Swaziland blood donation

Swaziland Flag, Image by Marc Mongenet, from CIA World Factbook.Here’s an interesting story from recent weeks about the PA for the Deputy Prime Minister of Swaziland and her encouragement of openness to blood donation and transfusion.

Swaziland is a country that some people have not even heard of before.   I’ve only ever driven through, and gotten lost in it for that matter, so I can’t claim to know a lot about it specifically. For a fairly decent documentary primer, watch Without the King.

However, in this case, Swaziland proves interesting for several reasons:

1) According to the CIA World Fact Book it recently became the country with the world’s highest known HIV/AIDS prevalence rate. TransplantInformers has touched on  how HIV/AIDS can impact the discussion about donation.

2) It ranks 156th in the world in terms of physician density, a fact that likely affects the level/type  of health care available.

3) It has one of the world’s last remaining absolute monarchies. It has been characterized as a despotic outpost bordered by democratic nations.

4) The source of this story is the Times of Swaziland, which is the nation’s main privately owned newspaper. And it is not given much liberty to criticize the government. State control of the media is very stringent (source: BBC News)

Given all these factors, it raises several question about this specific case, the motivation behind this type of story, its take on religious beliefs, health care inequalities and regional dependence, and who benefits from this type of increased openness to blood donation, which seems to be emerging as a government position.

But in a context where HIV/AIDS is so high, and in a developing country, hemovigilance concerns are most certainly at play. For more on hemovigilance read here.

As the article states:

“I want to urge people out there who are not sure about going through blood transfusions that they must not to fear it because there is nothing sinister about it. The blood is checked and it is normally clean,” said Dlamini.

I do understand the Southern African context to a certain degree, as a site for my fieldwork. What I find interesting about this article is the particular regional dependence on South Africa. Not only on trade and commerce alone, but also for medical treatments.

In my own research I had respondents who had traveled to South Africa from neighboring countries specifically to receive treatment that was not available in their own country. One civil service employee had given up his job to bring his son to a private hospital in Cape Town because, as Jehovah’s witnesses, South Africa was the only nearby place where they could get a particular treatment  for their son’s hematological disease that was not in violation of their religious objections to blood transfusion.

In fact, the article at hand discusses a special government program that allows certain patients to go to South African hospitals for treatment, and it also has an extensive testimonial against religious dogma that has lead to death upon refusal of a live-saving transfusion.

The question of how much a developing country can and should fund their own provision of treatments, or how much citizens are expected to go to a regional hub for treatment engages an important matter of inequality of access. Who receives these government grants to travel for treatment? For the regional hub the undue strain on its resources can also be a key factor. Furthermore, the issue of migration for medical treatment, or medical tourism are other considerations that this article implicates.

Moreover, it also brings up this important question of if and how to respect people’s religious beliefs, even when it leads to their decision to die. The moral and cultural quandaries therein are definitely worth further discussion.

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