Kenya’s blood banks are holding less than 18 percent of the demanded blood transfusions, pointing to the acute shortage that has left families making frantic calls on social media to save lives.
Units of blood donated and stored by Kenya National Blood Transfusion Service (KNBTS) fell to a three-year low of 155 600 in the year ending June 2019 against the demand of over one million units, the government says.
The fall was from 160,000 units in the year to June 2018 and 158,378 units in the preceding period, pointing to the growing shortage of the essential product that usually means life and death to those requiring it.
Every 10 minutes, about seven Kenyans need blood and are at risk of dying if it is not available, according to the KNBTS. This means that every day, 1,008 people are asking for blood.
Just three teaspoonfuls of blood are enough to save the life of a premature baby, the agency adds. Yet, the shortage in blood banks had made this a taxing need to satisfy.
The KNBTS, which is mandated by the government to ensure the provision of adequate safe blood, has been struggling to meet the rising needs, forcing many Kenyans to rely on social media platforms to crowdsource for blood.
“With the rise of non-communicable diseases like cancer, need for blood products has exponentially increased since management of cancer requires huge volumes of blood and blood products,” the Ministry of Health notes.
The agency relies only on six regional and 25 satellite centres to collect blood in a country of 47 counties, 290 constituencies and a population of 47.6 million.
Finding blood donors has proven to be a tedious task with many calling on relatives and friends to rush and donate during emergencies.
Social media platforms such as Facebook, WhatsApp and Twitter are awash with families appealing for blood to save their loved ones.
Such was the case with Omwocha Nyaribo, who on January 9 put up a Facebook post appealing for blood donations for his father who was scheduled for surgery the following day.
By the following day, people had responded — some unknown to him — helping the family to meet the blood deficit.
“To our friends, and our friend’s friends who willingly donated blood when he (father) needed more blood, we are truly indebted by your kindness and sacrifice,” Mr Nyaribo later posted showing the success of the appeal.
Similar success stories are also found on Twitter and WhatsApp, showing the growing importance of social media in sourcing for blood. This has led to the creation of many social media groups to mobilise donations.
Amos Monoi, a Nakuru-based regular blood donor, started a donation group on January 1 and now has more than 5,000 followers.
He says that the Facebook group, called Blood Group 0 Kenya, helps at least seven people per week, mostly those in emergencies.
“The network helps us to respond to cases urgently to save lives. Members facilitate themselves to where the patients are and that means we have to build membership in all corners of Kenya,” says Mr Monoi.
Other groups, rely on social media to recruit members and then put them into different platforms such as mobile applications.
RedSplash, a Mombasa-based non-profit organisation that mobilises blood transfusion says it dreams of time this commodity will be made available faster than the time it takes to deliver pizza.
Launched in mid-February last year, the organisation has so far received 1,417 blood appeals and managed to satisfy 837 of the cases with the 1,211 units of blood.
The organisation started RedSplash app, which is available on Google PlayStore and helps users identify the nearest donor and facilitate the donation.
Kenya has only about 561 transfusing facilities split between government, faith-based and private facilities, all which receive blood from the KNBTS.
The Ministry of Health says the current collection by the agency can only meet 18 percent of the demand.
The situation is set to worsen with the exit of development partners after Kenya was classified as a middle-income country following a statistical reassessment of its economy in 2014.
Donors have been a key pillar in Kenya’s quest for a strong blood bank. For instance, the achievement of 18 percent blood needs has been made possible by Sh1.6 billion from funding partners and only Sh320 million from the Kenyan government.
“With the development partners withdrawing, having cushioned 80 percent of achievements of blood collection, KNBTS stands a risk of extremely diminished collection,” warns the ministry.
This could deal a major blow to patients such as those in cancer wards, given they require a lot of blood in their treatment process.
About two of every three units of blood in Kenya are transfused to mothers and children, according to KNBTS. This means they will be the most affected.
