Blood shortage hits Uganda health facilities

Pints of blood at the Uganda Blood Transfusion Services in Nakasero, Kampala. Shortage of blood has hindered service delivery countrywide.

Blood shortage has continued to paralyse operations in many hospitals across the country, forcing health workers to suspend some procedures that require blood transfusion.

At St Mary’s Hospital Lacor in Gulu District, Dr Emintone Odong, the medical director, said service delivery, especially to those that need blood, had been paralysed due to blood shortages.

“Our hands are tied as we watch our patients die yet we could save their lives if there was blood. We feel indebted to the lives we are losing every now and then,’’ Dr Odong told Daily Monitor on Monday.

Dr David Turyamumanya, the Gulu Regional Referral Hospital principal administrator, said the hospital had decided to spare the little blood mainly for expectant mothers.

“The little we have in store are reserved for critical conditions such as operations of expectant mothers and others that require blood,’’ Dr Turyamumanya said.

“We are worried of a long blood shortage and the dilemma our patients are already facing even when the situation has not yet worsened like the previous years,” he added.

In eastern Uganda, Mbale Regional Referral Hospital is facing a similar scarcity.

The hospital handles a huge number of patients who include expectant mothers and accident victims who require surgical procedures.

Dr Emmanuel Tugaineyo, the hospital director, said they receive an overwhelming number of patients in need of blood but the facility receives about 50 to 60 units of blood from the national blood bank.

“The number of patients, including referrals from lower health centres that are in need of blood is extremely high. The hospital gets little blood compared to the number of patients,” Dr Tugaineyo said.

Pallisa Hospital administrator Geoffrey Ekisa said they had recorded one death by yesterday as a result of lack of blood, adding that the shortage has been on for three weeks.

Mr Ekisa said the hospital is supposed to receive between 25 and 30 units of blood daily from Mbale Regional Blood Bank but on some days, they receive less than that.

In Budaka District, the situation is not any different. The officer-in-charge of Budaka Health Centre IV, Dr John Wogabaga, said all emergencies that require blood were being referred to Mbale hospital due to lack of blood.

At Anaka Hospital in Nwoya District, major operations had been halted due to inadequate blood, according to the district spokesperson, Mr Axuma Odokonyero.

“Major operations have been halted and now the emergency cases are referred to either St Mary’s Hospital Lacor or Gulu Regional Referral Hospital,’’ Mr Odokonyero said.

However, there was some news of relief in Mbarara District.
“We have had no crisis. We are operating normally. Sometimes people with a unique blood group may fail to get blood. When such a person doesn’t get, they say there is no blood in hospital. Uganda Blood Bank will collect more blood when students come from holidays,” Dr Celestine Barigye, the director of Mbarara Regional Referral Hospital, said.

At Jinja Regional Referral Hospital in Busoga Sub-region, the shortage was also pronounced.

“We haven’t been getting adequate quantities of blood since December 2018. Sometimes when we have a patient who needs blood, we have to look around by sending for blood from Nakasero blood bank and this takes time,” Dr Edward Nkurunziza, the hospital administrator, said.

Asked about the severity of the situation, Dr Nkurunziza said the hospital is currently getting about 60 per cent of what it used to get weekly.
He was noncommittal on the actual volume of blood the hospital receives, saying he had to first verify with the data office.

“When making performance, we quote blood used per month and not what we order against what we receive,” he said.

At Kibito Health Centre IV which is the main facility for Bunyangabu District, expectant mothers who needed blood were referred to Fort Portal in Kabarole District, according to Dr Richard Obeti, the district health officer.

“Our staff last night delivered a mother and she was bleeding. We did not have blood at the facility and we tried at Buhinga Regional Referral Hospital. They told us that the machine for screening blood had mechanical problems but we managed to get one unit of blood,” Dr Obeti said.

In Rakai District, Dr Yasin Kiyemba, the hospital superintendent, said for the past two weeks, they had been hit by blood shortage, but yesterday they received 18 units which are expected to take them for three days.

He said they had been referring the patients in need of blood to Kitovu and Masaka referral hospitals to avoid fatalities.
Dr Kiyemba, however, said they expect to get more blood supplies from the regional blood bank next week.

At Mubende Regional Referral Hospital, the director, Dr Alex Andema, said they usually order for blood whenever need arises but their main concern is that at times they do not receive enough supplies as required.
He said they usually order for 30- 50 units of blood twice a week but they often receive less.

The Masaka Regional Referral Hospital director, Dr Nathan Onyanchi, said the hospital had not suffered blood shortage.

He said since Masaka hospital houses the blood banks, it has been receiving blood as soon as cases that require blood come up.

Not affected
Masaka Regional Blood Bank manager Ayub Mutebi said they had enough blood unlike other blood banks.

“We have not been affected. We have enough blood, the issue of lack of blood testing kits did not affect us much since we had stocked some kits,” he said.

Mr Mutebi asked health units that need blood in Masaka region to make their requisitions and receive blood.

Dr Steven Kawooya, the Mityana General Hospital senior administrator, said the facility had received blood supplies last Friday, but added that they were using the new blood units sparingly.

“We are handling the blood we have in a special way [because] blood shortage is now a big problem from our suppliers,” Dr Kawooya said.

Cause of problem

Last week, Dr Dorothy Kyeyune Byabazaire, the Uganda Blood Transfusion Service (UBTS) director, admitted that they had been unable to supply blood to health facilities across the country for half a month.

Dr Kyeyune said the failure was due to “lack of reagents” used to test blood for several infections before it is declared safe for use.

“Much as we know that blood can save life, if blood is not tested and made safe…..our standard policy is that all blood must be made safe before it is sent to hospitals,” Dr Kyeyune said in Kampala last week.

“All the blood we have been collecting for the last two weeks throughout the country, we have been storing it in our cold rooms and we have not been able to give this blood to hospitals because we did not have reagents to test it,” she added. Reagents meant to test a unit of blood cost $29 (Shs107,300) and the national blood bank has a target of collecting 300,000 units, half of which has been collected.

To treat the said blood units, Dr Kyeyune said, Shs39.2 billion is needed but government provided only Shs12.88 billion. Mr Micheal Mundane, the spokesperson of the UBTS, yesterday said the situation had “normalised” and health facilities were starting to get blood supplies. “It is a small problem we had but it has been normalised. We are giving our services normally,” Mr Mundane insisted by telephone.