Eric Bimpong has a money-making proposition to Ghana's legions of jobless young men: sell your blood.
Bimpong spends his days outside schools, bars and on the streets of poor neighbourhoods in Accra, scouring for teenagers and 20-somethings to give blood outside the capital's largest hospital.
Commercial blood donors, as the authorities call them, fill a void in a country where blood is often in short supply and cultural and religious beliefs keep some from donating.
When a patient needs blood and the blood banks are empty and family and friends unavailable or unwilling to donate, the paid donors step in for a price.
"In this country, when people go to the hospital, they don't want their relatives to know," to hide certain illnesses, Bimpong said. "So they come to us."
While their donations likely save the lives of bleeding patients, public health officials worry that the donors spread diseases like HIV or hepatitis to those who receive their blood.
"It's abnormal. We don't really encourage this kind of donation," said Stephen Addai, a spokesman for Ghana's National Blood Service. (NBS)
"Sometimes they don't even know their blood group."
- Fear of needles, disease -
Ghana has prospered in recent years off exports of gold, cocoa and oil as well as the country's reputation as a rare stable democracy in tumultuous West Africa.
While its economy has recently begun slowing down, Ghana's government is investing heavily in building new hospitals and renewing old facilities.
But keeping blood banks stocked remains a constant struggle, Addai said.
The NBS usually relies on students to donate the approximately 250 units per-day of blood used in the southern third of the country, which includes the capital.
But they still run short, particularly when students go on holiday, Addai said.
The NBS has sounded the alarm about blood shortages repeatedly on radio stations and in newspapers, encouraging people to come out and donate.
During a recent blood donor drive at a shopping mall in Accra, the NBS hoped to get 1,500 donors, Addai said. Instead, they got just five.
"They are afraid of the syringe," Addai said. "They are not aware of the importance of it because of certain beliefs. They've heard stories of certain diseases."
- Chronic blood shortages -
Chronic blood shortages have forced hospital blood centres to improvise.
When a patient arrives in need of blood and a hospital has none to offer, nearby clinics are contacted to see if they might have some available, Addai said.
If the clinics don't, family members are called to come and donate. Friends will suffice, too -- if they're willing.
If that fails, "it means that the victim will not survive", Addai said.
More than 42 percent of Ghana's unemployed are aged 15 to 24 and just under a quarter of the population of 26 million live below the poverty line of 3.60 cedi ($1, 0.77 euros per day).
As a result, Bimpong finds a ready supply of volunteers at high schools, drinking spots and in market places.
"I go to places where I can see people are not working," he explained.
The going-rate per pint (0.57 litres) of blood is between 100 cedis and 120 cedis. Bimpong keeps 20 cedis for himself.
According to Addai, donated blood is tested for HIV, hepatitis B and C and syphilis and donors are asked if they've been sick with malaria.
Despite screening, there have been a number of cases involving contaminated blood in other parts of the world.
From the 1970s onwards, more than half a dozen countries, including Britain, France, Italy and Japan, were hit by scandals over tainted blood for transfusion. The biggest scare was over contamination by the AIDS virus.
Last July, the medical journal The Lancet published a study saying that one in almost 3,000 blood donors in England carry hepatitis E and that small amounts of the virus had made it into blood banks.
But Bimpong shrugs off concerns about safety.
Laboratories should be responsible for screening, he said, adding: "It's not up to me."
- 'We are helping people' -
Inside the packed waiting room of the blood centre at Korle Bu Teaching Hospital, signs encourage people to donate every four months.
When a face becomes too familiar, it's likely that person is a commercial donor, said Victoria Atiapah, a nurse at the centre.
"When you see them the first time, they say they're relatives. But when they come the second time, third time, then you know," Atiapah said.
Anyone who tries to donate more often than the recommended four months is turned away, she said.
Jean-Pierre Allain, a professor at the haematology department of the University of Cambridge in Britain, said that commercial blood donors make up perhaps less than 10 percent of donors in Ghana.
In Nigeria the rate is between 30 and 60 percent.
But Ghana's rate of hepatitis, which is spread through blood, is about 15 percent and a worrying sign, Allain said, estimating that about 10 percent of donors have the virus.
Bimpong, though, is unconcerned about the impact of his business. A man has to make a living, he said as he sat outside a kiosk selling sodas and meat pies to nurses and patients at Korle Bu.
"This country's hard. No work," he said. "We are helping people."