two’s refrigeration in the morgue” or deal with the gruesome consequences of a decomposing corpse.

Cecilia Matias was only sixteen when she died from yellow fever.  Her Aunt, Madalena Matias revealed that that the grieving family had to find the equivalent of nearly four hundred dollars for Cecilia’s body to be preserved while they arranged her funeral.

“We bought two {200 litre) barrels of diesel at the pump, at a cost of 64.000 kwanzas, to keep Cecilia’s body preserved for two days in the morgue.”  That’s 383 US dollars at the official exchange rate, to supply the diesel to run the generator to supply power to the refrigerated unit.

“We were told by the hospital administration that they had no fuel.  One of the hospital directors told us, in person, what it would cost and instructed their mechanic to take the two barrels of fuel in payment to run the generator”, explains Madalena Matias.

To add insult to injury, there was a further demand: “We had to pay another 10,000 kwanzas to the morgue security to guarantee the one refrigeration unit that is working.  The other five are not fully functional and bodies stored in them emerge stinking.”

According to sources in Cafunfo Hospital, the morgue handles between three and five cadavers each day. In every case, the family members of the deceased are faced with a demand to supply 200 litres of fuel, or hand over the equivalent cost in cash.

Eduardo Muatxivumbi went through the same ordeal, paying 30,000 kwanzas for one night’s preservation in the morgue of the remains of his 21 year-old nephew, Silva André.  “I handed over the money in the hospital administration office where all payments are made.  They don’t give receipts. Only when you pay up do they transfer the body to the morgue”.

And that wasn’t all. The hospital then demanded another 2,000 kwanzas to issue a death certificate.  “We ended up so frustrated by the successive demands for money that we refused to pay for the death certificate and buried Silva without one.”

What happens to families who don’t have this kind of money?

Local activist Salvador Fragoso explains: “People who can’t come up with the money have got to bury the body on the same day.  If you don’t pay, there’s no room at the morgue”.

This sorry state of affairs is confirmed by a source in the hospital administration (who asked not to be named).  “It’s true.  The area lacks a power supply so the government gave us a generator.  But it doesn’t supply the fuel to run it.  That is why we have to ask families to co-pay for the preservation of the corpses of their loved ones.”

The staffer tries to justify the reasoning behind these egregious morgue fees, given that the diesel supplies power to the whole hospital and the residential neighbourhood beyond.

“The generator only functions at night, from 6pm to 11pm and then again from 4am to 8am for the transfer and removal of bodies. During the day, patients are treated in natural light.  Our doctors have even had to take the risk of conducting operations during the power blackouts.”

Legitimate fee or bribe?

The key phrase in that ‘justification’ is that the generator supplies power to the whole neighbourhood.  That would be the neighbourhood where the Deolinda Rodrigues School is located as well as the grace-and-favour residences of local bigwigs such as the municipal administrator, the MPLA Secretary, the district attorney and others.

This macabre shake-down takes place right in the heart of Angola’s enormously rich alluvial diamond-mining region.  None of the fabulous wealth from the diamond trade trickles down to the region’s inhabitants, nor apparently to the local administration which is supposed to guarantee the operation of public services.

Cafunfo regional hospital’s one Angolan and six North Korean doctors serve the populations of six municipalities (Cuango, Caungula, Xå Muteba, Lubalo, Capenda Camulemba and Cuilo), for a combined population of 324,000 people. But staffers say it’s regional in name only and give further evidence of its total administrative disarray: “wages are in arrears since February for contract workers, and April for the permanent staff.”

Maka Angola contacted Angélica Kaumba Sassão, the municipal administrator of Cuango, for comment.  She expressed surprise regarding the payment of ‘fees’ for the morgue.  “I don’t know anything about this.  Could it be a worker who is doing this without the knowledge of the hospital director?” she wonders.

When told that family members report they are making these payments directly to the hospital’s administrative secretariat, Angélica Kaumba Sassão can only repeat “I don’t have that information.”  She guarantees that she will be questioning the hospital director about these egregious fees.  “This is a big surprise to me because only 15 days ago we sent them enough fuel to run the generator.”

Cafunfo Regional Hospital isn’t only suffering from an energy crisis, according to local activist Salvador Fragoso.  “The hospital doesn’t even have syringes to carry out bloodwork analyses.  Each patient has to buy a syringe at the market and take it with them to their medical consultation.”

He goes on to say: “the hospital is powerless to do anything except enlist the help of local churches to spread the word that people must take greater care of themselves because the hospital doesn’t have the resources to treat people.  And a lot of people are dying every day because of the outbreak of yellow fever here.”

Turning a blind eye to yellow fever

Zinha de Castro was aged 40 when she passed away in the early hours of May 4.  Her former husband, Justino Pedro, told Maka Angola, that she died from yellow fever. “We had to buy a [200 litre] barrel of diesel costing 35,000 [US $212] kwanzas to ensure her body would be preserved in the hospital morgue.  We handed it over to the manager, Simão Jonas.”

Justino Pedro says that an epidemic of yellow fever is spreading from community to community in Cafunfo..

“Every day we are burying 10 people or more. Due to the lack of vaccines, syringes or even so much as an Aspirin in the hospital, people are resorting to pawpaw, mango, avocado and orange leaf tisanes to try to treat the sickness.”

People in the area routinely would cross the border to seek treatment for their ailments in the neighbouring Democratic Republic of Congo, but this cross-border traffic has been stopped because of the yellow fever outbreak. “The DRC is preventing Angolans from entering, because they don’t want yellow fever to be spread over there.”

A hospital source (preferring not to reveal their name) said “doctors are in denial that there is na outbreak of yellow fever here.  But the symptoms can be seen with the naked eye and we know it is the cause of many deaths every day.”

“The hospital doesn’t do any diagnostic work because we have only one lab technician and no syringes, gloves or cotton wool; and let’s not even mention ] (the lack of) medicines.