BENIN: Blood shortage proves deadly

Friday, October 10, 2008

Fear, a lack of blood donation supplies and ill-trained health staff have led to a dangerous blood shortage in Benin, said the head of the country’s blood donor association.

“If the outcry over blood shortages were the same as the uproar over AIDS, we could avoid a lot of damage and death,” said Rynce Agassoussi, the president of the Beninese Association of Blood Donors. He said it is hard to know how many people die because of blood loss because hospitals do not indicate that as a cause of death.

He told IRIN that since the beginning of 2008, blood reserves have dropped significantly in eight of the country’s 12 blood storage facilities. The four that have sufficient levels receive Belgian support through a programme known as PASTAM to improve blood transfusions in the northern regions of Atacora and Donga and the southern regions of Mono and Couffo.

“That leaves us with a 75 percent coverage rate for the country,” said Agassoussi, “At least 25 percent of people [who need blood] are dying needlessly.”

The director of the blood bank at the country’s largest hospital, National Hospital Centre and University (CNHU), Andre Bigot, told IRIN the situation is worse than he has ever seen: “There are leukaemia and sickle cell patients who arrive [at hospital] needing blood, but there just isn’t any…It is impossible at times to even get them a drop of blood.”

Supplies lacking

Cotonou-based lab technician Augustin Vodounon said even if there are blood donors, who are not paid to give blood, supplies are often lacking: “In recent months, the shortage of materials has become untenable. There is a nationwide shortage of activating agents [needed to test blood]. We cannot draw blood without testing it.”

The blood donor association estimates it will cost up to US$2 million to purchase enough testing agents to cover the country’s blood needs. The Ministry of Health gives the association US$1.2 million to run the country’s 12 blood storage facilities, according to Agassoussi.

It takes a long time to order and receive agents, and without them, donated blood is useless, he added.

Donor drop

But it is these tests also, Agassoussi said, that hold back some potential donors: “With so many infectious diseases, including AIDS and hepatitis, many people are scared to come because they are afraid we will detect these illnesses through the required blood test.”

A Cotonou resident who gave his name as Benoit N. said he will donate blood only under one condition: “I do not want to create any problems for myself. If there were no required tests, I would easily give blood. But the moment my blood is submitted for various tests, which reveal dubious diseases, I will be in trouble.”

Willing donors exist, especially among students, but they can be unreliable, said Agassoussi: “We generally collect twice as much from students as we get at the donation centres. But when it comes to vacation or exam time, they disappear.”

Health system problems

The government-appointed doctor in the Belgian-funded PASTAM project, Edgar Lalia, said blood shortages are due in part to a disorganised health system: “There needs to be a welcome facility, a well-equipped laboratory, available supplies and qualified staff.”

However, he said, the government has made efforts to improve in recent years, with Swiss, Belgian and German support.

Hospital blood facility director Bigot said numerous nationwide strikes by paramedics demanding better work conditions have cut the number of trained staff able to process blood donations: “Donor willingness may have declined if they were greeted by unmotivated health workers frustrated with their work conditions.”

The national blood donor association reports 15,000 occasional donors in 2007, or 2,000 fewer than in 2006. It estimated, in addition, 4,000 people who regularly donate. The official count for 2008 is not yet ready, but with periodic paramedic strikes, association president Agassoussi predicts a continued drop.

Patients turn elsewhere

“A few days ago, I had to buy blood in [neighbouring] Togo, I did not have a choice,” said a woman who gave her name as Aline. She said she had first accompanied her mother to the blood storage facility at CNHU in Cotonou.

CNHU’s Bigot told IRIN: “It is a shame that we have gotten to this point.”

In Benin, a 450-centilitre government-subsidised packet of blood costs about US$4, while patients pay three to four times this amount outside of Benin.

With dwindling blood stock, CNHU’s blood storage facility has turned into a collection site— waiting on donors.