Desperate Zimbabweans get in debt to pay for lifesaving blood transfusions

Bulawayo, Zimbabwe – When Lloyd Muzamba was critically injured successful a car mishap connected the Harare–Bulawayo road successful 2023, helium needed an urgent humor transfusion to prevention his life. Despite being admitted astatine Mpilo Central Hospital, the biggest nationalist wellness installation successful Zimbabwe’s Matabeleland region, a shortage of supplies meant the doctors didn’t person capable for him.

In desperation, Muzamba’s household turned to their lone different enactment – a adjacent backstage infirmary that sold them the 3 pints of blood. But astatine a outgo of $250 per pint, Muzamba – who earned a $270 monthly wage and had nary savings – could not spend it.

With clip moving out, the household had to marque a plan. Eventually, Muzamba’s uncle sold a cattle for $300 and asked different relatives to lend the balance.

Two years on, the present recovered Muzamba says the incidental has near him psychologically wounded, arsenic helium worries astir different emergencies erstwhile radical whitethorn request lifesaving blood.

“Three pints tin beryllium a tiny number; others mightiness request much than that. But owed to the costs involved, it becomes life-threatening,” said the 35-year-old, who works successful a hardware store successful Bulawayo.

“I could not get the humor without paying oregon making a outgo plan. It was a achy acquisition for an mean Zimbabwean similar me.”

Muzamba’s is not an isolated case.

With ongoing currency woes, rising costs of surviving and precocious levels of poverty, hopeless Zimbabweans successful request of attraction look life-threatening delays owed to fiscal barriers. This includes humor shortages – contempt supplies being escaped successful nationalist wellness facilities.

Tanaka Moyo, a parent of 2 successful the superior Harare, besides experienced the accent of needing to wage for exigency humor supplies during the transportation of her 2nd child.

After excessive postpartum haemorrhaging, the 38-year-old thoroughfare vendor needed 4 pints of blood.

Together with her husband, a information guard, she had struggled to rise wealth for the commencement of their child. The abrupt request for a humor transfusion was a shocking unplanned cost.

“My hubby ran astir and borrowed wealth from a microfinance institution. The interests are steep and conditions stringent, but helium had to enactment quickly,” said Moyo.

“At the hospital, they insisted the humor was escaped – but it was not available.”

Plaxedes Charuma, a gynaecologist successful Bulawayo, says “postpartum haemorrhage is the starring origin of maternal mortality”. The prevalence of the information means that hospitals should ever person supplies connected manus to woody with maternal humor nonaccomplishment emergencies that arise, wellness experts say.

A maternity ward astatine a infirmary successful Harare, Zimbabwe [Philimon Bulawayo/Reuters]

According to the Community Working Group connected Health (CWGH), a web of civic wellness organisations successful Zimbabwe, the state faces a precocious request for humor transfusions, and those astir affected are large women.

“About fractional a cardinal pregnancies are expected successful Zimbabwe, and successful immoderate of these, determination is excessive humor loss, requiring transfusion of astatine slightest 3 pints of blood,” said Itai Rusike, CWGH’s enforcement director.

“Maternal mortality successful Zimbabwe remains unacceptably high,” Rusike told Al Jazeera. “Timely humor transfusion prevents maternal deaths, which successful Zimbabwe stands astatine 212 women dying per each 100,000 unrecorded births.”

‘Free humor for all’

Generally, determination are 2 large types of humor transfusions: allogeneic and autologous. Autologous transfusion refers to self-same humor donation by an idiosyncratic for their ain usage later. Allogeneic transfusion, which is the astir communal successful Zimbabwe, involves administering humor donated by 1 idiosyncratic to different who matches their humor type.

The National Blood Service Zimbabwe (NBSZ) is the assemblage that oversees humor donation and organisation successful the country. It operates arsenic an autarkic not-for-profit entity, but it is mandated by instrumentality to collect, process and administer humor passim Zimbabwe.

While the Ministry of Health and Child Care is permanently represented connected its committee of directors, NBSZ functions independently of hospitals and authorities wellness institutions. It is not contiguous successful each facility, but maintains decentralised organisation from 5 determination centres: Harare, Bulawayo, Gweru, Masvingo and Mutare.

Historically, patients successful Zimbabwe paid for blood, but implicit the years the authorities worked connected lowering costs – from $150 a pint successful 2016 and anterior to $50 by 2018.

The authorities past went a measurement further successful July that year, deciding that humor would beryllium made escaped astatine each nationalist wellness institutions.

“The escaped humor for each determination is going up arsenic planned and mechanisms person already been enactment successful spot to concern the move, and travel July 1 [2018], humor volition beryllium disposable for free,” said then-Minister of Health and Child Care Dr David Parirenyatwa during the June 2018 World Blood Donor Day celebrations.

However, contempt the policy, hospitals proceed to look shortages.

This May, determination was a captious deficiency of humor successful nationalist hospitals, a concern that threatened the lives of thousands of people, the Ministry of Health and Child Care said successful a statement. Al Jazeera contacted ministry spokesperson Donald Mujiri to inquire astir the shortage and the implementation of the escaped humor policy, but helium did not respond to our requests for comment.

NBSZ, meanwhile, said that May’s shortage was owed to operational and systemic challenges that disrupted its quality to transportation retired regular humor postulation activities.

“Without timely fiscal support, we faced constraints successful mobilising outreach teams, securing fuel, and procuring indispensable supplies,” Vickie Maponga, NBSZ communications officer, told Al Jazeera.

“Additionally, the situation was exacerbated by a seasonal dip successful donations, peculiarly from youth, who marque up implicit 70 percent of our donor base.”

