Trying to tiptoe away
December 15, 2006
It appears that the Ministry of Health and the National Blood Transfusion Service (NBTS) are trying to tiptoe away from a report titled the ‘National Strategic Plan for Blood Safety 2006-2010'.
When Kaieteur News highlighted some very disturbing conclusions in the report, a few weeks ago, Minister of Health, Dr Leslie Ramsammy, claimed the news report was out of context. He declared that the report was presenting a more global perspective on the issue of suspected unsafe blood in respect to what happens in other parts of the world.
Director of NBTS, Dr Clement McEwan, also refuted the article, which stated that sometimes patients get blood that has not been tested for disease. He said the Blood Bank supplies all hospitals with blood for transfusions, and it never allowed untested blood to be transfused. The NBTS claimed that the report was “not necessarily” referring specifically to the Blood Bank. Everyone would like to accept the assurances of these gentlemen, but it is hard to get around one uncomfortable fact. The relevant passages in the ‘National Strategic Plan for Blood Safety 2006-2010', under the subhead ‘Weaknesses', are as plain as day. The actual text states definitely and unambiguously that there are serious risks associated with blood transfusions in Guyana .
To let readers judge for themselves, here, again, is the actual text in the report under the section ‘Analysis of the Current Situation of the Blood Transfusion Service'. “The NBTS lacks the support of a National Blood Policy and the relevant legislation within which to operate. The current blood supply is not sufficient to meet the demand. Inefficiencies in the system led to only 67 percent of blood being garnered from prospective donors in 2004.”
This passage specifically refers to the NBTS. It certainly does not appear to be referring to any global situation at all. It continues: “This may well be the result of an almost total dependency on family replacement rather than volunteer blood donors. Furthermore, pre-transfusion testing in all the hospital transfusion services is not complete, leading to an occasional blood transfusion being administered prior to completion of testing for transfusion for transmissible infections. This potentially catastrophic situation results from organisational problems.”
Look at the passage carefully, and take a close look at the context and use of the words “… pre-transfusion testing in all the hospital transfusion services is not complete, leading to an occasional blood transfusion being administered prior to completion of testing for transfusion for transmissible infections.” Can anyone reasonably interpret this as a “global perspective,” as Minister Ramsammy suggests?
The report also states: “The lack of clinical guidelines for the appropriate use of blood and blood products is of great concern. The lack of knowledge of the minimum requirements of the blood cold chain, particularly during transportation, holding on the ward, and infusion, also contributes to weakness in the system. There needs to be greater temperature control of the refrigerators with the appropriate knowledge of the reasons and frequency for checking and control of temperature of the blood during the transfusion to patients.”
The report continues: “Transfusion related record keeping in the clinical setting is almost non-existent, and there is no information available of the purposes for which blood and its products are actually being used. There is also no information on adverse reactions, blood provided but not used, and how much is returned.
“Some senior staff at the NBTS have additional responsibilities outside the scope of the blood programme. For example, the chief technologist is an employee of FXB and provides only part-time service to the Blood Bank. Some staff time is also taken up with providing non-blood banking services, such as clinical infectious disease testing, routine testing services for the Ante Natal Clinics in Region Four, and HIV testing for VCT and PMTCT sites and the GUM Clinic.”
The passages above make specific references to the Guyana situation. In any context, they raise serious concerns about the quality of blood transfusions in Guyana . It is an issue that the media should pursue vigorously. The Ministry of Health and NBTS should be compelled by the force of public opinion to explain to the public how the writers of the report came to the disturbing conclusions that they wrote down so clearly.