Clinton's blood clot an uncommon complication

The kind of blood clot in the skull that doctors say Hillary Rodham Clinton has is relatively uncommon but can occur after an injury like the fall and concussion the secretary of state was diagnosed with earlier this month.

Doctors said Monday that an MRI scan revealed a clot in a vein in the space between the brain and the skull behind Clinton's right ear.

The clot did not lead to a stroke or neurological damage and is being treated with blood thinners, and she will be released once the proper dose is worked out, her doctors said in a statement.

Clinton has been at New York-Presbyterian Hospital since Sunday, when the clot was diagnosed during what the doctors called a routine follow-up exam. At the time, her spokesman would not say where the clot was located, leading to speculation it was another leg clot like the one she suffered behind her right knee in 1998.

Clinton had been diagnosed with a concussion Dec. 13 after a fall in her home that was blamed on a stomach virus that left her weak and dehydrated.

The type of clot she developed, a sinus venous thrombosis, "certainly isn't the most common thing to happen after a concussion" and is one of the few types of blood clots in the skull or head that are treated with blood thinners, said neurologist Dr. Larry Goldstein. He is director of Duke University's stroke center and has no role in Clinton's care or personal knowledge of it.

The area where Clinton's clot developed is "a drainage channel, the equivalent of a big vein inside the skull — it's how the blood gets back to the heart," Goldstein explained.

It should have no long-term consequences if her doctors are saying she has suffered no neurological damage from it, he said.

Dr. Joseph Broderick, chairman of neurology at the University of Cincinnati College of Medicine, also called Clinton's problem "relatively uncommon" after a concussion.

He and Goldstein said the problem often is overdiagnosed. They said scans often show these large "draining pipes" on either side of the head are different sizes, which can mean blood has pooled or can be merely an anatomical difference.

"I'm sure she's got the best doctors in the world looking at her," and if they are saying she has no neurological damage, "I would think it would be a pretty optimistic long-term outcome," Broderick said.

A review article in the New England Journal of Medicine in 2005 describes the condition, which more often occurs in newborns or young people but can occur after a head injury. With modern treatment, more than 80 percent have a good neurologic outcome, the report says.

In the statement, Clinton's doctors said she "is making excellent progress and we are confident she will make a full recovery. She is in good spirits, engaging with her doctors, her family, and her staff."

___

Online:

Medical journal: http://dura.stanford.edu/Articles/Stam_NEJM05.pdf

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Ruling over bumper-car injury supports amusement park

SAN FRANCISCO — The California Supreme Court, protecting providers of risky recreational activities from lawsuits, decided Monday that bumper car riders may not sue amusement parks over injuries stemming from the inherent nature of the attraction.

The 6-1 decision may be cited to curb liability for a wide variety of activities — such as jet skiing, ice skating and even participating in a fitness class, lawyers in the case said.

"This is a victory for anyone who likes fun and risk activities," said Jeffrey M. Lenkov, an attorney for Great America, which won the case.

But Mark D. Rosenberg, who represented a woman injured in a bumper car at the Bay Area amusement park, said the decision was bad for consumers.

"Patrons are less safe today than they were yesterday," Rosenberg said.

The ruling came in a lawsuit by Smriti Nalwa, who fractured her wrist in 2005 while riding in a bumper car with her 9-year-old son and being involved in a head-on collision. Rosenberg said Great America had told ride operators not to allow head-on collisions, but failed to ask patrons to avoid them.

The court said Nalwa's injury was caused by a collision with another bumper car, a normal part of the ride. To reduce all risk of injury, the ride would have to be scrapped or completely reconfigured, the court said.

"A small degree of risk inevitably accompanies the thrill of speeding through curves and loops, defying gravity or, in bumper cars, engaging in the mock violence of low-speed collisions," Justice Kathryn Mickle Werdegar wrote for the majority. "Those who voluntarily join in these activities also voluntarily take on their minor inherent risks."

Monday's decision extended a legal doctrine that has limited liability for risky sports, such as football, to now include recreational activities.

"Where the doctrine applies to a recreational activity," Werdegar wrote, "operators, instructors and participants …owe other participants only the duty not to act so as to increase the risk of injury over that inherent in the activity."

