By Elijah Ugani – Calabar
TOWARDS A SUSTAINABLE CONTEMPORARY BLOOD DONOR PROGRAM
By
Senator Professor Sandy Ojang Onor,
National Assembly Complex,
Abuja.
It is a privilege and honour for me to give the keynote to this professionally distinguished audience on this auspicious and remarkable occasion commemorating the World Blood Donor Day.
When I was contacted a couple of weeks ago to give this address, I wondered why I was being honoured, or should I say, saddled with this challenging responsibility considering the fact that though blood flows in my veins constantly, I am a complete “outsider”, and a total stranger in matters connected with the epistemology of blood.
The centrality and criticality of blood to human existence has been known to mankind through time and space. Because of this, nobody can claim total ignorance of the fact that man and his many cousins in the animal kingdom cannot survive without blood; indeed, its inadequacy signals the beginning of the end of life. Beyond this elementary knowledge, many of us, especially scholars of the humanities would not dare to venture into the contentions and contestations among medical and biological experts on blood.
Against all this, I accepted the invitation to deliver this keynote address because of my deep respect for medical personnel who always put their lives on the line for others, not minding the kind of environment in which Nigerian medics work – an environment of severe deprivation, of strains and stresses, of disappointed hopes, and of uncertain future.
I was informed that this occasion is part of the activities marking the 2020 World Blood Donor Day. A quick check on the internet reveals that the World Blood Donor Day is celebrated on 14th June every year to raise awareness on the need for safe blood and blood products and to thank voluntary, unpaid blood donors for their life-saving gift of blood and also to raise awareness of the need for regular blood donations to ensure that all individuals and communities have access to affordable and timely supplies of safe and quality-assured blood and blood products, as an integral part of universal health coverage and a key component of effective health systems. The event is holding in Calabar today due to the postponement occasioned by the novel covid-19 pandemic.
The global theme for this year’s celebration, which has already been held in several corners of the world is “Safe Blood Saves Lives”. It is promoted with the slogan “Give blood and make the world a healthier place.” The idea is to focus on the contribution an individual giver can make to improve health for others in the community. This slogan aims at calling on more people all over the world to become life-savers by volunteering to donate blood regularly.
The three basic functions of blood – transportation of gases, nutrients, waste, cells and hormones throughout the body; protection against diseases through phagocytic white blood cells and antibodies and the regulation of pH, temperature, water content of cells are essential to the proper functioning of the human body. Blood supplies oxygen and nutrients to body cells, remains invaluable in the practice of medicine and in saving the lives of patients. The need for blood by patients is such that every few seconds, someone somewhere will need blood transfusion. Since blood is not manufactured, the need for a robust sustainable blood donor programme cannot be overemphasized.
The good news, according to the World Health Organization (WHO), is that a population’s annual need for blood can be met by 1% of the population who are regular voluntary blood donors. This means that Nigeria with a population of about 200 million needs 2 million regular donors per year, and Cross River state with 3 million needs just 30,000 regular donors, annually.
Lastly, beyond maintaining adequate donor pool, blood utilization must be made efficient to avoid unnecessary transfusions and wastages.
There are several situations that trigger the need for blood. Some of the well-known situations are: blood disorders, pregnancy complications, surgical operations, road traffic accidents, fire incidents, and natural disasters, among others. Timely intervention with transfusion of safe blood in such critical cases is known to be live saving.
Despite current advances in the field of medicine, there are still medical conditions that have no other remedy than blood transfusion. Consequently, there is always the need to make blood available through blood donation. Apart from saving the lives of patients, blood donation benefits the donor as well. The practice of routine blood donation improves the health and well-being of the blood donor as it provides opportunity for a mini health check. The potential blood donor undergoes several medical and laboratory tests which helps him stay healthy, and where any abnormality is detected, early intervention can be commenced.
Furthermore, donating blood reduces excess iron, fat, and cholesterol, while making the bone marrow which produces the blood healthy and active. With these attributes of blood donation, the practice is not only imperative for the blood recipient but presents a win-win situation for both blood donor and recipient.
While blood is vital in several medical conditions, it is important that the blood is both safe and available in a timely manner.
The need for safe blood is universal. Safe blood is critical both for treatments and urgent interventions. It can help patients suffering from life-threatening conditions live longer, with a better quality of life, and supports complex medical and surgical procedures. An adequate supply of safe blood can only be assured through regular donations by voluntary unpaid blood donors. This is why the World Health Organization in 2005 designated 14th June every year as a special day to thank blood donors and encourage more people to give blood freely. But access to safe blood is still a privilege of the few. Most low- and middle-income countries struggle to make safe blood available because donations are low and equipment to test blood is scarce.
Globally, 42% of blood is collected in high-income countries, which are home to only 16% of the world’s population.
Transfusion of unsafe blood could be worse than not transfusing blood at all and as such every effort must be made to ensure the safety of blood. Even as the world marks the 2020 World Blood Donor Day amid the COVIID-19 pandemic, the World Health Organisation which believes that it is still safe to donate blood at this time, however, warned that donors and blood collection centres must apply extra caution and follow laid down requirements during the process. The safety of blood starts from careful selection of blood donor, through adequate testing and processing, to proper transfusion practices. To ensure provision of safe blood, cost is usually incurred especially in testing, and processing of blood. Studies have shown that commercial or paid blood donation reduces the safety of blood and World Health Organization (WHO) condemns sourcing blood from such donors. Thus, the campaign for regular, voluntary, unpaid, blood donation.
