Monday September 1 2014

Who is in need of that precious liquid?

Gerald Abwooli shows units of blood stored at the Nakasero

Gerald Abwooli shows units of blood stored at the Nakasero Blood Bank. Many people are reluctant to donate saying they do not see why they should give their blood away for free. 

By Ali Mivule

What is blood?
Blood is a combination of plasma (watery liquid) and cells that float in it. It is a specialised body fluid that supplies essential substances and nutrients, such as sugar, oxygen, and hormones to our cells, and carries waste away from those cells. Blood also contains clotting agents.

Anybody 18 years and above has a responsibility to donate blood to save lives. However, disappointing statistics from the Nakasero blood bank suggest that only 0.2 per cent of Ugandans donate blood.

Who is in charge of collection and distribution?
The blood bank in Uganda has seven regional blood banks. These are found in Arua, Gulu, Mbale, Nakasero, Masaka, Mbarara and Fortportal.

They are supported by blood collection and distribution centres. Health centres in Moroto however, get blood from Nakasero Blood Bank and it is delivered by air.

In Kampala, the Nakasero Blood 01.09.2014 00:00 Kampala which is then distributed to different hospitals.

Apart from the main blood bank, there are 22 mobile blood collecting teams which go out every day to collect blood. Averages of 40 units of blood are collected per day.

Politics of collection
Blood collection is not easy. Henry Bukenya, one of the blood collectors at the Nakasero Blood Bank, says it takes a lot to convince donors to part with their precious blood.

“We have to talk to our blood donors as to why they have to donate, otherwise many people refuse.
Many of them claim they buy blood so they do not see the need to give it out for free.”

Statistics from the blood bank show that students are the main contributors, with 80 per cent of blood collected countrywide coming from schools. This perhaps explains why blood scarcity is mainly experienced during the holidays. Not all the blood collected is used. It is first tested and that which is not good is disposed of.

The cold room in Nakasero Blood Bank where the blood is stored has a fridge which stores the blood between 2-8 degrees centigrade. The blood fridge costs about $20,000 (about Shs50m).

The room stores about 10,000 units of blood, with the tested units separated from the untested ones.
One of the laboratory attendants says he is busier during school days, where he handles about 400 units a day but during holidays, he handles about 80 units a day explaining the importance of schools in blood donation.

How it is distributed
Hospitals in every region request for blood from their regional blood banks. For hospitals around Kampala, blood is requested for, every day and others for six days.

Surgical and accident emergencies prompt many hospitals to ask for blood every day. Because it is universal (can be given to any blood group) blood group O is the most requested for. The blood is issued according to the stock available and hospitals have to account for the earlier blood units

Blood is free regardless of the ownership of the hospital. Both private and government hospitals are not supposed to sell blood to patients. Only health Centre IVs are supposed to carry out blood transfusions.

Who receives more?
• According to Dr Dorothy Kyeyune, the executive director of Nakasero Blood Bank, the disease burden consumes about 50 per cent of the blood collected, with malaria especially in children, being the lead cause of demand. Here is why. According to Dr Vincent Karuhanga of Friends Poly Clinic, malaria parasites feed on red blood cells. As the parasites multiply, more red blood cells are consumed leading to the reduction in the blood quantity. This then requires that the child is given blood.

• Women who get complications during birth and lose blood account for around 30 per cent of the receivers of blood.

• People involved in road accidents account for 10 per cent.

Challenges
With more than 34 million Ugandans, only about 0.2 per cent gives blood. That means about only 72,000 Ugandans are willing to donate. Also, limited funding has hindered blood drives with most of the funds coming in from corporate bodies.

The Permanent secretary in the Ministry of Health, Dr Asuman Lukwago, says they have given the central blood transfusion services an addition of Shs3b for more sensitisation on blood donation. Because students are the main blood donors, more sensitisation has been directed towards schools.

The government also has a master plan to have a blood bank for every regional referral hospital by 2017. The target is to have 13 regional blood banks by then.

To ease pressure on government blood banks, the government is also welcoming private blood banks with one at Mengo hospital already in place.

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