A local hospital in Zimbabwe has been exposed as charging women $5 (£3.30) every time they scream while giving birth, a report reveals.

The practice was catalogued in an extensive new report from Transparency International, an anti-corruption organization. The hospital screaming fee was allegedly a charge for “raising a false alarm” but patients have claimed it is intended to make money out of suffering mothers-to-be.

This fee accompanies a flat $50 delivery cost that all Zimbabwean hospitals charge. Meaning that in one of Africa’s poorest countries, where average annual income per head is around $150, a mother who uttering only a few cries of distress might owe half her annual income as a result of giving birth.

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According to a follow-up report by Transparency International, women who can’t afford these payments are sometimes detained by the hospitals and charged interest until their families pay up.

As a result, many Zimbabwean mothers after forced into giving birth at home because they can’t afford the high charges. The United Nations estimates an average of eight mothers die during childbirth each day in Zimbabwe.

The Washington Post revealed that Transparency International’s Zimbabwean branch contacted the national health ministry over the issue and sent a formal letter. The health ministry admitted to receiving the letter but then continued to do nothing. When the organization pursued the matter an official said they’d lost the letter.

A member of Transparency International finally met with Zimbabwe’s deputy Prime Minister, who promised to look into the problem. Since then, the NGO says, it’s heard no more complaints about the screaming fee, the $50 delivery charge however, still persists.