On Friday, January 5, at 1pm the stand-in national referral hospital for women, Kawempe General, had only two units of blood in its storage fridges.
Under normal circumstances, the hospital bank must have at least 40 units daily for emergencies. As The Observer entered the labour suite on the fourth floor, there were many women due for emergency caesarean section but were unattended to and in immense pain because doctors had stopped operations.
A similar suspension of services was seen at the China-Uganda Friendship hospital at Naguru and Mulago national referral hospital also due to the blood stock-out.
The helplessness of medical staff in the face of such tragic circumstances highlights just how bad Uganda’s perennial blood shortage problem has become. Blood is vital though perishable. It can’t be kept beyond 35 days, which is why the bank has to be regularly replenished.
Stranded at Kawempe, was Alice, a new mother referred there from St Mary’s hospital Lacor in Gulu with a retained placenta. There was another severely bleeding woman after giving birth to twins. A third needed an emergency operation to give birth. Nothing could be done for them.
“We are in a crisis since the ambulances bring in patients every minute to give birth when they are bleeding and they need blood. Other mothers might deliver well or the operation might be successful but later bleed severely,” Joseph Kiiza, the manager of the blood bank at Kawempe, told The Observer.
“And when there is no blood, there is nothing doctors can do even if they give her all types of medication and care. She can die within an hour when doctors are watching but can’t save her yet when blood is available, it takes a minute to save her life,” he said.
“The death rates for mothers have increased due to blood shortage in hospitals but [we] can’t tell exact figures [which] alarm the public because even if we do, the government will not change fast or invest money quickly in Uganda Blood Transfusion Service (UBTS),” he said.
John Baptist Ebaat, an administrator at this hospital, said patients in need of blood come in from regional referral hospitals across the country.
“Some three kids were referred here last week when they were anaemic but died because we didn’t have blood. We receive women daily referred here when bleeding and some die when they fail to get blood,” he said.
He told The Observer that Uganda’s increased population, high birthrate and diseases like cancer which require constant blood transfusion, have led to increased blood consumption yet very few people donate.
Donor funding cuts
This year, things have worsened with the withdrawal of a key Western donor. State minister for Primary Health Care, Sarah Achieng Opendi, said over the weekend that 45 percent of Uganda Blood Transfusion Services’ (UBTS) budget was funded by the US PEPFAR initiative.
“PEPFAR withdrew funding and government took over by taking a critical look at the operations of UBTS. We are aware they have expensive equipment that are being used to process blood but we may review this in line with the funding challenges,” she said.
“We have requested for additional supplementary funding from the ministry of Finance and I have had discussions with Finance Minister Matia Kasaija and this will be resolved. Last financial year, we received an additional Shs 7bn but this budget was not maintained in this year’s budget,” Opendi said.
Kiiza said UBTS used to supply 100 units daily for use in Mulago, Kiruddu and Kawempe but now he collects less than 20 units.
“At the moment, there is no blood in our blood bank at Kawempe. The most demanded blood group ‘O’ which donates to all blood groups is also not available. The only two units available are group A and AB because their blood groups are rare. At times we go to UBTS five times and there is no blood and then the mother dies. So, we are in a very risky situation and more women will die as they give birth,” Kiiza said.
The public relations officer at Mulago said the crisis is more pronounced with blood group ‘O’.
“Previously, we have been receiving between 50 and 60 units per day, but at the moment we get between 25 and 40 units, which is not enough. Since students are still in holidays, we call upon public to donate since it’s a national problem,” Enock Kusasira said.
Mobilization for donation requires money which is not there. Michael Mukundane, the blood donor recruitment coordinator for Central region, said continuous blood shortage partly arises because less than one per cent of the population donates blood.
“The community’s response to donate blood is not yet very good. We target to collect over 270,000 units of blood annually but we only collect 240,000 units,” he said.
Budget allocations have dropped from Shs 9.4bn in 2017/18 to Shs 8.9bn in the coming financial year.
But Jim Mugunga, the spokesman for ministry of Finance, took a dim view of UBTS officials blaming the blood crisis on budget cuts. He said what was slashed is non-core spending on purchase of new vehicles, travel abroad, trainings, allowances and workshops.