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‘NBSZ not making profit from blood’


As the world celebrates women’s month, the Zimbabwe Independent chief business reporter Taurai Mangudhla (TM) interviewed one of Zimbabwe’s top women business leaders Lucy Mary Marowa (LM, pictured) around the role of women in the economy and her personal journey to leadership in a male dominated world. She is not only at the helm of a critical institution the National Blood Services Zimbabwe, but is chair for the women’s desk at the country’s largest industry body, the Zimbabwe National Chamber of Commerce

(ZNCC). Below are excerpts:

TM: Please kindly start by describing your professional/entrepreneurship journey highlighting the milestones and major challenges you have had to overcome.

LM: My entrepreneurship journey began many years ago when I completed my university studies and began to work and fend for my family. I was not married then but I had to look after my mother and other extended family members hence the need to find additional streams of income.

I started off as an informal trader, mainly focussing on commodity broking, sourcing for goods both locally as well as from neighbouring countries. I sold goods mainly out of the boot of my car because the business was on a very small scale, was not properly registered and basically done according to what was selling at the time. There was not much of a structure to it; I basically sold anything and everything. Later on I got married and still felt that business should continue so I partnered with my husband in multiple projects, some failed and some worked out and are still running to date.

However, I cannot point at any of them and say that is mine since we set up everything together and it is that knowledge/revelation that made me decide that I should start something of my own some three years ago. I therefore put all my resources together and set up a pharmacy in collaboration with a pharmacist friend. This year I am working on my second big project, which I shall reveal when the time is right.

The challenges I faced over the years were to do with lack of knowledge on the businesses that I found myself in such that sometimes I was out of my depth; lack of capital for huge once-off investments as well as having to work behind male counterparts who seemed to know the landscape better than I did, hence there was always an improper balance of power to my disadvantage.

TM: Turning to your job as NBSZ, what is NBSZ doing to increase awareness in the country?

LM: As part of NBSZ awareness campaigns, we have a digital marketing strategy that we deployed to reach out to both the general public and blood donors (active and lapsed) through various mediums. We target the general public because an informed and knowledgeable public is the cornerstone of a successful blood donation programme. This is the pool where we recruit potential blood donors, especially adult donors, to join our ever-growing donor database. Through the effective use of social media platforms, our digital marketing strategy aims to amplify the message for wider awareness. One innovation is the partnership between NBSZ and Facebook Africa, that introduced a Facebook blood donation feature which makes it so easy and convenient for Facebook users to register as blood donors through their Facebook personal accounts. NBSZ is also rigorously engaging various media houses to assist in raising awareness on the importance of giving blood because the media is a critical stakeholder in the success of the blood donation programme. Our Planning and Recruitment function also carries community-based awareness campaigns like roadshows where we go to the people in their different neighbourhoods and preach blood donation. These are followed up by blood drives that have yielded positive blood collections. We also have bulk sms platforms and whatsApp platforms catering for each province through regional branch offices.

TM: How much blood is required annually in Zimbabwe and how much is generally donated and what is NBSZ doing to close the gap if any?

LM: Blood collection targets are based on hospital demand patterns; hence blood requirements vary each year influenced by these hospital consumption patterns. For the year 2019 we collected 96 131 units of blood whilst in 2020, we collected 54 831 units of blood, in 2021 we aim to collect about 97 500 units of blood. On average, blood required annually in Zimbabwe is about 83 000 units. Based on this assessment this should adequately cover the blood and blood products needs in Zimbabwe.

TM: Can you give statistics of the amount of blood donated, how much of that was useful and how much was actually given to people who required the blood in the past two years?

LM: The amount of blood donated over the past two years is 150 962 units of blood (2019 — 96131; 2020 —54 831).
How much was potentially useful: (Wet packs) — 139 853 units of blood (85196 — 2019; 54 657 — 2020).
How much was distributed for transfusion: (based on Red cell components) — 120 303 units were distributed (70 515 — 2019; 49 788 — 2021).
TM: A lot has been said about the high cost of blood, can you explain why blood is then sold at a price a number of ordinary citizens cannot afford though it would have been donated?

