Clinton's Blood Clot Could've Been Life Threatening

Hillary Clinton's latest health update -- cerebral venous thrombosis -- is a rare and potentially "life-threatening" condition, according to medical experts, but one from which the globe-trotting secretary of state is likely to recover from.

In an update from her doctors, Clinton's brain scans revealed a clot had formed in the right transverse venous sinus, and she was being successfully treated with anticoagulants.

"She is lucky being Hillary Clinton and had a follow-up MRI -- lucky that her team thought to do it," said Dr. Brian D. Greenwald, medical director at JFK Johnson Rehabilitation Center for Head Injuries. "It could have potentially serious complications."

The backup of blood flow could have caused a stroke or hemorrhage, according to Greenwald.

"Imagine this vein, where all the cerebral spinal fluid inside the head and spine no longer flows through this area," he said. "You get a big back up and that itself could cause a stroke. In the long-term … the venous system can't get the blood out of the brain. It's like a Lincoln Tunnel back up."

A transverse sinus thrombosis is a clot arising in one of the major veins that drains the brain. It is an uncommon but serious disorder.

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Hillary Clinton Has Blood Clot From Concussion Watch Video

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Hillary Clinton's Concussion: Doctor Orders Rest Watch Video

According to Greenwald, the clot was most likely caused by dehydration brought on by the flu, perhaps exacerbated by a concussion she recently suffered.

"The only time I have seen it happen is when people are severely dehydrated and it causes the blood to be so thick that it causes a clot in the area," said Greenwald. "It's one of the long-term effects of a viral illness."

Drs. Lisa Bardack of the Mt. Kisco Medical Group and Dr. Gigi El-Bayoumi of George Washington University discovered the clot during a routine follow-up MRI on Sunday.

"This is a clot in the vein that is situated in the space between the brain and the skull behind the right ear," they said in a statement today. "It did not result in a stroke, or neurological damage. To help dissolve this clot, her medical team began treating the secretary with blood thinners. She will be released once the medication dose has been established."

Clinton is "making excellent progress," according to her doctors. "She is in good spirits, engaging with her doctors, her family, and her staff."

Clinton, 65, was hospitalized at New York-Presbyterian Hospital Sunday. She suffered a concussion earlier this month after she hit her head when she fainted because of dehydration from a stomach virus, according to an aide.

Dehydration can also precipitate fainting, according to Dr. Neil Martin, head of neurovascular surgery at University of California, Los Angeles Medical Center.

He agreed that the condition could potentially have caused a brain hemorrhage or stroke and been fatal.

"In patients with no symptoms after many days, full recovery is the norm," said Martin. "However, some cases show extension of the thrombus or clot into other regions of the cerebral venous sinuses, and this can worsen the situation considerably -- thus the use of anticoagulants to prevent extension of the thrombus."

But, he said, anticoagulants can be a "double-edged sword." With even a tiny injury within the brain from the concussion, these medications can cause "symptomatic bleed," such as a subdural or intracerebral hemorrhage.

The clot location is not related to the nasal sinuses, but are rather large venous structures in the dura or protective membrane covering the brain, which drains blood from the brain.

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Chavez suffers new post-surgery complications

CARACAS (Reuters) - Venezuelan President Hugo Chavez is suffering further complications linked to a respiratory infection that hit him after his fourth cancer operation in Cuba, his vice president said in a somber broadcast on Sunday.

Vice President Nicolas Maduro flew to Cuba to visit Chavez in the hospital as supporters' fears grow for the ailing 58-year-old socialist leader, who has not been seen in public nor heard from in three weeks.

Chavez had already suffered unexpected bleeding caused by the six-hour operation on December 11 for an undisclosed form of cancer in his pelvic area, and officials say doctors then had to fight a respiratory infection.

"Just a few minutes ago we were with President Chavez. He greeted us and he himself talked about these complications," Maduro said in the broadcast, adding that the third set of complications arose because of the respiratory infection.

"Thanks to his physical and spiritual strength, Comandante Chavez is confronting this difficult situation."

