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April 10, 2005
Less is More
Mozambique is hard at work on reducing its number of blood banks by 75 percent. "It's not a better system but it's one in our condition that is feasible," says Joel Samo Gudo, the head of the country's blood system. Twenty-seven local hospitals now have blood banks, but rather than creating a stable stock of blood, this decentralized system means that blood for transfusions gets provided on an ad hoc basis, often by patients' family members.
Unlike some countries in the region, Mozambique screens its blood for HIV, which it has done since 1988. Transfusion is the most efficient way to transmit the virus, so accurate screening is crucial. But getting test kits to rural hospitals is not always easy, particularly during the rainy season when roads disappear. Twenty-seven blood banks means 27 sets of staff to train on testing procedures, and 27 places things could go awry. "Can you meet with hundreds of guys each time?" Gudo asks. "It's difficult." He has a staff of four to do training. A more centralized system, like neighboring Zimbabwe's, should cut down on the potential for errors.
Ironically, U.S. funding exists for this project for exactly the reason America's approach is often criticized. Rather than pool money and let the Mozambicans spend it according to their plans, the United States gives money directly to aid groups and other folks on the ground. "Probably blood transfusion would not be a priority" for the government, Gudo says. "The ministry would say 'no, I have something more important.'" In this case, the U.S. Centers for Disease Control, along with the American Association of Blood Banks, is providing "technical support," which is a popular euphemism that can mean anything and everything.
Posted by Adam Graham-Silverman at April 10, 2005 10:01 PM