Preventing blood wastage

If a country is to meet its requirement for safe blood, it would suffice if 1 percent of its citizens dote blood. For life-threatening injuries, childbirth, burns, poisoning, shock and various blood diseases including leukemia, large blood transfusions are needed during critical surgeries. Every year India needs an estimated 12 million units of blood, but collects barely 9.9 million units from around 9.5 million donors. Clearly, there is scope for improvement here, considering the misconceptions against blood dotion. Public health being a State subject, there are State-level councils to monitor such services. State government agencies periodically undertake awareness drives and voluntary blood dotion camps to sensitize people to come forward. After all, a unit of blood can potentially save at least three lives, so says the World Health Organisation (WHO). But while collection needs to improve, the government needs to do far better on the blood storage front. Shockingly, over 1 million units of blood are discarded every year on average. According to Union Health Ministry data placed in the ongoing Parliamentary session, the reasons for this wastage are primarily because of deterioration during storage and expiry due to outdating. Specifically blood units get spoiled due to bacterial contamition, infections, haemolysis, discolouration, not meeting quality parameters and other factors. The tiol AIDS Control Organization (CO), which functions under the Union Health Ministry, also has its take on the matter. In response to an RTI query this year, CO revealed that the shortfall in blood units was also due to lack of coordition between blood banks and hospitals. More elaborately, a Health Ministry report primarily based on CO data in 2016 showed that most government-run blood banks in the country are neither regularly inspected nor comply with the best healthcare standards. Licensing of blood banks too was lax, with just 55% blood banks having valid and current licence.

There are around 2,800 blood banks across the country, including some 80 blood banks in Assam. Apart from whole blood, its components like plasma, red cells and platelets also need to be stored. But only around 40% blood banks in the country have such component separation facility. What is more, the proportion of private sector to government blood banks having such facility is roughly 2:1. And Assam with 19.2% blood banks having blood component separation facility, figures among the laggard States with the likes of Odisha, Madhya Pradesh and Bihar. While proper storage of blood is important, health experts also point to the need for safe transfusion. There have been widely reported cases in Assam like five persons administered HIV positive blood at Mangaldoi Civil Hospital in 2013, as well as a child suffering from serious burn injuries given transfusion of HIV infected blood at Gauhati Medical College and Hospital in 2015. These heart-rending incidents forced the State government to order re-testing of all blood units in public blood banks, as well as to mull steps like issuing identity cards to donors and installing CCTVs and modern equipment in blood banks. But there are still frequent reports of professiol donors demanding money from patients, with their touts operating freely in some hospital premises. A positive development is the state-of-the-art Nucleic Acid Test (T) lab facility installed by some blood banks, which can screen transfusion transmitted infections (TTIs) like HIV and Hepatitis B & C viruses. The sooner blood component separation and TTI screening facilities are installed by all blood banks in the State, the better for patients. This apart, effective coordition between blood banks and hospitals remains a vital public health issue. On this front, the launching of an e-blood bank software in Assam by the State Health Minister last year promises to bring about this synergy. The crying need for a centralised database, ensuring accessibility of blood supply, accurate tracking of donors and minimal processing time for patients through this platform can hardly be overstated. All these measures need to be properly implemented with adequate government support. Considering the large numbers of road accidents, childbirth deaths, strokes, aemia and haemophilia cases in Assam — shoring up the blood storage and transfusion system will add significantly to effective medical intervention.