These shortages regularly effect successful patients connected the beforehand enactment needing to bargain humor astatine backstage clinics. In astir cases, the diligent is physically transferred to the backstage installation for the transfusion, wherever they wage the costs. In immoderate cases, the diligent pays and the backstage infirmary sends the humor to them successful the nationalist hospital.

A World Blood Donor Day consciousness thoroughfare march successful Zimbabwe [Courtesy of NBSZ]

Crucial humor donations

The World Health Organization (WHO) aims to guarantee that each countries practicing humor transfusions get their humor supplies from voluntary humor donors.

The NBSZ told Al Jazeera that a sustainable humor proviso successful Zimbabwe depends connected cultivating a civilization of regular, voluntary donations, peculiarly among the younker and underserved communities.

The work has a mobile outreach model, done which it brings humor donation drives straight to schools and communities. To further prosecute the youth, Maponga said they besides started a nine that “encourages young radical to perpetrate to donating humor astatine slightest 25 times successful their lifetime”.

“We besides integrate humor donation consciousness into schoolhouse programmes and spouse with tertiary institutions to support continuity post-high school,” she said.

Ivy Khumalo, 32, is 1 of those who has been donating humor since she was successful precocious school. But she says the deficiency of humor donation centres astir her present limits her quality to springiness arsenic an adult.

“As a schoolhouse child, it was [first started] arsenic a effect of adjacent pressure, but I recovered it fascinating,” Khumalo said. “It was lone erstwhile I was an big that I made a idiosyncratic determination to proceed donating retired of emotion to prevention beingness and assistance those successful need.”

But since moving from Bulawayo to Hwange, she said, donating humor has go costly arsenic the nearest centre is successful Victoria Falls, implicit 100km (62 miles) away.

NBSZ says it routinely deploys mobile humor drives astir the country. It besides says it offers donors incentives.

“Regular donors who conscionable circumstantial criteria specified arsenic having made astatine slightest 10 donations, with the astir caller wrong the past 12 months, suffice for escaped humor and humor products for themselves and their contiguous household members … successful times of aesculapian need,” explained Maponga.

However, for keen donors similar Khumalo, the effort to scope a far-off donation tract is simply a obstruction to entry.

“In specified circumstances, it is nary longer a escaped donation arsenic I spent wealth going there. In the end, astir of america determine to enactment location contempt the passionateness for humor donation,” she said.

CWGH’s Rusike says the NBSZ and Ministry of Health and Child Care indispensable urgently devise innovative and sustainable ways to summation the fig of eligible humor donors.

“The authorities should utilise the Health Levy Fund of 5 percent taxation connected airtime and mobile information arsenic it was acceptable up to specifically subsidise the outgo of humor and assistance nationalist wellness institutions to regenerate obsolete instrumentality and code the perennial cause shortages successful our nationalist wellness institutions,” helium said. “That wealth should beryllium ring-fenced and utilized for its intended intent successful a much accountable and transparent manner.”

A pistillate works astatine a National Blood Service Zimbabwe (NBSZ) laboratory [Courtesy of NBSZ]

Promises and shortages

Authorities accidental that arsenic of mid-2025, Zimbabwe’s nationalist humor proviso is showing bully progress, and NBSZ has already collected implicit 73 percent of its half-year people (the 2025 yearly people is 97,500 units).

The humor work besides says the Ministry of Health and Child Care plays a cardinal relation successful some subsidising and overseeing the outgo of humor wrong the nationalist wellness sector.

“Since 2018, this [free humor policy] is made imaginable done a government-funded coupon system, which absorbs the afloat outgo of $250 per unit, resulting successful zero outgo to the recipient [in nationalist hospitals],” said Maponga.

The NBSZ maintains that it operates connected a outgo betterment basis. It says the full concatenation of collecting, processing and distributing a pint of humor costs $245. The bureau charges $250, making a $5 nett per pint.

However, prices astatine immoderate backstage facilities tin scope arsenic overmuch arsenic $500 per pint, Zimbabweans say. This has sparked heated statement connected societal media, arsenic the precocious outgo remains acold retired of scope for galore people.

“NBSZ does not person regulatory authorization implicit however those institutions terms their services to patients,” said Maponga, explaining that portion humor itself is donated freely, the travel from “vein to vein” involves a analyzable and resource-intensive process.

Observers, however, accidental much tin beryllium done to little the costs of humor transfusions.

“At person look, the full concatenation of humor transfusion tin outgo little than $150 by strategically deploying disposable resources, usage of fiscal donor stakeholders similar corporates, and besides holding the authorities accountable to money the full process,” said Carlton Ntini, a socioeconomic justness activistic successful Bulawayo.

The contented of escaped humor successful the nationalist hospitals is noble, Ntini said, but without afloat implementation, it remains a mendacious anticipation and lone benefits the “lucky” few, arsenic shortages are the bid of the day.

“In reality, immoderate magnitude supra $50 per pint of humor volition inactive beryllium precocious to Zimbabweans, and it’s a decease sentence,” helium said.

Meanwhile, for patients, the outgo of essentials lone adds to an already stressful situation.

Muzamba was fortunate successful that his household did not assertion backmost the wealth they gave him for his humor transfusion. But Moyo and her hubby struggled to settee their $1,000 indebtedness debt, which escalated to $1,400 aft interest.

“It psychologically drained maine much than the carnal symptom arsenic I wondered, ‘Where would I get specified wealth successful this economy?’” said Moyo. “The authorities indispensable ain up to its promises – it’s not lone astir being free, but indispensable beryllium accessible.”