Blood Transfusion in Tanzania

Well what a busy few months I’ve had- hence no blog updates, sorry!  I expect you have had enough of stories of my fun times so I will explain a bit about what has been going on at work.. after all I am here to work, not just to sit on the beach.

In October I visited the Mtwara regional Blood Transfusion Centre (Damu Salama).  It is housed in an impressive purpose built building in the grounds of Mtwara’s Ligula district hospital and I was shown around by the very helpful Mr Msanja.   The centre has excellent facilities for collecting donations, the laboratory is modern, clean and well equipped with new equipment that some UK labs would be jealous of, and their policies, SOPs and systems are complete and thorough.  Only one slight problem, there is no blood!  When I visited there were only 3 units of blood in the bank fridge to serve the entire Mtwara and Lindi regions.

Recruitment and retention of donors is the major problem for the Tanzania BTS and this is due to many reasons.  Generally there is a lack of awareness and education about the necessity for blood donations, and the process involved and there is also some stigma and false information such as donating blood can give you diseases.  There is also the issue of HIV status as many people do not want to know their status and so will not donate blood as the BTS will tell them.  They do have an advertising and education campaign, but like most things in TZ, it is pole-pole (Slowly).

 The main source of donations is from college or university students and the BTS runs a mobile donation clinic during term time visiting locals institutions (I visited during school holidays hence there was no blood).  Collecting from students also helps to reduce the risk of Transfusion transmitted infections (TTI) as the HIV rate is lower amongst the younger generation.  Whilst the BTS does screen donations for TTI and has a comprehensive pre-donation exclusion questionnaire, the risk of TTI is still higher than in more developed countries due to the high prevalence in the community.

Given the erratic supply of blood, most hospitals in the region including Nyangao still rely on donations from patient’s relatives collected at the hospital.

Whole blood is still the main product used in Tanzania, although the BTS has the facilities to separate packed red cells and produce FFP and even platelets.  However, there seems to be a lack of education about blood components and their uses amongst medical and laboratory staff, as well as transportation and storage constraints which prevent the use of platelets and FFP in many hospitals.  (What use is an FFP freezer when there are regular power cuts?  And platelets stored at room temperature?  Well, RT is about 35C here!). 

Before I left I donated a unit of blood, bringing the grand total number of units in the region to 4!