Seeing students and health professionals crowding the Amphi, the square found at the heart of Adama Science and Technology University’s main campus, is common for the university community. Such gatherings mean a blood donation program is underway.
The university has a blood donation club called ASTU Club 20/25. The club was established in 2014 to encourage students to donate blood 20 times before the age of 25. The club has been working efficiently in the past six years collecting blood from students at least 3 times per year.
“We are preparing the donation every three months and we have at least 300 donors every session,” says the club’s coordinator Befekadu Alaro, who’s also a senior student at the university.
Ketema Dereba, the head of Adama Blood and Tissue Bank, also confirms, “We are working in schools and Adama University is one of them. Getting people to donate blood is challenging. The community’s awareness level is still poor.”
Ketema explained that they target the university for blood donation as the standard age of donors is 18 and most students are above 18. The students leave campus before the age of 25 and volunteers are able to donate blood 20 times starting from their 18th birthday.
The Ethiopian Blood Bank has two types of blood collection bags: 350 ml and 450 ml, with their specific standards. Every donor has to be above the age of 18 and weighing 45 kg. Once a person starts donating, they are encouraged to do it every 3 months with the 350 ml bag. For the 450 ml bag, the donor must weigh above 50 kg with consideration of the Body Mass Index.
The chemicals in 350 ml and 450 ml bags are different. The chemicals in the 350 ml bag are used only to collect whole blood and the 450 ml bags have chemicals that help to extract the blood products.
There are blood recipients who need whole blood - tested and ready to be transfused - and there are recipients who need only extracted components of blood such as platelets, plasma and CRC.
The blood bank prepares the blood products like platelets, plasma and CRC from the collected blood in 450 ml bags while the blood in 350 ml bags is tested and stored as a whole.
Ketema explained that because of their weight most of the students can only donate 350 ml bags. These bags cannot be processed by laboratories for blood products. This leads to poor blood products supply in terms of the extracted components.
The Adama Blood and Tissue Bank planned to collect 18,100 bags of blood in the current year. However, the donation surpassed the plan and the bank was able to collect 21,500 units of blood.
17,713 units of blood were distributed to health centers until May 31. As Ketema explained, they fully achieved their goal but in terms of blood products, their achievement was below the expectation.
From the distributed 17,713 units of blood, 13,627 units are whole blood, 745 units are frozen plasma, and 394 units are platelets and there are 2,947 units of CRC.
“The demand for blood products like platelets, plasma and CRC is not satisfied as requested by the health centers. The standard is 95 percent but our achievement is around 88 percent,” says Ketema.
Awareness on the practice of blood donation and its benefits is limited among the general population of Ethiopia, according to Beyene GA’s 2020 article on voluntary blood donation knowledge, attitudes, and practices in the country.
The study confirms that lifetime blood donation rates range from 18.4% to 26.4% among the general public while it is 23.6% to 32.6% among students and healthcare professionals.
The major reason Adama’s blood bank is targeting university students is the fact that they are considered educated and aware of the blood donation benefits. Adama University’s volunteer blood donors’ contribution is remarkable in addressing the shortage of blood noticed around Adama’s health centers, according to Ketema.
Abemelek Demissie, a student at ASTU, has been a constant donor for the past two years. He says, “When the club 20/25 organizes a donation I get a text message. For me, donating blood is a noble thing to do as it saves lives. Apart from saving others’ lives, it also keeps me healthy.”
Apart from limited awareness in the community, accessing the necessary equipment to collect blood, such as blood testing reagents and kits, is also a challenge, according to Ketema.
Moreover, the two major fasting seasons for Christians and Muslims, Abiy and Ramadan, take a span of at least 3 months together. During these seasons blood supply drops as people don’t donate blood while fasting, adding to the hurdles of blood donation nationwide.
Once blood is collected, it passes through a testing process before use. In the laboratory, the collected blood is tested for four transmitted diseases: HIV, Hepatitis A and B and syphilis.
After the blood units are proved to be healthy, the Adama Blood and Tissue Bank distributes them to 35 health centers around Adama.
Adama Comprehensive Special Hospital is one of the recipients of blood from Adama Blood and Tissue Bank. It also gets blood from Addis Ababa National Blood and Tissue Bank as the referral hospital serves more than 6 million people in the surrounding communities.
Mengestu Emiru is the hospital's laboratory supervisor. He says, “The hospital's monthly demand for blood is in the range of 400 and 500 units, but the blood products like platelet supply does not meet our demand.”
Mengestu states that the hospital has a big demand for blood since it is a referral hospital. As a solution, he suggests Adama Blood and Tissue Bank should open branches in the vicinity of the hospital to increase the blood supply.
Dr. Tariku Geleshe, the medical director of the newly established Muse General Hospital in Adama, says “I worked in a public hospital and observed that more blood is needed on night shifts and holidays as the rate of accidents increase.”
He also noticed that O negative and RH negative blood types have the least of all supplies. Shortage of platelets is also a repeated case.
Dr. Tariku suggests decentralizing the efforts of blood collection from schools in the town to the surrounding communities might alleviate the problem. “I saw the blood bank's informative indicators in health centers but they were not active,” says the medical professional, pointing out that this means there is shortage and he encourages the health centers to build their own facilities like laboratories and refrigerators to preserve the reserve blood.
The National Blood Transfusion Services (NBTS) was established in 1969 by the Ethiopian Red Cross Society and since 2004 it has been transferred to the Federal Ministry of Health. The Ethiopian Blood Bank Service under the Ministry of Health is responsible for community mobilization and education on voluntary blood donation as well as the laboratory processing, testing & production of blood. It also distributes tested blood to health facilities, promoting appropriate clinical use of blood.
The Service also oversees, supports and monitors the activities of regional blood banks in the country that are administratively under their respective regional health bureaus.
Adama Blood and Tissue Bank is one of the ten blood banks under the Oromia Health Bureau. The bank provides blood for 35 private and public health centers with no more than 500 constant blood donors. For the coming summer, the blood bank plans to collect 5,000 bags of blood in three months.
The National Blood and Tissue Bank reported, in the past 11 months, 313, 762 units of blood were collected , 86 percent of the annual plan being met. Before 2011, the main blood collecting means were replacement of lost blood from the recipient’s caregivers or relatives.
However, volunteers like the university students of Adama are changing that trend by donating blood at least 3 times a year.
Still more work needs to be done. Ketema recalled that there was a nationwide shortage of reagents and kits in the past weeks. For this reason, the health centers were advised to give priority to emergency cases.
A week ago, the Adama Blood and Tissue Bank sent a memo to the health centers in the area explaining the shortage and that blood products should only be used for emergency cases, postponing elective surgeries.
Coincidentally, the International Blood Donors Day was celebrated on June 13 and at the national level, an event was held in Jigjiga city, Somali Region. The motto of the program was "Donating blood is an act of solidarity. Join the effort and save lives”.
Serious medical conditions are increasing in Ethiopia as well as road traffic accidents. These incidents call for a change in attitude towards blood donation in the country. The youth are volunteering to donate blood but this practice is only limited in towns and cities.
This needs to be organized and strengthened across the nation. Awareness creation and health education programs targeting blood donation practice should be strengthened, according to a 2020 BioMed International study.