{
  "abstract": "Objective What happens to a new mother experiencing postpartum haemorrhage when there is no blood available? Limited blood stores in remote areas called ‘blood deserts’ leave both providers and patients in dire situations. Several strategies are routinely deployed to address shortages in the absence of banked blood. We describe the current state of these strategies, synthesise research on their efficacy and discuss how they may be used in practice, relying on the frontline stories of Dr Anthony Wanjala, an obstetrician and gynaecologist working in Kapenguria County, Kenya.Summary of key arguments While several interventions have been successful at reducing rates of postpartum haemorrhage, there are circumstances in which blood is critical to the patient’s survival. In low- and middle-income countries (LMICs), the blood delivery pipeline is affected by low donation rates, limited testing and storage sites and under-resourced blood banking infrastructure along with geographic dispatch challenges. Stop-gap measures to address blood unavailability, including walking blood banks, intraoperative autotransfusion and drone-based delivery, are operational in many countries, although several barriers limit more widespread use of these modalities.Conclusion Improving access to blood in LMICs is likely to require integrating and scaling stop-gap measures while continuing to build sustainable blood delivery infrastructure. In moments where obstetric patients rely on blood, these tools can offer life-saving potential for mothers across the world.",
  "authors": [
    {
      "affiliations": [
        "Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA",
        "Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Isita Tripathi"
    },
    {
      "affiliations": [
        "University of California San Francisco East Bay Department of Surgery, Oakland, California, USA",
        "Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA"
      ],
      "name": "Nikathan Kumar"
    },
    {
      "affiliations": [
        "Department of Women’s and Children’s Health, University of Liverpool, Liverpool, England, UK"
      ],
      "name": "Andrew Weeks"
    },
    {
      "affiliations": [
        "Blood D.E.S.E.R.T. Coalition, Boston, Massachusetts, USA"
      ],
      "name": "Caroline Wesonga Wangamati"
    },
    {
      "affiliations": [
        "Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA",
        "Blood D.E.S.E.R.T. Coalition, Boston, Massachusetts, USA",
        "Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Nakul Raykar"
    }
  ],
  "title": "Emergency blood delivery for women in blood deserts: Closing the gap in postpartum haemorrhage care",
  "uid": "2a58e36d-cc6c-5731-9486-788cb4a84aac"
}