By Mustafa Abdi Ibrahim
The tragic incident at Hargeisa Group Hospital—involving a pregnant woman who reportedly suffered a fatal fall—cannot be dismissed as a fleeting news story to be read and quickly forgotten. If the circumstances are as described, this event demands a thorough investigation, genuine accountability, and a serious effort to understand what transpired before the situation reached such a heartbreaking conclusion.
A pregnant woman requires specialized care, compassion, protection, and urgent medical attention. Expectant and new mothers must not be subjected to additional burdens—particularly financial strain, neglect, unnecessary delays, or inhumane treatment.
As the largest public hospital and primary referral center in Somaliland, Hargeisa Group Hospital receives hundreds of patients daily, including numerous expectant mothers. Its responsibility, therefore, extends far beyond medical treatment—it must be a place where even the poorest patient feels their life holds inherent value.
A Public Hospital or a Fee-for-Service Facility?
The pressing question today is this: if Hargeisa Group Hospital is a state-run institution, why do vulnerable patients so often feel that every service comes with a price tag?
Studies and prior reports indicate that the Hargeisa healthcare system relies heavily on cost-recovery, requiring families to pay for specific services, medications, and medical supplies. Research on maternal delivery, for instance, highlights a cost-sharing model for cesarean sections, where the government covers part of the surgical cost while the family bears the expense of medications and supplies.
However, a clear distinction must be drawn between a structured cost-sharing policy and a situation where patients are made to feel that care is contingent upon their ability to pay. The government bears a fundamental duty to safeguard those who cannot afford medical expenses. Illness does not discriminate by wealth, and poverty is not a choice.
The Poor Must Not Become Victims of the System
It is deeply troubling when a sick or pregnant woman arrives at a public hospital seeking help, only to confront a system where money has become the primary gateway to care. Patients should first be seen as human beings in desperate need of assistance, with the logistics of payment addressed only afterward.
If a person is denied service—or is neglected—due to an inability to pay, this is no longer merely a healthcare problem. It becomes a crisis of health equity, governance, and social justice.
This Incident Demands an Independent Investigation
While it is inappropriate to assign blame to any single individual without a formal inquiry, it is equally unacceptable for an incident of this gravity to be met with silence.
It is crucial to establish:
· What exactly happened to this woman?
· How was she treated during her stay at the hospital?
· Was there any medical or psychological care she needed but did not receive?
· Were there costs that she simply could not afford?
· Was a responsible staff member consistently monitoring her condition?
· How does the hospital currently manage vulnerable expectant mothers, and what is the official protocol for patients who cannot pay?
These questions must be answered while upholding the dignity, privacy, and legal rights of the patient and her grieving family.
The Ministry of Health Must Reform the System
The Ministry of Health must move beyond paperwork and actively monitor service quality, financial procedures, patient complaint mechanisms, and the protection of vulnerable populations. Moreover, Somaliland’s own health policy documents have previously identified systemic challenges, including governance failures, weak oversight, and declining public confidence in Hargeisa Group Hospital.
Consequently, the problem is not confined to one staff member or a single event. If the system itself contains flaws, then the system itself must be corrected.
A Public Hospital Must Serve Everyone
Hargeisa Group Hospital must inspire confidence across all socioeconomic divides. It must ensure that:
- Both paying and non-paying patients receive quality care.
- Every expectant mother receives care, respect, and a safe environment.
- No one is denied essential medical treatment due to financial constraints.
- Healthcare workers are evaluated on service quality, compassion, and life-saving outcomes—not on how much revenue they collect from patients.
Rather than devolving into a partisan dispute, this tragedy should prompt a hard reckoning with the foundational principles of Somaliland’s healthcare system. If a public hospital does not serve those who cannot afford to pay, then who serves the poor? A person’s life has no price tag.
What Is Needed Now
What is required is not mere condemnation, but an independent investigation, genuine accountability, and systematic reform of the services at Hargeisa Group Hospital. An expectant mother deserves care and safety—not additional burdens imposed by the very system meant to protect her.
Healthcare is a human right, not a commodity accessible only to those who can afford it.
Finally, the Ministry of Health and the management of Hargeisa Group Hospital are now at a critical juncture where accountability is unavoidable. If they cannot properly fulfill their duties, they must vacate their positions.
May Allah have mercy on the deceased and grant patience and faith to her family.
