Safe Blood Starts with Me - libdoc.who.int - World Health Organization
Safe Blood Starts with Me - libdoc.who.int - World Health Organization
Safe Blood Starts with Me - libdoc.who.int - World Health Organization
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WHO/BCT/01.03 • Original: English • Distr.: Limited<strong>Safe</strong> blood starts <strong>with</strong> me!<strong>Blood</strong> saves lives!Stories and souvenirsfrom <strong>World</strong> <strong>Health</strong> Day 2000together <strong>with</strong> useful informationon blood safety
Ordering code: WHO/BCT/01.03Pr<strong>int</strong>ed: December 2001Copies may be requested from:Department of <strong>Blood</strong> <strong>Safe</strong>ty andClinical Technology<strong>World</strong> <strong>Health</strong> <strong>Organization</strong>1211 Geneva 27, SwitzerlandFax: +4122 791 4836E-mail: blood safety@<strong>who</strong>.<strong>int</strong>www.<strong>who</strong>.<strong>int</strong>/bct© <strong>World</strong> <strong>Health</strong> <strong>Organization</strong> 2001This document is not issued to the generalpublic, and all rights are reserved by the <strong>World</strong><strong>Health</strong> <strong>Organization</strong> (WHO). The document maynot be reviewed, abstracted, quoted,reproduced or translated, in part or in <strong>who</strong>le,<strong>with</strong>out the prior written permission of WHO.No part of this document may be stored in aretrieval system or transmitted in any form orby any means—electronic, mechanical orother—<strong>with</strong>out the prior written permission ofWHO. The views expressed in documents bynamed authors are solely the responsibility ofthose authors.Cover photo: Perre-Yves DhinautOverall direction: Jean C. EmmanuelPrincipal editor: Kay L. BondDesign and layout: minimum graphics
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESContentsForewordvIntroduction 1<strong>Blood</strong> saves lives at WHO Headquarters 4International Federation of the Red Cross and Red CrescentSocieties 6<strong>Blood</strong> saves lives in WHO’s Regional Office for Africa 8Algeria 10Burundi 13Côte d’Ivoire 15South Africa 17Zimbabwe 20<strong>Blood</strong> saves lives in WHO’s Regional Office for the Americas 24Argentina 28Chile 32Honduras 37<strong>Me</strong>xico 40Nicaragua 45<strong>Blood</strong> saves lives in WHO’s Regional Office for theEastern <strong>Me</strong>diterranean 48Bahrain 50Egypt 53Jordan 56Syria 59Tunisia 60<strong>Blood</strong> saves lives in WHO’s Regional Office for Europe 63Croatia 65Estonia 68Poland 70Romania 74Slovenia 78<strong>Blood</strong> saves lives in WHO’s Regional Office forSouth-East Asia 82Bangladesh 84Bhutan 87India 89Indonesia 93Sri Lanka 95<strong>Blood</strong> saves lives in WHO’s Regional Office for theWestern Pacific 98Cambodia 100People’s Republic of China 105Japan 107Mongolia 110Viet Nam 113iii ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Annex 1: Pledge 25—a blood donor club <strong>with</strong> a difference 117Annex 2: Questions and answers about donating blood 118Annex 3: Information for National <strong>Blood</strong> Programmes 122Annex 4: Information for Clinicians 125Annex 5: Information for National <strong>Health</strong> Authorities 128Information boxesWhat is safe blood? 12<strong>Safe</strong>ty from me to you, throughout 23PAHO/AMRO Questions and answers about blood 26Good health contributes to safe blood 31The appropriate use of blood... 36Research and progress in blood products 47Vector-borne diseases, parasites and blood 77Genetically determined diseases and blood 81Emergency, conflict and health 86Give safe blood and save a life 124iv ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
It is our hope that the ideas and experiences outlined in this collection of<strong>World</strong> <strong>Health</strong> Day 2000 stories may also serve as a useful toolkit for bloodsafety activities in the future. We would be pleased to receive any newideas—particularly <strong>with</strong> an educational perspective—to add to our<strong>int</strong>eractive database of blood safety initiatives.In this context, I should like to draw your attention to one such initiativecalled “Pledge 25”, first launched in the 1990s by the youth of Zimbabwe(see Annex 1). Realizing that an adequate and safe blood supply waslargely <strong>with</strong>in their own hands, a group of school leavers set up a clubwhereby they pledged to donate blood 25 times <strong>with</strong>in their life time. Thefirst group of Club <strong>Me</strong>mbers reaching this target were honoured atgraduation ceremonies during the year 2000, many on their 25th birthday.It is thanks to the commitment of this group and their efforts to promotehealthy living among their peers that the availability and safety of theblood supply in Zimbabwe dramatically increased.This initiative has since been successfully launched in neighbouring SouthAfrica. Why not in your country? If you would like to start your own“Pledge 25”, the WHO <strong>Blood</strong> Transfusion <strong>Safe</strong>ty team would be happy toprovide you <strong>with</strong> information and advice.We aim to create a global environment whereby safe donors give bloodregularly and whereby 100% of donated blood is tested before transfusion.It is a case of the three ‘A’s: blood should be available when needed ataffordable costs and used appropriately.This document is organized as follows:IntroductionChapter 1 places WHO’s <strong>World</strong> <strong>Health</strong> Day in context, and describes theobjectives, plans and expected results of <strong>World</strong> <strong>Health</strong> Day 2000.Global activitiesAn occasion to commemorate and to celebrate: opening commentariesfrom WHO/HQ and its principal partner in <strong>World</strong> <strong>Health</strong> Day 2000, theInternational Federation of the Red Cross and Red Crescent Societies.National eventsFive countries are highlighted from each of WHO’s six regions. Eachcountry portrays in words and images its blood safety challenges andsuccesses, accompanied by a regional summary.Annexes and bibliographyA comprehensive set of information for clinicians, national healthauthorities, blood programmes and the general public, is compiled as aneasy-access reference kit.In conclusion, I would like to pass a personal message of appreciation tothose <strong>who</strong> participated in <strong>World</strong> <strong>Health</strong> Day 2000 “<strong>Safe</strong> blood starts <strong>with</strong>me—blood saves lives” and those <strong>who</strong> give blood regularly, voluntarily,and seek nothing in return… Thank you.“<strong>Safe</strong> blood starts <strong>with</strong> me” is indeed a personal message, a reminder thatwe owe it to ourselves, to our friends and family, but especially to those<strong>who</strong>m we may never know, to offer this precious gift of life. Let’s build onthis momentum, let’s make blood safe. It’s up to us.Dr Yasuhiro SuzukiExecutive Director<strong>Health</strong> Technology and Pharmaceuticalsvi ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESIntroductionWhat is <strong>World</strong> <strong>Health</strong> Day?<strong>World</strong> <strong>Health</strong> Day (WHD) iscelebrated each year on 7 April incommemoration of the founding ofthe <strong>World</strong> <strong>Health</strong> <strong>Organization</strong>(WHO) in 1948. The objective ofWHD is to raise global awarenessof a specific health priority of the<strong>Organization</strong> and serves as alaunch for a long-term advocacyprogramme to address andimprove the situation.<strong>World</strong> <strong>Health</strong> Day 2000<strong>World</strong> <strong>Health</strong> Day 2000 wasdedicated to blood safety, the keyobjectives and messages of whichwere the following.ObjectivesThe aim of WHD 2000 was toincrease awareness among thepublic, policy makers/politiciansand health professionals of theimportant issues related to bloodsafety and to strengthen globalefforts in this regard.Key messages— There is a significant, positivehealth impact from safe blood.— <strong>Blood</strong> safety means availabilityof quality blood and bloodproducts as well as transfusionsafety, covered by nationalpolicies and legislation.— There is a vital need for moresafe blood donations.— We should safeguard ourhealth—blood donors must beaware that their blood cantransmit a virus to therecipient.— Effective and appropriatemeasures are needed toprevent the transmission ofblood-borne diseases,especially through injectionsafety.— Donated blood must be usedsafely and appropriately toensure patient safety, anddemonstrate respect for thedonor.WHD 2000 highlighted the broadconcerns of blood safety, e.g. the<strong>int</strong>errelation <strong>with</strong> maternal andchild health, malaria, injectionsafety, trauma, HIV/AIDS,hepatitis infection and wastemanagement.In addition, the “<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong>With <strong>Me</strong>” event witnessed WHO’scommitment to developingpartnerships. The InternationalFederation of Red Cross and RedCrescent Societies was a primarypartner in this important project.Other collaborators included theInternational Society for <strong>Blood</strong>Transfusion, the <strong>World</strong> Federationof Haemophilia and theInternational Federation ofThalassemia, as well as healthorganizations that take an active<strong>int</strong>erest in <strong>World</strong> <strong>Health</strong> Day eachyear.ImpactThe countryreports in thisbook are a clearreflection of themomentumcreated aroundsafe blood. Theseefforts, however,will only be<strong>Safe</strong> blood logospecially designedfor WHD 2000rewarded if the objectives of WHOand national health authorities areattained in the longer term. Theexpected outcomes outlined belowwill be reviewed over the next fiveyears <strong>with</strong> a view to providing1 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
continual technical assistance toensure an improved global supplyof safe blood.The success of this ambitious goalwill depend on the commitment ofboth policy makers and anincreased body of voluntary, nonremuneratedblood donors.Expected outcomes of <strong>World</strong><strong>Health</strong> Day 2000— Increased awareness amongthe public that blood donationis a safe process, handled inconfidence and professionally.— Awareness of the need forblood and thereby regularblood donations.— <strong>Health</strong> professionals will bebetter equipped to makerational decisions on the needfor blood transfusion.— <strong>Health</strong> authorities will be moreinformed of the requirementsof blood services to deliver safeand adequate blood supplies.List of activitiesEvidence shows that participatoryactivities at both grass roots andnational levels lead to effectivechanges in perception. The role ofthe WHO regional and countryoffices was therefore consideredkey to ensuring the success ofWHD 2000, which is why supportwent directly to countries tocommemorate WHD 2000 andenhance safe blood in the mostfitting way <strong>with</strong>in each nationalcontext.<strong>Health</strong> professionals, policymakers,politicians, young people,governmental agencies,nongovernmental organizations,<strong>int</strong>ernational agencies, the privatesector and the general public weretherefore offered the followingsuggestions for activities thatcould be organized <strong>with</strong>in fourpriority areas. Each countryprioritized their activities so as tomake a real impact given theresources available, often centredaround existing networks (bloodtransfusion services, educationalestablishments, health centres,specialized <strong>int</strong>erest groups, etc).1. <strong>Organization</strong> andmanagement— Panel discussion on TV/radio<strong>with</strong> representatives of thenational blood service,transfusion experts,prescribers of blood, publichealth experts, scientists,patients’ societies(thalassaemia or haemophiliasocieties).— Create national web site onblood transfusion services,advertise widely, and create e-mail address for commentsfrom community.— Speeches by dignitaries <strong>with</strong>messages on blood donation.— Telecast from patients <strong>who</strong>selives were saved by bloodtransfusion.— Telecast of video spotsmoderated by celebrities <strong>with</strong>messages of thanks fromrecipients; donor <strong>int</strong>erviews;quiz programmes; pressconferences.— Encourage nationally-basedtelevision/radio “soaps” towrite <strong>int</strong>o their story linesaspects of safe blood andtransfusion services.— Publish letter of thanks fromgovernment to donors in localpapers.— <strong>Me</strong>ssages from blood recipientson websites, newspapers, etc.2. Voluntary blood donorrecruitment— National appeal for voluntaryblood donors.— Students as target groups todevelop “Pledge 25 Clubs” (i.e.form a club, pledge to giveblood after leaving school, getT-shirt/cap/badge, andencourage others to becomedonors.— Poster campaign amongschoolchildren <strong>with</strong> prizes fromairlines.— Information messages relatedto blood safety on mass media<strong>with</strong> complete information onwhere to go for blood donation.2 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
— A “walk/run of life” for blooddonor awareness by the youth(student nurses, youth blooddonor clubs) and distribution ofWHO kits <strong>with</strong> blood safetybrochure, stickers, posters,CDs or other educationalmaterial—calendars, T-shirts,banners, mugs, leaflets, etc.— Banners <strong>with</strong> blood safetymessage on important nationalbuildings and public transport.— School essay/slogan/postercompetitions: winnersrewarded (this could promoteidea of first donation on a givenbirthday, e.g. 21st).— Donor recognition and rewardfunctions.— Educational talks in schools,colleges and universities.— Release of balloons <strong>with</strong>message.— Launch hotline for informationabout blood donation.3. Appropriate screening ofblood— Training in “Quality Assurancein <strong>Blood</strong> TransfusionLaboratories” for medical/laboratory staff in bloodtransfusion services.— Talk on TV/radio on importanceof screening, good laboratorypractice and quality assurance.— Guided tour of blood service toTV producers fordocumentaries.4. Effective clinical use of blood— Training programme on“Effective Clinical Use of<strong>Blood</strong>” in hospitals forclinicians from blood userdepartments.— Talk by blood services forschools and public on TV/radioon importance of effectiveclinical use of blood byprescribers of blood.— Local medical associationshave lectures around WHD onappropriate blood usage anduse of alternatives for fluidreplacement such ascrystalloid and colloids. ▲3 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