Amusement parks will continue to be required to use the utmost care on thrill rides such as roller coasters, where riders surrender control to the operator. But on attractions where riders have some control, the parks can be held liable only if their conduct unreasonably raised the dangers.

"Low-speed collisions between the padded, independently operated cars are inherent in — are the whole point of — a bumper car ride," Werdegar wrote.

Parks that fail to provide routine safety measures such as seat belts, adequate bumpers and speed controls might be held liable for an injury, but operators should not be expected to restrict where a bumper car is bumped, the court said.

The justices noted that the state inspected the Great America rides annually, and the maintenance and safety staff checked on the bumper cars the day Nalwa broke her wrist. The ride was functioning normally.

Reports showed that bumper car riders at the park suffered 55 injuries — including bruises, cuts, scrapes and strains — in 2004 and 2005, but Nalwa's injury was the only fracture. Nalwa said her wrist snapped when she tried to brace herself by putting her hand on the dashboard.

Rosenberg said the injury stemmed from the head-on collision. He said the company had configured bumper rides in other parks to avoid such collisions and made the Santa Clara ride uni-directional after the lawsuit was filed.

Justice Joyce L. Kennard dissented, complaining that the decision would saddle trial judges "with the unenviable task of determining the risks of harm that are inherent in a particular recreational activity."

"Whether the plaintiff knowingly assumed the risk of injury no longer matters," Kennard said.

maura.dolan@latimes.com

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Cold-Weather Aid Trickles Into Afghan Camps

But camp leaders and Afghan government officials criticized the aid delivery as inadequate to protect residents from the weather and to prevent more deaths.

Last winter, more than 100 children died of the cold in refugee camps around Kabul, with 26 dying in the Charahi Qambar camp alone. That is the same camp where the 3-year-old died Friday; it was the first confirmed death because of the cold this winter.

The distribution of supplies at the camp, which is home to about 900 families in western Kabul, had been scheduled before news reports about the child’s death, said Mohammad Nader Farhad, a spokesman for the United Nations refugees agency in Kabul.

On less than an hour’s notice, the agency convened a news conference with Afghan government officials at the camp to announce the distribution.

Each family was given warm children’s clothing, blankets, tarps, cooking utensils and soap. Separately, other aid groups, financed by the United Nations and other donors, will be distributing charcoal once every month through February, officials said.

United Nations officials acknowledged, however, that the fuel distributions in themselves were not enough to heat the mud and tarp huts throughout the season, and there were no plans to distribute food to the families. In most cases the men, who are largely war-displaced refugees, are unable to find day work as laborers in the cold weather, so they are usually unable to buy food.

“We are happy to receive this,” said Tawoos Khan, one of the camp representatives. “But we want food, and we need more fuel; we have all run out of firewood and charcoal.” He and other camp officials said large sacks of charcoal were distributed to every family more than two weeks ago, but supplies had run out.

“It’s supplementary,” said Douglas DiSalvo, a protection officer with the United Nations agency who was at the Charahi Qambar camp. “People have some level of support they can achieve for themselves.”

Mr. Farhad said, “The assistance we are providing, at least it is mitigating the harsh winter these families are experiencing right now.”

The estimated 35,000 people in 50 camps in and around Kabul are not classified as refugees from an international legal point of view, but as “internally displaced persons.” Since the United Nations agency’s mandate is to primarily help refugees — defined as those who flee across international borders — it has not provided support to the Kabul camps in the past. That changed late last winter when the Afghan government asked it to do so in response to the conditions that were taking so many lives.

This year, the agency is spearheading the effort to supply the camps, along with the Afghan government’s Ministry of Refugees and Repatriation, other United Nations agencies, and several aid groups, in order to prevent a recurrence of the crisis last winter.

Ministry officials, however, criticized the effort on Sunday — even though they were among the sponsors. “We have never claimed that we provided the internally displaced Afghans with sufficient food items, clothing or means of heat. We admit this. What the internally displaced people have received so far is not adequate at all,” said Islamuddin Jurat, a spokesman for the Ministry of Refugees and Repatriation.

