Zimbabwe’s Bulawayo: When Lloyd Muzamba was seriously hurt in a car accident on the Harare-Bulawayo highway in 2023, he required a swift blood transfusion to save his life. Despite being admitted at Mpilo Central Hospital, the biggest public health facility in Zimbabwe’s Matabeleland region, a shortage of supplies meant the doctors didn’t have enough for him.
The family of Muzamba turned to a nearby private hospital to purchase the three pints of blood out of desperation. Muzamba, who earned a $ 270 monthly salary and had no savings, was unable to afford it because it cost $250 per pint.
With time running out, the family had to make a plan. After selling a cow for $300, Muzamba’s uncle requested contributions from other relatives.
The now-recoverable Muzamba claims that the incident has psychologically damaged him, as he worries about other situations where people might require life-saving blood.
“Three pints can be a small number, others might need more than that. However, the risks are severe because of the cost, according to the 35-year-old who works in a Bulawayo hardware store.
Without making a payment plan or paying, I was unable to get the blood. It was a painful experience for an ordinary Zimbabwean like me”.
Muzamba’s is not a singular case.
Due to financial constraints, desperate Zimbabweans in need of care are facing life-threatening delays because of ongoing currency problems, rising living costs, and rising poverty rates. This includes blood shortages – despite supplies being free in public health facilities.
When her second child was delivered, Tanaka Moyo, a mother of two in Harare, also experienced the stress of having to pay for emergency blood supplies.
The 38-year-old street vendor needed four pints of blood after excessive postpartum hemorrhage.
Together with her husband, a security guard, she had struggled to raise money for the birth of their child. A blood transfusion was unexpectedly necessary, and it cost unanticipated money.
“My husband yelled at a microfinance agency and borrowed money.” The interests are steep and conditions stringent, but he had to act quickly”, said Moyo.
The hospital insisted that the blood was free, but it was not.
Postpartum hemorrhage is the main cause of maternal mortality, according to Plaxedes Charuma, a gynecologist in Bulawayo. The prevalence of the condition means that hospitals should always have supplies on hand to deal with maternal blood loss emergencies that arise, health experts say.
The Zimbabwean community working group on health (CWGH), a network of civic health organizations, claims that pregnant women are the most vulnerable in the country because of the country’s high demand for blood transfusions.
“About half a million pregnancies are expected in Zimbabwe, and in some of these, there is excessive blood loss, requiring transfusion of at least three pints of blood”, said Itai Rusike, CWGH’s executive director.
According to Rusike, “Maternal mortality in Zimbabwe continues to be unacceptable high.” According to the saying, “Timely blood transfusion prevents maternal deaths, which are estimated to be 212 for every 100 000 live births in Zimbabwe.”
‘ Free blood for all ‘
There are typically two main blood transfusion types: autologous and allogeneic. An individual can donate the same blood to another person for their own use later, known as an autologous transfusion. Allogeneic transfusion, which is the most common in Zimbabwe, involves administering blood donated by one person to another who matches their blood type.
The organization that regulates blood donation and distribution in Zimbabwe is known as the National Blood Service Zimbabwe (NBSZ). Although it is a self-contained, not-for-profit organization, Zimbabwe’s government has mandated that it process and distribute blood throughout.
While the Ministry of Health and Child Care is permanently represented on its board of directors, NBSZ functions independently of hospitals and government health institutions. It is distributed decentralised throughout five regional centers: Harare, Bulawayo, Gweru, Masvingo, and Mutare, but it is not present in every facility.
Patients in Zimbabwe used to pay for blood, but the government has since worked to lower costs, going from $150 to $50 by 2018.
The government then went a step further in July that year, deciding that blood would be made free at all public health institutions.
During the World Blood Donor Day celebrations in June 2018, former minister of health and child care, Dr. David Parirenyatwa, stated that “the free blood for all move is proceeding as planned and mechanisms have already been put in place to finance the move. By July 1]2018, blood will be available for free.”
Hospitals are still in shortages despite the policy, though.
This May, there was a critical lack of blood in public hospitals, a situation that threatened the lives of thousands of people, the Ministry of Health and Child Care said in a statement. Al Jazeera reached out to ministry spokesman Donald Mujiri to inquire about the situation and the implementation of the free blood policy, but he did not respond to our requests for comment.
NBSZ, in contrast, claimed that operational and systemic issues that prevented the organization from carrying out routine blood collection activities contributed to May’s shortage.