leaflets, flags, pins, stickers and awealth of other safe bloodmaterial was being distributed.In the large marquee erected forthe occasion, a very festiveatmosphere prevailed <strong>with</strong>pluricultural gastronomicspecialities, music from studentchoirs and folklore groups,ending—appropriately—<strong>with</strong> areception in honour of voluntary,non-remunerated blood donors.A colourful event was thereleasing of safe blood heliumballoons by tiny tots, and forseveral days, the buses andbridges of WHO’s Genevaheadquarters dressed for theoccasion, <strong>with</strong> giant versions ofthe safe blood logo.This was a very stimulating day.But <strong>World</strong> <strong>Health</strong> Day is not a 24-hour event. WHO, in collaboration<strong>with</strong> its partners, will continue toraise public awareness ofimportant issues related to safeblood over the next five years andbeyond. We count on your support.Other activitiescoordinated by WHO/HQ— WHO Director-General’s letterto Heads of State and Ministersof <strong>Health</strong>— <strong>Me</strong>dia campaign in<strong>int</strong>ernational newspapers,radio and TV— Development of fact sheets andpress releases— Special issue of United Nationsmagazine— CD-Rom, film, video andmaterial for Public ServiceAnnouncements (PSAs)— Information pack (brochure,poster and sticker) in Arabic,Chinese, English, French,German, Russian, Spanish,Farsi, Greek, Hindi, Khmer,Lao, Mandarin, Pashto,Portuguese, Japanese,Vietnamese, Turkish amongothers— Website <strong>with</strong> photobank (seewww.<strong>who</strong>.<strong>int</strong>/bct)— Exhibition panels. ▲March to UN squareFor further information on bloodsafety activities at WHO/HQ,contact:The Coordinator<strong>Blood</strong> Transfusion <strong>Safe</strong>tyDepartment of <strong>Blood</strong> <strong>Safe</strong>ty andClinical Technology<strong>World</strong> <strong>Health</strong> <strong>Organization</strong>1211 Geneva 27SwitzerlandTel: +41 22 791 2262Fax: +41 22 791 4836E-mail: bloodsafety@<strong>who</strong>.<strong>int</strong>Internet: www.<strong>who</strong>.<strong>int</strong>/bct5 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
INTERNATIONAL FEDERATION OF THERed Cross and Red Crescent Societies<strong>World</strong> <strong>Health</strong> Day Report7 April 2000A global partnership between theInternational Federation and the<strong>World</strong> <strong>Health</strong> <strong>Organization</strong> waslaunched on 7 April, 2000 in aseries of jo<strong>int</strong> news conferencesaround the world. From Sarajevoto New Delhi, from Kuwait City toHelsinki, the theme of blood safetywas highlighted and theimportance of voluntary, nonremuneratedblood donationstressed by health officials andspeakers from Red Cross and RedCrescent Societies.In Geneva, at the official openingceremony marking <strong>World</strong> <strong>Health</strong>Day, spokesperson for theInternational Federation, Dr JukkaKoistinen (Director, <strong>Blood</strong> and<strong>Blood</strong> Components, Finnish RedCross), underlined the importanceof the slogan “<strong>Safe</strong> blood starts<strong>with</strong> me” insofar as it helps dispelone of the common myths oftensaid in reference to major globalhealth problems, i.e. “There isnothing I can do to help!”“The fact is that medicine, andtransfusion medicine as well, eventoday is a science still far fromperfect, and each one of us can doquite a bit to help, particularly <strong>int</strong>he issue of global blood safety,”said Dr Koistinen.“Today’s theme—safe blood starts<strong>with</strong> me—will penetrate farbeyond our National Societiesinvolved <strong>with</strong> blood servicesKenya Red Cross volunteers donatingblood on <strong>World</strong> <strong>Health</strong> Day 2000.because so much of our work isdirectly concerned <strong>with</strong>supporting numerous communityhealth programmes: strategies toprevent AIDS, hepatitis, or tocontrol diseases like measles andcholera. Fundamental to thesuccess of any blood programmeis a good basis for the safestpossible source of blood supply.Any programme, therefore, that isfocused on disease prevention orhealth promotion, a programmewhich gradually develops healthylifestyles in local communities, isin fact working towards theformation of a low-risk populationwhich forms the source of a bloodsupply that is as safe as possible.For this reason we can confidentlyclaim the WHO has 100% supportof all 176 National Societies <strong>int</strong>heir celebrations today,” addedDr Koistinen.Dr Koistinen also po<strong>int</strong>ed out thataction was needed at the highestlevels in some countries toaddress crucial factors which ourNational Societies believe are realobstacles in the goal of achievingglobal blood safety.“Here we refer to the lack ofnational blood programmes andpolicies and in some countries theexistence of payment for blooddonation which can undermine thebasis of a safe blood supply, anderode all our efforts in theexpansion of voluntary, nonremuneratedblood donation andstructured blood transfusionservice systems,” said DrKoistinen.Dr Koistinen’s message hadparticular significance for SouthAsia, where the partnershipbetween the WHO and theFederation was launched <strong>with</strong> ajo<strong>int</strong> news conference held at6 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
WHO House in New Delhi. In thisregion the partnership isabsolutely crucial where the needfor greater advocacy in bloodsafety is so essential. GeoffreyDennis, head of the Federationregional delegation in South Asia,spoke about the vital role playedby Red Cross and Red Crescentvolunteers in motivating andretaining voluntary donors:“<strong>Safe</strong> blood should not beperceived solely as blood that hasbeen screened for diseases. <strong>Safe</strong>blood is about advocatingindividual and collectiveresponsibility at all levels—donors, providers of bloodservices and governments alike,”he said.The New Delhi news conferencehighlighted the problem of demandand supply in the region. Indiaalone faces a shortfall of 3.5million units of blood every yearand the gap continues to widen.Geoffrey Dennis stressed the needfor the rational use of blood in theregion and said that the nationalRed Cross and Red Crescentsocieties in the region wereactively involved in promoting andpopularizing the use of bloodcomponents amongst healthpractitioners. ▲For further information on bloodsafety activities at the IFRCRCS,contact:<strong>Health</strong> and Care (<strong>Blood</strong>)International Federation of RedCross and Red CrescentSocietiesP.O. Box 372, 1211 GenevaSwitzerlandTel: +41 22 730 42 22Fax: +41 22 733 0395E-mail: secretariat@ifrc.orgInternet: www.ifrc.org<strong>Me</strong>ssage fromKofi Annan, Secretary-Generalof the United Nations on <strong>World</strong> <strong>Health</strong> Day 2000Each year, blood transfusions save millions of lives. They are anessential component of the health-care system. The theme forthis year’s <strong>World</strong> <strong>Health</strong> Day “<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>—<strong>Blood</strong> SavesLives” is a timely reminder of the importance of an accessible, safeblood supply for the world’s people.The safety of blood transfusion continues to be a critical problem inmany parts of the world. Technological advances have led tosubstantial improvements in industrial countries, but progress indeveloping countries has lagged behind.<strong>World</strong> <strong>Health</strong> Day 2000 draws our attention to the avoidable deathsthat result from a lack of safe blood supply. Current estimates suggestthat each year about 13 million unites of untested blood aretransfused. The women, children and poor people of the developingworld are particularly susceptible to infections transmitted throughtransfusion. Although considerable progress has been made, muchremains to be done to ensure global blood safety.Of the 191 WHO <strong>Me</strong>mber States, only 43% systematically screendonor’s blood for hepatitis B and C and HIV, and 29% have nationalpolicies and plans to ensure blood safety. <strong>Blood</strong> safety must be akey element of national health systems.On this <strong>World</strong> <strong>Health</strong> Day 2000, let us commit ourselves to the goalof making safe blood supplies available to every patient <strong>who</strong> needsthem, wherever he or she may live. We should see this as one of theessential services to which every human being is entitled. ▲7 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
BLOOD SAVES LIVES IN WHO’S REGIONAL OFFICE FORAfricaOverviewThe WHO Regional Office forAfrica (AFRO) commemorated<strong>World</strong> <strong>Health</strong> Day 2000 byorganizing a week-long awarenesscampaign among all <strong>Me</strong>mberStates of the Region on the needWHO/AFRO Press Release, 24 April 2000for safe blood donation.Throughout the week, educationalmessages were broadcast by themedia, at seminars andconferences <strong>with</strong> high-levelparticipation from ministries ofhealth and universities.Ten students from different countries have won the poster competition organizedby the WHO Regional Office for Africa to commemorate this year’s <strong>World</strong> <strong>Health</strong>Day. They designed posters to illustrate the theme “give a little of your blood tosave a life”.The competition was held for two categories of students: those in primaryschools and those in secondary schools.The winners in the primary school category are: Julie Vander Veen of Namibia;Kanda Assuncao of Sao Tomé e Principe; and Darrel Lozaique of Seychelles.The secondary school winners are: Boiki Nthibe of Botswana; Ott Ott PatrikAndré of Cameroon; Retselisitsoe Chigando of Lesotho; Yasmina Eyasim ofMauritius; Cremlido W. Zandomela of Mozambique; Nayo Ankuvi and KokouPetida, both of Togo.The winners were selected from among 61 candidates nominated from 19countries.In addition to a school postercompetition (see inset), a videowas produced in collaboration<strong>with</strong> the national televisionnetworks and blood transfusionservices of Angola, Cameroon,Côte d’Ivoire, Guinée and Uganda.Interviews <strong>with</strong> the RegionalDirector, AFRO, blood donors andpatients featured on this video.Reports from the 46 countries ofthis Region confirm the immense<strong>int</strong>erest and participation of ourpopulations during the manydifferent activities that took place,and increased awareness of theissues related to blood transfusionsafety in Africa.The message of the RegionalDirector—repr<strong>int</strong>ed below—was drawn on during officialceremonies and by the variousmedias across the continent.<strong>Me</strong>ssage of RegionalDirector to <strong>Me</strong>mber StatesThe theme of the <strong>World</strong> <strong>Health</strong>Day this year is “<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong>With <strong>Me</strong>. <strong>Blood</strong> Saves Lives”. Thistheme has been chosen becauseblood safety is one of the prioritiesof WHO and because of theimportance of safe blood to ourhealth.<strong>Safe</strong> blood can be defined as“blood that does not contain anyviruses, parasites, drugs, alcohol,chemical substances or otherextraneous factors that mightcause harm, danger or disease tothe recipient”.<strong>Safe</strong> blood is important to thehealth of an individual, right fromthe womb and throughout the lifecycle. <strong>Health</strong>y blood contributes toa healthy life. On the other hand,unhealthy blood is a threat to lifeand health.8 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESAlgeriaMinister leadsofficial launch<strong>World</strong> <strong>Health</strong> Day was officiallyinaugurated on 4 April 2000 bythe Minister of <strong>Health</strong> andPopulation, Mr Amara Benyounes.Using the slogan “<strong>Safe</strong> <strong>Blood</strong><strong>Starts</strong> With <strong>Me</strong>—<strong>Blood</strong> SavesLives”, the National Institute ofPublic <strong>Health</strong> hosted a series ofevents, ranging from scientificdebates, exhibition stands,information programmes and videotransmissions. Two major themeswere identified, namelyDeveloping <strong>Blood</strong> Donor Loyalty,and <strong>Safe</strong> <strong>Blood</strong> Transfusion. Forboth themes, invited expertsfacilitated discussions on tengiven topics, for example thequality control of blood bags.Among the 250 guests at this highlevel launch were delegates frommany ministries and UnitedNations agencies. The success ofOfficial safe blood posterthe Day was also assured by thekeen participation of the AlgerianScouts Movement, as well as theNGO community, includingassociations and federationsrepresenting disadvantagedgroups.Festivities were spread overseveral weeks. The Tlemcendistrict (wilaya) in the extremewest of the country was the firstto commemorate <strong>World</strong> <strong>Health</strong>Day on 28 March. The capital cityheld an “Open Day” on 10 April <strong>int</strong>he heart of Alger, under theauspices of the Department of<strong>Health</strong>; and the town of Mascarawas the last to devote a specialInformation Day to bloodtransfusion safety, on Sunday16 April 2000.Scouts Honour!In fact, it was the ScoutsMovement that kicked off thefestivities in Algeria a fortnightbefore <strong>World</strong> <strong>Health</strong> Day. Incollaboration <strong>with</strong> the National<strong>Blood</strong> Agency, a course wasorganized for trainee scouts fromAlger on safe blood transfusion.The training was timed to lead <strong>int</strong>oseveral blood donation campaigns,planned by the Scouts Movementfor 7 and 8 April in schools anduniversities in the city.<strong>Me</strong>dia impact ahuge successThe messages passed by theexcellent media campaign—pressconference, radio programmes, TVbroadcasts and press articles—were instrumental in sensitizingpeople to the need for safe blood.Journalists at the pressconference, held on 2 April at theMinistry of <strong>Health</strong> and Population,were keen to support theawareness-building campaign forincreased and sustained blooddonation and safe blood transfusion.The WHO Liaison Officer,Dr N. Dekkar, emphasized thatblood donation concerns everyone,not just the Ministry of <strong>Health</strong>,acknowledging nonetheless that10 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