Maduro, flanked by his wife Attorney-General Cilia Flores, Chavez's daughter Rosa Virginia and her husband, Science Minister Jorge Arreaza, said he would remain in Havana while Chavez's condition evolved.

Chavez's resignation for health reasons, or his death, would upend politics in the OPEC nation where his personalized brand of oil-financed socialism has made him a hero to the poor but a pariah to critics who call him a dictator.

The president's allies have been openly discussing the possibility that he may not be able to return to swear in for his third six-year term on the constitutionally mandated date of January 10.

Opposition leaders say a postponement would be another signal Chavez is not in a fit state to govern and that new elections should be called to choose his replacement.

They believe they have a better shot against Maduro, who was named earlier this month by Chavez as his heir apparent, than against the charismatic president who for 14 years has been nearly invincible at the ballot box.

Any constitutional dispute over succession could lead to a messy transition toward a post-Chavez era in the country with the biggest oil reserves in the world.

Maduro has become the face of the government in Chavez's absence, imitating the president's bombastic style and sharp criticism of the United States and its "imperialist" policies.

(Additional reporting by Deisy Buitrago and Mario Naranjo; Ediitng by Kieran Murray and Todd Eastham)

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Talks stall as fiscal cliff looms

WASHINGTON: Two days of last-gasp talks produced no deal Sunday between US political leaders struggling to averting a fiscal calamity due to hit the American and world economy within hours.

Party leaders in the US Senate groped for a compromise to head-off a punishing package of spending cuts and tax hikes that is due come into force on January 1 and which could roil global markets and plunge the US into recession.

Senate Republican minority leader Mitch McConnell warned that, despite through-the-night talks, negotiators were still a long way from success, as they raced against the ebbing 2012 calendar in search of a compromise.

McConnell told AFP he received no response to a "good faith offer" to Senate Democrats and had spoken twice by telephone with his old friend and sparring partner Vice President Joe Biden in the hope of breaking the stalemate.

Senate Democratic Majority Leader Harry Reid agreed that talks were at a standstill, and warned that Americans could ring in the New Year with no deal to avert a budget disaster known as the "fiscal cliff."

"There is still significant distance between the two sides, but negotiations continue," Reid told the Senate, after huddling for nearly two hours with his Democratic caucus on one of the latest December Senate workdays in 50 years.

"There is still time left to reach an agreement, and we intend to continue negotiations," he said, as he ordered the Senate back into session at 11:00am (1600 GMT) Monday, New Year's eve and the last day before the deadline.

Reid said Democrats were unwilling to brook talk of social security cuts.

"This morning, we have been trying to come up with some counter-offer to my friend's proposal," Reid told the Senate. "We have been unable to do that."

The already tense mood on Capitol Hill had soured during Sunday's confusing hours, when some lawmakers tossed out varying versions of what may or may not be in Democratic and Republican offers.

"I'm incredibly disappointed we cannot seem to find common ground. I think we're going over the cliff," Republican Senator Lindsey Graham said on Twitter.

Moderate Democrat Clair McCaskill was also pessimistic.

"This is definitely not a kumbaya moment," she said.

Earlier, President Barack Obama accused Republicans of causing the mess, saying they had refused to move on what he said were genuine offers of compromise from his Democrats.

"Now the pressure's on Congress to produce," Obama said, in an interview with NBC's "Meet the Press" that was recorded on Saturday, a day after he expressed modest optimism that a deal could be reached.

Obama said it had been "very hard" for top Republican leaders to accept that "taxes on the wealthiest Americans should go up a little bit, as part of an overall deficit reduction package."

But Republicans were irked by Obama's tone.

"I don't know if this is the president saying $250 (thousand) or 'Go to hell'," Graham told reporters, referring to Obama's insistence that taxes rise on households income greater than a quarter million dollars per year.

The Senate's number two Democrat, Dick Durbin, said Republicans want the tax threshold be raised to $550,000 per household and that Democrats might counter with $450,000, considerably higher than the president's $250,000.

But Reid warned: "We're still left with a proposal they've given us that protects the wealthy and not the middle class. I'm not going to agree to that"

If no deal is reached, a package of tax cuts for all Americans that was first passed by then-president George W. Bush will expire on January 1.