Martha Wambui came face-to-face with this shortage at Kenyatta National Hospital (KNH) on January 10. Two days after admitting her child, she was told the hospital did not have O negative blood type that was needed.
“I thought KNH was just being insincere and so I mobilised four family members to donate other blood types. This was in hope KNH would then release to us the O negative blood,” she says.
This never happened because KNH did not have the O negative blood.
A family friend linked her to Blood Group 0 Kenya. The same day, two volunteers came and donated the blood. Ms Wambui was discharged last week and the child is responding well to treatment.
Kenya’s maternal death per 100,000 live births stands at 362 with one of the major causes of death being bleeding just before or after childbirth. That translates to about 20 women dying every day from childbirth-related complications.
The average cost of providing safe blood or blood products ranges between Sh10,000 to Sh14,000 per unit, meaning that shortage adds to the already high cost of medication.
The funding crisis comes at a time the National Treasury is cutting down on budget to accommodate austerity measures in an environment of rising debt burden and depressed tax revenue collections.
Keeping the 31 regional and satellite facilities spread across the 47 counties operational will require increased allocation from the exchequer.
This, therefore, calls for increased allocation to continue running the 31 regional and satellite facilities spread across the 47 counties.
According to the Health ministry, urgent funding from exchequer is required if Kenya is to maintain and increase collection of blood to satisfy the demands of universal health coverage (UHC) and improve quality of service and products offered to patients.
Kenya is also lagging in meeting its blood policy as well as that of international best practices and the World Health Organisation.
The policy requires that blood be transfused with the components- packed red cells, platelets, fresh frozen plasma, cryoprecipitate and paediatric packed cells- as opposed to universally giving whole blood.
About 95 percent of all transfusions require blood components and only about five percent require whole blood but Kenya has struggled to make this possible.
“This preparation of components requires dedicated skilled staff, special blood bags, and appropriate infrastructure including transport and blood storage equipment,” the ministry notes.
The ministry says there is an urgent need to establish additional satellite centres to cover the counties so that people can access blood easily. This will further mean that these sites will need to be empowered to prepare blood components.
Such initiatives require a lot more money given the reduced donors. Public health programmes and national blood transfusion services have been largely dependent on development partners for financing.
However, with the attainment of middle-income status, Kenya has seen a reduction and even cessation of funding of public health programmes by partners such as GAVI and Global Fund.
This means that the government will struggle to safeguard and sustain the gains made in the donor-funded regime unless it significantly increases funding to the sector.
Other strategic programmes affected by donor withdrawal include immunisation, family planning commodities, nutrition, HIV/Aids, malaria, tuberculosis, public health and disease surveillance and response.
All these programmes will be competing for the KNBTS for increased funding. Yet, the Treasury pronouncements are pointing more towards budget cuts.
The ministry is proposing innovative financing mechanisms such as joint ventures and public-private partnerships and ensuring efficiency in the utilisation of allocated funds.
Many Kenyans are generally reluctant in donating blood, meaning that bringing centres closer to them is important but not the silver bullet in hitting say 500,000 units.
The KNBTS also grapples with the imbalance between first-time donors and repeat donors, according to the agency’s director, Dr Josephine Githaiga.
The agency says in 2018, about 77 percent of those who donated blood were first-time donors while only 23 percent were repeat donors.
“Since repeat donors voluntarily walk into our clinics, if enhanced this would significantly reduce our cost,” says Dr Githaiga during a blood donation drive last year.
Murang’a Women Representative Sabina Chege, who chairs the parliamentary Committee on Health, is sponsoring a Bill that seeks to commercialise blood transfusion. This has, however, received a split opinion. The Kenya National Union of Medical Laboratory secretary-general Enoch Wanyonyi says the move will hurt the quality of blood transfusion.
“The proposed transfer blood transfusion process from, medical laboratory to physicians and pharmacists would compromise the safety of blood transfusion practices set universally,” he says.