They wait, hoping someone somewhere will give them life, just by donating blood they are unable to afford or access. This is the story of people who have died for lack of blood and how Nigerians can change future stories.
Narratives
Mrs. Martha Abu, after being married for 10 years, finally welcomed her first child, a baby boy, on August 15. Unfortunately, a month later, the baby was diagnosed with jaundice, a medical condition with yellowing of the skin or whites of the eyes. Three days after admission, they were asked to get blood type O, for the baby’s transfusion. The Abuja-based hospital had no blood available and they had to resort to buying blood elsewhere. They were charged N15, 000 per pint, meaning three pints would cost them N45, 000, so they sought for any relative with the same blood type who could donate. This became a problem and dragged for five days until the baby died.
Another scenario involved two-year-old Hafsah who has a tumor on her face. She was scheduled for surgery on September 20, to have the tumor removed and the doctors said three pints of fresh blood was crucial to its success. The blood type needed was A-plus.
The blood Hafsah needs can be gotten from the National Blood Transfusion Service (NBTS) but the family can hardly afford it. They turned to the public for help, but everyone wanted something in return before donating their blood. So she was discharged and awaits now for a willing donor.
After Adama Mohammed had her 5th child in August 2017, she bled to death. This happened because all efforts to get her extra pint of blood asides what she had donated as required during her antenatal proved abortive. The hospital lacked blood and asked the family to get people to donate. Before an extra pint could be cleared and brought to her, she gave up, leaving her new born baby and family in agony.
Donors
A voluntary donor, Malam Usman Sani, 38, tries to donate blood every three months since he noticed what women pass through in hospitals. Always on a mission to pray for the sick, he was touched by the state of women with complications during child birth. “If I can’t make financial impact in someone’s life, I can at least save one through this means,” he said.
Madam Franca, a mother of two who is pregnant with her third child said her husband always donates blood for her whenever she is pregnant. Though she ends up not using it, she says she is happy as long as it helps save lives of other women in life threatening situations.
The situation of lack of blood has become worrisome to Mallama Hannatu who uses blood donated by her husband because she always has a case of bleeding after childbirth. She has good reason: “I have witnessed about three women die after childbirth, so asides the blood collected from my husband during antenatal, I have my relatives stand by in case more blood is needed. In that light, I also donate blood and have made it a point of duty to remind my family members to donate because we don’t know whose life depends on it.”
Nathaniel Yakubu’s wife was expecting her first baby and he was asked to donate blood, “just in case your wife needs it,” he was told. He did, and paid N3, 000 for the bag used to store it. Later, after his wife’s safe delivery, he realized that he gave his blood for free and yet there’s no guarantee those who may need it will be given free. This discouraged him from donating blood, “after all, it’s like business to the hospitals. At least, I will be happy knowing that I paid for donating my own blood and another person who needs it will get it for free, especially if he or she can’t afford it.”
Blood scarcity
Lack of blood is a serious problem in Nigeria. Health practitioners have always advocated that it’s crucial for women to have rapid access to adequate, safe and affordable blood for transfusion. But the question today is how many women, children or even men have easy access to safe and affordable blood in Nigeria?
The Woman Trial Event and Blood Clock event which launched on the November 9 in London which had the founder, Wellbeing Foundation Africa, Mrs Toyin Sarki in attendance representing Nigeria, discussed how to stop women from bleeding to death during childbirth.
The event was aimed at raising awareness on the issue of severe bleeding after childbirth (postpartum haemorrhage) which kills around 100,000 women globally each year. Women dying due to blood loss in hospitals or at home have become a recurring incident in the country. It is not news that the lack and scarcity of available blood in most hospitals has had a huge effect on the increasing number of deaths of mothers and children.
Blood is often needed during or following childbirth, or for an exchange transfusion in new born babies.
Reality
Monitoring social media and other social apps for health institutions in Nigeria, the request for blood donation for a particular blood group is something that happens every two to three days. This signifies that the country is in dire need of adequate blood availability.
Nigeria Health Watch once tweeted that too many patients are lost in Nigeria every year due to lack of donor blood. The requests for blood donation ranged from victims of cancer, sickle cell, leukemia, anemia, pancreatic, pregnant women, new born babies and a whole lot of others.
Every year during the World Blood Donor Day, beautiful policies and strategies are proffered but how realistic has the implementation levels been? All over the country, lives are lost on causes of childbirth, accidents, illnesses and so many other medical issues due to the fact that blood is not readily available when needed to save lives. Blood transfusions over years has become one of the most versatile tool used in medicine for saving lives, yet the availability of blood seems to be very scarce nationwide as many die on hospital beds due to the scarcity of it or lack of funds to purchase a pint of blood.
Saddle of the NBTS
The Core Mandate of the National Blood Transfusion Services (NBTS) is to provide a centrally coordinated blood transfusion service on a country-wide basis within the National Health Plan; provision of safe, quality and adequate blood in an equitable and accessible manner.
With the establishment of the NBTS by the Federal Government in 2005, it is expected that it would provide a reliable platform for safe and quality blood availability to all those in need but unfortunately, the opposite is the case as they are faced with some challenges and limitations.