All American workers will see their own paycheck hit and the broader economy will suffer from massive automatic spending cuts across the government.

Experts expect the US economy to slide into recession if the standoff is prolonged, in a scenario that could cause turmoil in stock markets and hit prospects for global growth in 2013.

The president won re-election partly on a platform of raising taxes on the rich, but Republicans who run the House of Representatives oppose tax hikes as a point of principle and claim Obama is addicted to runaway spending.

Any deal must pass the Senate, before going to the House, where such is the power of the conservative bloc of the Republican Party, it is unclear whether any solution backed by Obama can win majority support.

If leaders fail to find agreement, Obama has demanded a vote on his fallback plan that would preserve lower tax rates for families on less than $250,000 a year and extend unemployment insurance for two million people.

Republicans admitted such an option could emerge on Monday.

-AFP/ac

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Castrate all rapists, says Zubin Mehta

BEIJING: World famous composer of Indian origin, Zubin Mehta, called for castration of all accused in the Delhi gang-rape case and others found committing the rape in India. He expressed excitement about the protests against the gang-rape of Nirbhaya and expects positive changes to come out of it.

"I am fuming, but I see a very healthy sign of public objection, public demonstration. I hope it will not die down. I hope it will not be short-lived," Mehta told Toi in an exclusive interview.

He said the Indian government should realize what the people really want from it. "It is not only about justice, but the future of India. Police has to take it seriously".

Mehta said the issue is being discussed the world over like the case of Malala, the Pakistani girl, and brought shame to Indians. He also questioned the government's decision to shift the rape victim for medical treatment to Singapore. "Where they trying to remove her from the locality, for her own safety?" he asked.

The least that should be done is to castrate all the four accused in the Delhi gang rape case, he said. "I heard that a girl who reported rape was advised to marry one of the criminals. How can a human being do such a thing?" he asked.

"An important issue that needs to be addressed is how to look after the poor ladies who have been attacked," he said.

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Kenya hospital imprisons new mothers with no money

NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."

"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.

"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.

Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

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Associated Press reporter Tom Odula contributed to this report.

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Hillary Clinton Hospitalized With Blood Clot

Dec 30, 2012 8:11pm

(MICHAL CIZEK/AFP/Getty Images)

Secretary Hillary Clinton was hospitalized today after a doctors doing a follow-up exam discovered a blood clot had formed, stemming from the concussion she sustained several weeks ago.

She is being treated with anti-coagulants and is at NewYork-Presbyterian Hospital so that they can monitor the medication over the next 48 hours, Deputy Assistant Secretary Philippe Reines said.

Her doctors will continue to assess her condition, including other issues associated with her concussion. They will determine if any further action is required, Reines said.

Clinton originally fell ill from a stomach virus following a whirlwind trip to Europe at the beginning of the month, which caused such severe dehydration that she fainted and fell at home, suffering a concussion. No ambulance was called and she was not hospitalized, according to a state department official.

The stomach virus had caused Clinton to cancel a planned trip to North Africa and the United Arab Emirates, and also her scheduled testimony before Congress at hearings on the attack on the U.S. consulate in Benghazi, Libya.

According to a U.S. official, the secretary had two teams of doctors, including specialists, examine her after the fall.  They also ran tests to rule out more serious ailments beyond the virus and the concussion. During the course of the week after her concussion, Clinton was on an IV drip and being monitored by a nurse, while also recovering from the pain caused by the fall.

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India gang rape victim dies in Singapore hospital

SINGAPORE (Reuters) - The Indian gang rape victim whose assault in New Delhi triggered nationwide protests died of her injuries on Saturday in a Singapore hospital, potentially threatening fresh protests in India where her case is a rallying point for women's rights.

The 23-year-old medical student, severely beaten, raped and thrown out of a moving bus in New Delhi two weeks ago, had been flown to Singapore in a critical condition by the Indian government on Thursday for specialist treatment.