“Before the arrival of harsh winter,” he added, “we asked the international community and donor countries to help the internally displaced people, and luckily today U.N.H.C.R. provided them with some humanitarian assistance. But again we believe it’s not sufficient at all.”

Both aid officials and the Afghan government have said they are wary about providing too much aid for fear that it would encourage more people to leave their homes. That fear has also been why the Afghan government has refused to allow permanent buildings to be erected in the camps, many of which are five or more years old.

“The illegal nature of these squatter settlements poses an obstacle to more lasting interventions and improvements,” said Mr. Farhad of the United Nations refugees agency. “Coordination this year has been very strong, and we expect that the multiagency effort will help us to detect and respond to particular problem areas as the winter progresses.”

Little is provided in the way of food aid. The only food aid in the Charahi Qambar camp is a hot lunch program for 750 students at a tented school run by Aschiana, an Afghan aid group.

The United Nations High Commissioner for Refugees is providing the cold-weather packages to 40,000 families, 5,000 of them in the Kabul camps, at a cost of $6 million. Other Kabul camps will receive distributions in the next two days, Mr. Farhad said.

The packages, which cost about $150 each, include two tarps, three blankets, six bars of soap, a cooking utensils set, and 26 items of clothing ranging from jackets and sweaters to socks and hats, mostly for children.

Taj Mohammad, the father of the child who died, Janan, said Sunday that he believed that his son might have survived if the cold-weather kit had arrived earlier. But like many of the refugees, he was critical of its contents, which he said were hard to sell in exchange for food.

“I didn’t know a package costs $150,” he said. “It’s a lot of money. It would have been much better if they had given us the money, and we would have spent it on what we need the most.”

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Kobe Bryant Finally Joins Twitter — Kind Of

Long among the sports world’s biggest Twitter holdouts, Kobe Bryant has finally joined the social network. But he hasn’t opened an account, and won’t be around for long.

Social savvy fans are being blessed with his presence thanks to Nike Basketball, which has turned over its account to Bryant since Tuesday.

[More from Mashable: Avery Johnson’s Teenage Son Unloads on Twitter After NBA Firing]

Nike Basketball, which sponsors Bryant and produces his official sneaker, announced the Kobe takeover in a Christmas Day tweet. The account’s name is now “Kobe Bryant” although its handle remains @nikebasketball. Kobe has spent the past few days tweeting about a variety of subjects using a series of hashtags that play off the theme #counton-fill-in-the-blank.

He’s tweeted about the Lakers progress as a team:

[More from Mashable: FanDuel Is Fantasy Sports With a Twist]

He’s tweeted behind-the-scenes snippets of training and treatment:

And he’s tweeted a totally normal, typical, everyday holiday family portrait:

Bryant actually joined Twitter for realsies back in 2011, but then deleted the account after racking up more than 35,000 followers in a just a few hours. He’s one of the NBA’s few stars without a Twitter presence. Nearly 90% of the league’s players are on the social network, according to Twitter.

But Bryant did become much more active on Facebook this summer, especially while traveling with the United States’ Olympic basketball team. He has nearly 15 million fans there, and reportedly writes his status updates and messages himself, with editing and actual posting done by support staff. In November he asked Facebook fans whether to join Instagram or Twitter next, and on Monday hinted in a status update that he may soon open an Instagram account.

What athletes would you most like to see get more active on social media? Let us know in the comments.

BONUS: 30 Must-Follow Twitter Accounts This NBA SEASON

1. @NBA

The NBA is arguably the world’s most engaging sports league on social media. Follow its official Twitter account for news, highlights and promotions.

Click here to view this gallery.

Thumbnail image courtesy Flickr, Keith Allison

This story originally published on Mashable here.

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Hillary Clinton Hospitalized for a Blood Clot

12/30/2012 at 08:55 PM EST

Hillary Clinton has been hospitalized.

The Secretary of State was admitted to New York Presbyterian Hospital on Sunday after doctors found a blood clot during an exam related to the concussion she suffered during a fall earlier this month, CNN reports.