“Without timely financial support, we faced constraints in mobilising outreach teams, securing fuel, and procuring essential supplies”, Vickie Maponga, NBSZ communications officer, told Al Jazeera.
“Additionally, a seasonal decline in donations, especially from youth, who make up over 70% of our donor base, exacerbated the crisis.”
Patients on the front line frequently need to buy blood at private clinics as a result of these shortages. In most cases, the patient is physically transferred to the private facility for the transfusion, where they pay the costs. In some circumstances, the patient pays and receives blood in a public hospital via a private hospital.
Crucial blood donations
The World Health Organization (WHO) wants to make sure that all nations that perform blood transfusions use voluntary blood donors receive their blood supplies.
The NBSZ claimed for Al Jazeera that cultivating a culture of regular, voluntary donations, particularly among the young and underserved communities, is essential to ensuring a healthy blood supply in Zimbabwe.
The service has a mobile outreach model, through which it brings blood donation drives directly to schools and communities. Maponga added that they have started a club that encourages “young people to commit to giving blood at least 25 times in their lifetime” to further engage the youth.
She added, “We also incorporate blood donation awareness into school initiatives and work with tertiary institutions to ensure continuity after high school.”
Ivy Khumalo, 32, is one of those who has been donating blood since she was in high school. She claims that her ability to donate as an adult is now hampered by the absence of blood donation centers nearby.
It was [first started] as a result of peer pressure, according to Khumalo, who said it was fascinating. “It was only when I was an adult that I made a personal decision to continue donating out of love to save life and help those in need”.
She claimed that because Victoria Falls, which is located more than 100 kilometers (62 miles) away, is the closest hospital to donate blood, she said, it has become expensive since moving from Bulawayo to Hwange.
NBSZ claims that it regularly runs blood drives throughout the state. It also says it offers donors incentives.
In times of medical need, regular donors who adhere to a certain set of requirements, such as having made at least 10 donations, with the most recent one occurring within the past 12 months, are eligible for free blood and blood products for themselves and their immediate family members, according to Maponga.
However, the struggle to get to a far-off donation site is a barrier to entry for ardent donors like Khumalo.
“In such circumstances, it is no longer a free donation as I spent money going there. Despite our passion for blood donation, the majority of us ultimately choose to stay at home, she said.
Rusike, a spokesperson for CWGH, claims that the NBSZ and the Ministry of Health and Child Care must quickly come up with creative and sustainable strategies to increase blood donations.
“The government should utilise the Health Levy Fund of 5 percent tax on airtime and mobile data as it was set up to specifically subsidise the cost of blood and assist public health institutions to replace obsolete equipment and address the perennial drug shortages in our public health institutions”, he said. That money should be ring-fenced and used in a more accountable and transparent way.
Promises and shortages
According to authorities, Zimbabwe’s national blood supply is showing good progress by the middle of 2025, and NBSZ has already collected more than 73% of its half-year goal (the annual target is 97,500 units) annually.
The public health service claims that the Ministry of Health and Child Care is responsible for controlling and subsidizing the blood cost.
“Since 2018, this]free blood policy] is made possible through a government-funded coupon system, which absorbs the full cost of $250 per unit, resulting in zero cost to the recipient]in public hospitals]”, said Maponga.
The NBSZ maintains that it operates on a cost-recovery basis. A pint of blood is collected, processed, and distributed throughout the entire cost-sharing chain, according to the statement. The agency charges $250, making a $5 profit per pint.
However, some private establishments charge up to $500 per pint, according to Zimbabweans. Due to the high cost, many people are still unaffordably aware of it, which has sparked a heated debate on social media.
“NBSZ does not have regulatory authority over how those institutions price their services to patients”, said Maponga, explaining that while blood itself is donated freely, the journey from “vein to vein” involves a complex and resource-intensive process.
However, more can be done to lower the cost of blood transfusions, according to observers.
According to Carlton Ntini, a socioeconomic justice activist in Bulawayo, “the entire chain of blood transfusions can cost less than $150 when strategically deploying available resources, using financial donor stakeholders like corporates, and also holding the government accountable for the entire process.”
The issue of free blood in the public hospitals is noble, Ntini said, but without full implementation, it remains a false hope and only benefits the “lucky” few, as shortages are the order of the day.
Any sum exceeding $50 per pint of blood is actually a death sentence for Zimbabweans, he claimed.
The cost of essentials only further complicates an already stressful situation for patients.
Muzamba was fortunate in that his family did not claim back the money they gave him for his blood transfusion. However, Moyo and her husband struggled to pay off their $1,400 loan debt.
Source: Aljazeera
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