THERE has been shortage of blood in the country for the last six months, but the problem worsened early last month
By Vision Reporters
OUR baby lived for a week. All he needed was a few units of blood, narrates Moses Agaba, a Kampala businessman.
We searched for blood of Group O+ from Nsambya and Nakasero Blood Bank for two days in vain. Our baby finally died at about 3:30pm on Sunday, the distraught father mourns.
“The doctors wanted blood to save our baby’s life, but there was no blood in Nsambya. We rushed to Nakasero Blood Bank with a donor, but they said they didn’t have the gadgets for testing blood,” explains Agaba.
“The baby eventually died. Although we can say it was God’s plan, we cannot fail to blame the blood bank officials for negligence,” he says.
Agaba’s baby is one of many patients who have died in a period of about a month when hospitals across the country have been without blood even as thousands of blood units remained stacked in regional blood banks.
Robert Mbowa, a sales executive with Nile Breweries in Mityana, says he lost his two-year-old son, Elijah Kyeswa, last week at Mulago Hospital due to lack of blood.
The son had been diagnosed with Malaria in Mityana before being referred to Mulago. He needed blood Group O to survive.
“He was admitted to Mulago on Tuesday, but the medical personnel kept telling us to wait as they looked for it until the child died on Thursday evening,” Mbowa narrates.
Nyapea Hospital, the only one in Zombo district, last week lost a child because there was no blood of Group O, according to Dr. Sam Ajoga, the district health officer.
In Nalufenya Children’s Hospital in Jinja at least 4% of the deaths there are a result of blood shortage. There has been shortage of blood in the country for the last six months, but the problem worsened early last month as all the seven blood banks in the country ran out of testing kit and reagents.
Procured by the National Medical Stores (NMS) on a quarterly basis, the kit is used to test blood to determine its group and for transfusion transmissible infections including HIV, Syphilis and hepatitis B and C.
“All regional blood banks have all along been well stocked with enough blood, which they could not release to hospitals before it was tested,” Dr. Benjamin Wabwire, the acting Uganda Blood Transfusion Service (UBTS) director, confirmed.
Dr. Balina Nseko, the Jinja Hospital deputy director, said the hospital, that requires at least 80 units of blood per week, is currently facing a shortage, with patients in dire need of it being referred to Mulago.
He said the most affected are pregnant women, the critically ill and patients at Nalufenya Children’s Hospital which is attached to the hospital.
Irene Nabirye, whose two-year-old child has been admitted to Nalufenya with malaria for a week, said health workers sent her to look for blood elsewhere, but she had failed to get it in any health unit in the district.
Kamuli Hospital requires 50 units of blood per week, but has been dry for the last three months.
Dr. Robert Isabirye, the medical superintendent, said when they contacted the blood bank, they were initially told blood was not being delivered because students who are the biggest donors were in holidays.
“They later told us that our ‘Cool Box’ in which it is meant to be transported had got lost. Up to now, we are still wondering how it disappeared, but we hope to replace it within a week,” he said on Friday.
Sarah Nakayiza, the officer in charge of the laboratory at the hospital, says they received 14 units of blood on Friday, only five of which are for adults.
She says the maternity ward takes most of the blood supplied. The ward admits over 100 mothers and whoever delivers normally, is discharged immediately to create room for others.
Patients in Nebbi pay sh2,000 for blood kit. Juliet Apio, a resident of Jupangiri, Nebbi sub-county had to borrow sh2,000 from her friend to buy a blood giving-set for her twoyear- old daughter at Nebbi Hospital.
Dr. Charles Kissa, the medical superintendent Nebbi Hospital, said they have been operating without the bloodgiving- set for the last three weeks. As a result, they have been forced to ask patients to buy them.
Dr. Abraham Kakule Masinda, the officer in charge of St. Paul’s Health Centre IV in Kasese, says they have been operating without blood for three weeks and most of the patients who need blood have been referred to Kagando and Buhinga hospitals.
He said the centre has been acting as a sub-referral for anaemic cases in the district, but now it has been overwhelmed by demand.
Dr. Thomas Ochar said Tororo Hospital has never run short of blood despite the continued crisis that has hit other hospitals due to lack of testing kit.
Lack of testing equipment causing blood shortage
Experts have blamed the acute shortage of blood in the county on lack of blood-testing kits. Officials from the Uganda Blood Transfusion Service (UBTS) and the National Medical Stores (NMS) insisted yesterday that the problem was due to inadequate funding.
Dr. Dorothy Kyeyune, the director of Uganda Transfusion Service, examining blood units.
While the UBTS required about sh18b this financial year, the Government provided only sh7b, leaving a gap of sh11b. The ministry’s budget for blood testing kit and reagents has been met largely by donors, mainly the US government.
Donors gave UBTS sh5b this financial year, sh500m of which was for medical and laboratory supplies where the testing kit falls.
According to World Health Organisation standards, Uganda needs at least 300,000 units of safe blood per year to meet the minimum requirement.
To acquire this number of units, at least 350,000 units have to be collected, according to Dr. Wabwire.
However, due to inadequate funding, Wabwire says they can collect only 250,000 units a year. This explains the usual inadvertent blood shortages.
The country requires about 1,200,000 testing kit per year to cater for the 20,000 units of blood collected per month, according to Wabwire.
Dan Kimosho, the NMS spokesperson, said the funds allocated for procuring the kit and reagents this financial year ran out after barely six months.
Although NMS officials were reluctant to reveal the cost of the kit, it is clear that the tests are expensive with hepatitis B and C costing about $5 (sh12,500).
A doctor at Nalufenya Hospital said: “This blood shortage has been going on for long, but is now worsening. Health is no longer viewed a priority. The sector is underfunded.”
As a result, Mulago Hospital got overwhelmed with referral cases from upcountry hospitals, while dozens of patients in dire need of blood died, according to New Vision investigations.
Most affected at Mulago are the wards for children and expectant mothers. The hospital administrators have been forced to give blood only to emergency cases as patients who need elective surgery are put on hold.
“There are patients who need surgery, but their problem will not kill them if the surgery is delayed for some time. We have kept these ones waiting until we get enough blood,” said Dr. Baterena Byarugaba, the hospital’s executive director.
Byarugaba revealed that although they received some units of blood last week, they were still operating below normal levels.
Even the sh800m the health ministry diverted from its noncore activities to arrest the situation in April, also ran out after a few weeks, paving way for the current crisis.
Rukia Nakamatte, the spokesperson for the health ministry, said another consignment of testing kit was expected soon following the passing of a supplementary budget.
The consignment is expected this week. With the sh1.7b supplementary budget, NMS supplied testing kit to Nakasero, Mbale and Mbarara blood banks, which have automated testing systems.
Gulu, Fort Portal, Masaka and Arua blood banks that are still using a manual blood testing system are yet to receive the much needed kit.
Major hospitals still lack blood