Birth and Resistance: Recent Episodes
Alissa Jordan
A podcast about birthing, care, and racial capitalism in the context of "hospital detention", where hospitals lock mothers and newborn babies inside to force debt repayment. Using creative ethnographic storytelling, first person narration, conversation, and critical analysis, we explore the neoliberal global health practice of imprisoning mothers for debt. What kind of silences are built around medical detention? How do these silences relate to histories of colonial medicine and black motherhood? How do mothers, healthcare workers, journalists, and others resist this silence?
What is it like to give birth in a hospital where your life is traded for your freedom? How and why has hospital imprisonment become an institutionalized post-birth experience for BIPOC women around the globe? What kind of silences are built around this practice, and how are mothers and families fighting back against them?
This podcast combines creative ethnographic storytelling, first person narration, conversation, and critical analysis to understand a global health phenomena called "hospital detention",whereby mothers and newborn babies are routinely imprisoned within hospitals following birth in order to forcibly extract surgical fees from their families and communities. Co-hosted by anthropologist Alissa Jordan and birth activist and photojournalist China Tolliver, this episode explores the emergence of these “hospital-prisons” in Haiti and around the world. We focus on two Haitian mothers—Likna and Naomi—and their experiences of birthing in Euro-American mission hospitals where they were then imprisoned.
Held captive with their infants, and neither provided food, water, or toiletries, these US-operated hospitals leveraged Naomi, Likna, and their companions as “corporeal collateral”---holding them hostage in order to force families and communities to pay outstanding debts for obstetric surgeries. We connect their stories to broader conversations on birth justice and racial capitalism, highlighting how hospital-prison works to commericalize kin ties and collateralize black and brown bodies.
Called global public health’s “open secret” (Cowgill & Ntatumbe 2019) the practice of hospital detention is widespread—a standard practice in western neoliberal medicine across 52 countries of the world. It overwhelmingly impacts black women, indigenous women, and women of color and their babies during birth journeys. In spite of its ubiquity, the amount of academic articles written on the practice can fit in a single hand---even though local journalists across the world (from Kinshasa to Nairobi, and Madhya Pradesh to Bogota) have published volumes of accounts on mothers (and others) experiences of clinical captivity.
Special thanks to "Likna", "Naomi", "Nel", "Guerlande", "Marcele", "Pierre" and to Carmelle and Jennifer at MamaBaby Haiti, to Robert Yates & Chatham House, Dr. Karen Cowgill at the University of Washington and Prof. Abel Ntambue of the University of Lubumbashi, Prof. Kakudji Yumba Pascal of the University of Lubumbashi, to Maria Cheng of the Associated Press, and to Charmaine Jordan
English Mastered by: Jared Blalock www.molotovbliss.com Sound Credits: Nicu Hospital Beeps by JGeralyn, freesound.org; Tearing Paper Sound Effect by Keweldog freesound.org; Cash Register by CapsLock, freesound.org; Thick Bed Cover, Ruffling Blankets by CMorris035, freesound.org; Pen Click and Writing by BarkersPinhead, freesound.org; Cafe Ambient Sound by EVSecrets, freesound.org; Tearing paper by Panska Stranska Michaela, freesound.org; Stamp by Desrsuperanton freesound.org; Creaky Metal Gate by Arnaud Coutancier freesound.org; Haiti ambient street sounds by Kyles freesound.org; Prison Door Closing by BrianBaltar freesound.org; Emergency Room Sounds by Bruno Auzet freesound.org; Chopping Vegetables by Ancorapazzo freesound.org; Fence Rattling by Starvolt freesound.org; Running in the Forest by Taira Komori freesound.org; Dishes by Bevibeldesign freesound.org; Sipping Drink by VPP 2015 freesound.org; Person Falling by Blouhound freesound.org; Dufflebag by JRSevers3 freesound.org; Frying Roasting Vegetables in Oil by Neil RAouf freesound.org; Short Run and Stop by Lekingoo freesound.org
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Dr. Karen Cowgill is an epidemiologist based in Seattle, whose Fulbright Fellowship to the Democratic Republic of Congo led to important collaborative research on maternal hospital detention with Professor Abel Ntambue of the University of Lubumbashi. Dr. Cowgill sat down with China Tolliver and Dr. Alissa Jordan (remotely) to discuss hospital detention, her research, and maternal health. In this clip, Cowgill connects hospital detention to other birth injustices, as a fundamental violation of women's autonomy that is not exceptional but connected to myriad other ongoing violations of autonomy that women can experience during birthing.
