“There are risks and costs to a programme of action, but they are far less than the long-range risks and costs of comfortable inaction.”-late US president John F. Kennedy.

As if true to late Kennedy’s wise statement over a year down the line, failure to address the blood shortage in Malawi’s public hospitals has taken a new twist since taking advantage of the situation including economic hardships selling blood has boomed in the lakeshore district of Mangochi over 300 Km from the capital, Lilongwe!

The blood bank at Mangochi District Hospital has dried up and the matter has forced some patients with no choice but buy blood from some residents who are pegging a pint of blood at K7,000 (about $23).

An anaemic patient Hawa Ntila recenly gave birth to twins at Makanjira Hospital in the same Mangochi District and is bedridden at Mangochi District Hospital.
She paid K7,000 for a pint of blood and few days later had also to part with the same amount to a blood donor.

Ntila works for Women and Law in Southern Africa (Wilsa) Malawi Chapter as a Community Based Facilitator.

Gender Rights Campaigner also Wilsa Malawi Chapter National Coordinator Seodi White got furious with the blood sales reports.

She disclosed that Ntila paid the K7,000 on Sunday September 22 for a pint of blood.

“But it was enough. She was told that she needs another pint of blood,” said White also a lawyer adding they were surprised by this and she even enquired as to how this was happenning.

She further disclosed that President Joyce Banda’s Advisor on Civil Society Affairs Reverend Mc Donald Sembereka learnt about of the on-going blood for sale syndicates in Mangochi on her [White’s] Facebook wall.

The matter forced Sembereka travelling to Mangochi on September 25.
White said of great painful was that Mangochi District Hospital officials were aware that the malpractice of selling blood was taking place.

She further explained that her organization plans to jointly with the Ministry of Health organize a blood donation day in Mangochi.

Following the on-going blood sales boom, Mangochi bycycle taxi operators are standing outside Mangochi District Hospital entrance offering to donate blood for K7,000 a pint.

Malawi’s Health Ministry officials confirmed the developments in Mangochi, expressed their shock and said have already launched investigations on the matter.

Despite the importance of blood, in Malawi however, the country’s blood banks are always thirsty for more blood due to low blood donations.

To encourage more people to donate blood to save lives in times of emergency, former First Lady Madame Callista Mutharika also founder of the Callista Mutharika Safe Motherhood Foundation urged Malawians to donate blood.

“We need adequate blood in times of emergency in our hospitals to save mothers and children therefore, we are appealing to people to come forward to donate blood to the Malawi Blood Transfusion Service (MBTS) centres in the country,” she said.

She observed that in Malawi it has been indicated that 807 out every 100, 000 women die due to child birth complications including loss of blood during labour.

Reproductive Health Unit Officer Wilfred Dzama concurred with Mutharika saying blood loss in women during labour is among one of the major direct causes of death in pregnant women during childbirth in Malawi.

“Delay in supplies of blood transfusion facilities during labour increase death risks for pregnant women during labour,” he said.

Out of her own experience as a mother, Malawi’s President Joyce Banda also emphasized the importance of stocking adequate safe blood for emergency purposes including for pregnant women during labour in the country.

Banda disclosed that many years ago during labour she lost a lot of blood.

“I was told that I lost a lot of blood and it had to take an intervention of a doctor to save my life,” she said.

MBTS Executive Director Natasha Msamala said despite that blood is the most precious gift of life that anyone can give to another person many people in Malawi are unwilling to go to her organization’s centres to donate blood.

“Donating blood regularly by sufficient number of healthy people is necessary to ensure that blood will always be available whenever it is needed,” she said.

Msamala said in Malawi blood is commonly used for women with complications of pregnancy, such as haemorrhage before, during and after child birth.

“Blood also saves lives of children with severe anaemia, often resulting from malaria or malnutrition as well as for accident victims including patients undergoing surgical procedures,” she said.

Msamala therefore, appealed to people aged from 16 to 65 in Malawi to go to MBTS Centres to donate blood.
She disclosed that as a country Malawi needs about 80,000 units of blood per year but has just slightly over 35,000 units hence not adequate to meet the demand.

Msamala attributed to Malawians’ reluctance to donate blood due to among other things some misconceptions.

