A wealth of global activityFirst aid, youth programmes, social welfare, nursing, health clinics, disaster preparedness, blood donations, emergency relief and overseas aid all added up to a massive body of global activity. The number of applications to the Empress Shôken Fund increased dramatically. On average, more than 20 societies applied for funding, with only a third receiving an allocation. Due to the high revenue earned by the fund, especially in the 1980s, the amounts allocated increased substantially.
A report commissioned by ICRC and the League, Agenda for the Red Cross, and written by Canadian Donald Tansley, concluded that the Movement should concentrate on the core activity of protection and assistance in war and disasters, and it should downgrade many of the other programmes that had developed over the years. Contrary to this, the 1970s brought a crop of new ideas on how to help those in need. Healthcare in slums, programmes for people with disabilities, reforestation, dune protection, market gardening, social programmes for pilgrims – these all illustrate the strength and diversity of the Movement and its roots in the communities it helps.
Blood transfusion servicesBlood transfusion programmes are another core activity of National Societies which have often been supported by the Empress Shôken Fund, although today, most blood banks are managed by public authorities.
The early days of blood transfusion programmesIn the 19th century, blood transfusions made a comeback after failed attempts with animal blood some 300 years earlier. But the popularity of transfusions once again waned when it was discovered that more than half of the transfusions performed had ended in the death of the patient.
It was the discovery of different blood types at the start of the 20th century that brought about renewed confidence in blood transfusions – just in time for the First World War when blood was liberally given to wounded soldiers. In 1921, all members of the British Red Cross members decided to give blood and the first voluntary blood donation service was born.
Just before Second World War, the Americans and British opened the first blood bank and the war increased the demand for blood. Thousands of civilians donated blood and helped save the lives of countless servicemen and civilians.
Safe and sustainable programmesAfter the widespread use of blood transfusions in the Korean War in 1954, concern over transfusion-related diseases – in particular hepatitis – came to the fore. Then, in the 1980s, came the more serious threat of HIV, when it was found that blood was contaminated with HIV, the virus that leads to AIDS. At first, the blood banks were reluctant to consider that their supply might be tainted; indeed, many of them treated the information with some scepticism. However, scandal broke out in one country after another as blood supplies were discovered to be contaminated with HIV – and a number of National Society blood services were also implicated.
Voluntary non-renumerated blood donors, particularly those who donate blood regularly, provide the foundation for a safe, sustainable blood supply that meets the needs of all patients. Today, HIV transmission through blood transfusions is rare in developed nations because of enhanced screening. However, HIV transmission continues to be a problem in developing countries that don’t have access to blood screening facilities.
Red Cross Red Crescent involvementBlood transfusions are now considered an essential part of modern healthcare and every government has a duty to provide good healthcare for its citizens. However, blood programmes represent a serious commitment in terms of financial and human resources, and many Red Cross Red Crescent societies work with their countries’ ministries of health to determine the best way to assist.
Many National Societies assist in educational activities or by mobilizing people to donate blood voluntarily. In some countries, where there is a still dependence on blood donations from a patient’s relatives or from paid donors, increasing voluntary blood donations helps shift the responsibility for blood provision to the healthcare system. This also discourages people from selling their blood. To date, 54 countries, including resource-limited countries, have achieved a national blood supply based on 100 per cent voluntary blood donations.
National Society blood transfusion programmesIn 1948, the 17th International Conference of the Red Cross in Stockholm stressed the importance of National Societies being involved in the establishment of blood transfusion and donor services. In 1954, the League reported that “somewhere in the world, every 20 seconds, someone receives a transfusion of blood supplied through the Movement”.
In the United States during this period, over 40 per cent of all blood given to civilians came through the Red Cross. By 1960, 2.4 million units of blood had been collected. Many National Societies were also made specifically responsible for ensuring the supply of military blood banks. Transfusion services were developed to such an extent that the word ‘blood’ was used as frequently as the word ‘disaster’. In other countries, where blood transfusions were the responsibility of the public authorities, National Societies were often actively engaged in the recruitment of voluntary blood donors.
