As a Nigerian, being the subject of a medical or obstetric emergency or among the few survivors in a mass casualty event such as fatal accidents could spell doom, in a country starved of the supply of a life-saving commodity: blood.
When an accident occurs, lives are lost at the spot of the incidence. On the way to the hospital, more people die. But most pathetic of all, another set of casualties, who could have won the wrestle against death with the support of a solid blood base, still die on arrival at the hospital from blood deficit.
“The transfusion that we have in the country is based on family replacement donation,” said Sulaimon Akanmu, a professor and the head of department of Haematology and Transfusion Medicine, Lagos University Teaching Hospital (LUTH). “But we run into trouble with that in cases of emergency. Where will you get the family of someone travelling from Kano to Lagos and is involved in an accident? That is a big issue that is costing us a lot of lives.”
The university requires about 12,000 units of blood yearly and collects a little over 1,000 units of blood every month.
Of that 1,000, less than 10 percent comes from voluntary donors, corroborating existing data that over 75 percent of Nigeria’s blood donation comes from commercial channels as blood supply deficit nears 2 million.
Of the estimated 1,336,000 total number of blood units needed by Nigeria each year, Nigeria Blood Transfusion Service says approximately 1,130,000 units of blood are collected annually through the various types of donations, leaving a deficit of over 206,000 units.
The voluntary donors are the altruistic individuals who donate blood with the sole aim of saving a life, without regard to any form of inducement. They are usually mobilised through the mass media or blood donation drives to schools, churches and mosques.
The family replacement donors donate for a hospitalised relative, friend, or associate without expectations of remuneration. The sole focus is to save life.
However, chronic blood deficit coupled with increased poverty in Nigeria has been fuelling the rise of the commercial crop of donors who give blood strictly for monetary gratification. These have continued to increase in number and prominence in Nigeria, fuelled by the very huge deficit in blood supply and utilisation. But still, shortages severely trim people’s chances of survival.
According to Lifebank, a tech start-up ensuring efficiency in the mode of blood distribution to Lagos hospitals in the best conditions, lack of access to blood as and when needed is both a problem of scarcity and affordability.
The company has moved 13,000 pints of blood to save 3,100 lives but in all of these, calls from indigent quarters still come through seeking for help.
Lagos resident Abigail Chima’s husband was in one of the worst conditions when they reached out to Lifebank for assistance. There was no penny left from the trouble of holding three sessions of dialysis weekly due to the failure of her husband’s kidney. In fact, at the point they called, the dialysis sessions had dropped to one but he needed a sufficient amount in his system to make it happen. Her husband was supplied blood free of discovery and screening fee.
“It wasn’t easy. There was no money. There nothing. Dialysis that was done three times a week began to be done two and later on, once a week. We had to beg for blood to keep him alive. But at the end of everything, I lost him,” she explained tearfully.
In the case of about 10 children under the watch of Dorcas Foundation, the blood scarcity issue arose around May 2018.
Despite operating in collaboration with teaching hospitals to access sufficient and right amount for its mostly cancer patients, not a pint of blood was in view when transfusion need arose. A particular child was moved to Ogun State from Lagos in search of blood.
“Accessing blood for the children that we support has not been easy. It led us to research an organisation called Lifebank. Since then, they enrolled us on their CSR platform,” Akinkorede Akindele, programme officer, Dorcas Foundation, told BusinessDay.
To sustain the positive response to these growing calls for help, Lifebank is raising about N100 million from corporate donors under an initiative called Blood Oxygen Access Trust (BOAT). The initiative billed for launch on World Health Day will dedicate resources to ensure that blood is collected from eligible donors in the country, screened, and distributed to indigent Nigerians in time of need.
“BOAT is basically this idea of ensuring that the general population has access to blood. About 76 million Nigerians live on less than $2 a day and a significant chunk of them will need blood,” Temie Giwa-Tubosun, Lifebank’s founder, told BusinessDay.
“The average cost of a pint of blood is around N12,000 and most people need about two or more pints. So if you need two pints of blood and your income is not that significant, where are you going to get the money? Almost 75 percent of health spending in Nigeria comes of out people’s pocket which means that you have to pay for it. Many people don’t have insurance. A lot of times, they would call us begging for help and many times we have served them free of charge,” Giwa-Tubosun said.
Lack of access to blood could be the difference between life and death, according to experts. Women bleeding in childbirth have between 25 minutes and two hours to die because of lack of blood banks.
Experts want the National Blood Transfusion Service (NBTS) to be more aggressive in its campaign, saying higher government intervention could elicit positive attitudes towards donation.
Globally, 108 million blood donations are collected and half of these are in high-income countries with only 62 countries obtaining 100 percent of their blood supply from voluntary donors.
To donate or not
There are certain benefits which a volunteer returning donor – an individual who has donated blood twice for more than a period of 10 years – can enjoy, according to Akanmu of LUTH. Studies show that they live a healthier life compared with people who have never donated before.
“People who are volunteer returning donors tend to have a lifespan more than the lifespan of an average person. The lifespan of volunteer returning donors have three to five years more than an average person,” Akanmu said.
When blood is lost from donation, the area in the body where that blood is formed undergoes the haemorrhagic challenge. Normally, the blood is formed on a daily basis and is destroyed on a daily basis in the body. One percent of the blood is destroyed and replaced with another one percent which comes from the bone marrow. What produces the blood in the bone marrow, red marrow, with age, becomes yellow marrow and eventually turns into white marrow.
But individuals who donate regularly do not have their bone marrow ageing because it frequently undergoes the haemorrhagic challenge. When it ages, it becomes a yellow marrow which is capable of reversing to red marrow, producing more blood.
“The bone marrow of an individual who is a volunteer returning donor when he or she is at 70 or 80 will look like somebody between 40 and 50. The individual also does not suffer from anaemia of the age. They do not accumulate an excessive amount of iron in their bodies,” Akanmu said.
“The transfusion requirement of a community is met if 5 percent of the eligible donors donate once a year. If this happens, we will be able to meet transfusion needs,” he said.
Temitayo Ayetoto
