‘Nigeria needs more voluntary blood donors’
What would you say regarding blood transfusion in Nigeria? The current practice regarding blood transfusion is that people have to depend on relatives and sometime friends for blood or in a lot of cases on paid donors who sell blood. A lot of the time when blood is needed is in emergencies. So what happens […]
What would you say regarding blood transfusion in Nigeria?
The current practice regarding blood transfusion is that people have to depend on relatives and sometime friends for blood or in a lot of cases on paid donors who sell blood. A lot of the time when blood is needed is in emergencies. So what happens at the times when you need blood and there are no friends or relatives to donate? It means that you are at the mercy of God.
This is not a blame game. We know that where there is a vacuum, something has to be done to make up for it. What has happened is that because there has been no systematic way for hospitals to get blood, they depend on how best they know.
What has happened in Kano for instance is not the best and if it can happen in a place like Kano which is urban, one can only imagine what is happening in the rural areas where there is no much awareness and also where there is little supervision. It is harder to get into such places to see what they are doing.
Isn’t it more worrisome that the merchants are usually hospital staff?
It is sad. People need blood and the hospital staff are usually their first contact. The hospital staff decide to fill in the gap since the patients are going to have to still procure it some way or the other. So in helping the patients they also help themselves.
Is it within your jurisdiction to check these people’s activities?
In terms of legal empowerment, not yet. We do not yet have such a power. There is something in the pipeline but we are still a long way off. But as part of the national health bill which will soon be passed. The Minister of Health has the responsibility to set the standards. This is done through the National Blood Transfusion Centre. The National Blood Policy says that we should as much as possible obtain blood from voluntary blood donors.
What is the process for blood transfusion and donation?
There are very many reasons blood is needed. Many never have to donate blood until someone close is in need. Until then, many imagine that blood is like any other commodity or medicine. The thought of donating had never before come to their minds.
Blood has to come from humans and you do not want to wait until you need it to get it. From that end, you have all sorts and also have to deal with issues of maternal mortality where many of the women bleed to death because there are no donors and in some cases can’t even get access to medical facilities. Also, a lot of children die from anemia which is loss of blood. There are some needs for blood that can be planned for and some others that cannot.
This brings us to the donation part and the question of where blood can be gotten. You need to have clean safe blood when it is needed. Infections that the World Health Organisation (WHO) has mandated that we screen for are: HIV 1 and 2, Hepatitis B and C and Syphilis.
There are standard procedures for screening although some people say there are easier ways of doing this which do not require so much fuss. In cases of emergencies, the Rapid Test Kit is what is used. This process is fine when you are trying to screen blood from someone who suspects he/she might have an infection. Anybody who is screened positive from this test now moves on to have a confirmation and may or may not be positive.
It cannot be ruled whether or not that person has an infection because he/she is in what is called the window period where you have an infection but do not have enough of the infective agents in the blood for the test to pick it up. If the test is repeated after sometime, then the true status can be ascertained.
In a lot of area there is a tussle between whether medical personnel should wait to screen blood first or just go ahead to give the patient the blood and save their lives.
But we think that it is unpardonable in a State capital where you have a General Hospital; patients should not be shortchanged. The important thing is safety and adequacy. The only way we can have enough blood is to have voluntary blood donors who will give blood without looking for compensation. Interestingly, these donors also tend to be the safest. Before you give blood you have to have a good medical history that does not put the potential beneficiary in danger.
How often can one donate blood?
In Nigeria we have not done very deep studies but in some countries people are giving blood every fifty-six days. The safest in Nigeria would be three months for men and four months for women.
Is it only in emergencies that the Rapid Test Kit is used?
That is the only acceptable condition, although people use it more because it is more convenient and less expensive. The results can be gotten in fifteen to twenty minutes. If you are using the more sophisticated methods like the NBTC, you’ll want to put your samples together and not run tests that are not cost efficient. But the best thing to do is to screen the blood and preserve. Unfortunately, most hospitals do not have donors so they get their blood supply in trickles.
Therefore the only way you can have sufficient units of blood is when you are getting it from voluntary donors.
People still have fear of donating blood.
People don’t even know they should give blood or seen the process. Many have the belief that they’ll lose their life in the process or contact an infection and other such fears. But for many who are knowledgeable, the greatest fear is discovering their HIV status. They don’t worry too much about Hepatitis B or C but they don’t want to hear that they are HIV positive.
When done the right way, there is really no side effect. Some people feel dizzy afterwards. People who have complications after donating are usually those who have not been properly pre-screened and not had a proper health check to show that they are well enough to donate.
How functional are the available blood banks?
Blood banks that exist in hospitals are reasonably functional and some private ones exist as well as state government sponsored ones like in Lagos State. It pays them to have these places up and running so that blood can be easily transfused. We also know that many hospitals have blood coming into the hospitals and by-passing the blood bank and going straight into the wards and into the patients.
The black market thrives not only as a result of the inadequacies of the blood bank but also because of the monetary gains involved.
Even within the hospitals, they work to undermine the system. This is because there is no proper regulation.
Those guilty of illegal blood sale are fined and some even serve a jail term.