Indonesian babies held hostage by unpaid midwives By Rebecca Henschke

Bali, Indonesia Published duration 16 July 2011

image caption Reunited: Yetriana Lopez and her husband, Mulyono, with their three children

When a woman who has just given birth cannot afford to pay medical fees, there is a risk in Indonesia that her baby will be taken hostage.

A young mother watches as two three-year old boys chase each other around the car park of a health clinic on the Indonesian island of Bali.

Yetriana Lopez is keeping a close eye on her identical twins, understanding all too well what it means to lose one of them.

"When I was pregnant I didn't have an ultrasound," she remembers. "So it wasn't until I gave birth that I found out I had twins."

Ms Lopez and her husband Mulyono had only saved enough to pay the clinic for one birth - but twins meant the fee was doubled.

The clinic refused to hand over the second baby until a bill for $500 (£311) was paid.

Arist Merdeka Sirait, secretary general of the national commission for child protection, acknowledges that this is not an isolated case.

"In 2010, our commission received 36 reports of baby hostage-taking by hospitals, clinics and private midwives," he says.

"Those were just the cases that were reported to our commission so it's not accurate national data. The real figure is likely to be much more than that."

Rising bill

Ms Lopez was separated from her newborn son for four months while she and her husband tried to cobble together enough to pay the bill.

Every day the debt increased, as the clinic charged for the baby's upkeep.

But eventually the story came to the ear of Robin Lim, a 54-year-old American midwife, who decided something had to be done.

image caption Robin Lim decided to become a midwife after her own sister died during pregnancy

"I said 'OK, let's go and find out what the midwife wants. Let's not ask questions, let's just get this baby home,'" she told the BBC.

But when she accompanied Mulyono to the clinic to offer to pay the balance of his debt, they were told the baby had been sold to someone who could take care of him.

Just a few days earlier Mulyono had visited the clinic to pay an instalment of the debt, and the sum had been accepted gladly.

"There are lots of cases where, if the mother can't pay, the baby becomes the property of the hospital," says Mr Sirait. "They then believe they have the right to sell the baby to someone else."

Ms Lim contacted the police and local journalists, to launch a search for the child.

The fact that the boys were identical made him much easier to trace, and within three weeks he was reunited with his family.

"They asked me, 'Is this your baby?' And I knew it was because there was a birthmark," says Ms Lopez. "I put him straight to the breast and he took it."

Filling the gap

Universal healthcare for pregnant women in Indonesia is being rolled out this year under a scheme called Jampersal. But it has been beset with funding problems.

Until then, mothers will only qualify for free midwife care if they are officially deemed to be "poor" - but the means test designed to separate the poor from the rest of the population often fails to identify families in need.

To fill this gap Ms Lim set up a foundation called Bumi Sehat, in Ubud, Bali, in 2003.

It has a team of nine midwives who offer free pre-natal care, delivery services and medical aid to anyone who needs it.

After the tsunami of 2004, a smaller clinic was opened in Aceh to care for displaced survivors. Together the clinics have helped to deliver 5,000 babies.

Bumi Sehat is part of a global initiative to reduce maternal mortality and a member of the international coalition for maternal health, the White Ribbon Alliance.

Ms Lim points out that the Millennium Development Goals agreed by UN member states in 2000 set out to reduce infant mortality, improve maternal health and combat HIV/Aids and malaria, by 2015.

"I felt like as a midwife I could look at these really important issues," she says. "These are things that I do every day."