When Nasreen was caught in a crossfire and taken to the hospital, her relatives were asked to find blood donors. The hospital was unable to provide her blood without having someone donate blood in her place, because in Pakistan, in situations like this, the barter system operates; you have to give blood in order to receive blood. The hospital calls in the family, and tells them that the patient requires blood, and then they have to make arrangements.
For families who are undergoing the process for the first time, this is particularly shocking. The number of bags that are donated, have to equal the number of bags the patient receives. In emergencies like in Nasreen’s case, there is not a lot of time for patient’s relatives to actually collect the blood. The system clearly has flaws that need to be addressed.
In the past two years, a quiet revolution of sorts has been taking place in Karachi at the Indus Blood Center, a state-of-the-art facility set up by Dr Saba Jamal and her team, who felt there was a need that needed to be addressed.
“We realised that patients have some unique problems, and one of the problems was the availability of blood after an incident, so we are trying to fix that with a centralised blood bank which would be accessible to all the patients.”
The quick availability of blood in an emergency can make the difference between life and death
Dr Saba Jamal recalls a particular patient when she was working privately.
“I remember this case where a child with blood cancer would visit the hospital. His father would be called and would be told to arrange the blood through donors. I cannot even imagine what kind of a state he would be in, a father who is about to lose his child. I had asked my subordinates to not ask him for blood, but to give him blood from what we had in the stores,” she says. “Believe me, I used to hide from him; it is a very strange thing, seeing an adult cry like that. We used to feel guilty, we as doctors thought that there must be something that could be done …”
The Indus Blood Bank was set up at the Indus Hospital with a simple mission: “to mobilise Pakistan to 100 per cent voluntary blood donation,” says Dr Jamal, who is particularly excited by what her team has been able to accomplish in such a short span of time.
“Centralised blood banking system is based on a volunteer basis,” she says. “We look at institutions such as schools, colleges, madrassas, corporate sectors, factories and even apartment blocks and residential areas.”
Once an organisation agrees to be part of the blood drive, the Indus team schedules a day to collect the blood. The entire procedure is very thorough and starts with the team taking the history of the patient as well as a physical checkup of the donor to determine if he/she is healthy. The haemoglobin level is checked as well as the temperature, and once it is determined that the patient is healthy, they are further processed for collection.
|Dr Saba Jamal.—Photo by author|
“Once the blood is drawn at the event, we place it in freezers so that the blood is placed in a temperature-controlled environment. Once the blood leaves from the blood camp to the blood center; we start the production of our blood products,” explains Dr Jamal who personally oversees many of these drives.
The blood is then further tested for the presence of HIV, malaria and other viruses and diseases. Only once it is clear of everything is it processed further.
Hospitals waste a lot of blood because they are not equipped to separate blood into products. At the Indus Blood Bank blood is separated into three products: red blood cells, platelets, and plasma. The red blood cells are given to surgical hospitals and thalassemia centres. The platelets are given to cancer wards and the plasma is used in places where they treat burns. This means that there is zero wastage of blood.
To see all of this happen with such efficiency in Pakistan is eye-opening. Blood should be available in the hospitals all the time. The process that the hospitals have for medication and operations should be replicated with blood as well. Medication and the surgeries are done first and then the patients are asked to pay for it. With blood, it’s a different scenario: blood has to be donated from a donor first and only then will the hospital allow blood to be given to the patient. The quick availability of blood could be the difference between life and death.
Dr Jamal has now dedicated her life to ensuring that the success of Indus Blood Bank is replicated across the country.
“In hospitals which use the blood we have provided, patients don’t have to worry about arranging blood donations on their own,” she says with a smile. “We have received gratitude from patients and their families, because of how easily the blood was arranged. This gratitude, I would like to say is not for the doctors, but rather for the volunteers who donated blood.”
Published in Dawn, Sunday Magazine, June 21st, 2015