Rulindo District: Health Facility Recording Ghost Patients

Health officials at a facility located in rural Rulindo district may be conniving to inflate the number of patients treated there – a scheme likely happening at other facilities.

For the year 2020, the Kamushenyi health post located in Murama cell, Kisaro sector, recorded patients many of whom had never been treated there. When confronted with the scandal details, officials at the health post and sector level declined to speak and ignored phone calls.

A health post is the lowest medical facility at a cell level. For the past year, Kamushenyi health post submitted data to RSSB for health insurance refunds of 97 patients.

However, the patients we selected randomly verify if they were treated last year, said they were never there. Some of those recorded, had actually died long ago, or had relocated from that region.

Ntizihabose Emmanuel is recorded as having been treated May 20, 2020, yet he died a month earlier in April. The deceased’s wife, Mukahigiro Jeanette from Kabahura village, Rwagihura cell, Nyankenke sector in neighboring Gicumbi district, was furious when asked about her husband.

“That is mockery of my loss,” said the widow. “For God’s sake, they should leave my husband to rest in peace.”

The exact number of ghost patients at this facility may be difficult to find, until each of the recorded patients is individually verified. However, it partly confirms worries of the Rwanda Social Security Board (RSSB) which oversees health insurance.

The agency has been spending more than planned on health insurance, prompting suspicion that health facilities may be inflating patient numbers, among the tactics to get more repayments.

It was unearthed in February 2019. For the period from June-December 2018, the Board had planned for Rwf 47billion expenditure on health insurance.

But a mid-year review conducted shows it has spent Rwf 54.2 billion – incurring Rwf 7.2billion extra expenses for the first half of that financial year.

Even with this data, the Board’s head at the time, Richard Tusabe said there was a “criminal network” behind the losses. He is currently a state minister.

“I can’t tell you how much we lost,” he said at the time, adding, “But when you compare the number of beneficiaries we covered and the payments made, there is a big difference.”

He added: “You wonder whether there was an epidemic that may have caused the unusual increment.”

Since then, dozens of officials and pharmacy managers in different regions are facing prosecution for the mess.

Another ghost patient on the records of the Rulindo health post is a 78 year-old man. The records show he was treated at the facility in May 2020. Yet, when we located the elderly man, he was shocked, saying he has never been to that facility, and that he left the area when he was 13 years old.

Mukarugina Claudine is recorded as having taken her husband for treatment at the health post in July 2020. Physical verification found the husband left Rwanda in 2015 for Uganda.

What is clear is that the officials at this health post, in possible connivance with some superiors, do use names of existing people when falsifying the records.

When contacted to discuss the discrepancies with their records, officials at the health post and Kisaro health center which oversees this post, all declined to speak. They didn’t pick phone calls either.

In Kigali, RIB Spokesman Dr. Murangira Thierry said four officials from the area are under investigation.