political commitment and supportwere critical to the success of anysafe blood initiative, includingquality management followingWHO guidelines.“<strong>Blood</strong> donationconcerns us all,not just theMinistry of<strong>Health</strong>.”According tothe DirectorGeneral ofthe National<strong>Blood</strong> Agency,ProfessorKamal Kezzal,Algeriacollects about230 000 blood donations per year,which is sadly inadequate to meetthe needs of the nation. Moreover,of the eight donations per 1000population, 85% represent family,or “replacement” donations. TheDepartment of Preventive<strong>Me</strong>dicine told the press that blooddonors face insignificant riskssince they are seen by a doctor atthe <strong>Blood</strong> Transfusion Centre priorto donation, and only the higheststandards of hygiene aretolerated. What is moresignificant, is that donors arelikely to save someone’s life.Public radio <strong>with</strong> its three nationaland 22 local stations across thecountry, transmitted key messagesin all dialects, e.g. the need forvigilance to prevent transfusiontransmissibleinfections, despiteits low prevalence in Algeria. Thesame commitment applied toAlgerian Television, which devotedclose to a dozen programmes tothe theme of <strong>World</strong> <strong>Health</strong> Day, ormore than one broadcast per day.Champion blood donor Mohamed HadjSadok rewarded by MInister of <strong>Health</strong>WHO’s specific televised materialwas heavily exploited during newsbulletins, and on 7 April itself,nearly 20 minutes of the peakviewing 20h00 News were devotedto health and blood safety,including issues facing dialysispatients in Algeria. Every Algeriannewspaper—whether public orprivate—played its role in theinformation chain, conveying vitalmessages in a way that ensured<strong>World</strong> <strong>Health</strong> Day 2000 would notbe forgotten.Winning initiativesThe media were not alone insupporting blood safety. Specialnote should be made too of thereligious affairs leaders in thecountry, <strong>who</strong> dedicated thesermon, and the TV broadcasts, ofFriday 7 April 2000 to safe blooddonation and transfusion.<strong>Blood</strong> collection campaigns tookplace during the first week of Aprilright across the country, in healthfacilities, schools, universities andin the work place.With the support of WHO, 20,000posters were distributed to the 48District <strong>Health</strong> Offices. Fivehundred posters were displayed inPost Offices, schools and even insomemilitaryEvery Algeriannewspaperplayed its partin theinformationchain.centres.About800posterslistingthe rulesfor safebloodtransfusion were given to healthprofessionals; and 1,200information kits supplied by WHOwere disseminated to the differentnational and <strong>int</strong>ernationalpartners in this field.One million envelopes, distributedby the Ministry of Post andTelecommunications, wereembossed <strong>with</strong> a safe bloodmessage. The Ministry ofEducation is also considering the<strong>int</strong>roduction <strong>int</strong>o the schoolsyllabus of a class on safe blooddonation.11 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Another example of industrialpartnerships in safe blood wasSONATRACH, a national enterprisespecializing in the development ofhydrocarbons. This companycelebrated <strong>World</strong> <strong>Health</strong> Day <strong>int</strong>hree corners of the country byorganizing scientific debates andhosting galas so that the topSONATRACH blood donors couldbe duly recognized.<strong>World</strong> <strong>Health</strong> Day 2000 in Algeriawas not just 7 April, and theMinistry of <strong>Health</strong> and Population,<strong>with</strong> the National <strong>Blood</strong> Services,expect activities to continue well<strong>int</strong>o 2001. ▲For more information on bloodsafety activities in Algeria:Director GeneralNational <strong>Blood</strong> Agency, AlgerTel: +213 21 550370Fax: +213 21 550366E-mail: ans@ibnsina.ands.dzInternet: www.ands.dzand click on ANS!What is safe blood?<strong>Safe</strong> blood is blood that does not contain any viruses, parasites, drugs,alcohol, chemical substances, or other extraneous factors that might causeharm, danger or disease to the recipient. People <strong>who</strong> donate blood should bein good health and should not suffer or have suffered from any serious illnesses.The recipient should not be harmed by receiving blood; the donor should notbe put at risk by giving blood.The world relies on safe blood, yet only 20–30% of the world’s health systemsare able to provide a safe and adequate blood supply. There are a limitednumber of healthy people donating blood. Every year, over 100 million bloodunits are collected from blood donors. Many millions more are still needed tofulfil global requirements and ensure availabity of blood when and where it isneeded.Although blood can be screened for infectious agents such as viruses, it cannotbe treated to kill viruses and micro-organisms because the red blood cellswould be destroyed by the methods currently available. Supplies of blood testsfor screening blood are sometimes <strong>int</strong>errupted in poor countries. Honesty inanswering the donors questionnaire and at <strong>int</strong>erviews is critical for the safetyof blood transfusion. <strong>Blood</strong> donors take on a remarkable responsibility whenoffering themselves as life-savers.Governments should take every opportunity to review the requirements of allhealth authorities and see that they are committed to supporting the bloodservices <strong>with</strong> sufficient funding. The health authorities should also ensure thatall necessary safety procedures are available and in place, are supportedfinancially, and are protected and enforced by national legislation. ▲12 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESBurundiThe Head of State of Burundi lenthis personal support to the themeof <strong>World</strong> <strong>Health</strong> Day 2000, “<strong>Safe</strong><strong>Blood</strong> <strong>Starts</strong> WithTo give bloodis a gift oflove.<strong>Me</strong>”, which wascelebrated instyle on Saturday8 April in thenation’s capitalcity Bujumbura, next to the shoresof the beautiful Lake Tanganika.This day, organized by theNational <strong>Blood</strong> Transfusion Centrein collaboration <strong>with</strong> WHO and theRed Cross and Red CrescentSocieties, was first and foremostdedicated to blood donors.Dr Stanislas Ntahobari, Ministerof Public <strong>Health</strong>, rewarded 123 ofthe keenest donors <strong>with</strong> medals,diplomas and various other prizes,watched on by eminent personalities,including the Minister forHuman Rights, the President ofthe Burundi Red Cross, andrepresentatives of WHO, the RedCross and Red Crescent Societiesand the <strong>World</strong> Bank.First prize—an open return airticket to Kigali—went to bothNyamubiri Ménard andBarakanuza Léonidas, <strong>who</strong> hadalready donated blood 56 and 50times respectively.But the biggest prize of all went tothe public at large, since thisoccasion was taken to launch abrand new Voluntary <strong>Blood</strong> DonorsAssociation. The creation of suchan Association was the statedambition of the former Minister of<strong>Health</strong> of Burundi, on this samespot six months previously. Today,his wish has come true, and thenot-for-profit Association’smembers are thrilled at theopportunity to combine theopening <strong>with</strong> the celebration of<strong>World</strong> <strong>Health</strong> Day “<strong>Safe</strong> <strong>Blood</strong><strong>Starts</strong> With <strong>Me</strong>”.Mr Siméon Gitabu, Legal Adviserto the Centre, lamented the highcost of blood in public and privatehospitals alike, and wonderedwhether blood donors, in returnfor donating their blood for free,could be exonerated from paying ifa relative required a bloodtransfusion.The message of the day—safe blood donation is an act ofsolidarity and of fraternity—was chanted to the beat of therenowned Burundi drums,performed by tambourin playersfrom the Rukinzo Legacy Club. TheTo give blood is a signof solidarity.captivating rhythm of the drumsaccompanied activities throughoutthe day, and the singing anddancing, in turn, reflected the joyof giving blood to save a life.Graceful traditional dancers from13 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
the University of Bujumburatwirled, for example, <strong>with</strong>outstretched arms and smilingfaces in honour of altruistic blooddonors. Under blue skies, theyoung girls sang songs in praise ofthe Lord for the gift of safe bloodand paraded little baskets,decorated <strong>with</strong> the logo of the dayand containing packets of safedonated blood. They appealedparticularly to the women ofBurundi to donate their blood tosave a life, since giving life cameso naturally to them.The Director of the National <strong>Blood</strong>Transfusion Centre, Dr DéogratiasSongore, welcomed the crowdsthat had gathered to celebrate the<strong>Blood</strong> discriminatesagainst no one creed, ethnicgroup or frontier. It’s ourcommunal life line.event, and recalled the sense ofduty and responsibility of eachand every citizen to observe ahealthy lifestyle, and therebyprotect his or her blood fromharmful elements.This was followed by an<strong>int</strong>ervention by Dr Louis Mboneko,Inspector General for Public<strong>Health</strong>, <strong>who</strong> told blood donors“The 7th of April 2000 is yourday”. He congratulated them fortheir humane actions, and urgedthem to continue giving blood, andto spread the word to family andfriends. Give blood: give love.The theme of this year’s <strong>World</strong><strong>Health</strong> Day was taken as anopportunity to offer a workshopseminaron blood safety forclinicians across the nation. Fortwo days, Professor ReghisAbderezzak, Director of a large<strong>Blood</strong> Transfusion Centre inAlgeria, reinforced the messagesof appropriate use of blood andblood products. Used judiciously,blood transfusion saves lives. Theclinicians were shown, however,the many reasons why atransfusion may be unnecessary,and received a checklist designedespecially to assist clinicians inmaking decisions on whether ornot to prescribe blood.Dr Stanislas Ntahobari, MInister of <strong>Health</strong>, joins in.A People’s PledgeThe challenge that the Associationhas given itself is daunting: toraise the number of voluntary,non-remunerated donors from thecurrent level of 11,000 to 60,000over the next five years. That’s anincrease of nearly 450% <strong>with</strong> theaim of having one in everyhundred Burundians a safe donor.To attain this magnificent goal, theAssociation will launch a solidadvocacy campaign, targetingschools, universities and the army,in cities, towns, and villages—basically, anywhere where there isa community of people.The WHO Representative inBurundi, Dr P.M.M. Yankalbé, toldthe press that he was happy <strong>with</strong>the outcome of the day. “It isvital”, he said, “that blood donorsare part of an awarenesscampaign to sensitize theirfriends, family and neighbours tothe need for them to give blood, as<strong>Blood</strong> Saves Lives.” ▲For more information on bloodsafety activities in Burundi, contact:The DirectorNational <strong>Blood</strong> Transfusion CentreB.P. 3585, BujumburaTel: +257 22 35 76Fax: +257 21 73 6814 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESCôte d’IvoireThis West African nationcelebrated, along <strong>with</strong> the rest ofthe world, <strong>World</strong> <strong>Health</strong> Day on7 April 2000, a day devoted tosafe blood transfusion. Abidjan,Bouaké, Korhogo and Daloa—our four towns <strong>with</strong> a <strong>Blood</strong>Transfusion Centre—were thenatural choice for the focus ofactivities. Each location followed adesignated programme as follows:● global gathering followed by ablood donor march;● operation “give blood”;● official speeches;● a show on blood donation;● prize-giving ceremony for loyaland worthy blood donors;● cocktail and closing ceremony.A capital affairIn Abidjan, first city of the nation,more than a thousand blooddonors assembled at the Sa<strong>int</strong>Paul Cathedral under thepatronage of the Minister of<strong>Health</strong> and Social Affairs toembark on their 5 km marchtowards the Esplanade of theTown Hall. On this bright Fridaymorning, walkers sportingcolourful T-shirts <strong>with</strong> the “safeblood starts <strong>with</strong> me” logoadvanced to the catchy rhythm ofthe fanfare. All ten communes ofthe capital were represented, andcarried banners advertisingslogans such as “Someone’s blood,another one’s life” “To give blood isan act of brotherly love” or again“<strong>Blood</strong>: a shared lifeline”.Walkers received a special escortfrom the metropolitan PoliceForce, the Emergency <strong>Me</strong>dical AidService (SAMU), the Fire Brigadeand aides from the Red Crossthroughout the entire routetowards their destination.On arrival, they were greeted bydignitaries <strong>who</strong> had preparedspecial messages for the occasion.The Mayor of Abidjan’s representativewas the first to applaud theoccasion, followed by thePresidents of the National Unionof Voluntary <strong>Blood</strong> Donors and theIvorian Red Cross, theWHO Country Representativeand culminating<strong>with</strong> that of the Ministerof <strong>Health</strong> and SocialAffairs of the nation. Atthe heart of all theseaddresses were the needto motivate and retainblood donors, tostrengthen bloodtransfusion services,nationwide praise forblood donors and theircritical role in assuringgood health in the population ofCôte d’Ivoire.Integrated in the official tone ofthis commemorative event werespecially