Most of the blood and plasma were distributed by train to Senegal and the French Sudan, and by air to the major cities of French colonies throughout West Africa: Bamako, Conakry, Abidjan, Niamey, Ouagadougou, Lomé, and Cotonou, as well as Douala, Cameroun (a UN protectorate administered by France). This regional approach, and the possibilities it implied for centralized services and quality control, proved to be exceptional and temporary. For reasons of cost, increased demand, and the growing political-independence movements, separate transfusion services were soon created in each colony.
TABLE 2.1. Blood and plasma use, le Dantec Hospital, Dakar, 1950–52
| Year | Whole blood (250 cc units) | Plasma (350 cc units) |
| 1950 | 180 | 207 |
| 1951 | 384 | 286 |
| 1952 | 1,146 | 675 |
| Source: “Rapport annuel, Hôpital Central Africain,” 1950–52, box 32, IMTSSA. |
Before the establishment of the blood collection service in Dakar, there were reports of transfusions in the French Congo as early as 1933 and 1934. Additional evidence shows transfusions there in the late 1940s as well.32 Likewise, there is indirect evidence of transfusions from lab reports of blood group testing in French West Africa in 1939, most likely from the Dakar hospitals but also in the French Sudan between 1940 and 1945. Gabon reported blood group tests in 1950 and 1951, and, along with Togo and the French Congo, it established agreements in 1950 on the price paid for blood given by local donors, in accordance with the national agreement negotiated in 1949 between the Ministry of Health and the Fédération nationale des donneurs de sang de France et d’Outre-mer.33
These accounts suggest a pattern outside Dakar that followed the interwar record in Belgian and British colonies, where the individual interest of doctors or other circumstances determined the use of transfusions. And colonial health services moved doctors around fairly regularly. Thus, for example, the transfusions done in the French Congo in 1950 followed the appointment of Ouary as surgeon at Brazzaville Hôpital général after he left Dakar. In 1955 he was chief of the surgery service in Tananarive, Madagascar.34 Likewise, when Togo completed construction of a new hospital in Lomé in 1954, Amen Lawson headed the bacteriology department, and unilaterally started a paid blood donor service, because it was much cheaper and more responsive to immediate needs than service from Dakar.35
TABLE 2.2. Total blood units supplied, Centre fédéral de transfusion (Dakar), 1950–58
Note: Units are either 250 cc whole blood or 350 cc plasma. Three blood products were produced at the center: Whole blood, liquid plasma, and dried plasma.
Source: Unclassified records, CNTS Dakar.
The reports of overall blood and plasma production through 1958 give an indication of the number of transfusions in French West African colonies for which the blood was supplied.36 Of note was the rapid growth but quick leveling off of donations and units produced, likely due to costs, plus the very high rate of blood donation by the local population. African donors made up the vast majority from the start, and there was a steady growth of whole-blood collection. Plasma remained a significant portion of production but leveled off after 1954.
Detailed reports have not been found about where shipments went from the federal transfusion service in Dakar, and it was only in 1955 that an official category was created for blood transfusion in the annual French colonial medical reports. Nonetheless, based on intermittent reports, it is clear that transfusion was widely used, and in some places regularly established, in French West and French Equatorial African colonies by 1956.37
Given the widespread ability to do transfusions, it follows that the main initial effect of the Dakar service, as far as West African and Cameroon colonies are concerned, was to expand the practice. In other words, this was likely an unusual case of increased supply stimulating demand. Then by the late 1950s, as demand in the colonies began to exceed the ability of Dakar to supply blood and blood products, especially at a reasonable price, the hospitals in the other colonies developed their own local sources. Sometimes this was done publicly and openly, as in 1957, when the Ivory Coast officially voted to create its own blood transfusion service. The minutes of the territorial assembly reported the health minister’s testimony: “A blood bank is indispensable to the colony at this time because of the increase in patients who can benefit from whole blood and whose needs are always urgent in nature. The center in Dakar, he said, has prices that are too high. He has been forced on several occasions to order blood directly from France.”38 Other colonies, such as Togo, did not require such dramatic action. A hospital might simply ask a patient’s family to find a donor, or develop a more systematic way of insuring blood for transfusion quickly and affordably. In any case, the trend was clearly toward a decentralization of blood collection that foreshadowed the pattern for the period of independence.
TABLE 2.3. Transfusions reported with whole blood and plasma, French African colonies, 1955–56
| Colony | 1955 | 1956 | |
| French West Africa | |||
| Ivory Coast | 79 | 695 | |
| Dahomey | — | 286 | |
| Guinea | 164 | — | |
| Upper Volta | 25 | 40 | |
| Niger | 148 | 182 | |
| Senegal | — | — | |
| Dakar Hospitals | 577 | 867 | |
| Other | 1,054 | 293 | |
| Togo | — | 180 | |
| French Equatorial Africa | |||
| Ubangi-Shari | 37 | 33 | |
| Congo | 55 | 116 | |
| Gabon | 63 | 22 |