Safe blood for transfusions still problematic

Blood that has been tested and is safe for transfusion is a rarity in the South Kivu Province of the eastern Democratic Republic of Congo (DRC).

Despite a return to relative calm after a peace accord ended almost a decade of conflict in 2002, insecurity and persistent violence have plagued the region, with high numbers of injuries requiring blood transfusions.

Only a handful of institutions in urban areas can guarantee blood quality. Although health officials attribute nearly 80 percent of HIV infections to unprotected sexual relations, they recognise that untested blood is a contributing factor but there are no reliable statistics to determine the extent of the problem.

Panzi Hospital in Bukavu, provincial capital of South Kivu, has been able to provide effective healthcare, including safe blood for transfusions, because the European Commission for Humanitarian Aid (ECHO) donates essential medical supplies, with the support of other partners. Most of the patients are victims of sexual or other types of violence, or women in childbirth.

"All the transfusions in our blood bank are tested for HIV and hepatitis B," said director Dr Denis Mukwege Mukengere. The facility is also stocked with disinfectants and sterilizers, disposable syringes, a refrigerator for keeping blood at a constant temperature, and a generator that supplies electricity during frequent power failures.

At Bukavu General Hospital, the other source of "safe" blood, batches are tested and then dispatched to regional health centres, within easier reach of patents too ill or too poor to travel to the capital.

RURAL AREAS MOST AFFECTED

According to the National Multi-Sector Programme for the Fight Against AIDS, the prevalence rate for HIV/AIDS in South Kivu - officially estimated at 3.1 percent - could eventually exceed the national rate of four percent, mainly as a result of the continuing widespread and systematic use of sexual violence as a weapon of war by soldiers, rebels and other armed groups, especially in rural areas.

"In isolated areas ... there are enormous difficulties in ensuring that all patients receiving transfusions receive safe blood," said Alfred Bulakali, executive coordinator of the Movement of Academics for Health and the Environment (MHAE), which has been running an HIV/AIDS and reproductive health information centre in the province for the past three months.

People needing transfusions often have to make do with whatever blood is available without being able to ascertain its safety, either due to a lack of knowledge or because there are no alternatives.

"Prevention can't only come from health institutions like Panzi Hospital and Bukavu General, which can test blood donations for HIV/AIDS and other infections," he said. "Local populations must also understand that they should only be administered safe blood."

Patrick Nyamatomwa, of the Association for the Promotion of Health in Rural Areas, a local NGO, pointed out that "information campaigns about the different ways of contracting HIV/AIDS, particularly when it comes to blood transfusions, are very limited in rural areas."

Although the two main hospitals in Bukavu are better equipped than most health institutions to provide safe blood transfusions, the main problem is finding enough donors to supply blood to a population of 600,000, not including rural areas.

"From time to time, our blood bank suffers because donors demand that we buy them provisions," said Dr Mukengere. "We don't have the resources to meet these demands, so sometimes potential donors refuse to give blood."

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