created performances bytalented local artists, <strong>who</strong> drewattention to the vital need forvoluntary blood donations, and<strong>who</strong> were supported in theirefforts by the <strong>int</strong>ermittent playingof enchanting melodies offered by<strong>World</strong> <strong>Health</strong> Day 2000 in Abidjan, Côte d’Ivoire15 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Faithful <strong>Blood</strong> Donor Prizes1st 150kg rice2nd 100kg rice3rd 75kg rice4th 50kg rice5th 25kg ricea municipal fanfare.1 polo, 5 T-shirts, 2 caps1 polo, 4 T-shirts, 2 caps1 polo, 3 T-shirts, 2 caps1 polo, 2 T-shirts, 1 caps1 polo, 1 T-shirts, 1 capsWhen the applause finally dieddown, the ceremony turned to theimportant moment when loyalblood donors are justly recognized.Thus, under the auspices of theNational Union of Voluntary <strong>Blood</strong>Donors and their first competitionfor the best advocate for blooddonation, five altruistic blooddonors <strong>who</strong> had given their bloodon a regular basis, were publiclyrewarded.Five public schools, five religiousgroups, two public service groupsand two youth clubs also receivedhonorary diplomas from theMinistry of <strong>Health</strong>. Indeed, during1999, these groups had achievedthe commendable goal ofcollecting for the National <strong>Blood</strong>Transfusion Service between 200and 900 bags of bloodper event. Thistranslates <strong>int</strong>o a totalof five thousand, fourhundred and thirty fourblood bags! Last but byno means least, eightloyal blood donorshaving donated morethan 200 times were knighted <strong>int</strong>he enviable title of Order of <strong>Me</strong>ritof <strong>Health</strong> of the Republic of Côted’Ivoire. The President of theNational Union of Voluntary <strong>Blood</strong>Donors received the honour ofOfficer of the Order of <strong>Me</strong>rit for<strong>Health</strong> for his devotion, his senseof initiative in social mobilisationand for having instilled a newdynamism in the Union.The official representative of bloodtransfusion beneficiaries took thisoccasion to express his sinceregratitude to loyal and recurrentblood donors and to theauthorities for acknowledgingtheir valiant acts. He went on toencourage the general population,and particularly blood donors, tofollow a healthy lifestyle andcontinue to give blood, <strong>with</strong>outwhich there would be no safeblood transfusion.Inside elsewhereThe enthusiasm for <strong>World</strong> <strong>Health</strong>Day was no less articulated in theIvorian towns of Bouaké, Korhogoand Daloa, where dignitaries suchas local government leaders,mayors and regional healthdirectors participated in a veryanimated Day. Everywhere, thegeneral public—and especiallyblood donors—were out in massto celebrate the occasion.Diplomas were bestowed on blooddonors and associations that hadparticularly contributed to thepromotion of safe blood donationover the course of the previousyear.Special thanksThe entire nation was aware of<strong>World</strong> <strong>Health</strong> Day 2000 “<strong>Safe</strong><strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>—<strong>Blood</strong>Saves Lives”. This achievement isdue to the strong support of themedia and of WHO, <strong>who</strong> madepossible the technical and logisticassistance required. The commitmentand active participation ofthe local authorities and RedCross should also be noted, andthat of the Canadian Embassy andthe United Nations personnel, <strong>who</strong>organized a blood collection eventon the eve of <strong>World</strong> <strong>Health</strong> Day.This collection enabled more than60 unexpected blood bags to beavailable to the <strong>Blood</strong> TransfusionServices and, more importantly, tosave lives.The <strong>int</strong>ensity of <strong>int</strong>erest andcommitment in this special <strong>World</strong><strong>Health</strong> Day by blood donors andthe general public leads Côted’Ivoire to conclude that thecreation of a National <strong>Blood</strong>Donation Day would be a welcomeand useful measure towardsensuring the supply of safe bloodfor all. ▲For more information on bloodsafety activities in Côte d’Ivoire,contact:The National Centre for <strong>Blood</strong>Transfusion18 B.P., Abidjan 18Tel: +225 21 35 57 23Fax: +225 21 35 27 4316 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESSouth AfricaDrawing attention to theneed for safe bloodAs many as 15–20% of the SouthAfrican population have beenaffected by the HIV virus. Althoughits blood transfusion services(BTS) have the resources andtechnology to screen donations bythe most modern andsophisticated systems, the priorityis clearly to identify and educatelow-risk blood donors and tomotivate them to donate regularly.It is therefore not surprising thatthe BTS, the Department of<strong>Health</strong>, health care workers andthe public at large embracedWHO’s choice of blood safety asthe theme for <strong>World</strong> <strong>Health</strong> Day2000.National and <strong>int</strong>ernationalharmonyTo harmonize activities, April2000 was designated as national<strong>Blood</strong> Donor Month, during whicha blue ribbon lapel badge waswidely distributed as a symbol forblood donation and the quest forsafe blood. All stakeholdersenthusiastically adopted thenational and <strong>World</strong> <strong>Health</strong> Dayactivities. The Department of<strong>Health</strong> adopted a National <strong>Blood</strong>Policy in 1998, and on <strong>World</strong><strong>Health</strong> Day 2000, made public itspolicy to protect the blood supplyagainst the threat of HIV/AIDS.PartnershipsThe BTS collaborated <strong>with</strong> theDepartment of <strong>Health</strong> to maximiseimpact, widely distributing postersbefore, on and after 7 April. Thesuccessful build-up also involvedmajor businesses, religious communities,the media, telephonenetworks, educational institutionsand health care workers. Theresponse was overwhelming.The Democratic Nursing Organisationof South Africa (DENOSA), inassociation <strong>with</strong> the InternationalCouncil of Nurses, publiclyaffirmed their support in NursingUpdate. Nurses play a key role inMinister of <strong>Health</strong>, Dr Manto Tshabalala Msimang,<strong>with</strong> a blood donor.practising safe injection techniques,safeguarding health andblood, and providing counsel onhealthy life styles, combating drugabuse and promoting blood donorprogrammes.Major eventsOn <strong>World</strong> <strong>Health</strong> Day the Ministerof <strong>Health</strong>, Dr Manto TshabalalaMsimang chaired amedia launch at theJohannesburg InternationalAirport. Instressing that bloodis a nationalresource and thatall patients areentitled to low-riskblood, Mrs Msimangshowed that a safeblood supply is acornerstone of theNational <strong>Blood</strong>17 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
The Johannesburg cycling team.Policy. She also regards the BTSas a key arm of the educationalprogramme to limit the impact ofHIV/AIDS on the people of SouthAfrica.Lectures and symposia werearranged by the BTS at majorhospitals to emphasise theimportance of a safe blood supply.The risks involved in blood transfusion,the appropriate use ofblood and alternatives to bloodproducts were also discussed <strong>with</strong>all health care workers.The main event of <strong>Blood</strong>Donor Month was anational cycle tour of sixteams, departing frommajor cities of thecountry. Presentationson blood safety wereheld in sixty stopovercentres en route.Cyclists arrived inJohannesburg and insmaller towns(Hoedspruit, Cradock,Dordrecht and RichardsBay) as part of thecelebrations, but the highlight wastheir arrival in Bloemfontein on 14April. The kits of the cyclistsincluded the WHO slogan ‘<strong>Blood</strong>safety starts <strong>with</strong> me’, enthusiasticallyembraced by the localmedia and prominent members ofsociety. These dignitarieshonoured local blood donors,volunteer helpers and communityservice organizations.<strong>Me</strong>dia impactNumerous press articles appearedon or about the 7 April stressingthe need for safe blood, the threatof transmissible diseases, anddemonstrating the link between ahealthy lifestyle and a safe bloodsupply.On 7 April, many radio <strong>int</strong>erviewswere broadcast <strong>with</strong> blood transfusionpersonnel, health careworkers, hospital staff, patients<strong>who</strong> have benefited from bloodtransfusion and spokespersons forthe Department of <strong>Health</strong>. Themessage was clear: patientsdesperately need safe blood andthis can only come from regular,voluntary, non-remunerated blooddonors from low risk populationgroups.Presenters of popular TV programmessuch as Who wants to bea millionaire and the nationalnews prominently wore ribbonsand badges in support of <strong>World</strong><strong>Health</strong> Day, applauding thecommitment of blood donors toserve the community andexplaining the need for safe blood.A TV commercial sponsored by amajor retail consumerorganization and an <strong>int</strong>ernationalmanufacturer of blood bags waslaunched on 7 April. This one anda half minute promotion appealsto the public to donate blood andhighlights important facets ofblood donation, processing andtransfusion. The public isenlightened on laboratoryscreening, statistics on bloodusage and blood collection targets.The South African <strong>Me</strong>dical Journalhas agreed to publish an editorialon the theme during the course ofthe year.Other initiativesNational and private cellulartelephone networks transmitted toall <strong>who</strong> received calls on 7 Aprilthe Minister of <strong>Health</strong>’s messagethat “safe blood starts <strong>with</strong> me”.Exhibition stands were set up inmajor libraries and shoppingmalls; the Professional SoccerLeague adopted the blood safetyproject as a social responsibilityand the national football team,Bafana Bafana, wore the blueribbon all through April.18 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Scholars represent a key opportunityto spread the message thatsafe blood is the responsibility ofthe individual. A national artcompetition was launched, <strong>with</strong>secondary school students askedto submit artwork on the theme“a celebration of life”. Studentinvolvement has a positive effecton blood donation and makes themaware of the link between safeblood and the lifestyle of blooddonors.Honours were bestowed onvoluntary donors <strong>who</strong> had givenmore than 200 units of blood. InJohannesburg, tribute was paid toScholars stage a pageant to illustrate the role of a bloodtransfusion for crash victims.Anthony Heyns of the South African <strong>Blood</strong> Transfusion Services,rewards Rodney Richardson.Rodney Richards and MorrisCreswick <strong>who</strong> had clearlydemonstratedtheir commitmentto serve thecommunity bydonating morethan 300 units ofblood, on averagealmost six times ayear, for morethan fifty years: atruly remarkableachievement!In GautengProvince, theyouth stageda motorvehicle accident<strong>with</strong>health careworkersproviding firstaid andreplicated thedemonstrationon a truckthat paradedaround theneighbourhood.The processionaimed to illustrate the lifesavingrole that blood donors playin the treatment of casualties andgave the BTS an opportunity toeducate the community on theimportance of safe blood. Thisproject has motivated manymembers of the community tobecome involved in the bloodprogramme either as blooddonors, sponsors of blood donationor as voluntary helpers.<strong>World</strong> <strong>Health</strong> Day 2000 was agreat success in South Africa, andwill no doubt continue <strong>int</strong>o 2001,the Year of the Volunteer, <strong>with</strong> alasting and positive impact onpublic awareness, bloodprocurement and the practice ofblood transfusion in thiscountry. ▲For more information on bloodsafety activities in South Africa,contact:Chief Executive DirectorSouth African National <strong>Blood</strong>Service, Private Bag X14,Weltevreden Park 1715Tel: +27(11) 761 9111Fax: +27(11) 761 9113E-mail: aheyns@inl.sanbs.org.zaInternet: www.sanbs.org.za19 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESZimbabweNothing new in ZimbabweThe quest to provide adequate andsafe blood is not a new concept forthe National <strong>Blood</strong> TransfusionService (NBTS). The organizationhas followed WHO guidelines forthe appropriate collection,processing, storage anddistribution of blood and bloodproducts in Zimbabwe and hasbeen designated as a WHOCollaborating Centre, making itone of seven such centres in theworld. It was natural, therefore,that the NBTS welcomed thetheme of <strong>World</strong> <strong>Health</strong> Day 2000and was at the forefront ofactivities to coordinate, <strong>with</strong> theMinistry of <strong>Health</strong> and ChildWelfare and other stakeholders,the numerous commemorativeevents held at venuescountrywide.The key to success:prior commitmentTo ensure the success of the eventand secure commitment at thehighest level, the NBTScoordinated a strategic plan,which included regular contacts<strong>with</strong> a team chaired by an Officerfrom the Ministry of <strong>Health</strong> andChild Welfare. Also involved wererepresentatives from the ArmyKeynote address, Dr T.J. Stamps, Minister of<strong>Health</strong> and Child Welfareand Airforce of Zimbabwe, PrisonServices, The Zimbabwe Red CrossSociety, Harare City <strong>Health</strong>Department, hospitals and theMinistry of Education, Sports andCulture and that of Information,Posts and Telecommunications.Following an official launch of theevent in Harare by the WHORepresentative on 23 February, astrategy was initiated to decentralizeactivities of the day to ruralareas. The provincial blooddonor shield was chosenas the symbol of safe blooddonation. The shield isawarded to the school <strong>with</strong>the highest ratio of units ofblood donated per year pereligible blood donors.On 7 April itself, theMarimba Band and drummajorettes provided publicentertainment while othersmarched for blood safetyThe provincial blood donor shield,a symbol of safe blood donationdonned <strong>with</strong> special <strong>Safe</strong> <strong>Blood</strong>T-shirts. Banners and flyersabounded in towns and provincesto promote altruistic blooddonation.Youth: Zimbabwe’s keyto the futureTwo thirds of all blood used in thiscountry is donated by school20 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