"Her doctors will continue to assess her condition, including other issues associated with her concussion," Philippe Reines, deputy assistant secretary of state, said Sunday. "They will determine if any further action is required."

She's being treated with anti-coagulants and is expected to be hospitalized for 48 hours so she can be monitored.

Clinton, 65, suffered a concussion when she passed out and fell in her Washington, D.C., home. Reports at the time said dehydration suffered after a trip the former first lady took to Europe was the cause of her fall.

Clinton, who was recently named one of Barbara Walters's 10 most-fascinating people of 2012, plans to step down from her secretary post early next year.

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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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Pasadena-area leaders hold peace and unity rally against violence

Pasadena-area community leaders staged a peace and unity rally Sunday afternoon to denounce recent violence that claimed the life of longtime youth sports leader and community activist Victor McClinton, among others.

About 250 people gathered on the steps of All Saints Episcopal Church near City Hall to hear city leaders, clergy members and law enforcement officials discuss ways to stem the violence.

"It was a call for peace and for the community to come together in light of some of the recent gang violence and shootings that have occurred," said William Boyer, a Pasadena public information officer.

Speakers included the Rev. Ed Bacon of All Saints, Pastor Jean Burch of Community Bible Church, Pastor Kerwin Manning of Pasadena Church, Pasadena Mayor Bill Bogaard, Police Chief Phillip Sanchez and a representative from the Los Angeles County Sheriff's Department.

"The message was we need to do something about all the gun violence that seems to be happening across the country," Boyer said. "It can't just be the city alone. It has to be the public, the clergy, parents and young people. It has to be a collaborative effort. We have to take back the city, say no to gangs and say no to guns. We have to turn it into a message of hope for young people."

About 400 people gathered Thursday evening at Pasadena City Hall to mourn McClinton, who was killed by stray gunfire on Christmas morning.

McClinton, a Los Angeles County Sheriff's Department technician, died outside his home in the 1900 block of Newport Avenue, near Wyoming Street. A second man, who may have been the target of the drive-by shooting, was wounded, according to police.

McClinton, 49, founded the Brotherhood Community Youth Sports League nearly two decades ago and served as its volunteer director, the Pasadena Sun reported.

Two others were killed Christmas day when a driver being pursued by police crashed into a minivan. Tracey Ong Tan, 26, of Glendale and an 11-year-boy from Daly City, Calif., were pronounced dead at the scene. Three other occupants of the minivan were seriously injured.

On Friday, the Los Angeles County district attorney's office filed murder charges, with an enhancement for gang activity, against Darrell Lee Williams, 22, of Pasadena and Brittany Michelle Washington, 21, of Los Angeles. Williams was allegedly driving the Dodge Durango that struck the minivan. Washington was a passenger in the Durango. Two other passengers were not charged. All four occupants sustained moderate injuries.

Pasadena police said Williams was a parolee with ties to gangs and that there was a warrant out for his arrest at the time of the collision.

Williams is being held at Men's Central Jail in Los Angeles in lieu of $1.095-million bail. Washington is being held in lieu of $1-million bail at the Century Regional Detention Facility in Lynwood.

howard.blume@latimes.com

carlos.lozano@latimes.com

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To Save Wildlife, and Tourism, Kenyans Take Up Arms

ARCHER’S POST, Kenya — Julius Lokinyi was one of the most notorious poachers in this part of Kenya, accused of single-handedly killing as many as 100 elephants and selling the tusks by the side of the road in the dead of night, pumping vast amounts of ivory into a shadowy global underground trade.

But after being hounded, shamed, browbeaten and finally persuaded by his elders, he recently made a remarkable transformation. Elephants, he has come to believe, are actually worth more alive than dead, because of the tourists they attract. So Mr. Lokinyi stopped poaching and joined a grass-roots squad of rangers — essentially a conservation militia — to protect the wildlife he once slaughtered.

Nowadays he gets up at dawn, slurps down a cup of sugary tea, tightens his combat boots and marches off with other villagers, some who had never picked up a gun before and are little more than volunteers, to fight poachers.

“We got to protect the elephants,” said Mr. Lokinyi, whose hooded eyes now glow with the zeal of a convert.

