Sunday, October 2, 2011

A bond of blood

Dengue patients in Lahore have had a high mortality rate and usually it is the fallen platelet count in the blood that costs life. The dengue virus hampers and sometimes destroys the body’s capacity to produce new platelets. The normal body’s platelet count is 150,000-250,000 per ?l of blood. A dengue patients platelet count may have a steep fall and become lower than 100,000 per ?l (mm3). This is alarming because it can impede clotting, cause hemorrhages and result in internal and external bleeding. Once the bleeding starts, it is often irrecoverable.

“Government hospitals have a vast network of donors, emergency contacts of donors, stock of the most common blood groups and even co-ordination with other hospitals,” says Dr Syed Sohbin, the Additional Medical Superintendent (ADMS)of Jinnah Hospital. He adds that each hospital has a blood bank and a Blood Bank Officer. Usually, it is the family members who donate but the hospital can also provide donors.
There has been a dearth of blood donations in the city, which was utterly unprepared for an epidemic of this scale. However, the efforts of Lahore’s civil society have been commendable in this regard.
“We do not deal with blood donations and transmission but right now we are, due to the emergency conditions. We are doing the CBC test for blood count for Rs50. However, we cannot arrange donors and the patient has to do that himself. Usually it is a family member or relative,” says Anwar Iqbal, manager of Fatimid Foundation. He adds that the staff duty timings are 9 to 7, but these days they have to stay back late - sometimes till 2 in the morning - and they almost never refuse a patient in need.
A blood donation is not very easy to obtain because many people fear disease transfusion and any weakness that might follow. But much of this fear is baseless because blood transfusion has become rather advanced. Hospitals, even government ones are very particular and strict about hygiene, blood screening for Hepatitis, HIV, Syphilis and malaria and they work hard towards safe syringe disposal too. The syringe enters the dustbin only when its needle is broken and this ensures that it cannot be reused.
The donor is ideally aged between 20 to 40 years. This is because by the age of 20, the donor has fully grown bones, where blood is generated and past the age of 40, the donor is slightly aged and might have developed health complications already. Males are encouraged as compared to females because the latter lose blood every month and are often short of haemoglobin and iron.

One almost incorrigible problem is finding O-negative blood, a rare group that can donate to everyone but receives blood exclusively from within the O-negative group. Although a very small percentage of population is O-negative and there is a balance of donors and recipients, the dengue outbreak has caused a supply mismatch and significant shortage.

“We do not have Cell Separators, which are very swift, effective but a little expensive. Its chief benefit is that it can sieve platelets alone out of the blood, making the blood group of the donor and recipient is irrelevant” says Anwar Iqbal of Fatimid Foundation. He adds that Fatimid has a Cryofugue, which is slower and not as efficient. But it is cheaper. However the biggest disadvantage is that it cannot sieve the platelets alone and the blood groups of donors and recipients have to be compatible.

Dr. Syed Sohbin of Jinnah Hospital states that government hospitals maintain “special lists” for this rare blood group but usually someone in the family, parents or siblings is also of the same group and can help.
The cell separators are present in some private and government hospitals. The demand is however much greater than the supply, and some cell separators in the government hospitals require repair. Those in the private sector require Rs 13-15 thousand per transfusion and are unaffordable for the vast majority of Pakistanis.
Many social workers and activists utilised social networking sites to find donors, not just for their loved ones but also for a much larger network of people in need. Emails, SMSes, Facebook, Twitter and other media were used to appeal for blood donations. Most appeals have a phone number attached. On Facebook, not just personal profiles but other groups having a large following like “Go Green” and “Justice For Imanae Malik”, have been leveraged for this noble cause.
Shahid Khan, who works for ACCA, started using the online venues for his relatives in need but soon expanded his network because of the encouraging response. Now he is facilitating the treatment of his colleague’s pregnant sister and another friend’s O-negative mother who have developed complications.
“Since I use references when online, people respond to me within 3 to 4 hours” The screening and testing takes a few more hours so he is often able to help patients within 10 to 15 hours of his posting online. He praises a website called - a network of blood donors that rarely disappoints one in their hour of need.
Hopefully, this new trend in community service will continue and such co-operation will extend to other spheres of medical aid - and life in general.
This article was first published in The News on Sunday

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