I will not forget Mr Goodluck, lying on theGround, bleeding profusely. We took himTo Silveira. Where Dr Mitchell startedBy saying ‘he needs blood’.I will not forget my brother Jena, noseBleeding and losing several litres ofblood.We took him to hospital, where he wasGiven blood.I used to ask myself a silly question“Where do these doctors get the bloodfrom?”Do we have a lake full of blood?Do we have a river full of blood?Do we have a dam full of blood?No, No, No, blood comes from youSons and daughters of ZimbabweLet’s donate blood to rescue ourrelativesAnd friends before they die.By denying patients your bloodYou will be murdering somebodyindirectlyLet’s donate blood.Oswell Ushe4A, Simbaravanhu Secondary Schoolchildren. Therecognitionbestowed onprovincial schoolsthat donate thehighest number ofblood units as aratio of their eligibleblood donor populationis <strong>int</strong>ended tomotivate youngpeople, the future ofany blood bank, tocontinue donatingblood. It also aims toencourage youngpeople to minimizerisk-takingbehaviours thatcould lead tocontracting bloodtransmissibleinfections.To mark theoccasion, all schoolsorganized colourfulpupil-led eventssuch as drama,songs and poemshighlighting the <strong>Safe</strong><strong>Blood</strong> theme.Community leaders, traditionaland political leaders and pupilsfrom neighbouring schoolsattended all these activities, andpupils, teachers and headmastersgave <strong>int</strong>erviews to local radio,television, and newspapers ontheir beliefs about safe bloodprovision and healthy living. It isworth noting that of the eightwinner schools in 1999, four ofthem were girls only schools.Special funds were allocated toensure that school children couldparticipate in the events.Pledge 25Zimbabwe’s youth realized earlythat their future is in their ownhands. This is why, some yearsago, a project was launched by theyouth themselves which hassignificantly contributed to thesuccess of the nation’s safe bloodsupply. The project, already beingemulated in neighbouringcountries, is called “Pledge 25”.HIV caused <strong>Blood</strong> TransfusionServices across the world torethink seriously their blood donorrecruitment strategies and, in1989, Zimbabwe started targetingan as-yet untapped pool of lowriskdonors: school-children aged16–19. However, history provedthat—successful as theprogramme was—most schoolblood donors ceased to donateregularly upon leaving school.Pledge 25 was therefore createdby and for school leavers, <strong>who</strong>pledged to make at least 25 blooddonations after leaving school.<strong>Me</strong>mbers also actively shareinformation and knowledge <strong>with</strong>other current and prospectivedonors and, in this way, help topromote healthy lifestyles andreduce the amount of infectedblood collected. The first group ofmembers to graduate were salutedat the NBTS Annual General<strong>Me</strong>eting on 6 September 2000,and many of the pioneers areconsidering the formation of a“Pledge 50” division.The Club elects national andprovincial administrativecommittees to ensure the runningof their affairs. Selected PeerDonor Promoters now assist the21 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Masiyarwa Secondary School bannerpromotion activities for safe blooddonation. For example, it has beenobserved that schools that win theshield usually continue performingwell.<strong>World</strong> <strong>Health</strong> Day 2000 was justthe launch of the day andhospitals, clinics and rural healthcare centres continued tocommemorate the eventthroughout the year. Pledge 25,the National Youth Festival, theNBTS Annual General <strong>Me</strong>eting andthe Youth <strong>Blood</strong> Donors Day—ending the year’s festivities on9 December2000—are butexamples of thesecontinued activities.The NBTS looksforward to alasting partnershipin the field ofschool blood donorrecruitment,retention andmotivation. Withthe necessarysupport, youngpeople of this land can helpsustain the blood bank ofZimbabwe. ▲For more information on bloodsafety activities in Zimbabwe,contact:DirectorNational <strong>Blood</strong> Transfusion ServiceZimbabwe, HarareTel: +2634 707 801Fax: +2634 707 820E-mail: zimnbts@africaonline.co.zwInternet: www.epicnewmedia.net.nbts.<strong>Safe</strong>ty fromme to you,throughout<strong>Safe</strong>ty of blood and blood productsdepends on many factors, starting<strong>with</strong> the recruitment and recall (at safe<strong>int</strong>ervals) of voluntary, non-remuneratedblood donors <strong>who</strong> have been eliminatedfrom any risk. <strong>Safe</strong>ty is ensured by providingclean conditions for blood collection,appropriate screening of donors, extensivetesting, proper storage, and approprateclinical use of transfusion. ▲23 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
BLOOD SAVES LIVES IN THE PAN AMERICAN HEALTH ORGANIZATION/WHO REGIONAL OFFICE FOR THEAmericasNew initiative launchedon <strong>World</strong> <strong>Health</strong> Day 2000rallies the Americas onblood safetyUnsafe blood and blood shortagesthreaten the health of people <strong>who</strong>need blood transfusions in somecountries of the Americas. A newinitiative has been launched toencourage more blood donationsand raise awareness of theimportance of having a safe andadequate blood supply at all times,Dr George A.O. Alleynesaid Dr George A.O. Alleyne,Director of the Pan American<strong>Health</strong> <strong>Organization</strong>.This initiative, launched on 7April, <strong>World</strong> <strong>Health</strong> Day 2000,focused on the critical issue ofsafe blood throughout theAmericas and the world, <strong>with</strong> thetheme: <strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>,<strong>Safe</strong> <strong>Blood</strong> Saves Lives.It is critical for all countries tojoin the effort to raise awarenessof the importance of safe,adequate blood supplies and forpeople everywhere to donate bloodat least twice a year. <strong>Safe</strong> blood,<strong>with</strong> no infectious agents, can onlycome through adequate screeningand testing of blood. All citizens ofthe Americas must be assured ofreceiving safe blood when theyneed it, Dr Alleyne said. We wantpeople to understand and acceptblood donation as a desirable,altruistic act, and health workersto discourage replacementdonation and retain and educatevolunteer donors, he added.<strong>Blood</strong> for transfusion is obtainedfrom voluntary, unpaid donors inonly a small proportion ofcountries and territories in theAmericas. At the national level,only Aruba, Curaçao, Cuba,Canada, and the United States,report 100% voluntary donations.Only 16 countries—eight in theEnglish-speaking Caribbean, six inLatin America, and Canada andthe United States—reportscreening 100% of donated unitsfor the human immunodeficiencyvirus (HIV), hepatitis B (HBV), andhepatitis C (HCV).Available data for the Americas,excluding Canada and the UnitedStates, indicate that 99% of allunits of blood collected arescreened for HIV and HBV and60% for HCV. This means that,annually, around 50,000 units aretransfused that have not beenscreened for HIV and HBV, andaround 1,500,000 units aretransfused that have not beenscreened for HCV, according toPAHO figures from the countries.In a <strong>World</strong> <strong>Health</strong> Day 2000ceremony at PAHO, Dr Alleyneaccepted a donation ofUS$100,000 from the PanAmerican <strong>Health</strong> and EducationFoundation (PAHEF) for PAHO’snew regional blood safetyinitiative. It was given by Sandrade Castro Buffington, VicePresident of Corporate Communicationsfor BuenaSalud.com, anda member of PAHEF’s Board ofTrustees.The <strong>World</strong> <strong>Health</strong> Day observationin Washington featured USSurgeon General Dr DavidSatcher, American Red CrossPresident and CEO Dr Bernadine24 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Healy, American Association of<strong>Blood</strong> Banks President Dr PaulNess, America’s <strong>Blood</strong> CentersPresident Dr Celso Bianco, andAmerican <strong>Blood</strong> ResourcesAssociation Chair Dr Toby Simon.The observance was organized inconjunction <strong>with</strong> the AmericanAssociation for <strong>World</strong> <strong>Health</strong> andthe US Department of <strong>Health</strong> andHuman Services.We know that the risk oftransfusion-transmitted infectionsis higher when blood productscome from paid or replacementdonors, rather than volunteer andrepeat donors, so we must meetthe challenge of promotingvoluntary blood donation, said DrAlleyne.<strong>Safe</strong> and adequate blood suppliesare needed in every country, yetsome lack the necessary infrastructureto manage bloodcollection and distribution. Inaddition, wars, civil unrest ornatural disasters can place severestrains on blood supplies. Screeningof all donated blood forinfection <strong>with</strong> HBV, HCV, syphilis,Trypanosoma cruzi, which causesChagas disease, and HIV is a veryimportant step which must betaken by all blood banks, said Dr.José Ramiro Cruz, PAHO’s regionaladvisor on blood safety.As a result of PAHO initiatives,there has been a significantincrease in the proportion of unitsof blood screened for HIV, HBV,HCV, and T. cruzi in the past fouryears. Laws, regulations, andstandards governing blood transfusionsin the Latin Americancountries have been promulgatedor amended. National bloodcommissions have beenestablished in some countries, andin others, technical committeeshave been formed to find ways toimprove the quality of the bloodbanks. PAHO has set up trainingprograms for national personneland a Distance Learning Programon <strong>Safe</strong> <strong>Blood</strong> and <strong>Blood</strong> Productsin 11 countries. Nationalinformation systems help evaluateprogress in each country andidentify priority areas for <strong>int</strong>ervention.Academic institutions,professional associations, andothers also are involved toguarantee that the trainingreaches physicians, nurses,laboratory staff, and personnel<strong>who</strong> work <strong>with</strong> blood donors.<strong>World</strong> <strong>Health</strong> DayCelebrations set for 7 April<strong>World</strong> <strong>Health</strong> Day 2000, focusingon the critical issue of safe blood,was observed in all communitiesaround the world.We want to raise the awareness <strong>int</strong>he Americas about theimportance of blood safety andencourage every country toestablish national blood programsand pass blood safety legislation,Dr. Cruz said. Working together,we can improve the safety of bloodbanking services throughout theWestern Hemisphere, and thusachieve the goals adopted by theministers of health in this regionof screening all blood and havingall blood banks participate inquality control programs, headded.The Pan American <strong>Health</strong><strong>Organization</strong> (PAHO) which servesas the regional office of WHO forthe Americas, works to improvehealth and raise living standardsin all the countries of theAmericas. ▲For further information on bloodsafety activities in the Americas,contact:Daniel EpsteinOffice of Public Information<strong>World</strong> <strong>Health</strong> <strong>Organization</strong>/PanAmerican <strong>Health</strong> <strong>Organization</strong>525, 23rd Street N.W.Washington, D.C. 20037Tel: +1 202 974-3459Fax +1 202 974-3143E-mail: epsteind@paho.orgInternet: www.paho.org25 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Backgrounder issued by PAHO/AMRO for WHD 2000:Questions and answers about bloodWhat is blood?The average adult has 10–12p<strong>int</strong>s (or about 5 liters) of blood.Since it contains living cells, bloodneeds the nourishment provided byvitamins and minerals. <strong>Blood</strong>delivers essential ingredientsthroughout the body and removeswastes and disease. <strong>Blood</strong> iscomposed of trillions of tiny cellssuspended in a straw-colored clearliquid called plasma. Forty-fivepercent of these cells are red bloodcells, which carry oxygen from thelungs to all parts of the body. Forevery 100 reds, there is one whitecell; white blood cells fight diseaseand infections. The liquid plasmacarries these solid cells and theplatelets that help blood clot. Whenyou experience a minor cut, theplatelets cause the blood to clot.The bleeding stops. And, becausenew blood is always being madeinside of your bones, the bodyreplaces the lost blood. But if youlose a lot of blood through a majorwound, in surgery, or throughdisease, your body can’t manu—facture enough replacement bloodquickly. You have to get a bloodtransfusion, using blood from otherpeople.Who can donate blood fortransfusions?Professional <strong>int</strong>erviewers screenpotential blood donors before theydonate. Donors must be healthyindividuals <strong>who</strong> lead a healthy lifestyle,be 17 years or older, andweigh at least 110 pounds. <strong>Health</strong>ymeans that a donor must be free ofmajor cold, flu and allergy symp—toms. Acceptable donors can’t havehad a blood-transmitted infectionsuch as hepatitis or Chagas disease.Nor can they have had any riskbehaviors associated <strong>with</strong> HIV orAIDS.Why is donated blood safe?The blood donation is made understerile conditions, labeled, andimmediately sent to a laboratory forrigorous testing—and re-testing. It isthen sent to a blood bank, whichacts as a distribution center forhospitals, clinics, etc.Why should I be a blooddonor?There is no easier way for you tosave lives on a regular basis. Afterdonating, your body replaces theplasma in about a day, and the othercomponents <strong>with</strong>in a few weeks.You can donate blood every eightweeks. And chances are, you maybe helping yourself: you have a onein five chance of needing donatedblood at least once during yourlifetime.What type of risk is therefor someone <strong>who</strong> donatesblood?Donating blood is not risky. Theneedle that <strong>with</strong>draws the blood isnew and sterile. It is used only foryour donation, then thrown away.There is no chance of getting aninfectious disease such as AIDSwhile giving blood. The bones in yourbody continually make blood; ifyou’re healthy, then it is very safeto donate a unit <strong>with</strong>out major sideeffects.26 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