LM: Giving blood is a pure and selfless act from one person who voluntarily donates their blood for another unknown person, without pressure or expectation of any form of reward or payment in cash or kind. While blood is donated for free there is a value chain between its donation and transfusion to a patient and this value chain costs US$120, an amount that the NBSZ is recovering from the user in order to continue operating as a going concern. There is no profit that is made from blood and the financial statements of NBSZ are publicly available for scrutiny as testament to this. Whilst this amount of US$120 does sound exorbitant, this is the actual/exact cost that goes into the production of a safe unit of blood and the itemised cost build up is available for public scrutiny. There is more to the transfusion chain than the collection of blood freely from the donor. Meanwhile, the government of Zimbabwe decided to introduce the free blood initiative in 2018 and thus the government pays NBSZ the full amount for every unit utilised in public health institutions. Thus patients accessing treatment from non-private wards of public health institutions can get blood and blood products free of charge. Blood and blood products are also accessible free of charge at Council and Mission hospitals. Hospitals are allowed to charge a 5% administration fee on blood and blood products.

TM: Is there any special treatment given to donors in case they need blood for one reason or the other?

LM: NBSZ has a blood donor benefit policy that makes it possible for blood donors and their immediate family members to access blood products free of charge, provided they meet set criteria. Beneficiaries include the donor, the spouse, biological parents and children below 18 years. Criteria to access the blood donor benefit policy requires one to be a regular donor, must have donated at least 10 times, with at least one donation in the previous 12 months and provided that there’s no medical aid available since medical aids have a facility for blood products. In an instance where there is a medical aid, the procedure is that the patient or donor brings the medical aid details and the paperwork is processed for NBSZ to claim from the medical aid.

TM: What are the major reasons, in order of weight, people end up needing blood transfusions?

LM: Only human blood can be used for transfusion to another human being and to save life or prevent serious ill health. Main reasons for blood transfusions:

Women giving birth due to complications of pregnancy;
Children, due to anaemia from infections and illnesses;
Trauma that causes blood loss (eg road traffic accidents);
Blood loss due to surgical operations
Medical conditions requiring blood and component replacement, including Blood disorders (sickle cell anaemia)

TM: To what extent has the Covid-19 pandemic affected your operations?

LM: The Covid-19 pandemic is a global challenge that has affected other blood banks worldwide in many ways and Zimbabwe has similarly not been spared. Covid-19 brought about a general sense of fear in a lot of people and this drove a lot of people into isolating themselves by avoiding direct associations which were advised by health authorities as a way to not spread the virus. Furthermore, the lockdown measures introduced by the government had a negative impact on blood collections as it interrupted the steady flow of blood donations from high yielding panels especially schools and tertiary institutions that usually contribute over 70% of blood in the national blood bank. Even though NBSZ remained operational during the lockdown since it is an essential service provider, the lockdown limited movement of people and this meant that there were minimal numbers of blood donors who came to our clinics to give blood.

TM: To what extent has it threatened the safety of the blood and how does it compare with HIV, malaria etc?

LM: As guided by world blood transfusion medical research bodies, the risk of transmission of Covid-19 through transfusion of blood and components is only theoretical research and not factual. People can get infected when they inhale or ingest the virus, but not via a blood transfusion. There is no evidence of transfusion transmission for Covid-19, or any other coronavirus. HIV and other infections in comparison have been long-standing icons in epidemiological transition and this has given way to established approaches for avoiding their risks in transfusion chains. Donation screening is done through microscopic examination and immunological assays to improve the safety of blood and blood products by detection of major blood-borne pathogens, HIV, HBV, HCV, syphilis, and other parasites. NBSZ also has a Covid-19 response strategy in place to curb any chances of cross infection between blood donors and our staff.

