KARACHI: There is absolute silence in the ward despite presence of many children, all patiently seated in rows alongside their parents. While they look pale and exhausted, their faces barely reflect the pain they might be going through due to blood transfusion, a medical procedure they need regularly to stay alive.

Among them is Sabiha.

“My daughter needs blood every 10 to 15 days. Her treatment has been going on since she was diagnosed with thalassaemia 12 years ago,” says Afshan Sohail, a mother of two and resident of the Garden area, while talking to Dawn at the Afzaal Memorial Thalassaemia Foundation (AMTF), a non-governmental organisation dedicated to providing free-of-cost treatment to patients with blood disorders.

Currently more than 1,400 patients, largely children, are registered with the NGO.

Experts say many patients in need of blood die at healthcare facilities

Recalling the difficulties she faced when her daughter was first diagnosed with the genetic blood disorder at the age of six months, she says that initially doctors remained clueless about the cause of her weight loss and fever. “It took us a few more months to know what exactly she has been suffering from. Once her diagnosis was made, we found it very difficult to arrange regular blood supplies for her,” she explains, adding that financial constraints forced the family to look for free-of-cost treatment.

Seated next to her are 12-year-old Maaz accompanied by his grandmother and six-year-old Mohammad Hafeez being looked after by his father.

Sharing his struggle for her 17-year-old daughter’s life, Rehan Yasin says the greatest challenge is to arrange blood supplies every month. “It was the biggest hurdle 17 years ago and still is. Though the organisation with whom my daughter is registered arranges blood supplies, we know that collecting blood donations is not easy,” he says, explaining that his requests for blood have affected his social life as people have started avoiding him now.

Another thalassaemia patient, Omair Ali, 22, is also employed at the NGO as part of its continuing medical education programme. He says for him fighting the disease doesn’t end with having regular blood transfusions and patients like him are always at grave risk of developing serious health complications.

“Getting blood is a matter of life and death for us,” he says.

Ali points out that many blood transfusion sessions scheduled at the facility in recent weeks had been delayed due to an acute shortage of blood donations.

He recalls that he lost his sister to the same disease a decade ago.

According to Ateeq-ur-Rehman, executive director at the AMTF, the facility faces a serious shortage of blood supply despite publication of appeals in the media and contacts with many prominent private and government institutions.

“There has always been a shortage but this year has been the worst in terms of getting required blood donations. In desperation, we wrote letters to government officials, including the chief minister and the governor, but nothing has worked so far,” he says with disappointment.

M. Ashraf Ali, who is in charge of the blood banks and laboratory at AMTF, believes that this year’s shortage in blood donations is also linked to chikungunya and an increase in the number of patients registered at the facility.

“We had to refuse a number of requests for donation, because people had a history of having injections over the past three months. As per international guidelines, such persons are not suitable candidates for blood donation,” he explains.

Blood donations from parents and siblings are not accepted, as it can cause complications due to similarity in genetic make-up, according to the experts at the AMTF.

The issue is affecting the whole country as people are generally afraid of donating blood. Patients in need also include those awaiting medical procedures at hospitals.

Myths about donation

“Various myths and misconceptions are attached to what should have been perceived as a national and religious obligation. For instance, people think that blood donation will affect their health and they will contract some infection,” says Dr Rahat Hussain at Omair Sana Welfare Foundation, which works in the areas of blood diseases, medical relief and general welfare.

Ironically, the shortage of blood donors gets acute during Ramazan.

“During this month, we literally cry for blood donations, pleading with people attending Iftar parties to come forward and earn spiritual reward,” he says.

Asked if the social media has been of any help, Dr Hussain replies in the negative. “This medium has been proved fruitful only for creating awareness. Unfortunately, most people express sympathy but are reluctant to practically do something.”

Pointing out the benefits of blood donation, he says a blood cell lives only for 120 days in the circulatory system. Hence, a healthy person can donate blood thrice a year, which is like saving three lives.

“It boosts your immune system and mental sharpness as well as reduces risk for many diseases including cancer. Besides, donors can get free regular screening for diseases like HIV (human immunodeficiency virus) and hepatitis,” he says.

Rising need

“In fact we are in a regressive mode as our blood needs are climbing up due to multiple factors,” says Dr Hussain.

Seconding his opinion, Dr Ziaur Rehman of Fatimid Foundation says: “We have eight centres in the country; four in Sindh and the rest in Multan, Quetta, Lahore and Peshawar. Our staff has to work hard to educate and encourage people to donate blood.”

Dr Saba Jamal, director of blood centre and lab services at Indus Hospital, says availability of blood is a major problem and many patients in need of blood die at healthcare facilities.

“Blood screening needs at least four to five hours. Hence, it is important that health facilities have sufficient blood supplies. Unlike many countries like Iran, Indonesia and Malaysia with 100pc voluntary blood donations, 95pc blood donation in Pakistan comes from patient’s family.”

According to her, any healthy person with over 50kg weight and aged between 17 and 55 can donate blood.

“Detailed history is taken from the prospective donor that includes queries over any high-risk behaviour. We follow international guidelines and reject around 25pc requests for blood donations which don’t fit the criteria,” she says while urging people to inquire, visit facilities engaged in collecting blood donation and save lives.

Published in Dawn, July 21st, 2017