What is blood used for?Red cells are needed for surgicalprocedures and to treat patients<strong>with</strong> anaemia. Platelets are used inopen-heart surgery. They are alsoneeded by cancer patients undergoingchemotherapy, whichdestroys the body’s blood cells.Plasma is 90% water, 7% protein, andvery small amounts of fats, sugarand minerals. Plasma and concentratedclotting factors are needed bypatients <strong>with</strong> hemophilia and otherbleeding disorders.Why do we have to keepgiving blood?Like every living organism, blood hasa life cycle. Within the body, redblood cells have an average life spanof 120 days. Red blood cells indonated blood can be used up to 42days from the day of donation.Platelets must be used <strong>with</strong>in fivedays. Plasma can be frozen,expanding its shelf life to a year.What do I have to do togive blood?Call your local blood bank for anappo<strong>int</strong>ment or information aboutthe next blood collection drive. Thenight before, get a good night’ssleep. Eat breakfast. And drinkplenty of fluids several hours beforeyou donate blood. Be honest in yourpre-donation <strong>int</strong>erview. In the 10minutes it takes to give blood, read,relax or think about the lives yoursafe blood will save.What happens after I giveblood?After donating, rest for 5 or 10 min—utes. Drink juice or eat something<strong>with</strong> sugar to raise your blood sugarlevel. Don’t smoke for at least anhour, nor drink alcoholic beveragesfor five hours. Share your goodexperience <strong>with</strong> your friends, sothey’ll be encouraged to donate theirblood, too!Who should NOT giveblood?■■■■■People <strong>with</strong> AIDS, or anyone <strong>who</strong>has had a positive blood test forHIVAnyone <strong>who</strong> has injected illegaldrugs - even onceHemophiliacsAny male <strong>who</strong> has had unpro—tected sex <strong>with</strong> another malesince 1977.Any male or female <strong>who</strong> has hadsex for money or drugs any timesince 1977People should not use blooddonation testing as a method for discoveringtheir HIV status; thatinformation can be obtained throughyour local health department. ▲27 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESArgentina“<strong>Safe</strong> blood starts<strong>with</strong> us”: national andprovincial ministrieslaunch United PlanThe first successful blood transfusionusing sodium citrate as ananticoagulant was performed inArgentina by Dr Luis Agote in1914. This was an importantadvance since it led to thepossibility of storage of blood andthe creation of blood banks.Previously, the donor had to bepresent at the time of transfusion.“Yet we must not rest on ourlaurels”,“a drop ofbloodis morepreciousthan adiamond”warnedHéctorLombardo,Minister of<strong>Health</strong>,during theopeningceremony on<strong>World</strong> <strong>Health</strong>An invitation to give bloodDay. With the poignant image “adrop of blood is more preciousthan a diamond”, he announcedthe launch of a nationwidecampaign to attract altruisticblood donors, in collaboration <strong>with</strong>the Argentine Red Cross. “The<strong>int</strong>egration of nongovernmentalorganizations <strong>with</strong> the Ministry of<strong>Health</strong> is fundamental”, Lombardocontinued. The need for a unifiedapproach was reiterated acrossall 24 provincialministries, whereeducation materialwas distributed andspecial projectsinitiated.Ana del Pozo, Chief ofHaemotherapy at theJuan GarrahanHospital, couldn’tagree more. Ourefforts are in vain, shecautioned, if we do nothave an undivided, strongeducational message, that mustcome from the highest level andbe heard at the lowest.All together: altruismThis one strong message in theblood safety campaign was thevital need to increase the numberof voluntary, unpaid donors fromlow-risk population groups. TheMinister of <strong>Health</strong> of Argentinaaffirmed that “professional blooddonations should be curtailed andstrategies developed to put an endto this practice”, remarksreiterated by Juan Manuel Sotelo,PAHO/WHO Representative.Furthermore, the Ministerconsidered that the solidarity andgenerosity of the nation—particularly in emergencysituations when they rush to giveblood—has been underestimated.“Through education, we shouldharness this gesture of communalsolidarity”, he concluded.Commitment at thehighest levelWell in advance of thecelebrations, hosted at the toplevel, a National Work Commissionwas formed <strong>with</strong> representativesof the Ministry of <strong>Health</strong>, PAHO/WHO, the Argentine Association28 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Youth solidarity <strong>with</strong> the blood donor movementfor Haemotherapy andImmunohaematology (AAHI) andthe National Distance LearningProgramme on <strong>Safe</strong> <strong>Blood</strong>. All 24Provincial <strong>Health</strong> Ministries wereencouraged to look beyond thecommemoration of <strong>World</strong> <strong>Health</strong>Day, to the importance ofimplementing a <strong>Safe</strong> <strong>Blood</strong> Plan.Indeed, the <strong>Health</strong> Commission ofthe National Senate was motivatedto foster the modernization oflegislation on blood transfusion,incorporating the suggestions ofCOFESA (National <strong>Health</strong>Council).Governmental commitment to thecampaign was evident across thecountry, starting inBuenos Aires where theMayor Dr Anibal Ibarra,for example, planned touse the municipalelections, bringingtogether around twomillion voters, as anoccasion to encouragethe voluntary enrolmentof donors using their IDcards.In Cordoba, theprovincial Minister of <strong>Health</strong>invited experts to analyse thesituation of blood transfusionworldwide, and propose specificmeasures to increase the numberof altruistic blood donors in theprovince. To date, the requirementfor blood in the Province was notbeing met.“D” DayThe turnout in <strong>Me</strong>ndoza wassuperb, especially young people <strong>int</strong>he civic squares where a wealthof educational material awaitedthem at the decorated booths.Fifty free breakfasts also awaitednew and regular blood donors atthe haemotherapy service, afterwhich they could enjoy aproduction from the cast of “LaPericana”, or appreciate themusic specially composed andA token of appreciation for voluntary,non-remunerated blood donorsrecorded for the occasion bysinger Daniel Allaria. This wasindeed a special Day for Donors.In placing blood transfusion safetyin the context of overall healthgoals, the three most prominentreligious groups in <strong>Me</strong>ndoza(Catholic, Evangelical and Jewish)came together to agree on a planof action to increase awarenessand altruistic donors.The Hospital of Cachi was proudto announce its new <strong>Blood</strong> Bank toradio listeners, <strong>who</strong> could alsofollow the address of Dr GeorgeA.O. Alleyne, Director of PAHO,and Dr Gro Harlem Brundtland,Director-General of WHO. Thesuccess of the “safe blood starts<strong>with</strong> me” campaign was borne outby the increased number ofrequests for voluntary blood donorcards in April.National workshop onblood safetyThis was the first time that theMinister of <strong>Health</strong> has invited allprovinces nationwide to participatein such an important issue.At the workshop, responsibleexperts on blood transfusiondiscussed the survey speciallycommissioned to assess bloodservices countrywide, and theneed to form an ad-hoc <strong>Blood</strong>Committee of COFESA.Participants noted deficiencies <strong>int</strong>he national blood system, e.g. theaccuracy of data, and implementationof legislation. Dr del Pozopo<strong>int</strong>ed at a lack of coordination in29 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Argentina that led to wastage andinefficiencies. Taking advantage ofthe presence of the DeputyMinsiter of <strong>Health</strong> of Saskatchewanin Canada, she illustratedher po<strong>int</strong> by comparing the 500blood banks in Argentina to the 20Canadian counterparts. At the endof the Workshop, all provincessigned a 10-po<strong>int</strong> agreement toaddress the issues raised.Key partnersThe Argentine Association ofHaemotherapy and Immunohaematologywas among the manyorganizations that had specialeditions of their newslettersdevoted to safe blood donation. Inits March copy, the AAHI notedthat it was not money, but politicalwill and an organized educationalcampaign that would achieve thegoal of 100% screening of donatedblood. Colourful posters,calendars, Q&As, leaflets, allreinforced the central message toan increasing network ofindividuals.Leading hospitals and bloodbanks—such as theHaemotherapy Unit of the HospitalPablo-Soria (Jujuy), the GermanHospital, the HaematologyFoundation Sarmiento to name buta few—also campaigned to attractsafe blood donors. Sometimesprivate industry was targeted, atother times famous personalities,politicians, or religious orderssupported the cause. Certificateswere awarded to loyal donors atmany of the events, and theLaboratory of Haemotherapywrote personal thank-you lettersto donors on their register.Representatives from PAHOparticipated in a first meetingconvened by the DistanceEducation Programme to make anexternal evaluation of blood donorscreening and discuss theproposed document on Standardsin <strong>Blood</strong> Banks. Drs Ana del Pozoand Mabel Maschio, Directors ofthe Distance Learning Programmefor <strong>Blood</strong> <strong>Safe</strong>ty, announced thesuccessful training to date of3,780 professionals working inblood banks.<strong>Me</strong>dia messagesBoth the general andspecialized press—atnational, provincial andlocal levels—played amagnificent role indisseminatinginformation produced bygovernmental,nongovernmental andPAHO sources.“Did you know that one unitof your blood could savethree or four lives?”“Your new blood brotherawaits you—please answer his call”“Thank you for sharing yourhealth <strong>with</strong> others”Radio messages placed by theLaboratory of HaemotherapyThe awareness campaign in<strong>Me</strong>ndoza was so effective that thegovernment press office recordeda video that was later aired as aspot on both television channelsfor two weeks.Short convincing messages (seeinset) were aired on local andnational radio stations, and atelevision <strong>int</strong>erview outlined theobjectives of the Voluntary DonorsClub, which it is hoped to turn <strong>int</strong>oa genuine club <strong>with</strong> its own firstclassdatabase.A colourful educational campaign30 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
MaterialsEvery form imaginable was usedto make sure the message gothome. In close collaboration <strong>with</strong>PAHO, Spanish versions of thebrochure, posters, fliers, Q&As,press kits, videos, badges, andmuch, much more was madeavailable to Argentine citizenseverywhere in paper, digital andaudiovisual formats. Moderntechnology ensured that the <strong>Safe</strong><strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong> theme andinformation materials were allaccessible via the <strong>int</strong>ernet, on avariety of health sciences sites.Existing <strong>int</strong>ernet lists of users <strong>int</strong>he fields of health, education andcommunication, all received safeblood material. ▲For further information on bloodsafety activities in Argentina,contact:Mrs Ana del PozoChief of Transfusion <strong>Me</strong>dicineServiceHospital de Pediatría “Prof. Dr J.P.Garrahan”Buenos Aires.Tel/Fax: +54 11 4362 0645E-mail: adelpozo@garrahan.gov.arInternet: www.garrahan.gov.arGood health contributesto safe bloodGood health depends on lifestyle and disease prevention. Eating a balanceddiet <strong>with</strong> an adequate vitamin and micronutrient supply, keeping a cleanenvironment, and avoiding risk situations help to keep people, and their blood,healthy. A healthy society means more safe blood and a reduced need for bloodtransfusion.Iron-deficiency anaemia is one of the most widespread micronutrient deficienciesin the world. It affects about 50% of pre-school-age children and pregnant womenin developing countries. In children, it affects growth and impairs cognitiveperformance. In pregnant women, it increases the risk of diseases and maternalmortality. Additional iron in the form of iron supplements combined <strong>with</strong> a dietcontaining iron-rich food can improve iron status.Cancer patients are frequently recipients of blood transfusions, especially inindustrialized countries. Reducing the overall number of cancer patients throughprevention measures would reduce the need for heavy treatment schedulesand thus the need for transfusions. This would have many benefits including anoverall gain in health and quality of life, and in economic terms as well.Education, from primary schools onwards, plays an important part in ma<strong>int</strong>aininga healthy society and promoting risk-free behaviour, and in cultivating positiveattitudes towards voluntary, non-remunerated blood donation. Raising people’sawareness about the importance of unpaid blood donation should increase thenumber of regular, safe blood donations. ▲31 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESChileGlobal overview<strong>World</strong> <strong>Health</strong> Day focuses onactivities that span not just a day,but a <strong>who</strong>le calendar year, andthat’s just what happened in Chile.Starting early January 2000, theCommittee for Centralization of<strong>Blood</strong> Banks at the <strong>Health</strong>Ministry reviewed WHO’sproposals and planned a NationalWorkshop for all 28 <strong>Health</strong>Services to <strong>int</strong>roduce them to thetheme. Representatives at theWorkshop agreed on the need toaddress salient activities on bloodtransfusion, as follows:— a national policy for safe blood;— ways to switch to and sustainrepeated voluntary blooddonations, based on successfulexperiences in Chile;— training and the appropriateclinical use of blood, usingresults from an audit:performed by the <strong>Blood</strong>Commission at the <strong>Health</strong>Ministry and new ministerialguidelines for the activeevaluation of clinical use andhaemovigilance.To assist promotional activities,participants received posters inEnglish and Spanish, guidelinesfor blood collections, theprogramme for <strong>World</strong> <strong>Health</strong> Dayand the recommendations of theTransfusion <strong>Me</strong>dicine group at theMinistry of <strong>Health</strong>.The ValparaisoAgreement “Unity <strong>with</strong>the community”Valparaiso, a popular hub ofactivity on the west coast, was theChilean centre of attention <strong>with</strong> apacked programme. It wasattended by Dr Michelle Bachelet,Minister of <strong>Health</strong>, andDr Michelle Bachelet, Minister of<strong>Health</strong>, signing the ValparaisoAgreementrepresentatives from WHO/PAHO,UNICEF, the Red Cross, public andprivate health systems, scientificsocieties, universities, nongovernmentalorganizations (includingthe Association of Voluntary <strong>Blood</strong>Donors and the National Instituteof Youth), blood banks and,importantly, the community itself.The “Valparaíso Agreement”,solemnly signed by all individualsand organizations present, isreproduced at the end of thisarticle.Many other events took place <strong>int</strong>he capital city and throughout thecountry; for example a patient<strong>who</strong> had received multipletransfusions—Miss Maria LuisaAguayo—publicly expressing herthanks to a regular voluntaryblood donor (Mr Narciso García).Activities in Chile’sregional health servicesArica: a poster exhibition wasdisplayed at the Hospital JuanNoé, the outpatients clinics, andthe town centre. Celebrations alsotook place in local universities andother educational institutions.Radio and TV programmes, and apress conference supported theconstitution of the Transfusion<strong>Me</strong>dicine Committee and theapproval of a new bloodtransfusion request form.Iquique: Information was32 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
