Saturday, October 21, 2017

Better blood transfusion service needed


An eight-year-old child has contracted HIV from a blood transfusion.Why aren't heads rolling?
Why aren't we being told the whole story behind this tragedy?
It is evident that something went wrong. Why aren't we being told what that was or who was responsible?Why isn't there transparency? What is being done to deal with the panic of people who have gotten blood transfusions and who have to get blood for surgeries or blood transfusions now after this shocking news?
How on earth can telling a nation that affected families are receiving “counselling” bring any relief? Yes it's important, but we need answers.
We want facts.
We want the assurance that this will never happen again.
HIV has no cure. This child is now inflicted with a lifelong disease. No amount of millions or even billions of dollars can take that away.
This is a situation to anger any human being.
Can you imagine what this child is going though? The family? My heart aches.
A patient of mine had a newborn who received a blood transfusion two months ago.
She visited my office last week when the news broke and she was very upset, mortified at the thought that her baby could have been a victim.
People are plunged into fear, and rightfully so.
How can these fears be alleviated?
The blood bank is in dire need of proper management.
Past and present administrations are guilty of not putting proper management in place. The population is left to suffer. Last year, through this column, I raised concern over the deficiencies at the blood bank.
Nothing was done then and we have no assurances that anything will be done now as there's a cloud of mystery and secrecy as to why a child contracted HIV and what safeguards and protocols are being put into place now. I'm very sorry to state this but had changes been made before, that innocent child might not have been a victim today.
It is ridiculous; pure madness!
We have people complaining that when they go to give blood, they are willing and able but if they don't arrive before 10 a.m., the blood bank is closed and yet still we complain about a shortage of blood in the country.
When I was training as a young intern many years ago, the blood bank was open up to 6 p.m. and donors could go and give blood at their convenience.
Blood samples were taken by trained personnel, written protocols were adhered to, the samples would be screened for infections by two different technicians at the same time and if there were any discrepancies, confirmation had to be sought and a thorough investigation conducted before dispensing the unit of blood to the required facility.
So, is this a human error in testing a sample accurately?
We need to know.
The doctors and nurses need to know. The patients and their families need to know.
The National AIDS Control Organisation (NACO) said despite the best testing facilities, there still exists a period during which an infection cannot be detected by any test, even the nucleic acid test (NAT).
This problem is not new.
In the 1990s in China thousands of persons became infected with HIV via blood transfusions.
This horrified the medical world back then, but thank God HIV is no longer considered a death sentence and with the right treatment patients live long and productive lives.
Even back in 1969, 25 per cent of patients got hepatitis from transfusions and now it's closer to zero per cent.
Protocols were developed to decrease transfusion infections and these were highly successful.
Usually there are five layers of safety put in place 1) education, so the high risk donors themselves would not come
2) screening patient questions to eliminate high risk donors
3) testing of the patients
4)q uarantining of the blood for a while until it was guaranteed safe
5) quality practices.
But humans are needed to ensure all these protocols are adhered to and thus there is the risk of human error.
In May 2016 the Times of India reported a 3-year-old boy from Assam Kamrup got HIV via blood transfusion.
He attended Gauhati Medical College and Hospital and had a series of surgeries to help with a 40 per cent burn injury.
It was a case of human error.
Some people belonging to the Jehovah's Witness faith quote the biblical Book of Acts which speaks about abstaining from blood; they do not face the dilemma of receiving blood and going into panic mode to test months after a surgery.
But millions globally receive blood from others every day.
Anyone who received blood for a surgery recently must be concerned.
Thankfully there are many centres where one can be tested freely.
This tragedy does not happen very often but when it happens it causes great concern.
One is too many.
Blood is the gift of life, it has saved and will continue to save many lives.
The vital role of a director at the blood bank needs to be appointed to oversee this important institution which was left rudderless for too long.
We need written guidelines, transfusion specialists, strict control to ensure there is accountability and most importantly staff who are caring and willing to ensure that we are safe. We can't afford to have any mistakes.
Now is the time to get vex and insist that there is change and not just lip service.