Monday Night Football started in 1970 and when it started it was something extremely special because sports had not been aired in prime time. So it was a novelty and a lot of people thought it wouldn't work and of course it worked spectacularly well.
The answer was that in Burundi having a clean bill of health has taken on a very particular meaning: unless and until you have paid for your hospital treatment you simply can't leave you are in effect a captive.