Blood Safety in Asia and the Pacific

"During Earthquake management in Gujarat India, we could not maintain the minimum standards in health care, and surgical procedures including amputations were performed in open air without proper sterilisation", said Dr S K Nanda, Secretary Health, Government of Gujarat, India. Dr Nanda indicated that re-use of needles was rampant, and blood screening was also not possible. Blood banks had collapsed in the earthquake, and Red Cross support systems came to the rescue. A large part of the blood transfused came from the extended relatives of the patients or from voluntary donors. However in a recently concluded study to assess the number of HIV/AIDS transmission cases due to the re-use of needles, were just two in thousands of operative procedures performed during the disaster management. Dr C Gandhi, Project Director of State AIDS Control Organisation in Tamil Nadu, India, said that Tamil Nadu has over 200 blood banks and is banking on two sources of blood donations: voluntary donations and "replacement" donations - where the relatives of the patient donate blood to replace the blood transfused. A large part (50 percent) comes from replacement method. He said that getting voluntary donations is not a problem, but mobilising communities to donate blood in blood banks is a bigger challenge in India.

Anja Hauri indicated that the exact burden of disease attributable to re-use of needles in healthcare settings, is variable, but estimated that 56,649 cases of HIV infections are annually added in South East Asia and the Western Pacific region. Anja said that three major barriers to prevent this transmission of HIV are failure to stop re-use of injections/needles, failure to proper sterilise needles/injections, and lack of knowledge of sharp waste management processes. Proper pre-test and post-test counselling will also contribute to bring down the transmission rates here. The session chair, Elizabeth Dax, (Australia), said that the issue of bringing down HIV transmission attributable to unsafe injection/blood transfusion practices can only be resolved if we train all levels of healthcare workers, including nursing staff to medical professionals. Dr Nanda indicated that the availability and accessibility of proper PEP (Post-Exposure Prophylaxis) is also limited and is still, beyond reach to most of the healthcare staff in countries like India.