BLOOD TRANSFUSION SERVICES (BTS)

MISSION AND VISION: "SAFE BLOOD FOR ALL"!
Pakistan Red Crescent Society

Access to basic health is the right of every individual. Blood Transfusion Service (BTS) is an essential component of Government Health Service. Blood Banks providing this service are hospital based with 70% reliance on "family and replacement donors", who are considered as "unsafe" donors for blood collection. There are 450 Public and 2357 Private Blood Banks in the country that collect approximately 1.5 million blood bags / annum. Government BTS rely on 70% Family and Replacement Donors, 10% from Paid Donors who are "unsafe" and only 20% through "Voluntary Unpaid Blood Donors" who give blood of their own free will without any desire for reward, and are the providers of safest blood. Government BTS is fragmented, insufficient & inefficient lacking infrastructure, adequate financial, human & technical resources resulting in long-term detrimental effects on the health of the country. It is being reorganized for implementation of National Blood Policy and Guidelines with financial support from Global Funds through National Aids Control Program.
A National Blood Policy is in effect since 2003, National Blood Committee to which PRCS is a member is functional and health authorities are in place. All blood banks are now in the process of registration.

PRCS, SAFE BLOOD PROGRAMME
PRCS, Blood Transfusion Service is governed by the GOP National Blood Policy, Programme and guidelines. It consists of 03 blood banks located in Islamabad, Lahore & Karachi.
The aim of PRCS Blood Transfusion Service is to support the Government in its effort to improve Blood Transfusion Services and to ensure availability of Safe Quality Blood, whenever, wherever required; collected from 100% Voluntary Un-paid blood donors for the treatment of injured in disasters and vulnerable patients on daily basis by implementing a donor education / recruitment / recall & retention program and upgrading / standardization of laboratory.
The impediments to blood collection in the last 59 years are mainly due to lack of education and awareness for the need of safe blood in the community, importance of Voluntary Un-paid Blood Donors / Donation and high prevalence of Hepatitis B, C & HIV/AIDS. Absence of the subject matter in the school curriculum, parental opposition and health safety concerns of individual before, during and after blood donation are the main hindrances.

BLOOD DONOR CENTRE. NATIONAL HEADQUARTERS. ISLAMABAD
The Blood Donor Centre at National Headquarters established in 1979 is implementing a "Safe Blood Program" that embodies the spirit of 'Altruism' and principle of Voluntary Un-paid Blood Donation'. The PRCS, Blood Transfusion Service (BTS) is governed by the GOP National Blood Policy, Strategic Framework and Guidelines and organized through four (03) Blood Banks located at Punjab Branch, Lahore, Sindh Branch, Karachi and at National Headquarters, Islamabad. PRCS in collaboration with the Federal Directorate of Education had successfully launched a school based Blood Safety Education Program called "Society for Awareness of Blood Safety (SABS)" implemented from January 2003 till to date in 100 urban and rural schools of Islamabad targeting youth ages 14-16 years. There are total of 30,000 beneficiaries of the program. The program aims at developing volunteers for community services and to prepare the future generation of Voluntary Un-paid Blood Donors (VUBD) by enhancing awareness of blood safety for prevention of spread of transfusion-transmissible diseases i.e. Hepatitis B, C and HIV/AIDS.
Monitoring of the program shows excellent results and the teachers are asking for it and considering it important for addressing the fears and health concerns of the youth and parents. For the promotion of healthy lifestyles and voluntary blood donation, the PRCS aims to carry the SABS program forward to higher educational level in the form of "PRCS Youth Health Safety Clubs". For increasing blood collection, awareness campaigns are conducted and mobile blood camps held in colleges, universities, institutes, organizations and markets. There are 200,000 beneficiaries annually in awareness.
The Laboratory handles all collection and storage of blood, preparation of Fresh Frozen Plasma (FFP) and Packed Red Blood Cells (PRBC), grouping and testing for Hep B, C & HIV/AIDS and disposal of blood on need basis. Blood is provided "free of cost" to "zakat" deserving and against minimal charges for testing to the affording. All records are computerized. Reporting is daily, monthly, six monthly & annually. The program is subject to internal & external auditing.
The Centre has collected, processed and distributed over 33,000 units of blood. 86.5% is collected from Voluntary Unpaid Blood Donors, while 13.5% through replacement donation during summer. The main beneficiaries are the sufferers of Thallasaemia, Haemophilia, Cancer, Liver Failure, Renal Failure, complication of pregnancy and victims of natural and man-made disasters. Testing for HIV/AIDS began in 1990, Hepatitis B in 1992 and Hepatitis C in 1997. Preparation of Fresh Frozen Plasma (FFP) is ongoing since 1994. The Blood Donor Centre is a reputable blood bank appreciated as a model blood bank by WHO, EMRO, Delegate and its services are used by all hospitals with confidence.

EARTHQUAKE RESPONSE
On October 8, 2005 a strong earthquake hits Pakistan with a magnitude of 7.6 on a Rector Scale killing thousands of people and hundreds of thousands of people injured besides affecting millions. Pakistan Red Crescent Society Blood Donor Centre, being the leading humanitarian organization in the country was actively involved in fulfilling the blood needs of the victims of earthquake admitted in the designated hospitals of Rawalpindi and Islamabad. PRCS Blood Donor Centre staff immediately after the earthquake arranged two blood camps, one in front of Margalla Tower and the 2nd in PRCS Blood Donor Centre. PRCS BDC staff worked round the clock with dedication and commitment for the provision of free blood services to the victims of earthquake. BDC collected and distributed more than 4000 blood units to twenty (20) designated hospitals of Rawalpindi and Islamabad and airlift of blood to Muzaffarabad.
To meet emergency blood needs of the community, PRCS has developed an emergency plan for donor mobilization and blood collection. There is an urgent need to enhance first time donors and regular donors for which we need to expand our donor base into the corporate sector. PRCS will depend on the support & goodwill of the Corporate CEO's to motivate their staff in national, humanitarian interest for enrollment of healthy Voluntary Unpaid Blood Donors in the special category of "Standby Donors" & to gradually enhance PRCS annual blood collection to 10,000 units to meet the need of 125,000 units of blood for the twin cities with a population of 4,100,000 in 2005. At present, PRCS collects at an average 4,000 units of blood annually.
The criterion for selection of Standby Voluntary Blood Donor is he/she should be Healthy with a safe lifestyle, a high level of altruistic spirit for volunteering and commitment to donate in emergencies on PRCS request for saving lives in national interest. It is preferable they have their own transport and are available on cell phone.

FORWARD APPROACH
Blood Transfusion Services (BTS) is the responsibility of the government of the country. Ministry of Health and Ministry of Education can work together by including blood safety in school curriculum and launching of National Blood Donor Recruitment Program in partnership with PRCS and other Voluntary Blood Donor Organizations. PRCS and other authorized blood banks should phase out Replacement Donation with Voluntary Blood Donation, better management of deferred donors and Retention of voluntary donors as Regular Donors and screening of blood by the highest standards of testing to exclude Virus Markers e.g. Hepatitis B, C and HIV / AIDS.

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