Blood, Sweat, and Tests: Labor and Automation in South African Transfusion Services

• In Event: Disturbances, Recreation, and Renovation of Labor: AI, Robots, Platforms, and Algorithms - I

Abstract

Before 2005 the South African National Blood Service (SANBS) limited the use of black donors’ blood based on their rates of HIV, which posed “high risk” for transmitting infections through transfusions. Facing public backlash, SANBS laboratories implemented the strictest screening available in order to eliminate the racial profiling in its epidemiologically-based testing algorithms. They were the first blood service in the world to use nucleic acid testing on every donation. With the busiest labs in the Southern hemisphere, SANBS continues to be a testing ground for negotiating the ramifications of risk management with cutting-edge technologies, particularly around automation as a means to reduce the risk of transfusion-transmitted infections.
Drawing on participant-observation fieldwork, I examine how blood service staff balance the safety and efficiency benefits of automation in relation to South Africa’s labor economy dynamics. I focus on a lab instrument—the first of its kind in the world—developed specifically for South African blood services. Staff protested that the instrument presented work hazards, despite automating painstaking processes. Rather than dismissing the staff’s challenges to automation, I argue that blood service stakeholders should leverage the sociopolitical consciousness in blood service laboratories. Such engagement may offset the backlash that can come from an operational calculus and epidemiologically-based algorithms fixated on safety and efficiency. The labor context in South Africa, characterized by unionization and frequent protests, shouldn’t necessarily be viewed as a disruption to blood safety, but is an opportunity to regenerate a progressive approach to identifying and resolving conflicts concomitant with automation.

Author

• Emily Avera, Brown University