On June 14, every year, countries around the world celebrate what is now known as the World Blood Donor Day. First held in 2004, the celebrations serve to raise awareness of the need for safe blood and blood products, and to thank blood donors for their voluntary, life-saving gifts of blood. Rwanda will host this year’s celebrations, making it the second country in Africa to host the event following South Africa 15 years ago. Officials at Rwanda Biomedical Centre say that Rwanda was chosen to host the event because of the gains and innovations it has made in blood transfusion, among them, the use of drones to deliver blood to transfusing health facilities In addition, National Centre for Blood Transfusion (NCBT) has been able to fulfil the national hospitals demand for blood to more than 96 per cent in 2017 from 49 per cent in 2014. Blood collection has risen from 42,789 units in 2014 to 80,000 units currently. NCBT now holds a Level Three accreditation, the top most level that the African Society for Blood Transfusion (AFSBT) awards for quality and meeting international operational standards. Ahead of the World Blood Donor Day, The New Times’ Hudson Kuteesa interviewed Dr Thomas Muyombo, the Director of Regional Centre for Blood Transfusion Kigali, on the gains the country has made as well as outstanding challenges. Excerpts: What is your assessment of the successes made in blood transfusion? There have been significant strides registered in blood transfusion, but this not limited to the blood transfusion services. It is a general achievement in as far as health systems are concerned in Rwanda. Dr Thomas Muyombo. The blood that we produce in the blood transfusion services is used to treat patients who suffer from different conditions. These diseases are controlled by other divisions in the health sector, so, when they do it well, there are not many patients in hospitals needing blood; and this translates into good hospital satisfaction. I wouldn’t limit credit to the blood transfusion services. I would extend it even further to other services in the health sector. Rwanda has 96 per cent satisfaction for hospitals needing blood. What are the measures that have been used to increase people’s participation in blood donation? You know we get blood from people, we don’t buy it. It depends on people’s sympathy; how they feel they should save someone’s life even though they don’t know this person. We put some strategies in place to raise awareness, to increase involvement of different people and stakeholders. We also raised the awareness of treating physicians at the hospital level on how to utilise blood well, because when it is not utilised well, it is going to be insufficient. We have also put in place a system to make sure that we collect blood which has less transmissible infections so that we discard as little as possible. Ninety-six per cent hospital satisfaction is good; do you have plans to achieve 100 per cent? A hundred percent is ideal, but it’s not a guarantee that it can happen not only in Rwanda, but anywhere. Blood is not of the same type, so when the hospitals request for it; sometimes they need a specific blood group that may not be sufficient at that moment. So what we do is to find ways of making sure that this patient receives from another blood group if it’s an emergence situation. Or we can ask them to wait as we mobilise for donors with the same blood group. Blood also has a shelf life. It expires after a certain period of time. So, we can have enough today and after a few weeks, some of it expires. Therefore, 96 per cent satisfaction is actually already enough, however, we have to make sure that it is used rationally. So, we put strategies in place to educate and to provide trainings to the hospital personnel on blood transfusion, indications, and complications; to make sure that the blood we give them is used to the maximum. This is because sometimes you find that some blood expires at the hospital level, or they return some of it when they find that there is no one to receive it and it may perish. To what extent do we have regular donors? We have 34 per cent regular donors, those who donate every three months. Twenty-nine per cent are irregular blood donors, the ones who donated before but forgot to come back to donate. 36 per cent are new donors, the ones that had never donated before, and are coming to donate for the first time. How good are these figures? There are recommendations that we consider to know whether we are doing it right or not. It’s recommended by the World Health Organisation (WHO) that all blood donors donate blood without being paid. Here in Rwanda we have 100 per cent unpaid blood donors. In other countries there are different types of blood donation like munerated (paid) blood donors and family replacement (where someone donates so that a family member who needs to be transfused will get blood). Some other countries have 30 per cent or 40 per cent free donations. Another recommendation by WHO is that at least for every 1000 people, there should be 10 blood donations. That would equate to 120,000 units of blood a year. We are now at 80,000 units a year. But because of a well-functioning health system, this is enough. You know for someone to receive blood, most of the time they have to come to the hospital when their situation has totally deteriorated. In Rwanda, since we have a universal health system, people are able to seek medical help before their condition gets worse, and they don’t have to resort to blood transfusion. If we increased our blood collection to 120,000 units, we could find a lot of blood expiring in the hospitals. That is why we are safe to collect the 80,000 units which increase annually depending on the increase in the number of the population or the number of health facilities. Rwanda Defence Force is a main contributor toward the cause of blood donation, and donate blood quarterly. How did this partnership come about? Of course being part of the RDF means that you are already giving out as much as possible to the community. And you know they are the most energetic members of the population. So, as one of the strategies to ensure that there is continued supply of blood, we had to find a way of engaging them. Being people in the same place and busy doing things that don’t expose them to sexually transmissible infections, we had to go to them. Since, as soldiers, they already know the value of saving life, it was easy for them to agree to have a Memorandum of Understanding with RBC to donate blood. What’s your call to blood donors and the general population? The call, before asking them for more, I would first take this opportunity to thank them because without their will, without their gift of blood, we wouldn’t have blood to give to the patients. We don’t buy blood, so I would like to thank anyone who has ever donated, even those that no longer donate, because they saved someone’s life sometimes. In addition, I would also ask them for more because I normally say that donating blood is like eating. You can’t be full today and think that you won’t need to eat tomorrow. That’s why people work and go back to work the next day. We have patients at hospitals every day. We can’t tell someone who needs blood that certain point you received enough, don’t come back. If you are donating blood, you don’t have to stop, because first of all when the blood you give is used, it needs to be replaced so that even another patient who comes tomorrow will get blood. editor@newtimesrwanda.com
