A very rich source of evidence about transfusions in British African colonies before 1939 comes from the British Red Cross, which created branches in the colonies. In the settler colonies of Kenya and Southern Rhodesia, for example, blood donor panels, or lists of donors, were established in the 1930s as a way of obtaining more reliable sources of blood for transfusion both for Africans and Europeans. This method of donor recruitment was developed between the wars in the large cities of Britain, France, and the United States,56 where hospitals compiled lists of volunteers who were pretested for blood type and screened for illness. They were to be called, even on short notice, to have blood drawn when a transfusion was needed. Not only was this system inspired by the need for a more reliable source of blood for transfusions, but volunteering on these panels was seen as an activity to draw volunteers to help start Red Cross branches in the British colonies. The most obvious significance of establishing blood donor panels was to stimulate interest in transfusions by Western doctors already in place and with knowledge of the procedure. In effect, this was a case of supply stimulating demand.
The pioneer of this model of blood donor service was Percy Oliver, who was invited to give a talk at the 1930 British Empire Red Cross Conference, held in London, relating his experience of over a decade in that city. Shortly after the First World War, Oliver, his wife, and other members of a local Red Cross division in the London neighborhood of Camberwell answered a chance call from a local hospital to give blood for a transfusion. Until then, hospitals had relied on nurses, orderlies, or other hospital staff to serve as donors when no family member was available who matched the blood type of a patient in need of a transfusion. Oliver contacted other members of his neighborhood division, and over the years hospitals in London came to rely on this ready source of blood for transfusion. Oliver and his wife were called when the need arose, and the volunteer was sent to the hospital, where blood was drawn and given to the patient. Oliver reported that the organized service, which began in 1921, provided over 1,360 donations in 1929.57
The London conference was an opportunity for representatives from dozens of branches of the British Red Cross in colonies and dominions around the world to meet as well as to hear speeches and reports of activities. Oliver was one of the first plenary speakers, because his London Blood Transfusion Service was a very successful and highly visible program of the British Red Cross. At the 1930 conference he recommended work with blood donors “to all delegates as a very fine form of service for Red Cross members,” but he warned them not to serve simply as a channel to recruit donors to be placed in the hands of the hospitals. His “bitter” experience was that the chapter needed to act “as a buffer between the institutions and the donors, to protect their interests.”58
It did not take long for members in both Kenya and Southern Rhodesia, where Red Cross branches had been established only a few years earlier, to start blood transfusion services. The 1932 annual report for Kenya stated, “A blood transfusion service has been organized and has a panel of 24 donors, including 10 members of Toc H [a service club started by WWI veterans], for whom lectures on the subject were arranged.” The same year the Southern Rhodesia branch reported, “a Blood transfusion service has been organized and a number of VAD [Voluntary Aid Detachment] members have enrolled as donors.”59 Indirect evidence of blood transfusions in Northern Rhodesia is contained in a March 1931 administrative report from the commissioner of Northern Province about banyama, or vampire men, the rumors about which were being fueled by appeals for blood donors and transfusion in the province.60
As the numbers indicate, this was a small start, and in subsequent years the numbers did not grow very quickly. The Kenya Medical Research Laboratory, in Nairobi, reported annual blood group tests in the 1930s of between ten and thirty individuals each year. The Rhodesian Red Cross branch stated in 1939 that the number of volunteers had risen to 903, with 650 of them grouped. “No life will be lost for lack of a willing donor,” the 1939 annual report proudly boasted.61 In fact, that same year Southern Rhodesia proclaimed with much fanfare the establishment of a “National Blood Transfusion Service,” including a new building. This was, of course, a premature and hollow boast, partly because of the limited numbers, but also because it ignored the problem of saving the lives of all Africans. In any event, the war quickly put an end to such plans, yet this is at least an indication of the technical feasibility of a blood transfusion service in Africa.
These examples are telling of the practice of transfusion that can be found in the published literature and unpublished colonial reports before the Second World War. Yet they are not complete. For example, they do not discuss transfusion in French colonies, which will be covered in the next chapter, nor do they include unpublished or otherwise unrecorded individual cases, like Lejeune’s patient whose desperate conditions also prompted transfusions to save lives. In the end it is impossible to know the full extent of transfusion during this period because it simply was not always judged worthy of reporting. In fact, regular inclusion of transfusion in French colonial medical reports did not begin until 1955. Only rarely did a hospital or colonial report mention the establishment of a transfusion service, as in 1949, when the two big hospitals of Dakar did so. There were also reports of a handful of transfusions in surgery services of hospitals in the French Congo in 1933 and 1934.62 Another example of an exception that demonstrates the case in point, comes from Sierra Leone, a fairly small British colony (1931 census of 1,768,480), with few Europeans, and not particularly noted for significant investment in health or other Western development. Yet in 1936 the annual report of the pathology laboratory of Connaught Hospital in Freetown mentioned grouping seven blood donors (six African), a figure that rose to thirty-six (twenty-five African) in two years. Similar scattered examples show the widespread ability, even if limited in practice, to do blood transfusion in sub-Saharan Africa before the Second World War.63
In Uganda, for example, blood grouping was first reported by the Kampala Medical Laboratory in 1931. There were similar reports from Tanganyika in 1932 and the Gold Coast in 1935.64 The 1939 annual health service report for French West Africa stated there were 140 blood group tests by hospital laboratories (24 for Africans), a figure that rose to 891 the following year (813 for Africans).65 In the Belgian Congo, similar sources reported 18 blood group tests in 1929 in Katanga, rising to 46 (22 for Africans) in 1939. Similarly, the bacteriology laboratory in Léopoldville reported 75 blood group tests (27 for Africans) in 1937.66 Figures from these reports are, therefore, undoubtedly a low estimate of transfusions done, since they could be and certainly were also done using blood donated by a relative or member of a hospital staff, without assistance of donor panels, and without being reported.
TABLE 1.1. Transfusions reported (more than 10 annually) in African colonies by World War II
| Colony | Date and notes |
| Belgian Congo | 1924 Haut Katanga, 300 patients; 2 other locations by 1940 |
| Uganda | 1931 first blood-grouping reports from Kampala |
| Kenya | 1932 Nairobi, 24 donors |
| Tanganyika | 1932 first blood-grouping reports |
| French Congo | 1933 Brazzaville |
| Ethiopia | 1935 first report of transfusion service in Addis Ababa |
| Gold Coast | 1935 first blood-grouping reports |
| Sierra Leone | 1936 first reports, 38 in 1938 |
| Rhodesia |