“For instance some people are afraid to donate blood because they believe that doing so will make them grow thin and impotent,” she said adding that others are also discouraged to donate blood out of believing that MBTS sells blood.

Yet MBTS is a non-profit institution purely engaged in collecting blood from volunteers, test it before distributing it to all hospitals in Malawi to save lives of people in need of it.

“People should never believe in the misconceptions that have been circulating because they are not true, instead they should come forward to donate blood,” said Msamala.

To at least stock some blood in its banks, MBTS mainly depends on young people between 16 and 25 years especially from schools and colleges for blood donations therefore, its blood banks store inadequate blood against a high demand when students are on holiday.

Many people in Malawi have yet to understand the importance of donating blood that it saves lives.

According to MBTS a person can voluntarily donate 450 ml of blood at a time and has to be examined to make sure that he/she is healthy and medically meets standards before making a donation.

“We mainly depend on school and college students to collect blood so much so that when their premises are closed we struggle to source blood for the needy in times of emergency yet if more people come forward to donate blood we can meet the demand,” said Msamala adding that blood demand in the country is always high.

Demand for blood in Malawi according to MBTS statistics even always gets higher between October, November and December and early January annually.

Many people are in need of blood around this period because they become anaemic after contracting malaria due to rampant mosquito bites as it is rainy season.

Further, around the same period road accidents increase due to festivities such as Christmas and New Year.

To enable more Malawians understand the importance of donating blood in the country MBTS is engaged in tireless civic education activities including annually joining the rest of the world in commemorating ‘World Blood Donor Day’ on June 14.

Malawi, with a population of over 13 million is indeed struggling to have adequate blood in its blood banks in public hospitals.

To sample the blood availability challenges in Malawi, Eugene Kongnyuy from Child and Reproductive Health Group, Liverpool School of Tropical Medicine, United Kingdom (UK) conducted a research in the country.

“Malawi is one of the countries that have established a national blood transfusion service according to World Health Organization (WHO) recommendations and guidelines,” he said.

But Kongnyuy noted that the MBTS is not currently able to provide the total amount of blood required by the health facilities in Malawi.
“Therefore, in addition to the blood received from MBTS, some hospitals still continue to collect, test and store blood at the facility level,” he said.

The researcher further explained that for a long time hospitals in Malawi relied on family replacement blood donors whereby the hospitals asked patients’ guardians to look for family members to come forward to donate blood for the sick relative or friend.

“This system was found to be inadequate because time is wasted in the process of looking for donors, getting them to hospitals, testing for their blood groups, testing for infectious agents, and conducting a blood donation session,” said Kongnyuy.

The MBTS was therefore established by Malawi Government in 2003 with a 7.8 million Euros (then about K14.6 billion) funding from European Union (EU) to collect and distribute safe blood and blood products to the country’s hospitals for use in time of emergency to save lives.

“Now that the MBTS is not able to provide adequate supply of safe blood to hospitals, the two systems co-exist side by side,” said Kongnyuy.

To sample Malawi’s blood availability challenges Kongnyuy clarified that data was obtained from MBTS from eight hospitals that provide blood transfusion services in three districts of Lilongwe, Kasungu and Salima in central Malawi.

During the study the population of the three districts was estimated at 2,812,183 and there were 127,000 deliveries per year of which 40 percent took place in the public health facilities (hospitals and centres).

Kongnyuy said it was revealed in the study that a third of the blood used in these districts went to the maternity units and that the MBTS depended on students for blood donation.

“Continuity of blood supply is not ensured especially during examination periods and during holidays when students return to their homes. During these periods the MBTS frequently runs short of blood,” said Kongnyuy.

He disclosed that for example, during the period he conducted the study, the in-charge of Malawi’s major referral hospital [Kamuzu Central Hospital (KCH)] in Lilongwe disclosed that his hospital had been without blood for a week because students were on holidays yet the hospital continued receiving emergency cases in need of blood.

Similarly, Likuni [Catholic Mission] Hospital also in Lilongwe had not received blood from MBTS for two weeks during the same time of data collection for the study according to Kongnyuy.

“Looking at data from hospitals and MBTS, it was clear the number of pints of blood requested by hospitals from MBTS was less than the pints they require,” he said.

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