Uganda is grappling with a critical shortage of blood that is affecting services and putting patients’ lives at risk.
The health ministry’s blood bank facility in the capital, Kampala, which stores and distributes supplies to hospitals, is practically empty. It has just 150 units of blood remaining, not enough to meet requirements on an average day in the city.
Nationally, Uganda needs at least 340,000 units of safe blood annually, but usually only collects 200,000 a year.
The Uganda Medical Association, an umbrella organisation of doctors in public health facilities, said the shortage was “almost at crisis level”, resulting in the cancellation of hospital operations and prioritisation of cases.
Mukuzi Muhereza, the association’s secretary-general, said: “It’s a big, nationwide problem. It’s emergency level, a crisis. Nearly every hospital is crying out for blood. Nearly every regional referral hospital is complaining about blood.”
An extra 7 billion shillings (£1.4m) is needed to procure donor and testing kits, and to fund blood donation drives, to get the service back on track for the next six months.
Sarah Opendi, state minister for health, said the extra money has been requested from the Ugandan government. She dismissed media reports that some patients have died after being unable to get blood transfusions.
Last year, 14bn shillings was allocated to the national blood transfusion service and national medical stores. At least 21bn shillings was required, however.
The health budget has been cut from 1,850tn shillings in the current financial year to 1,714tn in 2018-19.
“What we are seeing with the blood crisis is synonymous with the rot in the healthcare delivery systems in the country. We do not seem to think ahead,” said Milly Katana, a public health specialist and HIV prevention campaigner. “The people responsible for the blood chain system must be brought to account for their offices and not simply sit and enjoy trips abroad where they go present papers.”
Dennis Odwe, health and policy specialist at the Foundation for Integrated Rural Development, said government priorities did not align with the needs of Ugandans.
“The blood bank, which should have more money to do its specialised work of collecting blood and saving lives, will be rendered useless by the budget cut … yet the demand for blood is very high in the country.
“Blood is needed by mothers in the delivery wards, accident patients and other clients that go to the hospitals. Investing less in blood means losing lives, yet this is something government can have control over.”
Opendi said it was up to everyone to donate blood. Existing blood drives are aimed at students, but anyone between the ages of 17 and 65 is eligible to donate.
“What can we do? There is no factory for manufacturing blood,” said Opendi. It should be everybody’s responsibility to ensure that they turn up and donate blood wherever Uganda Blood Transfusion Services requests.”
Muhereza said blood collections need to be decentralised to allow regional and district hospitals to do their own collections. “This is very possible … We have lab technology all over the country,” said Muhereza.
“If you decentralise at source we can always encourage people to donate. But you can’t donate blood in Gulu when the blood transfusions services is in Kampala.”