Kenyan blood banks run empty as MPs drag their feet on transfusion Bill

Kenya is staring at a blood crisis, with the volume in the banks in hospitals at the lowest levels. The situation is aggravated by the Covid-19 pandemic that has scared away donors.

The bulk of blood donors are learners who have been home since schools and colleges closed due to Covid-19 in March. Others are relatives of patients who sometimes travel from upcountry but whose movements are restricted by the nighttime curfew.

But even before the coronavirus outbreak, the blood reserves were low, putting at stake the lives of critically ill patients requiring blood transfusion.  

The Kenya National Blood Transfusion Service (KNBTS) has collected 164,468 units of blood, a drop from the 172,041 units that were collected between July 2018 and June 2019.

This is against the World Health Organization guidelines for the proportion of donors relative to the total population. Kenya requires between 500,000 to one million units of blood a year.     

An analysis of some hospitals reveals that many patients who are in dire need of blood are dying.

This is happening even as the Ministry of Health (MoH) reports that blood donated in Kenya is being sold in neighbouring countries such as Somalia.

Crisis

The extent of the crisis is far too familiar for Ms Sophie Kageche, 35, a business woman in Nairobi.

“We had a house manager who was expecting and she un-expectedly went into labour,” she said.

Ms Kageche told the Nation her worker was admitted to St Mary’s Hospital in Lang’ata urgently, and needed four pints of blood.

“Only my husband was eligible to donate because I had had a baby a few months earlier.”

Ms Kageche said the hospital gave the patient the blood, but they were required to replace it before she could be discharged.

“They compelled us to replace the blood.”

Not many Kenyans can show up at a hospital and find blood, the Nation has established.

“It is very tricky when you need blood urgently,” Mrs Kageche remarked. “There are so many patients out there who need blood.”

Dr Peter Mwamba Maturi, a haematologist at the government-owned Kenyatta National Hospital (KNH), that is now fully dependent on donations from relatives and friends of patients, reveals that the volume of blood and that of testing reagents is very low. “If there’s a big accident right now in Nairobi, there’s no blood unless we borrow, and people are dying.”

In the 2001 policy guidelines on blood transfusion, MoH committed to putting in place a comprehensive and well-coordinated national blood transfusion service.

“We used to get about 1,000 donors before the pandemic, but now we get 10 a day at most who specifically donate to their relatives,” said Dr Mwamba.

The World Health Assembly (WHA), to which Kenya is a signatory, passed resolutions urging member states to enact effective policies to govern operations of blood transfusion systems.

Before the Covid-19 outbreak, most of the blood at the KNH bank was donated by schools and colleges, which are now closed. Only candidates and final semester students are in session, preparing for exams.

“Most relatives on whom we depend for blood donations come from upcountry. With talks of lockdowns and existing curfews, they stopped,” explained Dr Mwamba.

The proposed Kenya National Blood Transfusion Service Bill establishes the service as a State entity, with the sole responsibility to regulate and coordinate blood transfusion in Kenya.

It proposes a semi-autonomous, centrally coordinated blood service with a specific mandate and governance structure to carry out blood transfusion within the country, in conjunction with county governments.

Murang’a County Woman Rep Sabina Chege, the chairperson of the National Assembly Health committee, tabled the team’s report and the Bill is due for debate. 

“There was Sh1 billion allocated by the World Bank for procurement of materials we need, which is usually done for us by Kemsa (Kenya Medical Supplies Authority). We are yet to receive anything,” Dr Mwamba told the Nation.

He acknowledged partial support from the Centres for Disease Control and Prevention (CDC) is helping them get by.

Wanadamu

“In 2011 there were so many blood appeals on social media and I decided to build a database of willing donors, in the event someone out there needs blood,” said Mr Evans Murio, 30, the founder of Wanadamu, a digital platform for blood donation. 

According to the initiative’s data, caseloads have increased tenfold during the Covid-19 pandemic as 80 per cent of blood picked by KNBTS is from schools.

Many of the donors have lost their jobs and moved to rural areas. Others don’t have means of transport or nannies to leave their children with so that they can go donate blood, he added. 

The Wanadamu database has all details on regular donors and whenever a patient from Ruiru, for example, is in need, the system sends an alert to the donor that is closest to that patient.

“Some 30-40 per cent of the cases we deal with are of cancer patients who need platelets, which can only be collected from fresh blood,” he disclosed and urged KNBTS to be more proactive.

Donors

“Many donors are now afraid of going to hospitals because of Covid-19 cases,” he said.

More awareness is needed from a donor’s perspective.

There is usually a very high demand for blood in December, around Christmas, due to an increase in the number of road accidents.

“Drink-driving costs us dearly and the National Transport and Safety Authority should do more to enlighten drivers,” said Mr Murio.

He would also like hospitals to be realistic with their charges, to change the people’s mindsets and cultivate the culture of donating blood.

The Nation reached out to Dr Nduku Kilonzo, the KNBTS boss, who did not want to comment, but promised a comprehensive response in the near future.