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High rates of blood wasted – PEPFAR report

Nov 27, 2008 News

By Neil Marks

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in its 2008 Country Operation Plan allocated US$1.2M for medical transmission and blood safety for this year, but there may still be problems with the management of blood, including dumping of blood that has been spoilt due to lack of inadequate or inappropriate storage facilities.

Reports reaching Kaieteur News indicate that the blood bank lacks adequate cold storage for the volume of blood it is receiving.

Part of the PEPFAR money was to be used to monitor the amount of blood doctors order for transfusions, while continuing pre- and in-service training for clinicians in the appropriate use of blood.

The PEPFAR action plan for this year also pointed out other challenges facing blood in Guyana, including the fact that weak data management systems contribute to high rates of wasted blood due to an absence of adequate tracking mechanisms.

The report noted a lack of human resource capacity at the regional level to ensure appropriate procedures for collecting, testing and transfusing blood products.

The action plan also noted that there are incomplete or unavailable standard operating procedures for staff engaged in the production of blood components and compatibility testing.

The U.S. funds were meant to address the structural and systematic barriers regarding blood donations and blood use.

There have been reports of dumping of blood at times when the storage capacity of the blood bank is outstretched.

In addition, reports indicate that doctors at the Georgetown Hospital sometimes request more blood than they really need, and when there is excess, they send it back, but not before the unused units of blood are spoilt, and so it has to be thrown away.

The PEPFAR report noted a lack of coordinated training for physicians, or doctors, in the appropriate use of blood. The PEPFAR action plan also points out that in addition to structural problems, the blood service is also hampered by significant barriers within the national healthcare system, namely the presence of multi hospital-based blood banks that are not linked to or coordinated by the central National Blood Transfusion Service (NBTS).

Through this Service, the Ministry of Health has been using the Funds provided by PEPFAR to develop regulatory mechanism and legislation to centralize operational responsibility for the national blood supply within the National Blood Transfusion Service.

PEPFAR noted that the Pan American Health Organisation is also advocating for the swift passage of blood service legislation.

Efforts to contact Minister of Health, Dr Leslie Ramsammy to respond to the reports of the dumping of blood proved futile.

The National Strategic Plan 2006-2010 acknowledged that the NBTS lacks the support of a national blood policy and the relevant legislation within which to operate.

The same plan noted that transportation and maintenance of the cold chain is an area that needs particular attention.

The cold chain is weak since there are no written guidelines or flow charts in place for ensuring adequate handling of blood and blood products during transportation and practices vary widely, the plan stated.

In addition, it was noted that temperature stickers are not available for monitoring blood temperature during transportation and while on the ward at the hospital.

The plan cited the need for training for doctors and nurses since “blood is often wasted because of inadequate storage on the ward”. It is estimated that the country needs 15, 000 units of blood per year.

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