The World Health Organisation (WHO) says Nigeria needs at least two million pints of blood annually, a far cry from the 25, 000 it currently generates.
Three months ago, a civil servant, Mr Obafemi who resides in Abuja was searching for blood for his wife who was due to have baby in March.
Obafemi’s wife had received a list from the General Hospital Kubwa where she had registered for her antenatal care, containing items she was required to provide during delivery, including blood.
As an O-positive blood type recipient, she could only receive blood from O-positive and O-negative donors, making her husband of the B-positive blood type, ineligible to donate blood to her.
The fact that her O-positive blood type tops the chart of donated blood in Nigeria should have made their search less challenging, but it did not. The situation compelled them to expand their search to friends and finally strangers.
“My fear was that I wanted to know the person that owns the blood before transfusion. I wasn’t just comfortable taking blood from someone I don’t know. I wanted to know the character of the person that owns the blood. It’s just my personal belief,” he said.
Finally through the Nigerian Red Cross Society, he was able to get a matching voluntary donor and only had to pay N8,000 for screening and storage.
The story was different for Yetunde Afolabi, an insurance company staff, who underwent a myomectomy procedure in 2021 at a private health facility in Lagos.
Afolabi, who has the B positive blood type, said she was asked to provide two pints of blood before her surgery, which she admitted was sourced from the blood black market at the cost of N25,000 per pint.
“I don’t have close family or relatives here in Lagos; so I had to get it through an agent. Altogether, I paid N50, 000 for two pints of blood,” she disclosed.
The need for blood is universal, but access to safe blood and safe blood products for all those who need it is not. Shortages of safe blood are particularly acute in many developing countries like Nigeria.
In the wake of the recent attack on a church in Owo, blood donors where sourced from various states to meet the demand of victims after those donated by friends and relatives proved insufficient.
Head of information and advocacy for the Nigerian Red Cross in Owo Ibrahim Laide said that blood donations were received from Akure, the Ondo state capital as well as other states like Edo, Ekiti, Osun and Port-Harcourt until the blood banks at the Federal Medical Centre and St Louis Catholic Specialist Hospital Owo reached their maximum capacities.
“People donated from the University of Benin Teaching Hospital, University of Port-Harcourt then from Ayo Babalola University Teaching Hospital too,” he said.
As the world marked World Blood Donor Day on June 14, WHO used the opportunity to thank voluntary, unpaid blood donors for their life-saving blood gifts and raised awareness on the need for safe blood and blood products to save more lives.
This year, the slogan ‘Donating Blood is an Act of Solidarity. Join the Effort and Save Lives’, aims to draw attention to the roles that voluntary blood donations play in saving lives and enhancing solidarity within communities.
We don’t sell blood– Hospitals
Humans have 35 major blood group antigens as well as other minor groups, but to ensure that a transfusion recipient receives compatible blood, only two antigens are considered – the ABO (which has A, B, O and AB categories) and RhD (which has negative and positive categories) groups.
A spokesperson in the Servicom Unit of the National Hospital Abuja, simply identified as Jacob said the hospital does not sell blood to patients but that he is aware some patients enter into private arrangements with paid donors.
“We don’t sell blood; it’s not possible. If there is anyone who has a case where blood was sold to them at the hospital, they should let us know.
“There are certain sensitive blood groups such as O Positive that we may not get on time and patients would have to source for donors and pay them. So, patients bring people to come and donate blood and they would give them money on their own.
We’re not involved. We only ask them to pay for screening the blood,” he said.
Jacob added that before any procedure is carried out, patients usually sign a form consenting to donate any unused blood to anyone that requires it within the hospital.
The head of laboratory, Nisa Premier Hospital Abuja Emmanuel Enejoh, explained that it is a world health standard practice to require patients to provide blood prior to delivery or surgical procedure.
Here, patients also give consent that the blood supplied is non-refundable. Where the blood is not transfused to the patient, it is used to cater to emergency situations that may arise.
“We have the emergency wing of our hospital. We have a sickle-cell clinic. When these crisis or emergencies come up, we don’t ask these people to go and look for blood, provided we still have blood that are within the expiration date of 27-30 days.
Enejoh further explained that although the hospital’s first line practice is to use relative donors, it sometimes recruits paid donors for patients who do not have and charge only a screening fee afterwards.
“If you don’t have your donor, that is where the remunerated donor comes in. Some of them would tell you they don’t even want to know these people. In this part of our world, because of the level of poverty, people have not woken up to the reality that you should come and donate blood free.
“Once we recruit a donor for a patient, we allow them to reach an agreement on pricing. We don’t charge patients any fee outside screening fee,” he stressed.
However, corroborating Afolabi’s claim about the blood black market, the operations manager at Haima Health Initiative, Ayobami Bakare, disclosed that Nigeria has an active blood black market which charges very exorbitant fees.
“At Haima Health Initiative, we organise blood drives for the NBSC (National Blood Service Commission) and we screen those blood and issue them out at N6, 000. Where the discrepancies come from is that there are a lot of private blood banks, especially in Lagos and Abujawhere people pay donors to get blood.
“There is also an active blood black market in Nigeria which is very exorbitant. The price of a negative blood can cost between N25, 000 – N30, 000, depending on the location. So they just extort patients because of the deficit. At every point in time, Nigeria needs between 1.8 million to two million pints of blood,” Bakare said.
Inability to fractionate whole blood still a major challenge – Commission
The National Blood Service Commission is in charge of coordinating, regulating and ensuring the provision of safe, quality blood transfusion services in Nigeria.
Nigeria established a national blood transfusion policy through a published set of guidelines in December 2006 essentially made up of action plans geared toward providing safe, available and affordable blood donor units where and when they might be needed in the country through.
The commission has disclosed that most hospitals in Nigeria transfuse whole blood to patients even when only specific components of the blood are required because the equipment for blood fractionation is expensive and not readily available.
The technical assistant to the director-general of NBSC Uneku Offor, said its a major challenge, but noted that the commission is working to surmount in the near future.
Offor revealed that only eight per cent of Nigeria’s population donate blood voluntarily, most of which come from relatives. The Commission, he said, has rolled out an initiative that targets to grow voluntary blood donation from 25, 000 per annum to one million as part of its 10-year strategic plan.
An individual can only donate blood a maximum of three times a year and in Nigeria, the highest voluntary blood donor is Benjamin Aghoro, who as at May 2022 has donated 106 pints of blood.
“There should be a reserve such that when such emergencies, mass casualties are encountered, such as the Owo church attack, we can easily mobilise those units of blood to the area that they may need it. That is what the one million safe blood units’ initiative is all about.
“Through the one million safe blood units’ initiative, we will start diversifying into components like red blood concentrates and the plasma, once we get a substantial amount of donated blood.
ICIR