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Dr. Karen Cowgill is an epidemiologist based in Seattle, whose Fulbright Fellowship to the Democratic Republic of Congo led to important collaborative research on maternal hospital detention with Professor Abel Ntambue of the University of Lubumbashi. Dr. Cowgill sat down with China Tolliver and Dr. Alissa Jordan (remotely) to discuss hospital detention, her research, and maternal health. In this clip, Cowgill describes what it means that hospital detention is an "open secret" in global public health, as she describes in her co-authored piece (with Abel Ntambue), “Hospital detention of mothers and their infants at a large provincial hospital: a mixed-methods descriptive case study, Lubumbashi, Democratic Republic of the Congo”, Dr. Cowgill and Dr. Ntambue call hospital detention a “gendered violence”.
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Dr. Karen Cowgill is an epidemiologist based in Seattle, whose Fulbright Fellowship to the Democratic Republic of Congo led to important collaborative research on maternal hospital detention with Professor Abel Ntambue of the University of Lubumbashi. Dr. Cowgill sat down with China Tolliver and Dr. Alissa Jordan (remotely) to discuss hospital detention, her research, and maternal health. In this clip, Cowgill describes why hospital detention is a gendered violence, and how she came to the decision to name it as such in her co-authored article (with Abel Ntambue), “Hospital detention of mothers and their infants at a large provincial hospital: a mixed-methods descriptive case study, Lubumbashi, Democratic Republic of the Congo”, Dr. Cowgill and Dr. Ntambue call hospital detention a “gendered violence”.
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Dr. Karen Cowgill is an epidemiologist based in Seattle, whose Fulbright Fellowship to the Democratic Republic of Congo led to important collaborative research on maternal hospital detention with Professor Abel Ntambue of the University of Lubumbashi. Dr. Cowgill sat down with China Tolliver and Dr. Alissa Jordan (remotely) to discuss hospital detention, her research, and maternal health. In this clip, Cowgill describes how her Fulbright—originally on a very different topic—was quickly transformed into a project on hospital detention while working at Jason Sendwe Hospital in Lubumbashi.
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Prof. Pascal Yumba Kakudji is a professor at the Faculty of Law – University of Lubumbashi, and the head of the Department of Private and Judicial Law, and his research focuses on medical law and bioethics. He sat down (remotely) with Alissa Jordan for a conversation about bioethics and hospital detention, an area of research that he has been invested in since 2014. In this track, listen to Kakudji describe the geographic distribution of nations where hospital detention is prevalent, and also hear about the bioethical problems that the practice creates.
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Prof. Pascal Yumba Kakudji is a professor at the Faculty of Law – University of Lubumbashi, and the head of the Department of Private and Judicial Law, and his research focuses on medical law and bioethics. He sat down (remotely) with Alissa Jordan for a conversation about bioethics and hospital detention, an area of research that he has been invested in since 2014. In this track, Kakudji discusses how medical detention challenges State juridical systems, executing a "private" form of justice, enforcement, and stripping of rights, that challenges State sovereignty . At the end of this talk, Kakudji reflects on the paths towards disconnecting the medical care system from imprisonment practices.
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Alissa Jordan and China Tolliver sat down to speak with Robert Yates, Executive Director of Universal Health Coverage at the Chatham House in the UK. In this clip, Yates discusses how countries have used bans on imprisoning mothers and new babies as a first step towards Universal Health Coverage
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Alissa Jordan and China Tolliver sat down to speak with Robert Yates, Executive Director of Universal Health Coverage at the Chatham House in the UK. In this track, Robert Yates discusses the difficulties that families face when they grapple with deciding to pursue healthcare in systems with user fees.
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Alissa Jordan and China Tolliver sat down to speak with Robert Yates, Executive Director of Universal Health Coverage at the Chatham House in the UK. In this track, Robert remembers his mother's story of falling ill as a child, and the decisions that had to be made about survival when the cost of care threatened to bankrupt her family.
