Blood Transfusion Service Does Not Meet Standards – Auditor General

Auditor General John Muwanga

On Thursday 27th June, 36 year old Remmy Wamala Nanono drove to Internal Hospital Kampala expecting her 4th child little did she know, it was her last journey on earth.

Auditor General John Muwanga
Auditor General John Muwanga

Dr Ronald Kisolo, a relative to the deceased says upon arrival at IHK, Doctors there said Nanono’s cervix had opened up to four 4 centimeters. This was good enough for a Doctor to tell whether Nanono would have normal delivery or a caesarian section. A woman cannot successfully give birth until she is fully dilated, which means that her cervical opening is 10 centimeters ,roughly 4 inches wide.

However, Dr Kisolo says that the medical workers there took time to take a decision on what to do with the deceased, who was wriggling in pain and bled profusely. Later on the Doctors then decided to carry out the C-section, unfortunately for Nanono who was of blood group B+, the hospital did not have her blood type in stock. In an attempt to save Nanono’s life her relatives ran around different city hospitals including Nakasero blood bank but only managed to get one blood bag instead of four that she needed.

She was later pronounced dead and buried in Busega on Sunday. The baby girl was lucky to stay alive.  Doctors at IHK say they are still carrying out a postmortem and will hand the results to the widower. The mother of four is just one of the people who die every day in Uganda due to lack of blood to save their lives.

Over the past few months, several lives have been lost in various hospitals across due to lack of blood for transfusion. Dr Jane Ruth Aceng and officials from the Blood transfusion services blamed the crisis on the lack testing kits.

However, a new report by the auditor general points to a bigger program.  According to the to the Auditor General’s report ending June 2012, Uganda Blood Transfusion Service does not know the actual blood requirement for the country. According to the report, in 2012 Uganda’s annual average blood collection was short by 72.1 percent.

The auditor general attributes this to the fact Uganda blood transfusion services sets its blood collection targets according to the number of teams available, instead of the recommended World Health Organization standard of 2percent of the total population of a given country especially for developing countries.

The report notes that the transfusion services blood bank records relating to issuance of blood transfusing units were inaccurate, because it was understating the blood requirement by 67percent. But Dr Sam Lyomoki Workers MP and former health committee chairperson says even though there were several shortcomings that could have led to the blood shortage, the blame should be put on inadequate funding. He explains that in the last financial year, the blood bank had a shortfall of six billion shillings, which meant they could not equip most of their laboratories that were constructed by donors and recruit new staff.

The auditor general also notes that Uganda blood transfusion services did not have a fully functional quality management unit and quality control system for handling blood and as a result, quality audits were not being conducted. The report also shows that the blood bank network also uses different testing algorithm, which may impact on the uniformity and consistency in the quality if blood and blood products.

On construction, the report shows that while government planned to construct one regional blood bank in each of the existing 13 regional referral hospitals, the blood bank had only planned to construct seven in its five year strategic plan.

By January 2013 they were only 6 blood banks at Nakasero in Kampala, Mbale, Mbarara, Gulu and Fort Portal indicating an under-performance of 62percent.

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