The History of Blood Transfusion in Sub-Saharan Africa (Perspectives on Global Health)

"This first extensive study of the practice of blood transfusion in Africa traces the history of one of the most important therapies in modern medicine from the period of colonial rule to independence and the AIDS epidemic. The introduction of transfusion held great promise for improving health, but like most new medical practices, transfusion needed to be adapted to the needs of sub-Saharan Africa, for which there was no analogous treatment in traditional African medicine. This otherwise beneficent medical procedure also created a "royal road" for microorganisms, and thus played a central part in the emergence of human immune viruses in epidemic form. As with more developed health care systems, blood transfusion practices in sub-Saharan Africa were incapable of detecting the emergence of HIV. As a result, given the wide use of transfusion, it became an important pathway for the initial spread of AIDS. Yet African health officials were not without means to understand and respond to the new danger, thanks to forty years of experience and a framework of appreciating long-standing health risks. The response to this risk, detailed in this book, yields important insight into the history of epidemics and HIV/AIDS. Drawing on research from colonial-era governments, European Red Cross societies, independent African governments, and directly from health officers themselves, this book is the only historical study of the practice of blood transfusion in Africa."--Provided by the publisher. Contents 6 Acknowledgments 8 Abbreviations 10 Introduction 12 Blood Transfusion and the Origin of AIDS 12 Africa and the History of Transfusion 14 Approaching the History of Transfusion in Africa 15 Blood Transfusion before the Second World War 20 Evidence of the First Transfusions 21 Blood Donation and the Uses of Transfusion in Africa 24 The Development of Transfusion Technology to 1950 26 The Knowledge and Motivation to Use Transfusion in Africa before the Second World War 29 Early Transfusion Services in the Belgian Congo 31 Early Transfusion in the British Colonies 34 Blood Transfusion from 1945 to Independence 39 Conditions in Africa during and after the Second World War 40 Doctors and Decisions about Transfusions 41 The Organization of African Blood Transfusion Services: General Trends and Periods 43 Transfusions in French African Colonies after the Second World War 45 Transfusions in the British African Colonies after the Second World War 52 Transfusions in British African Colonies: The Case of Uganda 55 Transfusions in the Belgian Congo after the Second World War 62 Blood Transfusion in Independent African Countries 76 The First Phase of Independence: Continued Growth to the Mid-1970s 77 Blood Transfusion in the First Years of Independence: The Example of Kenya 80 Blood Transfusion in the First Phase of Independence: The Example of Uganda 87 Blood Transfusion in the First Phase of Independence: The Example of Senegal 93 The Second Phase of Independence: Stagnation, Crisis, and Modernization after the 1970s 98 The Role of Intergovernmental Organizations in Supporting Blood Transfusion 102 Models of Assistance 105 The World Health Organization and Blood Transfusion in Africa 112 Who Got Blood ? 117 The Early Uses of Transfusion 117 The Needs and Motivation of Blood Donors 119 Reports of Transfusion Use before the AIDS Epidemic 131 The Use of Transfusion in Africa after the AIDS Epidemic 139 Who Gave Blood ? 142 Early Sources of Blood Donation 144 Early Blood Donors: The British Red Cross in Africa 148 The Postindependence Shift to Hospital-Based and Family or Replacement Donation 153 The 1970s and After: Development of Centralized, “Voluntary” Donation 157 Blood Transfusion and Health Risk before and after the AIDS Epidemic 164 The Historical Background of Risk in Blood Transfusion 165 The Risks in Blood Transfusion Specific to Africa 166 Early Examples of Transfusion Risk and the Response 168 The Assessment of Risk in Reports and Workshops of the 1970s 171 The Risks of Specific Diseases 173 Blood Transfusion after the Discovery of AIDS 178 African Blood Transfusion in the Context of Global Health 184 Notes 192 Bibliography 230 Index 246 This study of the practice of blood transfusion in Africa traces the history of one of the most important therapies in modern medicine from the period of colonial rule to independence and the AIDS epidemic. The introduction of transfusion held great promise for improving health, but like most new medical practices, transfusion needed to be adapted to the needs of sub-Saharan Africa, for which there was no analogous treatment in traditional African medicine. This otherwise beneficent medical procedure also created a "royal road" for microorganisms, and thus played a central part in the emergence of human immune viruses in epidemic form. As with more developed health care systems, blood transfusion practices in sub-Saharan Africa were incapable of detecting the emergence of HIV. As a result, given the wide use of transfusion, it became an important pathway for the initial spread of AIDS. Yet African health officials were not without means to understand and respond to the new danger, thanks to forty years of experience and a framework of appreciating long-standing health risks. The response to this risk, detailed in this book, yields important insight into the history of epidemics and HIV/AIDS. Drawing on research from colonial-era governments, European Red Cross societies, independent African governments, and directly from health officers themselves, this book is a historical study of the practice of blood transfusion in Africa." Chapters: Blood transfusion before the Second World War -- Blood transfusion from 1945 to independence -- Blood transfusion in independent African countries -- Who got blood? : indications for the use of blood transfusion, 1945/2000 -- Who gave blood? -- Blood transfusion and health risk before and after the AIDS epidemic -- African blood transfusion in the context of global health. [From back cover and contents]