targeted at health personnel of theHospital and the community onvoluntary blood donations. Radio,the local press and a pressconference issued safe bloodmessages, <strong>with</strong> the participationof health authorities andtransfused patients. Local schoolswere also involved, as well asclinicians, <strong>who</strong> were trained in theappropriate use of <strong>who</strong>le bloodand plasma.Antofagasta: a massiveinformation campaign waslaunched on voluntary blooddonation and the activities ofblood banks, <strong>with</strong> the keyparticipation of TV actors, and<strong>with</strong> a panel presentation on localTV and radio. Badges were issuedto loyal blood donors.Atacama: here too, the HospitalCopiapó was the nucleus of acampaign for health personnel andthe general population. Pressconferences were held in thecities of Chañaral, Copiapó andVallenar; articles appeared inlocal newspapers, includingtestimonies from people in need ofblood products and posters weredisplayed in all hospitals.Of note was the launch of aweb site atwww.saludatacama.cl and aprize giving ceremony forvoluntary blood donors.Coquimbo: eventsincluded a promotion in ashopping centre, a posterexhibition, free bloodtyping; press conferences;spots in the media; and theactive participation of localauthorities. Voluntary blooddonation and information onthe appropriate use ofblood were heavilypromoted at the hospitals ofSalamanca, Combarbalá,Los Vilos, Vicuña, andCoquimbo y la Serena.Conferences in localschools and a pa<strong>int</strong>ing competitionenhanced the momentum.Valparaíso-San Antonio : at thehealth services of these areas,blood safety messages werereinforced through stickers andpamphlets distributed in publicplaces. A press conference washeld at the regional <strong>Blood</strong> Centre<strong>Safe</strong> <strong>Blood</strong> Bannerand support to thecampaign ofpromotion,motivation andretention ofvoluntary blooddonors wasprominent at theGustavo FrickeHospital. <strong>Blood</strong>collections wereorganized at newvenues, drawn bythe donation of apublic person.Aconcagua: allhospitals of thisregion participatedin the campaign,supported bypublications in localnewspapers andradio. A local blood transfusioncommittee was also formed andofficial letters sent to blooddonors.O’Higgins <strong>Health</strong> Service: theclinical use of blood in the region,including the treatment ofcoagulation defects and an overallevaluation report, was the focus ofattention at the Hospitals SanFernando and Rancagua.Maule <strong>Health</strong> Service: ameeting was held for all medicalspecialities at the Hospital ofTalca focusing on the“Recommendations for the ClinicalUse of <strong>Blood</strong> and <strong>Blood</strong> Products”prepared by the Ministry of<strong>Health</strong>. Celebrities, including MrSergio Aguiló, MP, testified asblood donors and local schoolslearnt about voluntary blooddonations from students of theUniversity of Talca. The mainsquare showed exhibitions, asurvey on blood donation wascarried out and the creation of ablood transfusion committee wasmuch applauded.Bio-Bio <strong>Health</strong> Service:stickers, poster exhibitions,educational meetings for thecommunity and the distribution ofkey blood safety materials at allhealth centres in the regionfigured in the blood safetycampaign of this service. Thevoluntary blood donation of theHead of the Dialysis Unit, coveredby local press and TV, and the33 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
active participation of authoritiesfrom the 12 communes in theregion, contributed to the successof this campaign.Concepción <strong>Health</strong> Service :visual aids such as banners werealso prominent in the voluntaryblood collection campaign in alltowns in this region. Breakingnews was the signature of acooperative agreement <strong>with</strong> Maule<strong>Health</strong> Service, and a ceremony toacknowledge repeated voluntaryblood donors in the presence oflocal authorities.Talcahuano <strong>Health</strong> Service:the Hospital Las Higuerascampaigned to promote repeatedaltruistic voluntary blooddonations, carried out an audit onthe clinical use of blood and bloodproducts, and supported a meetingto discuss the clinical use of bloodguides.Araucanía Sur : the Temuco andValdivia hospitals were instrumentalin the success of a campaign topromote repeated voluntary blooddonations. The signing of acollaborative agreement <strong>with</strong> theRed Cross, a photographic exhibit,clinical meetings in hospitals, anaudit on the clinical use of bloodand blood products, and closecollaboration <strong>with</strong> local media allreinforced the messages of bloodtransfusion safety.Osorno <strong>Health</strong> Service: localmedia noted that regionalauthorities paid homage to thework of the blood bank in thisregion, the Red Cross dedicatedlocations to promote voluntaryblood donations, and thateducational materials weredistributed to all health services.Workshops were also held todiscuss the clinical use of bloodand blood products, andcollaboration was actively sought<strong>with</strong> all institutions andorganizations involved in bloodsafety.Llanchipal <strong>Health</strong> Service:organized a campaign consistingof a press conference <strong>with</strong> localmedia and a blood collection bythe Hospital Puerto Montt, theRed Cross and medical technologystudents.Aisén <strong>Health</strong> Service : hospitalsdistributed pamphlets andarranged panel exhibitions; themedia reinforced the messages,and meetings on the appropriateuse of blood took place at theCoyhaique and Puerto AisénHospitals. Clinical meetings <strong>with</strong>directors at different hospitalstook place to promote voluntaryblood donation and blood safety.<strong>Me</strong>tropolitan Central<strong>Health</strong> Service: The EmergencyHospital held a conference forworkers in the field of emergencyrelief and a poster exhibition onits voluntary blood donors club.<strong>Me</strong>gavisión broadcasted televisionspots and a blood collection wassuccessful at the University, <strong>with</strong>the blood mobile from the RedCross. In addition, a conference ontransfusion medicine wasspecially designed for surgeons.<strong>Me</strong>tropolitan East <strong>Health</strong>Service: At the Hospital ElSalvador, a clinical audit on theuse of blood was held at ToraxHospital and Neurosurgery.<strong>Me</strong>tropolitan South <strong>Health</strong>Service: the Sótero del Río andPadre Hurtado hospitals set uppromotions of voluntary blooddonation and blood bank activities,including a video. <strong>Health</strong> workerswere invited to participate asvoluntary blood donors and apanel was held at the hospitals onthis special <strong>World</strong> <strong>Health</strong> Day.The Hospital Barros Luco yExequiel Gonzalez Cortés sent aletter to all its personnelpromoting voluntary blooddonation and organized a bloodcollection at the San MiguelCouncil. An audit was also carriedout on the use of plasma insurgery, and a practical guide forthe clinical use of blood and bloodproducts was delivered at aclinical meeting.<strong>Me</strong>tropolitan West <strong>Health</strong>Service: Under the auspices ofthe Hospital San Juan de Dios, apromotional campaign was set upbased on panel exhibits and aconference and blood collection atthe University of Santiago. Clinicalunits had a meeting and audit onthe clinical use of plasma.34 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
<strong>Me</strong>tropolitan North <strong>Health</strong>Service: the Hospital San Joséwas the centre for this blooddonation campaign <strong>with</strong>in hospitalpersonnel, extending to schools <strong>int</strong>he area about voluntary blooddonation. Visits to the blood bankwere organized, an audit on theclinical use of red cells andplasma and a clinical meeting toreport the results of the auditwere highlights of <strong>World</strong> <strong>Health</strong>Day.Other health servicesactivitiesCatholic University <strong>Me</strong>dicalSchool: information waschannelled to the public throughthe Catholic University TV onvoluntary blood donation and<strong>World</strong> <strong>Health</strong> Day. <strong>Blood</strong> wascollected by medical students incoordination <strong>with</strong> the Red Crossand articles were published by themedia on voluntary altruisticblood donations.Chilean Navy: an exhibition wasmounted by the Hospital NavalViña del Mar in the main hall andoutpatient clinics on <strong>World</strong> <strong>Health</strong>Day and voluntary blooddonations. Further clinicalmeetings were organized <strong>with</strong>Internal <strong>Me</strong>dicine, Surgery,Obstetrics and Anesthesiology<strong>int</strong>roducing WHO concepts ofblood safety, the appropriateclinical use of blood and apresentation of the results of anaudit on the use of <strong>who</strong>le blood,red cells and plasma.SummaryAn evaluation of the activitiescarried out shows that:— The Chilean population issensitive to solidarity acts suchas voluntary blood donation,especially the youth, showingthat this could be attained <strong>int</strong>he mid term.— The authorities understand theimportance of the problem andare very involved in theactivities of blood banks.— It was possible to demonstratefailures in the clinical use ofblood in all places were anaudit was performed, allowingmany hospitals to take actionand form <strong>Blood</strong> TransfusionCommittees.Valparaiso AgreementWe the undersigned, representativesof organizations attendingthe <strong>World</strong> <strong>Health</strong> Day ceremonyhere in the city of Valparaíso, inconsidering past experiences,hereby endorse the “ValaparaísoAgreement” as follows:Current situation<strong>Blood</strong> is essential for life, bloodtransfusions are needed for sometreatments, and there is currentlyno substitute for it.The only source of blood fortransfusion is blood donation.Donated blood can be fractionated<strong>int</strong>o components, allowing thedevelopment of different areas ofmedicine. The fractionationprocess is more and moredemanding given the need toattain quality standards in line<strong>with</strong> the health services and dothis <strong>with</strong>in available resources.Although technological developmenthas provided alternatives tosome blood products, they are notalways used.In Chile, the blood supply is basedon family/replacement donations.The change from this system toone based on repeated, voluntary,altruistic blood donations, whichexhibit a lower incidence ofmarkers for infectious agents, is amedium term goal that dependsnot only on health workers, but onthe community as a <strong>who</strong>le.<strong>Blood</strong> transfusion, as <strong>with</strong> allhealth <strong>int</strong>erventions, is not riskfree,necessitating a constantreview of clinical practices inprescribing blood.To increase the safety of the <strong>who</strong>leprocess, we must simultaneouslycheck all links in the chain,starting <strong>with</strong> the blood donor,continuing <strong>with</strong> the processingand distribution and ending <strong>with</strong>the appropriate use in the bloodreceiver. To assure these linksneeds the active participation of35 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
