Thursday, May 27, 2010

A shortage of blood in Egypt

From IRIN, a story about a shortage in blood donations that threatens patient health in Egypt.

Outside downtown Cairo’s teeming Ramses train station, the crowd studiously ignores the health official, despite his repeated pleas for travellers to spare a few minutes to donate blood in a nearby minivan.

“Thousands of patients badly need blood in hospitals across our country,” Ahmed Abbas told IRIN.

A few kilometres away, Amira Mohamed, 10, is in Abulreesh Children’s Hospital, suffering from beta thalassaemia, a genetic blood disorder that reduces the production of haemoglobin. Her survival depends on monthly blood transfusions, which are expensive and increasingly hard to come by.

Her mother, Huda Shoeb, pays 100-700 Egyptian pounds (US$18-127) every month to buy her a bag of blood. “Nothing else can be done,” she says. “It was a bit easier to find blood in the past, but now things are difficult. You’ve got to pay a lot for it.”

While Egypt’s population has grown to just over 80 million in 2010, the number of blood donors has fallen sharply in recent years, according to health experts, threatening the lives of hundreds of thousands of patients.

“The problem is that supply has dropped, but demand has not dropped in the same way,” said Fatem Muftah, head of the National Blood Transfusion Centre, which manages a network of 24 such centres across the nation. “A drop in supply will eventually harm patients everywhere.”

Shortfall

Every day, the centres send out 70 fully-equipped blood donation minivans but they come back with a collective average of 2,000 units of blood (about 900 litres), 30 percent less than what the nation’s hospitals require. If they could increase collection to 3,000 units of blood a day, which would equate to 1.1 million units annually, demand would be satisfied, Muftah said.

“A large swath of the population stopped donating blood a long time ago,” Muftah said. “They think they will be harmed if they donate blood.”

Medical experts say there are various reasons behind the drop, including malnutrition, which has become common in Egypt.

“Malnutrition is an undeniable reality,” said Nelly Sedki, a blood expert. “How can an undernourished person donate blood?”

A report by the Health Ministry and the UN Development Programme in 2009 said almost a third of Egyptian children were malnourished. Another report said 23 percent of Egyptians lived below the poverty line.

Blood donations started to come under public scrutiny in 2007 when a local company was accused of providing the Health Ministry with defective blood. A Cairo criminal court will issue a verdict on 17 July to bring the case to an end, but many ordinary Egyptians have been deterred from donating blood as a result.

Hepatitis C

This has made life tough for Amira, whose mother must make several calls every month to find the blood her daughter needs.

The situation faced by some 150,000 hepatitis C patients needing regular transfusions is even worse, experts say. Nearly 10 percent of the population is infected with the hepatitis C virus, according to the Health Ministry.

“Around 2 percent of these people need blood transfusions on a regular basis,” Wahid Doss, head of Egypt’s National Institute for Liver and Communicable Diseases, said. “These people suffer the most because of the inadequacy of donated blood.”

The deficit and a ban on imports have led to an unprecedented rise in the price of blood. Hospitals sometimes pressurise relatives of patients to donate blood if they have the same blood type.

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