Bulawayo, Zimbabwe – When Lloyd Muzamba was critically injured in a automotive accident on the Harare–Bulawayo freeway in 2023, he wanted an pressing blood transfusion to avoid wasting his life. Regardless of being admitted at Mpilo Central Hospital, the most important public well being facility in Zimbabwe’s Matabeleland area, a scarcity of provides meant the docs didn’t have sufficient for him.
In desperation, Muzamba’s household turned to their solely different possibility – a close-by personal hospital that bought them the three pints of blood. However at a value of $250 per pint, Muzamba – who earned a $270 month-to-month wage and had no financial savings – couldn’t afford it.
With time working out, the household needed to make a plan. Ultimately, Muzamba’s uncle bought a cow for $300 and requested different family members to contribute the stability.
Two years on, the now recovered Muzamba says the incident has left him psychologically wounded, as he worries about different emergencies when folks may have lifesaving blood.
“Three pints is usually a small quantity; others may want greater than that. However because of the prices concerned, it turns into life-threatening,” mentioned the 35-year-old, who works in a ironmongery store in Bulawayo.
“I couldn’t get the blood with out paying or making a fee plan. It was a painful expertise for an extraordinary Zimbabwean like me.”
Muzamba’s shouldn’t be an remoted case.
With ongoing foreign money woes, rising prices of dwelling and excessive ranges of poverty, determined Zimbabweans in want of care face life-threatening delays on account of monetary boundaries. This consists of blood shortages – regardless of provides being free in public well being amenities.
Tanaka Moyo, a mom of two within the capital Harare, additionally skilled the stress of needing to pay for emergency blood provides in the course of the supply of her second youngster.
After extreme postpartum haemorrhaging, the 38-year-old avenue vendor wanted 4 pints of blood.
Collectively together with her husband, a safety guard, she had struggled to boost cash for the start of their youngster. The sudden want for a blood transfusion was a surprising unplanned price.
“My husband ran round and borrowed cash from a microfinance establishment. The pursuits are steep and situations stringent, however he needed to act rapidly,” mentioned Moyo.
“On the hospital, they insisted the blood was free – but it surely was not obtainable.”
Plaxedes Charuma, a gynaecologist in Bulawayo, says “postpartum haemorrhage is the main explanation for maternal mortality”. The prevalence of the situation implies that hospitals ought to at all times have provides available to take care of maternal blood loss emergencies that come up, well being specialists say.
In accordance with the Neighborhood Working Group on Well being (CWGH), a community of civic well being organisations in Zimbabwe, the nation faces a excessive demand for blood transfusions, and people most affected are pregnant ladies.
“About half 1,000,000 pregnancies are anticipated in Zimbabwe, and in a few of these, there may be extreme blood loss, requiring transfusion of at the very least three pints of blood,” mentioned Itai Rusike, CWGH’s government director.
“Maternal mortality in Zimbabwe stays unacceptably excessive,” Rusike instructed Al Jazeera. “Well timed blood transfusion prevents maternal deaths, which in Zimbabwe stands at 212 ladies dying per each 100,000 dwell births.”
‘Free blood for all’
Typically, there are two main sorts of blood transfusions: allogeneic and autologous. Autologous transfusion refers to self-same blood donation by a person for their very own use later. Allogeneic transfusion, which is the most typical in Zimbabwe, includes administering blood donated by one individual to a different who matches their blood sort.
The Nationwide Blood Service Zimbabwe (NBSZ) is the physique that oversees blood donation and distribution within the nation. It operates as an impartial not-for-profit entity, however it’s mandated by regulation to gather, course of and distribute blood all through Zimbabwe.
Whereas the Ministry of Well being and Youngster Care is completely represented on its board of administrators, NBSZ features independently of hospitals and authorities well being establishments. It’s not current in each facility, however maintains decentralised distribution from 5 regional centres: Harare, Bulawayo, Gweru, Masvingo and Mutare.
Traditionally, sufferers in Zimbabwe paid for blood, however over time the federal government labored on decreasing prices – from $150 a pint in 2016 and previous to $50 by 2018.
The federal government then went a step additional in July that yr, deciding that blood could be made free in any respect public well being establishments.
“The free blood for all transfer goes forward as deliberate and mechanisms have already been put in place to finance the transfer, and are available July 1 [2018], blood might be obtainable at no cost,” mentioned then-Minister of Well being and Youngster Care Dr David Parirenyatwa in the course of the June 2018 World Blood Donor Day celebrations.
Nonetheless, regardless of the coverage, hospitals proceed to face shortages.
This Might, there was a vital lack of blood in public hospitals, a state of affairs that threatened the lives of hundreds of individuals, the Ministry of Well being and Youngster Care mentioned in an announcement. Al Jazeera contacted ministry spokesperson Donald Mujiri to ask concerning the scarcity and the implementation of the free blood coverage, however he didn’t reply to our requests for remark.
NBSZ, in the meantime, mentioned that Might’s scarcity was on account of operational and systemic challenges that disrupted its skill to hold out routine blood assortment actions.
“With out well timed monetary help, we confronted constraints in mobilising outreach groups, securing gasoline, and procuring important provides,” Vickie Maponga, NBSZ communications officer, instructed Al Jazeera.
