HEALTHY DISCUSSION

What blood donation means to sickle-cell disease patients

Kenyans must build a legacy of donating blood at least twice a year to prevent shortages

In Summary

• SCD patients are often told there is no blood for an emergency transfusion

Sickle cells illustration
Sickle cells illustration
Image: COURTESY

Arjun Prasad Mainali, a citizen of the United States of America, is the highest blood donor in the world, having donated blood 171 times for the last 32 years, adding up to a total of 85.5 litres of blood.

Arjun is said to have saved 513 lives through his donation, going by the standards set by the World Health Organisation of one unit of blood saving three people.

Being the Sickle Cell Anemia Awareness Month, Kenya was fortunate enough to host Arjun during the weeklong blood drive organised by the Kenya National Blood Transfusion Service from September 9-13. The one-week blood drive will help save, among other patients, those suffering from sickle-cell disease, who require frequent blood transfusion.

 

Just the other month, on June 19, the world marked the 10th anniversary of World Sickle Day under the theme, “Shine Light on Sickle Cell”. Countries around the world celebrated this day differently. Here in Kenya, organisations such as Children Sickle Cell Foundation and the Joanne Chazima Sickle Cell Foundation, among others, converged at Uhuru Park with the aim of raising awareness about the disease.

Sickle cell disease (SCD) is a medical condition that affects haemoglobin, which is the molecule found in red blood cells responsible for delivering oxygen to cells throughout the body. SCD patients have a particular gene known as Hemoglobin S, which causes deformities of red blood cells. It makes them assume a crescent shape, slowing down or blocking blood flow and oxygen to the parts of the body. The result is severe pain, known as sickle crisis, and it is exceedingly devastating.

SCD is most prevalent in Africa, Mediterranean countries and in the Caribbean. In sub-Saharan Africa, over 300,000 babies annually are born with SCD, and this number is expected to increase up to 400,000 by 2050. Sickle cell is hereditary and here in Kenya, it is prevalent in Western, Nyanza and the Coast. But with the current trends in intermarriages, the disease is likely to spread to other parts of the country in due time.

SCD patients need medication (such as antibiotic and pain relievers, when a sickle crisis occurs), blood transfusion and, for a long-lasting solution, bone marrow transplantation, also known as stem cell transplantation.

Blood transfusion is one of the most important treatments for SCD patients, as it provides normal red blood cells to their bodies. This allows blood to flow freely, preventing any sickle crisis. SCD patients can undergo two types of blood transfusion: simple blood transfusion or exchange blood transfusion. During simple transfusion, which is normally given once or twice a month, healthy red blood cells are delivered to the patient’s body, and this helps in maintaining a healthy proportion of normal to sickle red blood cells. Exchange transfusion, on the other hand, exchanges the sickle red blood cells with healthy ones, lowering the concentration of the sickle cells.

Blood transfusion for SCD patients is critical when the sickle red blood cells block the flow of blood, preventing the flow of oxygen in the body. In this case, blood transfusion will help push the flow of blood to those areas where there is blockage, allowing for the flow of oxygen and preventing sickle crisis. Some of the SCD patients require blood transfusion as often as twice a month, and this makes the need of blood donation constant.

It is not uncommon for an SCD patient to walk into a hospital for an emergency blood transfusion, only to be told that there is no blood in the hospital, or to be forced to pay for the blood or call upon their relatives and friends for a donation.

 

This is because there is not enough blood in the hospitals, and this is the reason the Kenya National Blood Transfusion Services is always appealing for blood when a crisis hits the country, such as during the Dusit Complex attack.

Kenyans must build a legacy of donating blood at least twice a year. This way, blood donation appeals could be avoided and people would not have to go through hardships, beyond their medical conditions, before receiving blood transfusion in hospitals.

So, donate blood today and give a sickle cell patient an opportunity to walk into any hospital and receive blood transfusion as an emergency treatment.

 

Elizabeth is an Advocate of the High Court. Associate at Ibrahim Yakub & Associates Advocates. She is passionate about Medical Law and Ethics most especially the ethics of both living and deceased organ donation and transplantation