"We are very sad to report that the patient passed away peacefully at 4:45 a.m. on Dec 29, 2012 (3:45 p.m. ET Friday). Her family and officials from the High Commission (embassy) of India were by her side," Mount Elizabeth Hospital Chief Executive Officer Kelvin Loh said in a statement.

Most rapes and other sex crimes in India go unreported and offenders are rarely punished, women's rights activists say. But the brutality of the December 16 assault sparked public outrage and calls for better policing and harsher punishment for rapists.

The case has received blanket coverage on cable television news channels. The woman has not been identified but some Indian media have called her "Amanat", an Urdu word meaning "treasure".

"We are saddened to learn that she has succumbed to her injuries, and would like to extend our deepest condolences to her family during this time of bereavement," Singapore's Ministry of Foreign Affairs said in a statement.

Earlier on Friday, the hospital had reported that the woman's condition had taken a turn for the worse. It said that her family had been informed and were by her side.

T.C.A. Raghavan, the Indian High Commissioner to Singapore, said after her death that the family had expressed a desire for her body to be flown back to India. Moments later, the woman's body was loaded into a van and driven away.

Talking to reporters earlier on Saturday, Raghavan declined to comment on reports in India accusing the government of sending her to Singapore to minimize the possible backlash in the event of her death.

Some Indian medical experts had questioned the decision to airlift the woman to Singapore, calling it a risky maneuver given the seriousness of her injuries. They had said she was already receiving the best possible care in India.

Prime Minister Manmohan Singh's government has been battling criticism that it was tone-deaf to the outcry and heavy handed in its response to the protests in the Indian capital.

"It is deeply saddening and just beyond words. The police and government definitely have to do something more," said Sharanya Ramachandran, an Indian national working as an engineer in Singapore.

"They should bring in very severe punishment for such cases. They should start recognizing that it is a big crime."

"SIGNIFICANT BRAIN INJURY"

The Singapore hospital said earlier that the woman had suffered "significant brain injury" and was surviving against the odds. She had already undergone three abdominal operations before being flown to Singapore.

Protests over the lack of safety for women erupted across India after the attack, culminating last weekend in pitched battles between police and protesters in the heart of New Delhi.

New Delhi has been on edge since the weekend clashes. Hundreds of policemen have been deployed on the streets of the capital and streets leading to the main protest site, the India Gate war memorial, have been shut for long periods, severely disrupting traffic in the city of 16 million.

Commentators and sociologists say the rape has tapped into a deep well of frustration that many Indians feel over what they see as weak governance and poor leadership on social and economic issues.

Many protesters have complained that Singh's government has done little to curb the abuse of women in the country of 1.2 billion. A global poll by the Thomson Reuters Foundation in June found that India was the worst place to be a woman because of high rates of infanticide, child marriage and slavery.

New Delhi has the highest number of sex crimes among India's major cities, with a rape reported on average every 18 hours, according to police figures. Government data show the number of reported rape cases in the country rose by nearly 17 percent between 2007 and 2011.

(Additional reporting by Ross Colvin in New Delhi and Saeed Azhar and Edgar Su in Singapore; Editing by Michael Roddy and Mark Bendeich)

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The gang-rape on a bus that sickened India

NEW DELHI: After spending her evening watching "Life of Pi" in a New Delhi mall, the 23-year-old student and her male companion were looking for a quick lift home when a bus with tinted windows pulled over.

The pair were then subjected to a catalogue of violence and sexual depravity which has evoked comparisons with Anthony Burgess's novel "A Clockwork Orange" and brought simmering anger over the plight of women to the boil across India.

The Indian news channel NDTV greeted news of her death in the early hours of Saturday in a Singapore hospital with the banner headline "RIP: India's Daughter", in a reflection of how her plight had moved the nation.

Ever since she was attacked on the night of December 16, the country's leaders have lined up to offer their prayers and condemn the attack as well as paying for her treatment in Singapore.

Although the identity of the young woman has not yet been released, reports have said she was a medical student who hailed from a rural area of Uttar Pradesh, India's largest state which borders the capital New Delhi.

Her parents, who had travelled to Singapore after she was flown out by air ambulance on Wednesday night, are said to have sold their small piece of land in order to fund their daughter's education, often limiting their own meals to little more than rotis with namak (bread with salt), according to NDTV.