“Moreover, the disaster was exacerbated by a seasonal dip in donations, notably from youth, who make up over 70 % of our donor base.”
These shortages repeatedly lead to sufferers on the entrance line needing to purchase blood at personal clinics. Typically, the affected person is bodily transferred to the personal facility for the transfusion, the place they pay the prices. In some instances, the affected person pays and the personal hospital sends the blood to them within the public hospital.
Essential blood donations
The World Well being Group (WHO) goals to make sure that all nations training blood transfusions get hold of their blood provides from voluntary blood donors.
The NBSZ instructed Al Jazeera {that a} sustainable blood provide in Zimbabwe depends upon cultivating a tradition of normal, voluntary donations, notably among the many youth and underserved communities.
The service has a cellular outreach mannequin, via which it brings blood donation drives instantly to colleges and communities. To additional have interaction the youth, Maponga mentioned in addition they began a membership that “encourages younger folks to decide to donating blood at the very least 25 instances of their lifetime”.
“We additionally combine blood donation consciousness into faculty programmes and companion with tertiary establishments to take care of continuity post-high faculty,” she mentioned.
Ivy Khumalo, 32, is a type of who has been donating blood since she was in highschool. However she says the shortage of blood donation centres round her now limits her skill to provide as an grownup.
“As a college youngster, it was [first started] on account of peer strain, however I discovered it fascinating,” Khumalo mentioned. “It was solely after I was an grownup that I made a private resolution to proceed donating out of affection to avoid wasting life and assist these in want.”
However since transferring from Bulawayo to Hwange, she mentioned, donating blood has grow to be costly as the closest centre is in Victoria Falls, over 100km (62 miles) away.
NBSZ says it routinely deploys cellular blood drives across the nation. It additionally says it affords donors incentives.
“Common donors who meet particular standards akin to having made at the very least 10 donations, with the latest throughout the previous 12 months, qualify at no cost blood and blood merchandise for themselves and their rapid members of the family … in instances of medical want,” defined Maponga.
Nonetheless, for eager donors like Khumalo, the hassle to succeed in a far-off donation web site is a barrier to entry.
“In such circumstances, it’s not a free donation as I spent cash going there. In the long run, most of us determine to remain house regardless of the eagerness for blood donation,” she mentioned.
CWGH’s Rusike says the NBSZ and Ministry of Well being and Youngster Care should urgently devise progressive and sustainable methods to extend the variety of eligible blood donors.
“The federal government ought to utilise the Well being Levy Fund of 5 % tax on airtime and cellular knowledge because it was set as much as particularly subsidise the price of blood and help public well being establishments to exchange out of date gear and deal with the perennial drug shortages in our public well being establishments,” he mentioned. “That cash must be ring-fenced and used for its meant goal in a extra accountable and clear method.”
Guarantees and shortages
Authorities say that as of mid-2025, Zimbabwe’s nationwide blood provide is exhibiting good progress, and NBSZ has already collected over 73 % of its half-year goal (the 2025 annual goal is 97,500 items).
The blood service additionally says the Ministry of Well being and Youngster Care performs a central function in each subsidising and overseeing the price of blood throughout the public well being sector.
“Since 2018, this [free blood policy] is made potential via a government-funded coupon system, which absorbs the total price of $250 per unit, leading to zero price to the recipient [in public hospitals],” mentioned Maponga.
The NBSZ maintains that it operates on a value restoration foundation. It says all the chain of amassing, processing and distributing a pint of blood prices $245. The company costs $250, making a $5 revenue per pint.
Nonetheless, costs at some personal amenities can attain as a lot as $500 per pint, Zimbabweans say. This has sparked heated debate on social media, because the excessive price stays far out of attain for many individuals.
“NBSZ doesn’t have regulatory authority over how these establishments value their companies to sufferers,” mentioned Maponga, explaining that whereas blood itself is donated freely, the journey from “vein to vein” includes a posh and resource-intensive course of.
Observers, nonetheless, say extra will be carried out to decrease the prices of blood transfusions.
“At nearer look, the entire chain of blood transfusion can price lower than $150 by strategically deploying obtainable assets, use of monetary donor stakeholders like corporates, and in addition holding the federal government accountable to fund the entire course of,” mentioned Carlton Ntini, a socioeconomic justice activist in Bulawayo.
The difficulty of free blood within the public hospitals is noble, Ntini mentioned, however with out full implementation, it stays a false hope and solely advantages the “fortunate” few, as shortages are the order of the day.
“In actuality, any quantity above $50 per pint of blood will nonetheless be excessive to Zimbabweans, and it’s a dying sentence,” he mentioned.
In the meantime, for sufferers, the price of necessities solely provides to an already anxious state of affairs.
Muzamba was lucky in that his household didn’t declare again the cash they gave him for his blood transfusion. However Moyo and her husband struggled to settle their $1,000 mortgage debt, which escalated to $1,400 after curiosity.
“It psychologically drained me greater than the bodily ache as I questioned, ‘The place would I get such cash on this economic system?’” mentioned Moyo. “The federal government should come clean with its guarantees – it’s not solely about being free, however should be accessible.”