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Professor Abel Ntambue is Professor (PhD at Université Libre de Bruxelles) of Epidemiology at the School of Public Health at the University of Lubumbashi in the Democratic Republic of Congo. Prof. Ntambue sat down with his collaborator Dr. Karen Cowgill, as well as Dr. Alissa Jordan, for a conversation on his research into hospital detention and how it connects to his personal background as a professor, scholar, and a husband. In this clip, Ntambue discusses his personal story of involvement in the question of hospital detention in the Democratic Republic of Congo. For English, please see transcript below (translation and transcript graciously provided by Dr. Karen Cowgill).
English Transcript (Abbreviated)
I should say that when I was doing my nursing studies, I wasn’t too interested in women’s health – what interested me was children or stuff having to do with surgery. But the thing that really put me on alert was a death when I was a student from a cause that could have been avoided so I think from that point I began to see the thing a bit more with a lot of attention and to be interested up to the point where my own wife was victim of an [accident] or of a complication, which was a little bit closer to that which had killed the woman when I was a student. And there, well, I understand that if my wife survived, it was because, well, I was at least able to pay.
Once I was named in charge of the HIV program for PMTCT I had to coordinate, at that time, more than 20 maternity units in the city of Lubumbashi, and for women living with HIV. And so, beyond my actions concerning the management of the women who were infected, I also managed the elements of delivery – in fact, all the other obstetric care related to delivery. So I noticed – I had two observations, the first observation was that when the staff was informed [break in audio connection], they had the tendency to increase the cost of the delivery. Secondly, even when the woman racked up a little something, even ten dollars, fifteen dollars -- and more and more, I managed cases, I found cases where certain women had to spend 10 extra days, 15 extra days in the maternity ward, simply because in their state of poverty they were unable to pay those fees.
I had to, myself, as coordinator of the program, pay to free women who were kidnapped or detained in the maternity regardless of their status as PLWHA. And so more and more, the number of women was increasing, I had a lot of cases of the detention of women, and I realized that the problem wasn’t only among the women I was managing – the women infected with HIV, but also, when I went to the maternity unit, a lot of other women were retained, and that became more or less an object of marketing, especially when there were episodes of election in our country, so we had, like, parliamentarians, politicians, who had to go to pay to free the women. And it’s in that way that the problem became for me a lot more visible. So when I left Lubumbashi, where I live, to go to another province, Mbuji-Mayi, in Kasai province, I personally found a child who had already in total 6 months in a maternity and, so, I had to collect money with my friends to be able to pay. I went back to the hospital where I work and I realized that there were already also women who had more than 6 months, with children who had grown up, some close to reaching their first birthday in the heart of that maternity unit. And it’s thus that all of a sudden I began to get interested in the phenomenon of detention, and it’s in that way that, finally, all my [break in recording] started from there, and I thought it was a problem unique to the maternity at Sendwe which used to be financed by Gecamines but is no longer currently, but I realized that, overall, it’s a problem that touched a lot of other health facilities...
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Professor Abel Ntambue is Professor (PhD at Université Libre de Bruxelles) of Epidemiology at the School of Public Health at the University of Lubumbashi in the Democratic Republic of Congo. Prof. Ntambue sat down with his collaborator Dr. Karen Cowgill, as well as Dr. Alissa Jordan, for a conversation on his research into hospital detention and how it connects to his personal background as a professor, scholar, and a husband. In this clip, Ntambue discusses health politics and policies at the national level in the DRC.
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Professor Abel Ntambue is Professor (PhD at Université Libre de Bruxelles) of Epidemiology at the School of Public Health at the University of Lubumbashi in the Democratic Republic of Congo. Prof. Ntambue sat down with his collaborator Dr. Karen Cowgill, as well as Dr. Alissa Jordan, for a conversation on his research into hospital detention and how it connects to his personal background as a professor, scholar, and a husband. In this clip, Ntambue discusses the strategies that hospitals use to detain mothers, to keep track of their bills, and to prevent escape.
