PUMPING LIFE TO A LIFELINE

A brand new building in Narahenpita, a National Blood Policy covering both the state and private sectors and five centres around the country in addition to the 'hub' in Colombo are the latest developments in the blood transfusion service of Sri Lanka.

No other country in South Asia has a National Blood Policy for both the state-private sector, explains the Director of the National Blood Transfusion Service, Dr. (Mrs.) R.M. Bindusara, adding that an Act of Parliament is on the cards shortly.

Seated in her new office, part of the elegant structure that has come up adjacent to the Anti-Malaria Campaign building, Dr. Bindusara travels down memory lane to the time she took over as Director in 1995. By that time she had already been in the blood transfusion service since 1983 working in the periphery for about 10-15 years.

"At that time blood transfusion was a degraded subject. The Blood Bank was in the National Hospital of Colombo and the staff working there had no discipline or the correct attitude. They were frustrated working in an unhealthy environment.”

In 1990 having seen the Blood Bank in the United Kingdom, she realized the potential of this crucial field.

Drastic changes were needed not only in the form of a new building but also in the attitude of the people working in this field.

For three years her proposal for a new building went back and forth. The External Resources Department (ERD) was coordinating the foreign aid flow and at important meetings with donors, directors from different departments had to bid for funding.

The ERD Director at that time advised them not to fight in front of the donors but to prioritize. "In 1997, I felt I was going nowhere and at a meeting gave my card to a Japanese delegation and invited them to come visit the Blood Bank," she says adding that to her surprise they were there the next morning. "They looked into the fridges, saw the broken wires hanging all round and the rats running about," she says.

Two days later there was a wrap-up meeting, and shocked to see the state of the National Blood Bank, her proposal for a new building was taken up. They themselves suggested that they should do a feasibility study. She, meanwhile, readily agreed to get technical assistance from the WHO.

Later at a meeting Dr. Bindusara had with then Prime Minister Sirimavo Bandaranaike she pointed out the need to improve the blood transfusion service in the country and realizing its importance the PM put her letter to the National Health Council where all the ministers were represented.

That was the start of a major turn-around in the transfusion service. Whereas in 1995, there were only 35 hospital-based Blood Banks now there are 70.

By this time due to the decisions taken by successive Health Ministers A.H.M. Fowzie and Nimal Siripala de Silva, she and her staff had moved to two floors of the Anti-Malaria Campaign building in Narahenpita in 2001.

"We modelled two floors on the same way we would have our new centre," says Dr. Bindusara smiling that it was a major morale-booster to the staff. "They are now proud of the job they are doing."

The hospital-based Blood Banks those days used to cater only to individual hospitals and the policy was le dunnoth dennam. People with influence got blood and the poor suffered.

"After much discussion with doctors, we decided to move away from the hospital to a centre concept. Now there are five centres across the country, while the National Blood Transfusion Service is responsible for blood for the entire country," she says.

Another aspect that needed attention was the stagnant position of the medical officers in this field. "There was no future for them," explains Dr. Bindusara adding that after negotiation with the Post-Graduate Institute of Medicine, firstly a Diploma was introduced followed by an MD. "Earlier there were only 125 doctors in the service, now we have 300. Most centres have a diploma holder, while some have gone into the private sector. With the introduction of the MD, there are two Transfusion Medicine Consultants," she says.

Then arose the question: What was the purpose of having MDs and buildings if there was no blood? We needed voluntary blood donation and for that we got some marketing people activated.

"Voluntary blood donation and clinical use of blood - there was a waste risk. Now there were MDs to talk to other consultants. Most hospitals we have spoken to on the subject of clinical use of blood have set up transfusion committees who will hold a meeting once in six months among the administration, consultants and the hospital-based Blood Bank. One of our representatives will also attend these meetings," she says.

Our work is a wonderful multi-sectoral job. We have to dabble in public health, advise people on nutrition after checking the haemoglobin level, discuss diseases such as HIV and urge the people to seek medical assistance. People can talk to us and be counselled at no charge, she adds. “ If there is a will there is a way.”