“To whomsoever saved my life – ‘Thank you’ I owe you my blood” –Kid
It wasn’t the first time a heavy and prolonged period had sent Mma to the emergency room. Her monthly flow usually left her feeling extremely weak.
“Madam get blood, get blood”, the hospital officials kept telling me,” Mma’s mother says. “It was a desperate situation. My daughter was in a critical condition and only a transfusion could stabilise her. Thankfully, we were in my hometown and I was able to rally around and get family to donate the blood she needed.”
During that visit, the doctors had diagnosed her with a condition called Immune thrombocytopenic purpura (ITP), a rare bleeding disorder where the immune system attacks and destroys platelets which normally help the blood to clot.
After being diagnosed, 24-year-old Mma was given a blood transfusion and medication. “Although I didn’t have any more episodes, I kept going for regular checkups. In 2018, I went to Lagos for my National Youth Service (NYSC). It was a stressful year. Apparently, stress and pollution are some triggers for the condition,” she said. “When I went home for Christmas, I was on my period and although I had not had any issues since 2014, when I saw that my period was prolonged and heavy, I went to the hospital.”
At the hospital, they ran some tests that showed that her platelet levels were quite low. Her doctor ordered her not to move until she was given a blood transfusion. Because of her unique condition, blood transfusions are never easy. She always needs freshly drawn blood and where there is no formal list of registered donors who can be called on when the need arises, finding voluntary donors is never an easy task. Mma’s mother reached out to Angela Ochu-Baiye, a voluntary blood donation advocate and initiator of Jela’s Clinic Blood Drive. “As soon as Angela put out a call, people that I didn’t know kept calling me ready to donate blood. Total strangers were coming to donate blood for my daughter as soon as they were told”, she said. Mma received 10 units of blood over a 7-day period and it all came from voluntary donors.
1% Can Save Everyone
Blood transfusions save lives and improve health outcomes, but many patients who need transfusions do not have timely access to safe blood. With the goal of improving blood safety and availability, the World Health Organization (WHO) recommended the establishment of a coordinated national blood transfusion service that can provide sufficient and timely supplies of safe blood and blood products to meet the transfusion needs of everyone.
Rebranded in 2005 with support from the US Government’s President’s Emergency Plan For AIDS Relief (PEPFAR), Nigeria’s National Blood Transfusion Service (NBTS) has the mandate to provide safe, cost-effective, adequate and quality blood to every Nigerian. Immense efforts have been put in place to build a strong and sustainable national blood transfusion service. From the first centre which opened in Abuja in 2005, the service now has a network of 17 centres around the country. However, only five centres are functional – Jos, Abuja, Kaduna, Ibadan and Owerri. According to Dr Oluwatosin Smith, National Coordinator NBTS, PEPFAR continued to fund and manage NBTS until 2014 when they handed it over to be fully managed by the Nigerian government.
The blood donation process is a simple one. NBTS advocates for voluntary, non-remunerated blood donations from healthy individuals. Once a prospective donor is identified, they must be willing and able to donate – blood is collected and screened for blood type and infectious diseases, namely HIV 1 & 2, Syphilis and Hepatitis B & C. Dr Smith said that it costs about NGN 30,000 to screen one unit of blood. The screened blood is stored in a refrigerator, ready for purchase. Presently, the blood is screened using a semi-automated system which screens one pint of blood in three or four days. She, however, revealed that plans are in place to move to a fully automated system which means that NBTS will soon be able to screen one pint of blood within 24 hours of collection. This will be achieved in partnership with Abbott Nigeria Limited and will be piloted in the Abuja and Jos centres.
Although the staff at the headquarters of the NBTS in Abuja work hard to ensure that the service runs smoothly, they deal with a myriad of challenges that hinder their efforts to effectively meet the blood needs of patients. Inadequate funding is a major and fundamental challenge. According to Dr Smith, funding sometimes comes in, but it is largely inadequate and often comes so late in the year that it leaves them unable to achieve their targets.
“When we were adequately funded, every year we were doing close to 70,000 units in the NBTS network. But in 2018, we were only able to collect about 21,000 units within the same network,” she said. She added that the centre also faces the challenge of low awareness, inadequate staff strength, lack of a dedicated source of power and an inability to procure large amounts of reagents and other consumables.
The WHO says that blood donation from only one percent of the population can meet a nation’s most basic requirement for blood. Let’s do the math. The United Nations Population Fund (UNFPA) State of World Population 2019 report shows that Nigeria’s population has risen to 201 million. One percent of that figure is 2,010,000. To meet the WHO’s recommendation, NBTS must generate 167,500 units of blood monthly. Currently, because the NBTS does not collect anything close to the WHO requirement, it is safe to say that less than one percent of the population donates blood.
