I Love My Local Blood Bank

My sister is in Nigeria this summer interning as a nurse at some pretty rural hospitals. She sends us stream-of-consciousness emails every week or so detailing her wide-eyed experiences that are always weighted with complex health and socio-economic issues.

This time she tells us about a simple yet crucial system that is lacking in rural Nigerian hospitals: blood banks. I guess the lack of a stable blood bank system is a big problem for rural Nigerian hospitals making long surgeries difficult.

These email excerpts sum up the problem well (Note: She writes these email fast due to electricity/internet problems):

… Apparently there had been an accident and the person needed blood immediately.

In a previous email, my sister detailed how fatal car crashes happen at an extremely high rate.

…Here there is no way to store blood because the constant lack of electricity prevents freezers from staying cold. So, if you need blood, you had better hope that there is someone nearby willing to donate blood. It was so sad, because noone seemed to have O- blood or at least none willing to donate. Mr. Giebel came back in more of a panic 10 minutes later and begged anyone who had O- blood to come forward, but still noone offered.

…Dr. Giebel had gotten one pint of blood, but said that he needed at least 4 more pints because the pregnant lady was going to have an emergency operation. At this point Dr. Giebel was calling people in other villages desperately trying to find blood in time to save the patient.

Her hospital tried to run a small blood bank in the past but they couldn’t keep the blood at the right temperature due to frequent electricity drop-outs. Also, she says running a generator/battery-powered bank is too expensive for the hospital.

…The ER doctor’s quickly put me to work by having me help transfer the lady to a stretcher. When we moved the lady even the doctor’s gasped when they saw the large pool of blood underneath her. We quickly transferred her to the operating room with blood dripping along the sidewalk as we went. When we got to the operating room the doctor’s were in such a hurry that we just slipped off our shoes and went rushing into the operating room. After we got the lady on the operating table we started trying to slip off her dress without having to cut it. When they were tugging the bottom blood sprayed all over one of the medical students (on his skin, in his eye and everything) and all the doctors said was “sorry”…. i mean, this guy probably has AIDS or something now. I am just glad that I wasn’t standing at the feet of the lady!

Wow. Blood in the face isn’t good.

…Every 30 minutes Dr. Giebel kept telling people to go and beg for the blood bank to find blood.

…We somehow managed to get 3 pints of blood for the lady and she actually made it through the procedure and was breathing on her own by the end of the 3 hour surgery. At 2 pm I left because the lady had made it and all we really needed were 2 more pints of blood and she would be completely fine.

…

…An hour and a half later I was told that more blood had never come and she had passed away!

Damn.

If anyone knows about good blood bank solutions for rural hospitals with unsteady/gray power grids let me know.

Rick Ward

Hey Andrew,
Cool Blog. Here's an article about the opposite problem up in the state of Haryana, India. Blood Bank without anyone to run it.

To more directly answer your question: Artificial blood for emergency use is under development that requires little or no refrigeration, but is still experimental, and probably expensive.

As your sister encountered, there are some real problems out there that hopefully we can help overcome through technology (in this case maybe solar electric or wind power generation would help), funding for rural development, and trained people willing to invest their time and abilities.

Thanks for your interest, and for taking the time and effort to run this blog. Hopefully you are having a great experience since graduation.

http://www.tribuneindia.com/2002/20020505/harya...

2-yr-old blood bank awaits employees
Rahul Das
Tribune News Service

Ambala, May 4
A blood bank which was inaugurated with much fanfare two years back in Civil Hospital, Ambala Cantt is yet to become fully operational.

Although refrigeration of blood is being done at the new blood bank, testing of the blood has to be carried out at the blood bank located in Civil Hospital, Ambala City, from where it is transferred to the new blood bank.

Union Minister Sushma Swaraj had inaugurated the blood-bank building, constructed from the funds provided by Mr Swaraj Kaushal, the MP under the MP Local Area Development scheme on July 15,2000. Equipment for the blood bank was donated by Rotary Club, Ambala, Rotary Club, London and Rotary International, USA.

A recent direction from a senior district health officer for shifting some support equipment from the blood bank as it was not yet fully operational has stirred up a hornet’s nest. Rotary Club members are up in arms over the direction since they feel that the purpose of contributing for a much-needed blood bank would be defeated.

President of Rotary Club, Ambala, Dr Anil Jain, said that the support equipment in the blood bank was provided so that it became functional and there was medical intervention during times of need. “We have learnt that a direction was given by the Civil Surgeon for sending a refrigerator to Ambala City,” he said.

Dr Jain said that if the support equipment in the blood bank was transferred, it would be difficult to get it back. “The blood bank needs to be made fully operational since Ambala Cantt is sandwiched between the national highway and the state highway, where a number of accidents take place,” he said.

He said “We have been told that the blood bank, which was inaugurated two years back, is only, partially operational since trained manpower like lab technicians and blood transfusion officer were yet to be appointed”. “Once the blood bank becomes fully operational, absence of support equipment will be a handicap “he added.

Former president of Rotary Club of Ambala, Capt (Retd) Baldev Singh, said that it was sad that efforts made by us will come to a nought if support equipment was shifted. “We demand that the blood bank should be made fully operational at the earliest,” he said.

However, Civil Surgeon, Dr S.L. Kaushik, said only temporary shifting of the refrigerator of the blood bank at Civil Hospital, Ambala Cantt to Ambala City was required but it was eventually not carried out as the refrigerator in Ambala City was repaired.

The new blood bank is partially operational, since staff needed to man the blood bank for 24 hours is not yet available. Right now there is only one Laboratory technician while we require at least three Lab technicians, one reliever, one staff nurse and two Class IV employees, besides the Blood Transfusion Officer, he said.

Dr Kaushik said that he had taken up the matter with higher authorities. “About 25 units of blood are stored in the new blood bank and the tested blood is sent from Ambala City blood bank,” he said. “I must stress that no patient has been refused blood and we always make arrangements for blood,” he added.

Deputy Commissioner Ambala D.D. Gautam, said he would take up the issue of making the new blood bank fully operational with the authorities concerned. The question of allowing “shifting of support equipment, does not arise. The equipment meant for the blood bank will be utilised there itself and no transfer will be permitted,” he said.

Andrew Meyer

Hey Rick. Interesting article. My sister says her hospital tried a small blood bank in the past but unstable power and zero budget killed it. Sounds like they need something really hearty and fool-proof. And cheap.

I Love My Local Blood Bank

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