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Professor Abel Ntambue is Professor (PhD at Université Libre de Bruxelles) of Epidemiology at the School of Public Health at the University of Lubumbashi in the Democratic Republic of Congo. Prof. Ntambue sat down with his collaborator Dr. Karen Cowgill, as well as Dr. Alissa Jordan, for a conversation on his research into hospital detention and how it connects to his personal background as a professor, scholar, and a husband. In this clip, Ntambue discusses the public health system in RDC, in terms of care, quality, and structure.
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Professor Abel Ntambue is Professor (PhD at Université Libre de Bruxelles) of Epidemiology at the School of Public Health at the University of Lubumbashi in the Democratic Republic of Congo. Prof. Ntambue sat down with his collaborator Dr. Karen Cowgill, as well as Dr. Alissa Jordan, for a conversation on his research into hospital detention and how it connects to his personal background as a professor, scholar, and a husband. In this clip, Ntambue discusses the ways that alliances are built in hospital spaces, how detained mothers seek food, resources, and assistance from both medical staff and other mothers. Please see the English transcript of Ntambue's comments below, graciously provided by Dr. Karen Cowgill:
English Transcript
The first thing is that there is a type of solidarity that exists, that exists between, first, the staff, particularly the nurses and midwives, and the rest, even, if they are aware –everything depends on the attitude of the woman. At times, the nurses manage to take up a collection among themselves to help this woman. So, sharing, sharing food, that, yes.
Secondly, there are women who are not detained, the women who pay normally but who receive a lot of visits, and with a lot of visits, a lot of food. Those women, who are in a normal situation, end up sharing food with the women who are – who are in difficulty. So those are the common situations that are documented, so the women who delivered in the maternity and are not detained and receive food, they eat – bread, tea, coffee – and share with those who don’t have the means and are detained. That is common here, one sees those cases.
The nurses who receive something that they share, but I haven’t seen those cases there, because sometimes they must beg, they go begging to the others to find something to eat. So if a mother is lacking something to eat, it’s very difficult.
But in terms, now, of leaving – how are they going to leave? Yes, sometimes there are religious services that pass through the maternity to pray, the [aumoine (alms) or homme] who go to pray, there are also churches that arrange, like, services by week to distribute food in hospitals, so the women survive, because at that point when there are religious services come through, they have the opportunity to have some food. It’s thanks also to these religious services, for example, that they can find the possibility – as a function, obviously, of bills – to be freed. At that time, for example, one might ask the hospital to cut the bill in half, or accept what’s available – the politicians do the same thing – but solidarity among the detained women, if it exists, it’s more supported by the women who are not detained, who leave because, you see, they receive an excess of food, since they can’t throw it out, they will then try to help those who are altogether [without means].
---Prof. Abel Ntambue
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AP Journalist Maria Cheng, who has authored numerous investigative reports on hospital detention across the globe, sat down (remotely) with China Tolliver and Alissa Jordan to discuss the problem of hospital detention around the world. In this audio clip, Cheng discusses the length of time that the patients she worked with had spent imprisoned in hospitals, the amounts that they owed, and the spaces they are kept in.
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AP Journalist Maria Cheng, who has authored numerous investigative reports on hospital detention across the globe, sat down (remotely) with China Tolliver and Alissa Jordan to discuss the problem of hospital detention around the world. In this clip, Cheng reflects on the strategies that hospitals use, the spaces they create, and the guards that they hire in order to run hospitals both as centers of care and as centers of debt imprisonment.
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AP Journalist Maria Cheng, who has authored numerous investigative reports on hospital detention across the globe, sat down (remotely) with China Tolliver and Alissa Jordan to discuss the problem of hospital detention around the world. In this audio clip, Cheng discusses her approach to researching hospital detention across the globe.
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AP Journalist Maria Cheng, who has authored numerous investigative reports on hospital detention across the globe, sat down (remotely) with China Tolliver and Alissa Jordan to discuss the problem of hospital detention around the world. In this audio clip, Cheng discusses Roma women's experiences of imprisonment, discrimination, and abuse within Slovak hospitals.
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AP Journalist Maria Cheng, who has authored numerous investigative reports on hospital detention across the globe sat down (remotely) with China Tolliver and Alissa Jordan to discuss the problem of hospital detention around the world. In this audio clip, Cheng discussed the way that prisoners are held, where they are held, and other details about life as a prisoner of a hospital.
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