FIXING HEALTH: Blood Bank Bleeding
You are taking a drive to the country one day. You are in a good mood and enjoying the scenery. Without warning, a speeding bus swerves to avoid a pothole and careens into your vehicle. You are lucky to be alive but seriously injured.
You are taken to the nearest hospital where emergency surgery is done to stop the internal bleeding you suffered in the accident. The surgery is a success, but your life hangs in the balance. Not because of the condition of the hospital or the availability of staff, but because you cannot get the blood transfusions needed to keep you alive.
If you are lucky, you will have been in an accident soon after a blood drive. If you are not, as is sometimes the case, you may die because there is no blood.
This scenario is not far-fetched. It happens more often than you would imagine. It is difficult to quantify how many Jamaicans die from lack of availability of blood or blood products. However, one thing is certain, no matter your status in society or what wealth you have amassed, you face the same fate as everyone else. Nobody is immune from the shortage of blood.
NEED A DEDICATED TRAUMA SYSTEM
With the increase in violent crimes and the increased numbers of motor vehicle accidents occurring, Jamaica needs a dedicated trauma system. Key to such a system is a reliable blood banking service.
There are blood banks in Jamaica, so why is there such a shortage of blood?
This time we cannot solely blame the Government, the system or the health-care workers. The primary fault lies with each and every one of us Jamaican citizens.
We do not donate blood.
There are two types of blood donors. Voluntary donors, who give blood out of a sense of duty with no requirement for remuneration, and replacement donors, who donate because a family member or friend needs blood.
Voluntary, non-remunerated blood donors from low-risk populations are the safest blood donors.
In 2011, in 62 countries, national blood supplies were based on 100 per cent or almost 100 per cent voluntary, unpaid blood donations. Only 40 countries collected less than 25 per cent of their blood supplies from voluntary, unpaid blood donors.
In Jamaica, a mere 17-18 per cent are from voluntary donors. Compare this figure with our neighbours Cuba, CuraÁao and Nicaragua, which have 100 per cent voluntary donor supplies.
This reliance on replacement donors is akin to paying off an overdraft account at the bank. We always run a deficit because we do not voluntarily deposit blood to increase the reserves before they are needed.
NOT A CULTURE OF VOLUNTARY DONORS
Despite appeals by the National Blood Bank, the culture in Jamaica is simply not one of voluntary blood donation. We will rush to donate once a relative or friend needs blood. However, that may be too late as there are 'golden hours' soon after sustaining injuries where transfusions have a greater impact on survival. By the time replacement donors get to donate, the blood is tested for diseases, and sent to the hospital for further testing to ensure compatibility with the recipient, it could be too late. And to make matters even worst, oftentimes replacement donors are turned away because of recent illnesses, travel or tattoos. Had they and other potential donors contributed continually to the available pool, we may have had an adequate supply.
There are several myths that reinforce the culture against voluntary donation. Persons believe that the procedure is painful and shy away from it. Others think that they can get infections by donating blood. Both are false.
A small stick is an even smaller price for saving a life. The needles and tubes are sterile and discarded after each use. There is no serious risk to a healthy donor.
A public education campaign is needed to change these attitudes, similarly to those employed in other countries, such as Nicaragua, that saw a significant increase in the numbers of voluntary donors using such strategies.
The incentive must be one of pure altruism. Paying donors and enticing them with food exposes the blood bank to contaminated blood. Persons who stand to gain financially or otherwise are more likely to lie about their high-risk lifestyles and other factors that would see them rejected.
We must find some way to improve on our dismal rate of voluntary blood donation, as it is crippling the national transfusion service.
However, there are other challenges.
The Blood Bank currently gets a significant boost from corporate blood drives. However, not many companies view blood drives as a priority, as they are not 'sexy enough' for press releases. This is compounded by the lack of staff at the Blood Bank to man these drives.
In addition, when blood is distributed to hospitals, some units have to be discarded because of suboptimal transportation and storage. This fault lies partly with the Ministry of Health, which has not provided enough refrigerators to store the blood, and the staff that leaves the blood at room temperature for prolonged periods of time.
It is prudent to have continuing medical education sessions with the staff to ensure adherence to the rigid safety procedures that govern the handling of blood products. The Ministry of Health must make the provision of adequate storage and transport units a priority to minimise wastage of this precious commodity.
We have seen steps in the right direction with the acquisition of a mobile blood unit. However, what is equally important is the budgetary allocation for maintenance of the unit.
We as a people need to rally around this cause and ensure that we do our part, one unit at a time, to ensure that we have a functional national transfusion service.
The life you save may be your own.
- Combine blood drives with health fairs and wellness days.
- Civic groups and community organisations should organise blood drives.
- Civilian volunteers for blood drive staff.
- Adequately staff the blood banks.
- Train staff to handle blood products appropriately.
- Ensure adequate storage is available in hospitals.