Some of the ways NBTS could build up its blood bank, could be through advocacy and outreach programmes. “When we were on radio, our walk-in donors increased. People knew to walk in to donate blood.” Smith said. Another way is through partnerships between individuals or organisations. One of such partnerships is with Jela’s Clinic Blood Drive.
From Media to Action
In 2008, Angela Ochu-Baiye was diagnosed with a ruptured ovarian cyst and an ectopic pregnancy and she had to have emergency surgery. She urgently needed a blood transfusion, but couldn’t get blood in all the places she visited. One of the private hospitals she visited only had one unit of expired blood in their blood bank. She nearly bled to death, but the hospital managed to stabilise her. “I survived, and I must say, I was one of the lucky ones”, she said.
Years later, as a radio personality involved in daily conversations about different social issues, Ochu-Baiye realised that questions about blood-related matters kept popping up. There were complaints, questions, accusations and misconceptions. This drove her to do some research into the problem. Her findings revealed that people were largely ignorant about blood donation. To address this, she dedicated several episodes of her curated radio show called Jela’s Clinic on WE FM 106.3 Abuja to conversations about blood where she brought in experts to raise awareness and debunk myths surrounding blood donation in Nigeria.
“When I started planning the show, all I wanted to do was to have a group of people who were universal donors and who were willing to commit to being reached out to if we needed blood donors.” But because people were now better informed, soon, she was receiving requests from people who were not universal blood donors, but were willing to join the group as donors. Being a universal donor means you can donate blood to anyone. One of the experts she brought on the show suggested they get the volunteers to donate immediately instead of waiting till the need arises and this birthed a new initiative. He then introduced Ochu-Baiye to the coordinator of the NBTS and together, they planned the very first ‘Jela’s Clinic Blood Drive”, named after the radio segment that started it all.
The first blood drive was in March 2017 and since then, there have been five blood drives; the last one was on Wednesday, June 12, 2019. So far, a total of 255 units of blood have been collected during the blood drives. Beyond the blood drives, Ochu-Baiye is now known as a blood donation advocate and people call her when they have an urgent need for blood. She also helps raise awareness about the existence and activities of the NBTS. This provides much-needed publicity for them and helps with their own blood drive activities.
Determined to take advantage of the nation’s large population to save more lives, Ochu-Baiye decided to develop her original idea of getting donors who will commit to be available when blood is needed. Leveraging Artificial Intelligence (AI), she created a donor-focused system where willing donors can register to give blood. The system also allows those who advocate for blood donation to register. Those who register indicate their location and their blood type. In the event that someone on the platform needs blood, the system identifies donors based on location and blood type and notifies available matches. Ochu-Baiye hopes this system will help to increase the blood donation pool in Nigeria as one of the benefits of being a donor or advocate is that you are matched with another donor if you need blood for yourself or your loved ones. She said she designed the system this way because the problem is that people are willing to draw blood from the system but usually unwilling to give blood. The system has been tested several times and she plans to launch it soon.
Safe Blood for All: Establishing the National Blood Service Commission
The world celebrates World Blood Donor day on the 14th of June every year and this year’s theme was, “Safe Blood for All.” How can Nigeria talk about safe blood for all when we do not even have enough blood for all? Government, health authorities and blood service centres around the country must ensure systems are in place to increase the collection and storage of blood from voluntary, regular, unpaid donors. There is clearly a greater role that the private sector can play in driving up blood donations, whether it is through the logistics of collecting and delivering blood or supporting the cold chain in blood storage. An example of this is LifeBank, based in Lagos and run by Temie Giwa-Tubosun.
In 2018, the Federal Executive Council (FEC) approved an executive bill for the establishment of a National Blood Service Commission. The newly inaugurated 9th National Assembly should give serious consideration to this bill, because if passed into law, it will ensure that the NBTS will receive dedicated funding from the government and so taking care of one of their biggest challenges – funding.
Change is usually catalysed by a singular action. Jela’s blood drive and other similar initiatives are simple solutions to a seemingly complex problem. Much like the domino effect, this singular action, if duplicated by other individuals, schools, churches and businesses around the country could, slowly but surely, help the NBTS achieve the desired objective of ensuring that everyone gets safe blood when they need it.
Do you know of other blood drive initiatives in the FCT, or other initiatives that ensure people are able to get safe blood when they need it? Let us know in the comments!