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Kathmandu Sunday October 01, 2000 Aswin 15, 2057.
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Blood safety issues and
their implication
By Pitambar Aryal
Blood is a life sustaining fluid of every
human being. All biological developmental processes in a living person would not be
possible in the absence of blood. WBC, which is an integral compound of blood, plays
significant role in the human immune system. Likewise, other components have other
specific values in different functions in the body. In this way, blood circulation has
been putting essential effort to manage whole body functions in terms of transportation of
soluble forms of food nutrients, transportation of oxygen and purification of air within
and develop immune system for the protection of body against various micro organisms like
bacteria and virus. Blood also helps to excrete various waste minerals and salts from the
body. In fact, we can deduce that without well functioning blood of the human existence is
not possible.
Keeping in view the above fact,
WHO/International Federation of Red Cross/Red Crescent Societies observed World Health Day
on 7 April 2000 with the impressive slogan as: safe blood starts with me. The whole year
2000 will be marked with various activities focused on the slogan. The emphasis has been
given on awareness campaign and long-term advocacy programme throughout the world.
The Red Cross, a humanitarian
non-governmental organisation, has been providing various levels of humanitarian services
throughout the world since its establishment. The blood transfusion programme is one of
the major programmes of the International Federation of Red Cross and Red Crescent
Societies (the Federation). It may be the reason why WHO has involved the Federation to
conduct various activities on the occasion of World Health Day.
The main objectives of the day are to raise
awareness on blood safety issues globally, to encourage member-states to commit to and
support national blood programmes and to enact national legislation or legal framework for
national blood programme to ensure the provision of safe blood, to promote and retain
voluntary blood donors (altruistic), non-remunerated blood with low risk people.
Being a member society of the Federation,
Nepal Red Cross Society (NRCS) has been implementing various humanitarian developmental as
well as awareness creating activities through its different departments throughout the
kingdom since its inception in Nepal. Among these activities, blood programme is a
priority programme and the government of Nepal has handed over the sole responsibility to
NRCS for carrying out blood programme in the country. The central blood transfusion centre
was established in 1966 in Nepal and there is no commercial blood centre. All required
blood is collected by volunteers or by replacement donors. There are 45 blood transfusion
service centres in the country now, which are being run by the NRCS in 37 districts. These
centres are not enough to meet the nation's demand so far. These centres are mostly
located in urban areas of the kingdom. It is indicated that demand of blood varies based
on country situation and existing health facilities. Hence, demand of blood is higher in
major cities than in smaller towns. It is a difficult task to manage blood programme. The
NRCS is motivating youth through its 500,000 members organised under more than 2,500
junior/youth circles throughout the kingdom. However, motivational programme is not enough
to impart knowledge to meet the need and importance of blood. It is felt need that safe
blood education is necessary in the secondary as well as in the higher secondary schools'
curriculum to institutionalise blood service.
Emerging issues and their implication: Safe
blood is the most important element to maintain healthy life. The 21st century is
approaching to various health problems due to the emergencies and crisis of blood. In
Nepal, there is a very large proportion of people having limited access to health delivery
services. Most hospitals and health centres are concentrated in urban areas. Surgical
cares are carried out in those areas. Consequently, demand of blood is intensive in urban
areas. Likewise, low people with socio-economic, educational status are generally weak in
their position to adapt safe behaviour and avoid risky situations. According to NRCS Blood
Transfusion Centre, all the necessary blood is being collected through voluntary
non-remunerated donors and most of them (65%) are from 18 to 35 years of age group. The
records indicate that most of the blood donors are young and of physically and mentally
productive age group.
Nowadays, HIV is becoming a great challenge
for safe blood programme. Due to technical problem of window period, it is highly
difficult to identify whether donated blood is HIV positive or negative, although
pre-counselling service is being carried out to determine risk behaviours. Research
reports indicate that HIV prevalence rate is growing rapidly in young adults. It is also
indicated that more than 80% adolescent and youth, who are injectable drug users, possess
HIV positive. It is also difficult to detect early HIV or STD patients with no clinical
sign and symptoms. If any fault occurs to determine the serum status, the result will
bring a disaster.
To overcome the above problems, WHO and the
Federation expect political commitment and support from health authorities in countries
with approval and implementation of national policies and plan, increased general public
awareness and understanding of blood safety measures resulting in increased donations from
voluntary non remunerated blood donations from low risk population and increased awareness
among health professionals as to the importance of blood safety and their role in
supporting safe blood programme.
Special attention should be given by the
donors on adopting safe behaviour in terms of STD/HIV transmission, hepatitis, and blood
born diseases. Most of the physicians and surgeons recommend depositing blood for clinical
purpose but it may not be urgent as they think. Due to this, blood may not be utilised
appropriately and returned on time. So, there is a possibility of degradation in the
quality of blood. Blood programme is expensive because NRCS only charges for the cost of
blood bag and tests but does not charge overhead costs.
One can donate blood if he/she is eighteen
years old, over and once in every three months. Blood donation does not harm the body. The
blood donor is checked by trained persons or by a physician before donating blood. This
contribution will save someone's life that is struggling in between for life and death.
As it was stated earlier, the government of
Nepal has sole responsibility to NRCS to carryout blood programme. Although there are
several strengths while operating blood programme by Red Cross e g nationwide network,
humanitarian non governmental organisation, one of the largest voluntary organisations, 3
percent national population is covered by Red Cross volunteers with reliable services
however, there are many challenges as well. To face the forthcoming challenges and
strengthening the programme, it needs support in terms of financial as well as human
resources. Therefore, it needs strong commitment from the government in order to mobilise
resources, technical hands and development of long term vision, mission and strategy as
well. We hope that this day will provide new insight and perspective to solve the emerging
challenges through collective and collaborative efforts.
Conclusion: Safe blood programme is not
possible only through professionals who are directly involved in service programme.
However, great responsibility goes to the donors who provide the blood. Therefore, it is
requested to all volunteers and replacement donors to adopt safe behaviours in order to
make his/her blood safe and save life of the recipient. Further, for making safe blood
programme easily accessible and effective, it needs strong commitment and support of the
government. In this endeavour, every Nepali's contribution would be required to make blood
transfusion service safe. Therefore, let us join hands together to make safe blood
programme a grand success.
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