"These are simple, rustic people, who have never dreamt of boarding an aircraft, much less travel to a foreign country in an air ambulance," a source at the hospital told Singapore's Straits Times after meeting her relatives.

Before flying out to Singapore, the woman had managed to give an interview to police at Delhi's Safdarjung Hospital about the events on the night of her attack.

Police and prosecutors have outlined how six men picked the pair up outside the mall in a school bus which they had taken for a joyride after drinking heavily.

Even before they stopped outside the mall, they had allegedly picked up another passenger and then forced him to hand over the contents of his wallet.

After getting into an argument with the woman's male companion, the group are then alleged to have lashed out at the pair before taking turns to rape the woman in the back of the bus while driving around Delhi for some 45 minutes.

They also sexually assaulted the woman with a rusting metal bar, leaving her with severe intestinal injuries, before hurling her out of the vehicle.

The bus would have had to cross numerous police checkpoints at that time of night but at no stage was the vehicle pulled over by officers.

After news of the attack emerged, small-scale protests quickly swelled and were then repeated across the country -- fuelled in part by anger at the police's use of teargas and water cannon.

The Indian government has set up a commission of inquiry to investigate what mistakes were made on the night of the attack and in its aftermath.

But in an address to chief ministers from the country's states who gathered in New Delhi on Thursday, Prime Minister Manmohan Singh acknowledged that it was far from an isolated event.

"We must reflect on this problem, which occurs in all states and regions. It requires greater attention by the central government and states," he said.

Gang-rapes happen on such a regular basis that they are rarely reported in the Indian press although the attack in Delhi has led papers to shine a rare spotlight on such attacks.

On Thursday night, it emerged that a 17-year-old girl had committed suicide after police allegedly tried to persuade her to drop a complaint of gang-rape and instead either accept a cash settlement or even marry one of her attackers.

After quoting from the infamous gang-rape scene in Burgess's novel, a columnist for The Hindu wrote this week that "few Indians will need a dictionary of the teenage slang Burgess invented to grasp the horror of this passage".

"For progress to be made, we must begin by acknowledging this one fact: the problem isn't the police, the courts or the government. The problem is us," wrote Praveen Swami.

- AFP/ck

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Short-tenure appointments to top security posts raise eyebrows

NEW DELHI: A flurry of senior postings in paramilitary, intelligence and home ministry have raised more than a few eyebrows as appointments to key jobs fail to keep in view the need to provide incumbents at least a year in their assignments.

The shift of Ajay Chadha, who was special secretary (internal security) in the home ministry, as Indo-Tibetan Border Police chief seems puzzling as he was holding an important assignment in North Block and will retire by August next year.

If shifting Chadha -- a well regarded officer who has served in Delhi Police -- is surprising, the move to replace him with an officer who will have a short tenure is also causing some comment although the decision is yet to be finalized.

In the meantime, Subhash Joshi, who was serving as director general of National Security Guard, has moved to Border Security Force where he will remain till February 2014. Arvind Rajan, who takes charge of NSG, is also slated for a short stint.

Joshi headed NSG for a little more than six months while before him, Rajan Medhekar was in charge for nearly 20 months.

The postings seem to reinforce the impression of a degree of ad-hocism in dealing with important security-related assignments with some officers arguing that the Manmohan Singh government has lacked a serious engagement with policing and intelligence.

The nature of appointments to intelligence arms like IB and RAW in recent years have not resulted in the strategic upgrade in capacities and analysis that a major terror event like 26/11 should have resulted in. When West Bengal governor M K Narayanan was national security advisor, he took a keen interest in police appointments although he was also not seen to have built systems although he was a hands-on spook.

Chadha has moved to BSF but continues to hold effective charge of special secretary (internal security). His move to the paramilitary outfit was necessitated by Ranjit Sinha being appointed chief of the Central Bureau of Investigation.

Sinha's appointment has already drawn some controversy with Delhi Police commissioner Neeraj Kumar objecting to being excluded from the shortlist and BJP leaders Arun Jaitley and Sushma Swaraj asking the appointment to be stayed till a collegium is set up.

