blood transfusion service in the nigerian air force

8/14/2019 Blood Transfusion Service in the Nigerian Air Force

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of intensive hostilities in the ECOMOG operation (1991 1992).

During this period Ghana Contingent received regular blood supplies

through the Ghana Air force from the military transfusion service in

Accra while the Nigerian contingent had to rely on emergency donors

drawn from troops in the trenches. Today the situation has witnessed

some positive improvements but there is still a lot of work to be done.

This paper will dwell on the concept of safe blood transfusion service,

the state of blood transfusion in the NAF, blood transfusion policy for

the NAF and then discuss the way forward.

AIM

3. The aim of this paper is to discuss blood transfusion service in

the NAF with a view to making recommendations.

CONCEPT OF SAFE BLOOD TRANSFUSION PRACTICE

4. Modern health care has resulted in greater demand of blood

which is bound to increase with complex surgeries resulting from life

style diseases and greater access of people to health care services.

Blood has saved innumerable lives across the world in a variety of

conditions. Unfortunately, blood is also a potent vehicle for the

transmission of various micro organisms. The transfusion of

unscreened/poorly screened blood has the potential for infecting

recipients with lethal infections like HIV/AIDS, Hepatitis B and C, and

many others. Furthermore, the HIV pandemic has greatly promoted

public awareness of blood transfusion. There has been an increased

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concern for the safety of blood supplies and the need for

standardization and accountability. All these have led to the thought

of a better organized, resourcefully propelled and efficient blood

transfusion service for the NAF.

5. The WHO has identified some challenges to safe and

accessible blood. These includes; proper screening of blood for all

major transfusion against transmissible infections, identification,

recruitment and retention of voluntary donors, implementation of

quality management systems in blood transfusion services and

ensuring proper use of blood. In line with this development, the WHO

has introduced a global strategy for safe blood to include:

a. Establishment of a well organized, rationally coordinated blood

transfusion service that can provide adequate and timely supplies of

safe blood for all patients in need.

b. Collection of blood only from voluntary unpaid blood donors at

low risk of acquiring transfusion in transmissible infections, and

stringent blood donor selection criteria.

c. Testing of all donated blood for transfusion-transmissible

infections, blood groups and compatibility.

d. Production of blood components to maximize the se of donated

blood and enables the provision of therapeutic support for patients

with special transfusion requirements.

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e. Appropriate clinical use of blood and alternatives where

possible to minimize unnecessary transfusions.

f. Safe transfusion practice at the bedside.

g. Comprehensive quality assurance covering the entire

transfusion process, from donor recruitment to the follow up of

recipient of transfusion

6. The WHO strategy is an indication of the fact that the availability

and safety of blood depends on multiple steps in the transfusion

chain. This begins with a healthy and motivated population. Retention

of voluntary non-remunerated donors, processing and testing of all

donated blood, availability of blood and blood products, rational use

of blood and its components and post transfusion monitoring of the

patient.

THE STAGE OF TRANSFUSION IN THE NAF

7. Blood transfusion service has become an all encompassing

concept that needs to be fully integrated into the working of any

medical facility that worth its name. The NAF is yet to fully integrate

transfusion service into its health care system. The system of blood

banking in most of its health facilities is fragmented with no planned

process of donor motivation, recruitment and retention. The practice

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in most NAF hospitals and medical centers is a fire brigade approach

that is not only unreliable but dangerous because it encourages blood

touting. It includes captive voluntary donation, fringe benefit donation

and family/replacement/credit blood donation. This is at variance with

the standard practice which requires a donor to give blood, plasma or

other blood components on their own free will and receive no

payment for it either in cash or kind.

8. On 6 May 2004, a pilot project named the NAF Logistics Command

Blood Transfusion Service was inaugurated. The aim was to

enlighten and educate members of the community on the need for a

blood transfusion service and to promote the culture of voluntary non-

remunerated donation among our personnel and their family. The

blood donation campaign was taken to the mosques and churches as

well as a campaign walk round the barracks and was led by the then

AOC LC AVM ER Ejeh with all commanders and most officers,

Airmen and dependants participating. The response to this campaign

was spontaneous and voluntary donors turned up in drones. A roll of

honour board was unveiled for voluntary donors. In the first 2 years of

its operation, 338 bags of whole blood/blood product were transfused

in 445 NAF Hospital Ikeja. The success of this project should serve

as stimuli for the establishment of the NAF Blood Transfusion

Service.

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BLOOD TRANSFUSION POLICY FOR THE NAF

9. The safety and adequacy of blood supply largely depends on the

blood policy. A blood policy is the clearly expressed view of the health

authority on how blood donation and transfusion should be arranged

in a particular community, in this case the NAF. In view of the

important role of transfusion service in modern medical practice, it is

imperative for the appropriate authorities to articulate for the NAF a

blood policy which would provide a strategic framework and direction

for the management of our blood transfusion service.

10. Blood Transfusion Service all over the world has the same

modus operandi which includes;

a. Provision of adequate and save blood and blood products.

b. Ensuring appropriate and safe blood and blood products.

c. Offering advice and services in transfusion medicine.

d. Immunological services (Blood group serology, Lymphocyte

typing, Forensic service, Preparation of some reagents).

e. Training and research.

f. Monitoring and evaluation of blood use.

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11. In view of the above, the NAF blood transfusion policy should

address among others the following issues;

a. Consideration of Blood Transfusion Service as an

integral part of health care programme.

b. Administration and funding of the NAF blood transfusion

service to ensure regulatory control and promote sustainable

provision of save blood in all NAF medical facilities.

c. Development of technical guidelines and standard

operating procedures including donor recruitment and retention,

blood collection storage and transport, testing and processing

of blood and blood products, quality assurance and

accreditation. Others are universal safety precaution,

appropriate clinical use and the disposal of infected waste-

blood and other disposables.

d. Support for educational and training programmes related to

transfusion medicine.

e. Research and development.

f. Introduction of advance technology.

g. Indigenization of equipment, reagents, test kits.

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CONCLUSION

12. The Transfusion of blood or blood product plays a vital

therapeutic role in modern medicine particularly within the Armed

Forces during conflict or combat situations. The ECOMOG example

where Ghana contingent received regular blood supply through the

Ghana Air force from the Blood Transfusion Service available in the

Ghana Military at Accra is very illustrative of a well coordinated

Armed forces blood transfusion service. It is not a bad idea if the NAF

could take the lead in pioneering the establishment of a military

based blood transfusion service in Nigeria. This will ensure the

practice of a coordinated safe blood transfusion service in the NAF,

more so in this era of HIV pandemic.

13. The WHO global strategy for safe blood was conversed to be the

fulcrum on which the NAF Blood Transfusion Service should be

placed. The modest blood transfusion project started in 445 NAF

Hospital was highlighted and recommended as a right step in the

right direction that should be improved on. Furthermore, a policy

thrust for NAF was suggested to address Administration and funding

as well as technical procedures among others. Suggestions on the

way forward in order to ensure steady supply of the right blood for the

right patient at the right time were also discussed.

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RECOMMENDATIONS

14. It is recommended that;

a. The NAF should establish a well coordinated blood

transfusion service as part of its medical practice.

b. The NAF should build on the blood transfusion project

of 445 NAF Hospital and make it a model for the NAF blood

transfusion service.

c. The NAF should evolve a policy trust for the NAF blood

transfusion service.

N EKWURUKE

Abuja Fg Offr

Dec 09 OC Lab

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blood transfusion service in the nigerian air force

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