Covid Pandemic Prompts Blood Shortage Crisis

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Global Press Journal

IN FEBRUARY, as Enita Kwaramba’s anemia wracked her with headaches and dizziness, she went to a hospital in Mhondoro, a rural district in western Zimbabwe. She learned she needed two pints of blood.

The hospital had blood, but not enough for her.

She got one pint, but “they reserved the other one for emergencies,” says the 33-year-old single mother. Hospital officials promised to contact her once they received more blood from Harare, the capital. Two weeks later, it still hadn’t come.

“When you are told that you have low blood and you go to a hospital for medical care, but the blood supply is not enough, you end up having fears that you might end up dying,” says the tall, slim Kwaramba, her voice frail.

Zimbabwe finds itself struggling with a shortage of blood in large part because the country’s main source of donors — schools and universities — had up until recently been closed for months as the government scrambled to arrest the coronavirus pandemic.

The crisis, which potentially impacts thousands of patients who need transfusions, is the latest challenge faced by Zimbabwe’s beleaguered health care system, already burdened by staff shortages, strikes, and a lack of equipment and medication.

Zimbabwe’s blood troubles are far from unique during the coronavirus pandemic. An array of countries — including India, China, the United States, Turkey, Morocco, Ethiopia and Uganda — have faced similar struggles.

“As the lockdowns due to [the continuous] spread of SARS-CoV-2 across the world are putting blood donors’ movement in trouble, a lot of countries are facing shortage of blood reserves at their blood banks for meeting urgent needs,” Dejen Nureye and Eyob Tekalign of the College of Medicine and Health Sciences at Mizan-Tepi University in Ethiopia, wrote in a 2020 research paper.

The National Blood Service Zimbabwe (NBSZ) typically has five to seven days’ supply of blood. It recently announced that it had less than a day’s supply.

Donations in 2020 plunged 40% compared to 2019, and units of blood and blood components dropped 30%, says Ephraim Mubayi, NBSZ’s communications officer.

Dr. Christopher Pasi, acting chief executive officer for Sally Mugabe Central Hospital, says blood shortages sometimes force doctors to postpone surgeries. “At times people may not understand the situation and think that they are not being prioritized or someone has been put in their place,” he says.

In some instances, the lack of blood may end up delaying a procedure so long that a patient’s disease has advanced, Pasi says, which could hurt recovery.

Varaidzo, a nurse who asked to be identified by her middle name for fear of losing her job, works with children with cancer. Her patients often need blood because cancer — and treatments such as chemotherapy — can deplete and harm healthy blood cells.

“A child or two have died” due to the blood shortage, she says. In addition, “getting a blood transfusion late sometimes delays the process of healing, and they stay longer in hospital accumulating a phenomenal bill.”

Blood banks in Zimbabwe first came into being in the late 1950s. Today, the NBSZ is an independent non-profit with regional offices in major cities, including Mutare, Gweru, Bulawayo, Masvingo and Harare.

It always has been hard to attract donations from a large number of adults, Mubayi says. But recently, the government gave the NBSZ permission to collect blood in schools and tertiary institutions amid coronavirus restrictions. Donors from these combined groups now contribute more than 70% of the blood bank’s supply.

The Ministry of Health didn’t respond to requests for comment.

Schools reopened in mid-March, and Mubayi says blood supplies have improved in some areas. But Harare still faces shortages because demand is high. He says young people give because the bank holds educational programs and galas promoting blood donation. Students who donate in high school often continue in university.

On the other hand, some people don’t give blood because of health issues. (Someone who is HIV-positive or has hepatitis can’t donate, for example.) Others can’t make time in their schedules, and still others don’t donate for religious reasons.

Martha Madhuviko, 34, says she has never donated blood. Nor does she plan to do so.

“The fear of the unknown grips me,” says Madhuviko, an informal trader who sells baby clothes. “What if I already have low blood levels? Will I not faint if I go to donate?”

In 2018, the government began providing a subsidy to allow public and mission hospitals to give patients’ blood for free. Patients at private hospitals have to buy a pint for $120.

Madhuviko says that’s another reason for her to skip giving blood. “If I donate today and let’s say my relative is involved in an accident and in need of blood, I still have to buy it, so what’s the reason of donating if I have to buy it?”

Mutsa, who asked not to be fully identified for fear of stigmatization, says that in March her 31-year-old sister lost her baby during a caesarean section delivery. Then her sister needed surgery to clean out her uterus.

“Without blood it was impossible,” Mutsa says. “She had to endure the excruciating pain until the supply was found.”

They went to NBSZ, only to discover that the bank gave blood to hospitals, not individuals.

“We were stuck again,” says the soft-spoken Mutsa.

Her sister was only able to get blood after two days.

Mubayi says NBSZ has stepped up publicity campaigns, but he acknowledges: “Blood donation is voluntary, and a matter of conviction of one’s heart. We remain focused on cultivating the culture of giving blood among adults.”

For her part, Kwaramba now tackles her anemia with iron tablets and folic acid, and also has turned to herbal remedies, such as boiled blackjack weed and avocado leaves. She says her headaches and dizziness have eased.

Meanwhile, Mutsa says that before her sister’s travails, she hadn’t given blood in more than a decade. After her recent experience, she plans to start donating again.