From Tanzania to Cameroon, tens of thousands of elephants are being poached each year, more than at any time in decades, because of Asia’s soaring demand for ivory. Nothing seems to be stopping it, including deploying national armies, and the bullet-riddled carcasses keep stacking up. Scientists say that at this rate, African elephants could soon go the way of the wild American bison.

But in this stretch of northern Kenya, destitute villagers have seized upon an unconventional solution that, if replicated elsewhere, could be the key to saving thousands of elephants across Africa, conservationists say. In a growing number of communities here, people are so eager, even desperate, to protect their wildlife that civilians with no military experience are banding together, grabbing shotguns and G3 assault rifles and risking their lives to confront heavily armed poaching gangs.

It is essentially a militarized neighborhood watch, with loping, 6-foot-6 former herdsmen acting as the block captains, and the block being miles and miles of zebra-studded bush. These citizen-rangers are not doing this out of altruism or some undying love for pachyderms. They do it because in Kenya, perhaps more than just about anywhere else, wildlife means tourists, and tourists mean dollars — a lot of dollars.

It is not unusual here for a floppy-hatted visitor to drop $700 a night to sleep in a tent and absorb the sights, sounds and musky smells of wondrous game. Much of that money is contractually bound to go directly to impoverished local communities, which use it for everything from pumping water to college scholarships, giving them a clear financial stake in preserving wildlife. The safari business is a pillar of the Kenyan economy, generating more than a billion dollars a year and nearly 500,000 jobs: cooks, cleaners, bead-stringers, safari guides, bush pilots, even accountants to tally the proceeds.

Surprisingly, many jobs in the safari industry can pay as much as poaching. Though the ivory trade may seem lucrative, it is often like the Somali pirate business model, with the entry-level hijacker getting just a minuscule cut of the million-dollar ransoms. While a pound of ivory can fetch $1,000 on the streets of Beijing, Mr. Lokinyi, despite his lengthy poaching résumé, was broke, making it easier to lure him out of the business.

Villagers are also turning against poachers because the illegal wildlife trade fuels crime, corruption, instability and intercommunal fighting. Here in northern Kenya, poachers are diversifying into stealing livestock, printing counterfeit money and sometimes holding up tourists. Some are even buying assault rifles used in ethnic conflicts.

The conservation militias are often the only security forces around, so they have become de facto 911 squads, rushing off to all sorts of emergencies in areas too remote for the police to quickly gain access to and often getting into shootouts with poachers and bandits.

“This isn’t just about animals,” said Paul Elkan, a director at the Wildlife Conservation Society, who is trying to set up community ranger squads in South Sudan modeled on the Kenyan template. “It’s about security, conflict reconciliation, even nation building.”

The rangers tend to be hardened and uneducated, drawn from different ethnic groups and the surplus of unemployed youth. Gabriel Lesoipa was a goat herder; Joseph Lopeiyok, a cattle rustler; John Pameri won his coveted spot because he was fast — at the time he was selected, the first entry requirement was a grueling 11-mile race.

Many are considered warriors in their communities, experts in so-called bushcraft from years of grazing cattle and goats across the thorny savanna — and defending them against armed raiders. They can follow faint footprints across long, thirsty distances and instantly intuit when someone has trespassed on their land.

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Matthew & Camila McConaughey Name Their Son Livingston

12/29/2012 at 09:15 PM EST

Camila and Matthew McConaughey

Gary Miller/FilmMagic

Matthew McConaughey has spilled the beans about his new baby!

"Camila gave birth to our third child yesterday morning. Our son, Livingston Alves McConaughey, was born at 7:43 a.m. on 12.28.12," he wrote on his Whosay page Saturday night.

"He greeted the world at 9 lbs., and 21 inches. Bless up and thank you for your well wishes."

Camila, 29, and her actor husband, 43, welcomed their third child in Austin, Texas, Friday, PEOPLE previously confirmed.

The couple – also parents to Vida, almost 3, and Levi, 4 – announced the pregnancy in July, just one month after they wed in Texas.

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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.

___

Associated Press reporter Tom Odula contributed to this report.

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