Research says only 51,433 units of blood are collected from the NBTS annually, when a whooping amount of 1.8 million units are needed yearly across the country.
Daily Trust paid a visit to the NBTS office in Abuja where Dr. Omo Izedonmwem, the Abuja branch coordinator of the NBTS shed more light on the issues faced at NBTS, including how blood is not always readily available for all emergencies because of the gap between what is required and what is needed. “The number of blood donated voluntarily cannot go round to meet the stipulated need for those who really need the blood,” he said.
When asked the total number of pints readily available in the blood bank, he said no exact number is readily available in store. “On a daily basis, people are donating and some other people are in need of blood, it depends on how much the demand is.”
In situations where the O blood group is usually scarce and the need arises, the coordinator said a record of donors with the O blood group is usually kept to enable them reach out to them when the need arises.
Blood storage
Dr. Izedonmwem also explained that the blood bank is restocked every day as the center gets about 10 to 20 voluntary donors a day. He added that 4,000 unit of blood per month is needed to meet the blood banks’ needs yet they don’t get up to 600 per month and the individuals who donate don’t come at once, after which the blood will be screened and saved in the blood bank.
The blood is stored in a blood bag with an anti-coagulant and also in the refrigerator, with a maintained temperature of 2 degrees centigrade. The blood can be saved for a period of 32 to 35 days depending on the manufacturer.
Cost of Blood
Speaking on the issue that blood is being sold to patents Izedonmwem explained that “blood is not sold to hospitals or individuals, rather the hospitals collect the quantity they need after passing through the necessary protocols and an average of 200 to 300 pints of blood are collected. As for individuals, they don’t pay for the blood but rather pay an access fee and administrative charges of N5, 000 per pint of blood. This is for the screening of the blood and other materials that will be used for screening.”
The blood available in banks are usually voluntarily donated by persons as charity. The coordinator explained that it is against internal practice to give any stipend to people who donate. We make the donors see the advantages of donating and give them some other benefits beyond stipends, like counseling them on healthy living. Sometimes we give them light refreshments and if we have indigenes coming to donate, we assist with their transport fare.”
Funding
Every good cause has its challenges and the NBTS is not left out. The major challenge affecting the service is funding. Daily Trust gathered that sometimes there is zero allocation and at times N50 million budgeted, out of which the final amount released may be just N10million to N20 million to take care of the whole country, which is not even up to the amount just one of the 17 centres uses in a year.
Also, according to Dr. Izedonmwen, the main source of funding came from the American government through PEPFAR. “Before our part funders, the Health Systems Development Funds and the United States President’s emergency fund for AIDS relief, PEPFAR pulled out about a year ago. Considering that our activity is fund based, we also have a challenge of engine equipment which was procured about 13 years ago. Those are the machines we are still using and it is becoming obsolete, there is a need for investment in that area.”
He pointed out that some of the equipment bought when the Americans were fully funding the service is getting old and the NBTS needs money to buy reagents, keep generators running and also keep the blood wholesome and fresh, which involves a lot of money.
Izedonmwen added that “we recruit staff and train them on what they need to know. We also mobilize staff to sensitize the public on why they need to donate blood today to save a life. Screening the blood also needs money and diesel for the generator to keep the equipment running even in the absence of electricity.”
Social media blood donor activists
It is a well known fact that the Nigerian government alone can not carry the burden of blood bank funding. The reason why some blood donor activists have taken it upon themselves to advocate and enlighten the public concerning blood donations. They do not only advocate but also help in sourcing for blood from the general public for patients who need transfusions urgently. Some of such are SCAF_Nigeria, they are a sickle cell foundation that source for blood for sickle cell patients. Their slogan is ‘5 minutes of yourtime plus 350ml of your blood equals one live saved’. Blood Plus Project, they are an independent campaign group raising awareness for the need for regular and non-remunerated blood donation. Another is the Life Bank Nigeria, theymake blood available when and where it is needed. They mobolise donations and takeinventory of all blood available in the county, and deliver to the point of need. They use an effective cold chain system to deliver blood safelyto hospitalsand eventually save lives. Temi Giwa founder ‘Life Bank Nigeria’ in a tweet said she wastired of the senseless death and that is why the Life Bank Nigeria was created. Life Bank has been in existence for almost two years now. Haima Health is another plafform where patients seeking blood go to. They are a platformlinking blood donors to patients, organizing blood drives, building a data base of blood donors and saving lives. The general believe for each of these activists is that every donor is a hero.
The way forward
The way forward to having a sustainable and viable blood bank in Nigeria is that the government takes full responsibility in making adequate budget and funds available to the blood banks in the country. As it is today, the budget for the whole of the health sector in Nigeria is relatively low, which translates to the budget for the NBTS being insufficient. There is also need for full implementation of the National Blood Policy; that way safe blood will be readily available, which will automatically translate to the maternal and child mortality rates reducing in the country. There is also need for the relevant agencies to indulge in aggressive advocacy and sensitization to the public on the importance of blood donation. It’s high time we educate and change the perception or myth in the society that donor blood is used for diabolical activities.
A good starting point will be to refrain from talking about blood only during the blood donor day. This is one thing that should be talked about every day till individuals understand that donating blood is all about saving lives.
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