Blood Donation

As Nigeria joined the rest of the world recently to mark this year’s World Blood Donor Day, Martins Ifijeh writes on the need for Nigerians to imbibe the culture of voluntary blood donation

In many parts of the world, pregnancy is considered a beautiful thing.It is every woman’s dream to bring forth a child into the world. In fact, the pride of a baby bump is flaunted at every opportunity, even on social media because women in such climes are almost certain they will give birth safely. After all, pregnancy is not a disease, but a blessing.

The same cannot be said of Nigerian pregnant women who often times are unsure what the outcome of their nine months pregnancy journey will be. For them, it is a risky voyage which must be kept secret until the outcome is positive.

But can these women be blamed, since in Nigeria about 58,000 of them die due to pregnancy related complications every year -the second highest in the world- according to the President of the Association for Reproductive and Family Health, Professor Oladapo Ladipo.

The World Health Organisation (WHO) says of the several thousands of women dying from pregnancy related complications in Nigeria, more than half of such deaths are as a result of hemorrhage, better known as blood loss, often occurring during pregnancy, childbirth or postpartum complications.

Many healthcare facilities -public and private- where these deaths occur,complain of unavailability of safe blood in their hospitals or even in designated blood banks across the country.

Available information shows that one of the chief problems causing unavailability of safe blood in the country is because Nigerians do not have a culture of donating blood voluntarily, which the WHO says is the surest way of curbing scarcity of safe blood in a country.

Despite WHO insisting that one per cent blood donation by one per cent of the population of a nation can meet the citizens’ most basic requirements for blood, Nigeria still has scarcity of safe blood across the country, thereby resulting in several deaths of persons, especially women with pregnancy/maternal issues because healthcare providers are unable to replace the blood lost in these patients.

But Nigeria is not able to meet this minimum requirement. This is largely because 60 per cent of all blood donations are from commercial donors and 30 per cent from family replacement.

The WHO also says 57 countries are currently collecting 100 per cent of their blood supply from voluntary, unpaid blood donors with 112.5 million blood donations collected globally; and half of these are in high-income countries.

As Nigeria recently, joined the rest of the world to commemorate this year’s World Blood Donor Day, with the theme: ‘What can you do? Give blood. Give now. Give often’. Experts have called on Nigerians to cultivate the habit of donating blood voluntarily as often as they can.

They reasoned that if safe blood is available at every health facility in the country, the needless deaths occasioned by shortage of blood, especially among accident victims and pregnancy/childbirth hemorrhage, will drastically reduce or be curbed totally.

According to a Haematologist, Dr. Gregory Uwais, who stated that majority of those donating blood in Nigeria were either paid or family donors, said until Nigeria attains the level of voluntary blood donation, there would continue to be needless deaths.

He said for there to be adequate blood needed for transfusion challenges, accident victims, obstetric and hemorrhagic challenges, Nigeria must follow WHO’s recommendation which is at least one per cent of the population voluntarily donating blood, which he said should amount to about 1.8 million pints of blood per year being donated in the country.

“At the moment, blood supplies are not sufficient to meet the requirement, as only five per cent of blood used in Nigeria comes from voluntary blood donors. Others are from paid donors and family replacement. It is among those that donate blood we have that five per cent, not from the entire population,” he stressed.

He said he believed many Nigerians were not donating blood because they were unaware there was no negative health consequence attached to losing say one pint of blood. “Many Nigerians are healthy enough to donate blood, but some believe they don’t have adequate blood in them. Truth is, that you are slim or fat does not determine whether you have enough blood or not. Yours is to access a facility, where you will be profiled and checked adequately to know whether you are fit to give blood or not. If such a person is not fit, he or she will be told,” he added.

According to him, those qualified to donate blood must be within the recommended age gaps, which he said was between 18 years and 60 years, adding that such persons must be in general good health.

“Someone suffering from health conditions like heart disease, liver disease, diabetes, high blood pressure is advised not to donate blood. But anyone who is fit enough, should consider it his or her contribution to ‘living’ by donating blood voluntarily,” stressing that such donated blood may just be what a patient would need to be hale and hearty.

“Persons with human immuno virus, hepatitis, someone with low weight from 50 kg downwards, persons with tattoos, low hemoglobin, are not eligible to donate blood,” he added.

A Professor of Obstetrics and Gynaecology, Dr. Oluwa RotimiIreti says another way to curb the issue of shortage of blood was for the country to have a robust blood bank system, adding that this will drastically reduce deaths in the country.

“WHO has maintained that providing safe and adequate supplies of blood and blood products should be an integral part of every country’s efforts to improve maternal health. Studies have shown that safe blood transfusionis one of the key life-saving interventions that should be available in all facilities that provide emergency obstetric care,” he stated.

He stressed that provision of adequate blood facilities as well as increasing number of blood donors in the country would reduce the number of women dying during child births.

In the views of a member of the Lagos State Blood Transfusion Committee (LSBTC), Mr. Solomon Eka, at a voluntary blood donation drive, as long as Nigerian opinion leaders are opposed to blood donation, the country will remain far from attaining the required blood units for survival of patients.

“Presently, there are opinion leaders that do not support blood donation. If these opinion leaders are meant to have a change of attitude, and also demonstrate by donating blood, their followers will follow suit.”

Eka explained that regular blood donation also helps refresh anindividual’s blood. “It is not everybody that can donate, you must attain certain criteria before you donate, which include; you must be 50kg and above, blood pressure must be normal, PVC must be at an acceptable level to avoid any unforeseen crisis. Only healthy people aged 18 -65 are likely to donate blood,” he added.

According to the Minister of State for Health, Dr. Osagie Ehanire, in an address on World Blood Donor Day in Abuja, Nigeria requires innovative strategies for sufficient and safe blood supply.

Ehanire observed that access to safe blood transfusion requires innovative strategies to ensure safe and sufficient blood supply, to achieve 100 per cent voluntary blood donation and to ensure 100 per cent quality-assured testing of donated blood.

“There is also a need to optimise blood usage for patient health, develop quality systems in the transfusion chain, strengthen the work force, keep pace with new developments and build effective partnerships for safe blood.”

He acknowledged that while the demand for blood was growing in the developed world with longevity and increasingly sophisticated clinical procedures, national blood supplies were not sufficient to meet existing requirements in developing countries.

“Evidence-based strategies for blood safety and availability have been successfully implemented in most developed countries and some transitional and developing nations,” he added.

The minister said an adequate and reliable supply of safe blood can be assured by a stable pool of regular, voluntary, unpaid donors, who are also the safest group of donors, since the prevalence of blood borne infections was generally lowest among them.

Ehanire noted that it was important to create and expand a strong base of voluntary blood donors by healthy committed youths and adults, who consistently give blood to ensure adequate supply of safe blood throughout the year.

World Blood Donor Day (WBDD) is one of eight official global public health campaigns marked by WHO. Every 14 June since 2004, countries around the world celebrate the event on the birth anniversary of Karl Landsteiner – the Austrian-American pathologist and immunologist who distinguished the main blood groups.

WBDD serves to raise awareness of the need for safe blood and blood products and to thank blood donors for their voluntary, life-saving gifts of blood.