DailyNews Online Edition

Collecting blood is more difficult than it appears

Blood is daily collected from patients’ relatives and friends, at the Muhimbili National Hospital (MNH) Blood Transfusion Unit, in Dar es Salaam, to help meet its required demands. (Photo by Iman Mani)

IN keeping with our policy of finding out the facts so that we can inform our readers, as to why there is a shortage of blood donated for use in local hospitals, our Staff Writer, IMAN MANI,  during the week  talked with the spokesperson for the National Blood Transfusion Service, Rajab Mwenda, at their headquarters in the Mchikichini section of Dar es Salaam.

Following are excerpts of their conversation, which looked at, amongst other things, what measures they are taking to rectify this undesirable situation...

QUESTION: Can you please give a brief background of the National Blood Transfusion Service (NBTS)?

ANSWER: The NBTS was established in 2004 and officially started operating in 2006, with the objective of collecting, processing, storing and distributing blood to qualified health facilities. We are mandated by the ministry of health to make sure enough blood is available for hospitals to use when striving to save the lives of people in need of blood.

The NBTS has got seven zones around the country. There is the Western Zone, which covers Tabora, Kigoma and Singida regions. The Lake Zone is Mwanza, Kagera, Shinyanga and Mara regions, while the Northern Zone consists of Kilimanjaro, Manyara and Tanga regions. Then there is the Eastern Zone, which is here:  Dar es Salaam together with Dodoma, Morogoro and Coast regions.

There is also the Southern Highland Zone, which covers Mbeya, Iringa and Songea regions. Also there is the Southern Zone, which covers Mtwara and Lindi regions. Lastly, there is the Tanzania People’s Defence Forces (TPDF) Zone, which is located at the Lugalo Military base in Dar es Salaam.    

Q: Why is it that the military have to collect blood separately from the rest of community?

A: The TPDF Zone is responsible for the collection of blood from all the military camps in the country. We’re working together for this purpose. You see they have got their own principles and military bases are not freely accessible to civilians without official permission.

Further, military personnels cannot just walk into a donation centre at a time of their convenience, as is the case with civilians. Now we know that it is potential to collect blood from military camps so that is why we are collaborating with them because there are many camps around the country.  

Q: Before NBTS what was happening concerning blood collection in the country?

A: Before the establishment of the NBTS, blood was being collected by individual hospitals. Then the World Health Organisation (WHO) passed a resolution that each country has to operate a centrally co-ordinated blood transfusion service. That is why the NBTS was established in 2004, although it took two years before it was operational.

Q: Is the blood collected by the NBTS distributed only to government facilities?
A: The blood that we collect is first tested for HIV/AIDS, Syphilis and Hepatitis B and C. We then distribute the blood that has been approved to government, religious and private hospitals. 

Q: That being the case, then why is it that blood is being collected at hospitals?

A: We call the blood that is being collected at hospitals, Family Replacement Donation (FRD). Here in Tanzania, we’ve got two main types of blood donation: Voluntary and Family Replacement donations. FRD is whereby relatives or friends of a patient are asked to donate blood for that patient to be treated.

Voluntary Blood Donation is whereby people are donating blood voluntarily for distribution to hospitals, for the use of saving lives of anyone in need. It is our intention to abolish FRD in the future. At the moment this is happening because NBTS cannot meet the national need for blood; there is a deficit.

The national need of blood is an average of 400,000 units per year. At the moment we’re collecting 120,000 up to 140,000 units per year. It’s around 34 per cent of the national need, so the rest is covered by FRD.  

Q: What strategies are you employing to ensure that you will be able to meet the national need of blood without the assistance of blood being collected by hospitals under the FRD system?

A: We have a number of strategies in operation towards increasing the awareness amongst communities with regards to the necessity for them to donate blood. This, in itself, is a very big challenge we’re facing. People do not understand the importance of donating blood, so when you go through the communities, you find a lot of people don’t even know that there is such an organisation as the NBTS. So firstly, we need to increase their general awareness.

Second, we have introduced Blood Satellite Sites (BSS) throughout the country. These are small centres where people can go to donate blood. At the moment we have three sites nation-wide, which are at Mnazi Mmoja  in Dar es Salaam, another in Dodoma and the third in Lindi.

We have introduced these BSS, so as to make the service more available to communities. We hope to keep on increasing the availability of them, as our budget allows us to. Another thing is to keep on educating people on the importance of blood donation, by use of the media. We also have Donor Clubs, where members pledge to donate blood a certain number of times in a year.

As you know, a man can donate blood four times a year and a woman three times. So we have formed this club so that members can pledge to donate blood at least 25 times in their life-time. It’s two years now since we started this strategy. We also hold sensitisations programmes in schools and other higher learning institutions together with workplaces. The aim of this is to make sure that we get enough donations from the schools, colleges and the community at large.     

Q: How do you measure your progress?
A: We can measure our progress in terms of what we are collecting in a particular year. As I told you before, we officially started operating in 2006. By then we collected 52,000 units in that year. The following year we collected about 80,000 units, in 2010 it was very successful and we collected 1,129,000 units.

However, in 2011, the collection went down slightly. We believe this was due to lack of awareness within the communities.

Q: So how do you say that you’re being effective in your efforts to sensitise the people about the importance of blood donation. Why is it that your efforts do not match the need?

A: It is very unfortunate that we cannot cover more grounds than we are currently doing. I can assure you that we at NBTS wished that we could do a massive campaign about the importance of blood donation. But the major constraint to us is budget.

We are getting support from the United States of America through the Centre for Disease Control (CDC) and they are our largest financial contributor. The government is our main sponsor but CDC is providing more funds than they are, owing to their own restraints.