Health News of 2014-05-22

Blood: Essential medicine for saving lives

Blood transfusion throughout the world is an indispensable component of health care. It contributes to saving lives every year in both routine and emergency situations, permits complex medical and surgical interventions and dramatically improves the life expectancy and quality of life of patients with a variety of acute and chronic conditions.

The selection of blood donors, blood collection, testing, processing and use are purely technical and the use of Good Manufacturing Practice (GMP) and quality assurance in every aspect of these activities is required.

All the aforementioned processes are performed according to standard operating procedures by trained qualified staff of the Blood Service. However, the availability of this scarce human resource (raw material) depends entirely on the extraordinary generosity of blood donors who donate this most precious of gifts – the gift of life.

Voluntary blood donors, particularly regular donors, are recognised all over the world as the safest of donors because they are motivated by altruism and the desire to help others and by a sense of moral duty or social responsibility.

Current strategy of WHO

The current strategy of the WHO towards self-sufficiency in safe blood and blood products is based on 100 per cent voluntary non-remunerated blood donations. This strategy has evolved out of successive resolutions adopted by the supreme decision-making bodies of WHO to all its member states. Countries all over the world are, therefore, making strenuous efforts by embarking on various drives to reach this goal and Ghana is no exception.

Currently, Ghana has achieved only 28.1 per cent voluntary donations, that is according to the 2011 Progress Report on Availability, Safety and Quality of blood products; a figure which is far below the WHO projected 100 per cent voluntary non-remunerated blood donation target, even though the National Blood Service is working hard to meet the goal of countries in the sub-region.

Within the AFRO region, Ghana is classified under category C (countries that have attained less than 50 per cent Voluntary Non-Remunerated Blood Donation). Countries in category A in the West Africa sub-region that have attained between 80 and 100 per cent Voluntary Non-Remunerated Blood Donation include Ivory Coast and Burkina Faso (100 per cent), Togo (98.3 per cent) and Benin (92.1 per cent).

The National Blood Service, Ghana, has reiterated in all its communications to the public that indeed, blood needed for transfusion cannot be manufactured artificially. It must, therefore, be donated freely by well-meaning healthy Ghanaians, whether male or female, and between the ages of 17 to 60 years solely out of love for life.

Voluntary blood donor support

More often than not, whenever an appeal is made to the public for voluntary blood donor support, the question that is often asked is: Who benefits from the blood they freely donate?

It is indeed a legitimate question which all must be interested in answering. The truth, however, is that all voluntary blood that is collected is given to patients whose condition could only be managed by blood therapy and nothing else, and this process is referred to as the transfusion process. Needless to say, such patients may turn out to be closer than we think, since there is no telling who might need blood next.

In countries such as Ghana where diagnostic facilities and treatment options are more limited, the majority of transfusions are prescribed for the treatment of complications during pregnancy and childbirth, severe child anaemia, trauma, elective and emergency surgeries, and the management of blood disorders.

Haemorrhage

Haemorrhage, for example, accounts for over 25 per cent of the 530, 000 maternal deaths each year worldwide, 99 per cent of these are in the developing countries such as Ghana. Therefore, access to safe blood could help to prevent up to one quarter of maternal deaths each year and blood transfusion has been identified as one of the eight life-saving functions that should be available in a first-referral level healthcare facility providing comprehensive emergency obstetric and newborn care.

Children are particularly vulnerable to anaemia in malaria-prone areas as the parasites cause severe life-threatening anaemia, often exacerbated by malnutrition.

In Ghana, an estimated 1,323 people were killed in road accidents in 2013, according to statistics from the Motor Traffic and Transport Unit (MTTU) of the Ghana Police Service. Over five million people also got injured through these same accidents. These people often require blood transfusion during the first 24 hours of treatment. The timely availability of blood at emergency healthcare facilities is one of the determinants of patient survival.

The Southern Area Blood Centre, which is responsible for blood transfusion needs within the Greater Accra, Volta, Central and parts of Eastern and Western regions, need over 500 units of blood every day. In most cases, the National Blood Service is unable to meet this demand due to several factors, the first and most important of which is the difficulty in getting and maintaining voluntary blood donors.

National Blood Service

The National Blood Service, Ghana would want to reiterate that because blood is a drug which is administered to patients, we do not have to compromise quality and would want the general public to be guarded by this fact. For the blood to have its expected results, the Blood Service ensures that the entire blood safety value chain, from identification of potential donors, blood collection, testing, processing, storage, distribution, issuing of compatible blood for transfusion and usage is done in a validated and quality-assured manner. It is important to note that every unit of blood and blood components have a blood donation number, blood group and test results that allows the origin of the product to be traced from the patient to the donor.

This alone should make every donor and recipient of donated blood feel confident, secure and protected, knowing for sure that the National Blood Service is up to the task by ensuring safe, adequate and efficacious blood and blood products and also to ensuring its timely, accessible and affordable distribution to all hospitals in the country.