The safety of the blood donor is our priority. NBSZ introduced Covid-19 screening at all its static and mobile clinics for every donor each time they come to donate blood. Individuals who are suspected of having Covid-19 are deferred from donating blood and those who have suffered from the disease should refrain from donating blood for at least 28 days after complete resolution of symptoms. There however is no known end date in this fight against coronavirus, and the NBSZ needs the help of blood donors to ensure blood products are readily available for patients

TM: What is Zimbabwe’s position on human blood substitutes or artificial blood? What is your personal opinion on blood substitutes in the face of growing shortages?

LM: I am not aware of a national position on artificial blood and blood substitutes in our country, possibly because we have not invested in the relevant technology to be able to conduct studies on this.

Even the world over, studies on artificial blood are still ongoing and thus it is a constantly developing area, which has the potential to change the transfusion landscape. Personally I believe that it is worth our while as humanity to continue delving into this area as it has the potential benefits of providing efficacy minus the risks posed by normal human blood.

With the advent of this new Masters in Haematology programme which is now being offered by the University of Zimbabwe from this year, it is my hope that as a nation we will be able to investigate through research and contribute to the field of artificial blood.

TM: Now turning to your office at the ZNCC, what initiatives are in place to upscale women enterprises at the ZNCC ?The ZNCC runs four main programmes that are aimed at upscaling women enterprises and these are:

Women Enterprises Conference and Awards (WECA) — It is a platform that has been running since 2014, where women celebrate each other, commencing with a one-day workshop and ending with the gala awards dinner where women who have done well are recognised. It is during the one day workshop that issues affecting women in business are discussed, with resolutions being made on how the identified challenges ought to be tackled. Out of the past WECA conferences came the other initiatives below as well as other interventions that the women’s desk has made over the years.

Mentorship in Practise (MiP) — is a 12 month program in which upcoming women entrepreneurs are matched with suitable mentors, usually prominent business leaders and are assisted to become successful in their ventures.

Mentoring is one of the most important tools and relations for building a sustainable business and to improve the career and develop good leadership or specific competence among the participating mentors and mentees. It is proven that those who seek advice by contacting experts, mentors and coaches have a higher degree of success than those who operate only on their own by mere self evaluation. 150 mentees have been trained under the MiP programme since its inception in 2014 and paired with more than 30 pro bono mentors.

Woman Owned Brand Label (WOB) – this initiative seeks to assist women nationally to find markets for their produce by providing a certified label to all standard certified members. Also creating sustainable markets for Women Owned Enterprises (WOEs) through the Supplier Diversity and Inclusion (SDI) Program. 34 WOEs have benefited in the WoB and we currently have a successful model with Schweppes Africa Holdings as our corporate partner on the SDI program. It is anticipated to build on this model and partner with many more corporates, State owned Enterprises and other organizations in their supply chain to support women to grow their enterprises.

Look, Learn and Share Business Visits (LLS) is a program targeting Women Owned Enterprises which aims to foster relations between women in business through proven experience from other successful enterprises each quarter. A learnership initiative where women get to see how other WOEs operate and run successful ventures first hand.
TM: Based on the experience you have in your role at ZNCC, what challenges are being faced by women in business today and what can be done to make the path better for them?

LM: In my view, the greatest challenge of all that women have to deal with first is that of getting proper representation in key decision making positions and institutions, such that it is easier for women’s issues to be articulated at the relevant levels and be taken seriously enough to be given the desired attention. Poor representation of women in politics, economic institutions etc means that at national policy formulation level there is already a gap, which leads to inadequate remedies being crafted for traditionally known challenges that face women in business such as lack of capital due to limited or no collateral, uneven playing field due to harassment from male counterparts as well as limited availability of tailor-made financial solutions for women. Once this matter is addressed from the top, with proper representation of women in key positions and institutions, the rest will fall into place.

TM: The informal sector is critical in our future as an economy. What role is ZNCC playing to support the informal sector and in particular small women enterprise?

LM: The chamber representation is for formally registered companies and the only role we play has to do with encouraging micro and small enterprises to register and linking them to relevant entities that will assist them to be a formal entity.

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