In the newly independent states of the developing world, rudimentary services had been established shortly after the Second World War. The Joint Commission granted allocations for blood transfusion services to Paraguay in 1949, and to Italy and Thailand in 1950. In 1958, the Turkish Red Crescent opened a blood centre in Ankara, and the very first donor was the Turkish president himself.
Subsequent allocations were given to National Societies across Latin America, Asia and Africa to provide equipment for blood banks, mobile blood collection units and vehicles for transporting blood supplies. Even though allocations for blood programmes have been heavily reduced over the last 30 years, they have received funding as recently as 2007 and 2009.
A lack of information about HIV and AIDS – together with the increasing stigmatization of people living with HIV – has made it increasingly difficult to address the HIV epidemic. The Empress Shôken Fund enabled the Ukrainian Red Cross Society to implement a programme to reduce discrimination towards people living with HIV, through information-sharing and safe behaviour campaigns in train stations, through media coverage and by involving sports celebrities.
The Iranian Red Crescent Society implemented an awareness programme that focused on the wives and partners of prisoners, and people living with drug addictions – often people who receive little or no information on HIV and AIDS and addiction-related risks. By training female volunteers, it has encouraged people to take responsibility for their own protection, and increased public awareness of how to seek help at consultancy centres and clinics.
In Lesotho, one of the countries hardest hit by HIV and AIDS, there is a critical shortage of blood donors, a situation which is getting worse. In partnership with the government, Red Cross youth action teams had been formed and trained to work closely with blood banks and hospitals to recruit regular voluntary blood donors and establish blood donor clubs at community level.
Maintaining a blood supply and collecting blood is an issue in Ecuador. The National Society used funding from the Empress Shôken Fund to improve its donor recruitment strategies. It developed a communication strategy for behavioural change, with a focus on youth, and strengthened its Club 25 strategy – an international youth programme that focuses on saving lives by giving blood and endorsing a healthier lifestyle.
Comoros Islands (2009)
The Comoros Red Crescent Society received a grant allocation to increase the capacity of its blood donation programme in order to avoid blood shortages at the islands’ three main hospitals. The National Society created blood donor clubs throughout the country, and recruited up to 2,000 regular voluntary blood donors by training 30 facilitators, who work closely with the ministry of health to develop the project.
Red Cross Red Crescent blood programmes todayThe problems of HIV-contaminated blood led many National Societies to withdraw from the administration of blood banks, although it is still an important activity in India, Indonesia and Myanmar.
Today, the vast majority of National Societies run programmes related to HIV prevention, treatment and care, as well as anti-stigma and discrimination activities. In 2010, almost 18 million people had been reached by the Red Cross Red Crescent through HIV-prevention programmes; and over a quarter of a million people living with HIV and orphans received psychosocial support.
Grant allocations for vehiclesIn the absence of a coherent development policy, the Empress Shôken Fund made a significant number of grant allocations for vehicles, many of which were an integral part of wider National Society programmes.
Between 1960 and 1985, the Joint Commission financed cars, ambulances and equipment related to first aid, blood transfusion and disaster preparedness projects. Of the 175 allocations made during this period, 119 were for vehicles and 51 were for medical equipment.
The advantages of funding vehicles were numerous: the expenditure could easily be identified, it was simple to control and it did not require close follow-up to check how it was being used. Despite the fact that the vehicles were being used for a wide range of projects, the Empress Shôken Fund was becoming known as a “vehicle fund” and it lacked any significant influence over National Societies’ development policies.
This disapproval of funding vehicles led the Joint Commission to redefine its allocation policy and, in 1990, it revised its procedural rules accordingly. The commission was now to:
• allocate no more than half of the total annual allocation for transportation (cars, ambulances and other vehicles, including spare parts)
• allocate no more than half of the total annual allocation for human resources development projects – including training, staff on-loan support, volunteer and staff scholarship assistance
• allocate no more than one half of the annual allocation for equipment and materials that are clearly linked to the objectives of the fund
These new policy guidelines, which are still in force today, provided the Joint Commission with enough room for manoeuvre to adapt to and influence the activities of National Societies in developing countries.