The appointment of Asif Ibrahim as Intelligence Bureau chief saw the claims of Yashovardhan Azad and S Jayaraman being overlooked. The latter is now seen in the running for special secretary (internal security). Some feel that the appointment of Ibrahim's predecessor Nehchal Sandhu as deputy national security advisor could mean his continued say in IB matters as he is unlikely to have a foreign policy role.

The other intelligence appointment saw Alok Joshi being named head of the Research and Analysis Wing. His tenure follows that of Sanjeev Tripathi who is seen to have enjoyed an unremarkable tenure as RAW head.

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Kenya hospital imprisons new mothers with no money

NAIROBI, Kenya (AP) — The director of the Pumwani Maternity Hospital, located in a hardscrabble neighborhood of downtown Nairobi, freely acknowledges what he's accused of: detaining mothers who can't pay their bills. Lazarus Omondi says it's the only way he can keep his medical center running.

Two mothers who live in a mud-wall and tin-roof slum a short walk from the maternity hospital, which is affiliated with the Nairobi City Council, told The Associated Press that Pumwani wouldn't let them leave after delivering their babies. The bills the mothers couldn't afford were $60 and $160. Guards would beat mothers with sticks who tried to leave without paying, one of the women said.

Now, a New York-based group has filed a lawsuit on the women's behalf in hopes of forcing Pumwani to stop the practice, a practice Omondi is candid about.

"We hold you and squeeze you until we get what we can get. We must be self-sufficient," Omondi said in an interview in his hospital office. "The hospital must get money to pay electricity, to pay water. We must pay our doctors and our workers."

"They stay there until they pay. They must pay," he said of the 350 mothers who give birth each week on average. "If you don't pay the hospital will collapse."

The Center for Reproductive Rights, which filed the suit this month in the High Court of Kenya, says detaining women for not paying is illegal. Pumwani is associated with the Nairobi City Council, one reason it might be able to get away with such practices, and the patients are among Nairobi's poorest with hardly anyone to stand up for them.

Maimouna Awuor was an impoverished mother of four when she was to give birth to her fifth in October 2010. Like many who live in Nairobi's slums, Awuor performs odd jobs in the hopes of earning enough money to feed her kids that day. Awuor, who is named in the lawsuit, says she had saved $12 and hoped to go to a lower-cost clinic but was turned away and sent to Pumwani. After giving birth, she couldn't pay the $60 bill, and was held with what she believes was about 60 other women and their infants.

"We were sleeping three to a bed, sometimes four," she said. "They abuse you, they call you names," she said of the hospital staff.

She said saw some women tried to flee but they were beaten by the guards and turned back. While her husband worked at a faraway refugee camp, Awuor's 9-year-old daughter took care of her siblings. A friend helped feed them, she said, while the children stayed in the family's 50-square-foot shack, where rent is $18 a month. She says she was released after 20 days after Nairobi's mayor paid her bill. Politicians in Kenya in general are expected to give out money and get a budget to do so.

A second mother named in the lawsuit, Margaret Anyoso, says she was locked up in Pumwani for six days in 2010 because she could not pay her $160 bill. Her pregnancy was complicated by a punctured bladder and heavy bleeding.

"I did not see my child until the sixth day after the surgery. The hospital staff were keeping her away from me and it was only when I caused a scene that they brought her to me," said Anyoso, a vegetable seller and a single mother with five children who makes $5 on a good day.

Anyoso said she didn't have clothes for her child so she wrapped her in a blood-stained blouse. She was released after relatives paid the bill.

One woman says she was detained for nine months and was released only after going on a hunger strike. The Center for Reproductive Rights says other hospitals also detain non-paying patients.

Judy Okal, the acting Africa director for the Center for Reproductive Rights, said her group filed the lawsuit so all Kenyan women, regardless of socio-economic status, are able to receive health care without fear of imprisonment. The hospital, the attorney general, the City Council of Nairobi and two government ministries are named in the suit.

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Associated Press reporter Tom Odula contributed to this report.

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