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close this bookSafe Blood in Developing Countries - The Lessons from Uganda (EC, 1995, 151 p.)
close this folderSection One - Introduction and summary
close this folderChapter One - Safe blood and HIV/AIDS: The Uganda achievement
View the document(introduction...)
View the documentThe tragedy of the haemophiliacs
View the documentInfections carried by blood
View the documentThe unique features of Africa
View the documentThe global blood safety initiative
View the documentThe Uganda blood transfusion service: A portrait
View the documentThe wider contribution of the UBTS
View the documentThe view from an up-country hospital
View the documentThe matter of costs
View the documentThe dynamics of the project
View the documentA complex organisation
View the documentA view from Mulago hospital, Kampala
View the documentFour questions about AID
View the documentThe first visit for the EC
View the documentDr John Watson-Williams enters the scene

A complex organisation

Nevertheless, the UBTS has been forced to develop a complex organisation to deal with its problem in Uganda. The main characteristics of this (explored in detail later in this volume) are:

1. recruitment of a core group of unpaid, volunteer, repeating blood donors; in other words, people who can be relied upon to give blood regularly that is HIV-free, to replace the old paid and high-risk blood donors. This cuts down the wastage (contaminated blood has to be destroyed), the risks to hospital patients, and the costs. Before the Uganda project, many people believed that a voluntary system of blood donation was not possible in Africa.

2. systematic training of staff, so that public trust in the blood test results is high.

3. a central co-ordinating organisation, so that minimum standards and quality control can be defined and enforced, and scarce skills can be best used.

4. a complex web of transport arrangements, involving the UBTS's own road transport, public bus and taxi services, post office vans, and local air services, to overcome both poor local roads and security problems.

5. development of other sources of income, in addition to the EC's external funding, so that the UBTS has some degree of financial independence and can look ahead to the day when the Uganda government will be expected to take a larger share of the financial responsibility.

6. as mentioned, the extensive HIV education efforts that accompany the recruitment of blood donors.

7. the training of clinical staff in the appropriate use of blood, that is, to teach them when blood transfusion is really necessary, and when it is not. The lessons learnt 'on the ground' during the rehabilitation of the UBTS made a large contribution to the more theoretical efforts of the Global Blood Safety Initiative (GBSI), set up by the World Health Organisation, the Red Cross and others, to define the needs, methods and standards for safe blood world-wide.