Apart from ensuring safety, timely provision of safe blood is equally as important since this may be a determining factor between which patient lives, and which one dies. Blood and blood products are essential to care for women with pregnancy and childbirth associated bleeding; children with severe anemia due to malaria and malnutrition; patients with blood and bone marrow disorders, inherited disorders of hemoglobin and immune deficiency conditions; people with traumatic injuries in emergencies, disasters and accidents; patients undergoing advanced medical and surgical procedures, to mention just a few. This underscores the need for constant availability of safe blood in our health facilities.
A combination of robust blood donation programme and adequate facility for storage is needed to address the challenge of constant availability. Fortunately, the expertise, human and material resources to realize these abound in our environment but need to be harnessed.
There are several challenges militating against development of a robust blood donor programme, as well as timely provision of safe blood. Although challenges exist in the technical, attitudinal, and political aspects, the latter two pose greater problems in our environment. Whereas individuals in developed countries take pride in donating blood, our people are quick to come up with reasons why they will not donate their blood. Some of the reasons put forward include inadequate feeding, fear of developing shortage of blood and some belief in spiritual implications.
Additionally, there are no proper incentives to motivate potential donors, such as recognitions, free tickets to social events or some medical incentives. One of the fundamental aims of the world blood donor day is to encourage people, who might be a bit nervous or unsure about giving blood, to feel encouraged to sign up and start donating, so that the donor population doesn’t decline but stays strong. I use the opportunity of this keynote to appeal to everyone to find out his/her blood type and register as a voluntary, unpaid, blood donor and help make the world a healthier and safer place.We also need to encourage our friends and family to become regular blood donors.
The effort of various International organizations, including the World Health Organization, the International Federation of Red Cross and Red Crescent Societies, the International Federation of Blood Donor Organizations and the International Society of Blood Transfusion, among others, is both commendable and worthy of emulation. Individuals, groups, organizations and governments need to collaborate to save millions of lives annually.
On the political side, there is suboptimal support in terms of legislations, policies, and funding. Funding is very crucial as setting up and maintaining a robust blood donor programme is financially demanding. Budgetary allocation for health sector in Nigeria is a far cry from what is recommended by international communities.
To ensure proper testing and processing, as well as maximize the utility of blood and minimize wastages, several expensive equipment are needed. While not making excuses for government, there is no gainsaying that government cannot do it alone. There is room for everyone (corporate organizations, non-governmental organizations, public spirited individuals and groups, philanthropists, etc) to support the funding of this critical aspect of healthcare, as without funding, mere donation of blood will achieve very little.
At this juncture, I quickly commend the gesture from 1995 graduating class of Calabar University Medical Students Association in building and donating a wonderful edifice to the department of Haematology and Blood Transfusion, UCTH, for blood donation. Members of the public, other alumni and corporate bodies are enjoined to emulate this laudable gesture.
This year’s theme is also a call to action for governments, national health authorities and national blood transfusion services to provide adequate resources and put in place systems and infrastructure to increase the collection of blood from voluntary, non-remunerated blood donors; to provide quality donor care; to promote and implement appropriate clinical use of blood; and to set up systems for the oversight and surveillance on the whole chain of blood transfusion. There is the urgent need to raise wider awareness of the need to increase the availability of safe blood for use wherever and whenever it is needed to save life. Everyone who can donate blood should consider making regular voluntary, unpaid donations, so that people in need will have access to safe blood transfusions, when and where they need them.
Finally, I call on individuals and organizations to assist blood banks to optimize their blood donor recruitment programs with relative ease. This will help to arrest the downward trend in blood collection in the midst of the ever-increasing demands for blood transfusions.On the other hand, governments and non-governmental organizations should give priority to the funding of blood centers, capacity building and manpower training.
As the largest black nation in the world, the Covid-19 experience has taught us that we should give attention to our healthcare institutions. Nobody can doubt that it would be hell for Nigeria if blood transfusion was the gold standard treatment needed for Covid-19 infection. As lucky as we are, we have to admit that the future is unpredictable.
It remains for me to pay special tribute to the Hematology unit of UCTH for its continuing interest in the health and wellbeing of the generality of the people. For the rest of us, I urge us to join the league of voluntary, unpaid, blood donors. Everyone should support this campaign by selflessly donating blood and encouraging others to donate. Special commendations, once again, to 1995 graduating class of Calabar University Medical Students Association for building and donating a wonderful edifice to the department of Haematology and Blood Transfusion, UCTH, for blood donation. There is a new opportunity, as we commission the blood donor centre today, for altruistic donations (both financial and material) towards equipping this blood donor centre.
I therefore urge everyone to key into this uncommon opportunity to give back to society. I wish you remarkable success in this year’s celebration of the World Blood Donor Day. Thank you for your patience in hearing me through. May God who has provided salvation and healing through the blood and stripes of Jesus Christ continue to cleanse us of all sicknesses.
