|Safe Blood in Developing Countries - The Lessons from Uganda (EC, 1995, 151 p.)|
|Section Five - Key issues in blood transfusion: The Uganda experience|
|Chapter Thirteen - Other issues, and their solutions|
There are also other issues, for example, security, electrical and water supplies, environmental concerns, and legal and ethical principles.
On security, Dr Watson-Williams is too modest to mention that there was and is also a personal risk. His report to the EC for 1990 mentions that:
'On April 6 armed men robbed me of 2,000,000 Uganda shillings on the way back from the bank... From April 10 the Uganda police has supplied two armed men, every twelve hours, for round the clock security... one of these will accompany all bank trips.'
Dr Peter Kataaha, director of the UBTS, was on another occasion kidnapped and feared for his life.
On electricity and water, the need for continuous and reliable supplies is obvious enough. But in Uganda, as in other poor countries, they cannot always be guaranteed. So what fall-back arrangements can be made?
On environmental concerns, the 1992 proposal for continued EC funding of the UBTS points out that:
'A blood transfusion project handles a large amount of infected human blood. Some of the risks are known and measures to protect both the staff and the public must be developed and utilised with effective monitoring. This is much easier in a central facility [see arguments about central organisation - Ed.] than in widely scattered hospitals. The preferred method of handling contaminated disposable items in Uganda today is high temperature incineration. This necessitates a purpose built incinerator and this must be carefully managed to prevent toxic smoke and fumes in the local atmosphere.'
The legal and ethical rules that should govern blood transfusion, along with many other specialist aspects, are dealt with in the publication Safe Blood in Developing Countries: Principles and Organisation, issued by the EC.