The History of Blood Transfusion in Sub-Saharan Africa. William H. Schneider

transfusion center was drawn by mobile units at numerous locations including colleges, high schools, training centers, prisons, a convent, and the airport at Entebbe. The list of provincial collections was equally impressive, based on statistics for selected years between 1957 and 1965.⁵⁷

      TABLE 2.6. Blood donations reported, Uganda, selected years, 1957–65 (pints)

       *Total for 1963 from separate source.

      In 1948 when the Uganda Red Cross branch responded to the call for a transfusion service, its president observed that her organization’s reputation “carries considerable weight” that might help the project succeed. “It was felt therefore that if this blood transfusion service were started under the auspices of the Red Cross, it would win the confidence of the African far more than a Government-sponsored project.”⁵⁸ Whether true or not, already by 1952 the newly appointed governor of Uganda, Sir Andrew Cohen, attended the annual meeting of the Red Cross branch and made special note of the success of the blood transfusion service. His speech paid tribute and also made the following prophetic observation:

      If the Red Cross and other voluntary bodies can start new services, this may become so popular and may come to be regarded as so necessary and essential that eventually they will become part of the fabric of the Government, and Government, whether willingly or unwillingly, will be forced to take over those services and run them themselves. That is how public affairs go. We have an excellent example of this, if I am not wrong, in the Blood Transfusion service, which is a fine service which you are now running and which eventually no doubt will become the responsibility either of local government or of Central Government.⁵⁹

      As the use of transfusion expanded both in Kampala and Jinja, as well as at up-country hospitals in other parts of the protectorate, the government (both of the colony and subsequently of the independent country) took a more enlightened approach, giving the Uganda Red Cross Society a subsidy to continue its part in the transfusion service, rather than taking it over completely as a government service. By the time of independence, however, tensions were growing between the two parties because of increasing costs and the inability of the Red Cross or government to meet them. Sue Maltby, a British Red Cross worker in Uganda, stated in a report at the end of 1959 that the blood transfusion service, “continues to expand at an alarming rate,” with the result that it was always short of money. When the Red Cross asked for an increase in government subvention, it was refused. Members responded with letters written “to the minister from Lady Crawford [wife of the governor of Uganda],” followed by meetings, revised estimates, and more meetings. Only after all that, Maltby reported, was the Red Cross promised an extra £500 for 1959. And for the next year they agreed to an increase from £750 to £2,500 (current value of $60,000), “but not before we held the biggest pistol possible to their heads,” she concluded.⁶⁰

      When the women in the Red Cross were the wives of the doctors using the transfusion services, these matters could be worked out “within the family.” With the increasing use of transfusion and more turnover in Red Cross volunteers, however, the delicate balance between those using the blood that was provided by those doing recruiting, bleeding, testing, and storing was upset and disagreements resulted. Although the Red Cross had been offered government resources to help with the costs of its responsibilities, the Red Cross complained that the funding did not cover their rapidly rising costs. This was similar to what eventually happened in Zambia (former Northern Rhodesia) after independence.⁶¹