the entire community, because thecornerstone of the system is basedon people giving to people.The challengeWe want a situation where thepopulation of Chile can restassured that if they need a bloodtransfusion, they have access tosafe blood or blood productsmanufactured to the highestquality standards, free frominfection. To meet this challengewe propose that the <strong>who</strong>lecommunity must unite:— to instil the repeated, voluntaryaltruistic blood donation as themain source of blood fortransfusions in Chile;— to transform the currentsystem of hospital-based bloodbanks <strong>int</strong>o a network able toproduce and supply goodquality blood products to thepopulation as and whenneeded;— to improve the clinical use ofblood through a continuousreview of prescriptionpractices.— contribute to the continuousimprovement of the quality ofblood products for transfusion;— optimize the use of bloodproducts for a maximumbenefit to patients;— promote training for thoseinvolved in bloodtransfusion. ▲Signed:Dated: 7 April 2000For further information on bloodsafety activities in Chile, contact:Dr Maria de los Angeles RodríguezHead of <strong>Blood</strong> BankHospital Naval de Vina Del MarSubida Alessandri, s/nVina Del MarTel: +56 32 573 000Fax: +56 32 573 500E-mail:mangrodriquez@entelchile.netThe appropriateuse of blood...In many cases, blood transfusion may notbe the most appropriate, cost-effective orsafe therapeutic <strong>int</strong>ervention. It is importantto minimize the number of inappropriate bloodtransfusions through the effective clinical useof blood or blood products and the assessmentof existing alternatives. This implies a respectfor the use of blood, which should only betransfused if no alternative treatment ispossible. WHO recommends three keystrategies:■■■Developing national guidelines for givingtransfusionsTraining people <strong>who</strong> prescribe blood toavoid unnecessary or inappropriatetransfusionEnsuring accessibility and availability ofvolume replacement fluids, such ascrystalloids and colloids, for use whereappropriate. ▲36 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESHondurasBackgroundIn Latin America it is estimatedthat more than 10% of transfusedblood is collected from paiddonors. Honduras has beenworking very hard to improve thesafety of its blood supply, notablythrough the Honduran Red Cross<strong>Blood</strong> Programme, that has beenactively recruiting and retainingvoluntary non-remunerated blooddonors since 1978.In 1994, the Ministry of <strong>Health</strong>designated the Red Cross’ <strong>Me</strong>dicalDirector to be Secretary Generalof the National <strong>Blood</strong> Council.Together, they have developed thelegal framework for a bloodtransfusion system that includes anational policy and plan, as wellas norms and regulations on theprovision of safe and adequateblood supplies for the <strong>who</strong>lecountry. By the end of the year2000, the Red Cross bloodprogramme, which processes alldonated blood, was collecting,processing and testing about30,000 units per year from thetwo main cities.<strong>World</strong> <strong>Health</strong> Day 2000At the end of 1999, the HonduranNational <strong>Blood</strong> Council developeda plan for a year-long celebrationon the theme of <strong>Safe</strong> <strong>Blood</strong>, thehighlights of which are describedbelow.<strong>Blood</strong> donors reading aboutaltruistic donationPlanningSix months before the <strong>World</strong><strong>Health</strong> Day launch, informationmaterial was developed andwidely distributed, includingposters, pamphlets, stickers andpress articles.<strong>Me</strong>mbers of the National <strong>Blood</strong>Council appeared on televisionand gave radio presentations <strong>int</strong>he weeks leading up to <strong>World</strong><strong>Health</strong> Day to sensitize the public<strong>with</strong> key blood safety messages.Participants in the events belowincluded representatives from theMinistry of <strong>Health</strong>, the National<strong>Blood</strong> Council, the Honduran RedCross, the InternationalFederation of Red Cross and RedCrescent Societies and the WHOPan American <strong>Health</strong><strong>Organization</strong>. There was greatenthusiasm from all participantsand the general public in thecelebration of <strong>World</strong> <strong>Health</strong> Day.Graduation CeremonyThe pilot project for the WHO/PAHO Distance LearningProgramme was initiated in 1997following a regional workshop inEl Salvador. The programme wasformalized <strong>with</strong> an agreementbetween the Ministry of <strong>Health</strong>and one of the local universities.Seven students took part in theprogramme over a period of sixmonths. These participants then37 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
acted as instructors for the secondgroup, <strong>who</strong> graduated inSeptember 2000. Formalgraduation ceremonies took placein March and September 2000,<strong>with</strong> the first ceremony setting thescene for the launch of <strong>World</strong><strong>Health</strong> Day 2000.<strong>World</strong> <strong>Health</strong> Day CeremonyCeremonies were heldsimultaneously in Tegucigalpa, thecapital, and San Pedro, <strong>with</strong> theparticipation of health authorities,NGOs, the Red Cross, PAHO, blooddonors, and institutions that havesupported voluntary blooddonation over the years.Dr Plutarco Castellano, Ministerof <strong>Health</strong>, Dr Carlos Samayoafrom PAHO and Mrs <strong>Me</strong>neca de<strong>Me</strong>ncía, President of theHonduran Red Cross were unitedin emphasizing the importance ofvoluntary, non-remunerated blooddonation. They applauded theefforts being made to increase thesafety of the blood supply inHonduras, efforts that deserveenhanced support.Mrs Mary Flake Flores, First Lady ofHonduras, <strong>with</strong> her blood donor cardMrs Mary Flake Flores, First Ladyof Honduras and a long-standingblood donor herself, was the guestof honour. In a heart-felt address,she drew attention to the graveshortages of blood componentsthat afflict our hospitals, thedeaths that occur because of theseshortages, and how each one of uscan help alleviate the situation bydonating blood regularly.Special awards were conferred onrepeat donors, coordinators ofblood drives and institutions thathave held blood campaigns everyyear since the programme’sinception in 1978. An award wasalso presented to the winner ofthe National Award for Journalism(health).<strong>Blood</strong> Donation FairA Fair was held in Central Park,Tegucigalpa on <strong>World</strong> <strong>Health</strong> Dayitself, during which the communitycould learn about safe blooddonation from murals, leaflets,pamphlets and supportingeducational materials. The contactdetails of individuals <strong>int</strong>erested indonating blood were taken andforwarded to the blood collectionunit.Running for lifeRunning for Life—<strong>Blood</strong> SavesLivesThe race was organized on 9 Aprilby the Honduran Red Cross tocreate visibility for <strong>World</strong> <strong>Health</strong>Day. Both the start and finish lineswere located at the PAHO NationalOffice. There was so muchenthusiasm and good will that asecond race was scheduled for the21 October.38 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Campaign at local university<strong>Blood</strong> drive at the localuniversityA special campaign was organizedon 11 and 12 April to recruitvoluntary non-remunerated blooddonors at the National Universitymain campus. This drive was ofspecial importance because the148 units collected enabled amuch-needed reserve.National Workshop on theDevelopment of Guidelinesfor the Clinical Use of<strong>Blood</strong>In 1998, the Red Cross <strong>Blood</strong>Transfusion Service and WHO/PAHO organized a NationalWorkshop on the Development ofPolicies and Guidelines on theClinical Use of <strong>Blood</strong>. This groupof local clinicians and expertconsultants drafted a NationalPolicy on the subject and furtheridentified the need for clinicalguidelines on the handling andtransfusion of blood components.A second workshop held on 19May made recommendations onhow the guidelines, now available,should be implemented.Other events organized during theyear to respect safe blooddonations included…— a presentation for Ministry of<strong>Health</strong> officials entitled “LegalFramework for the National<strong>Blood</strong> Programme (April)—“The State of <strong>Blood</strong> Transfusionin Honduras, 1998–1999”a lecture by Drs Vinelli andFernández at the PAHONational Office MonthlyTechnical <strong>Me</strong>eting (June)— workshop on Quality Control <strong>int</strong>he <strong>Blood</strong> Bank (October). ▲For more information on bloodsafety activities in Honduras,contact:Dr Elizabeth VinelliSecretaryNational <strong>Blood</strong> Council2a AvenidaEntre 6a y 7a calleComayaguela, D.C.Tel: +504 237 2240/4620/8876Fax: +504 238 0185E-mail: cenasa@datum.hn39 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVES<strong>Me</strong>xicoIntroduction to bloodsafety in <strong>Me</strong>xico<strong>Blood</strong> safety is a priority issue forWHO and for <strong>Me</strong>xico. Last year,the President of the country, DrErnesto Zedillo Ponce de Leon, setthe tone in his official remarks byinviting his Secretary of <strong>Health</strong> tojoin him in donating blood, settingan example for all <strong>Me</strong>xicans, andto the great applause of thecongregation. He also announcedthe creation of the annual“Eduardo Liceaga” award forthose <strong>who</strong> devote their lives to aVisit of mobile blood unit to Los Pinos,official residence of the Presidentvaliant health cause. The firstdistinctions were bestowed by thePresident on Drs José NarroSamuel Ponce de León, RaúlCicero Sabido, Jaime KravzovJinich and Antonio Zimbrón Levy.National <strong>Blood</strong> TransfusionCentre (CNTS)The CNTS was set up in 1982 asthe central, executive organ toensures the application oftransfusion medicine andmanagement of blood and bloodproducts in the country. Today,<strong>Me</strong>xico counts 31 State <strong>Blood</strong>Transfusion Centres (CETS) and13 Regional <strong>Blood</strong> Banks. This hasallowed the creation of a usefultracking system of donors and useof blood for the CETS. In 1990, theInterinstitutional Committee of<strong>Blood</strong> Banks and Transfusion<strong>Me</strong>dicine was <strong>int</strong>egrated <strong>with</strong> theCNTS and other health sectorFigure 1. Accepted donors in altruistic blood donationcampaignsbodies, leading also to thecreation of <strong>int</strong>rahospital groups toensure the rational use of blood.Today all the CETS have their ownInterinstitutional Committee of<strong>Blood</strong> Banks and Transfusion<strong>Me</strong>dicine.Although in <strong>Me</strong>xico altrusticdonation does not have the valueit deserves,voluntary, nonremunerateddonations havesteadily increasedeach year througheffective campaigns(see Figure 1).Institute of<strong>Health</strong> of theState of <strong>Me</strong>xicoAccess to safe bloodand its derivativesis not only theresponsibility of the CETS, buteach and every one of us involvedin blood transfusion, especiallyour blood donors. <strong>Health</strong> workersmust seek efficiency and quality,but most of all care of donors andrecipients. <strong>Blood</strong> must be given asif it were to be transfused to ourown family, which implies threecriteria for the donor:40 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
— Love of our fellow humanbeings;— Responsibility to prevent risks;and— Altruism to give a tiny part ofyourself to save the life ofsomeone else.With these principles, the CETSorganized a major Conference forover 200 participants on Autoimmunehaemolytic anaemiaassociated <strong>with</strong> warm antibodies,<strong>with</strong> a wide variety of qualifiedhealth personnel.An inauguration ceremony alsotook place <strong>with</strong> the participationof health regulatory authorities,health and transfusion servicesand those from the social sector.Dr Luis Alfonso Hernandez Gómez,Secretary for <strong>Health</strong>, made amoving speech po<strong>int</strong>ing totransfusion medicine as a multifaceted,yet highly specializedfield that requires dedicatedprofessionals to cover the entirevein-to-vein process if we are toassure quality and safety. TV, radioand press audiences covered theevent.An educational campaign wasengineered to enhance publicawareness of altruistic donation.1000 students showed great<strong>int</strong>erest in the process and use ofblood units and received some ofthe hundreds of leaflets that weredistributed during the campaign.A campaign was also set up toidentify Rhesus negative donorsamong preparatory schools invarious municipalities. 1718 testswere carried out <strong>with</strong> the aim toenhance awareness of bloodgrouping among the studentpopulation.A radio spot was emitted onaltruistic blood donation <strong>with</strong> themessage “The Institute of <strong>Health</strong>of the State of <strong>Me</strong>xico invites the<strong>Me</strong>xican population to participateon 7 April in the “<strong>Safe</strong> <strong>Blood</strong><strong>Starts</strong> With <strong>Me</strong>” campaign. We areexpecting you—don’t let us down”.The 1st Altrustic <strong>Blood</strong> DonationCampaign 2000 took place underthe auspices of the AutonomousUniversity of the State of <strong>Me</strong>xicoto collect 200 units of blood anddistribute 12,000 leaflets andposters to over 900 students.Our youth today are the donors oftomorrow. The Institute of <strong>Health</strong>will therefore celebrateWHD 2000 every day and continueits education campaignsun<strong>int</strong>errupted until the goal ofonly voluntary, non-remuneratedblood donation is reached. Thenwe can say “<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong>With <strong>Me</strong>”.Learning programmes forblood transfusionIn honour of <strong>World</strong> <strong>Health</strong> Day2000, a new postgraduatequalification in transfusionmedicine was endorsed by theNational Autonomous University of<strong>Me</strong>xico and the Secretary for<strong>Health</strong>. This will build the capacityof blood banks to improve therational use of transfusions,supervise the use of bloodcomponents and the variousrelated therapies such asautologous transfusion orapheresis.In order to increase significantlythe capacity of blood transfusionservices while reducing the costsand time lost at work, <strong>Me</strong>xicowelcomes the Distance LearningProgramme on <strong>Safe</strong> <strong>Blood</strong> and<strong>Blood</strong> Products Diploma as anexcellent opportunity for thedecentralized development ofskills. Already in the State of<strong>Me</strong>xico on 7 April 2000, 31students had satisfactorilycompleted the course from manyhospitals in the State. Studentswork in all disciplines required forthe successful functioning of bloodbanks, e.g. general or specialistphysicians, chemists, nurses,social workers or laboratorytechnicians.Given the vast geographical,ethnic, cultural and religiousdiversity in <strong>Me</strong>xico State, thisform of education is invaluable inmotivating altruistic blooddonation. Training on the DistanceLearning Programme is in greatdemand and feedback fromcurrent and past students is veryencouraging, all of <strong>who</strong>m haveseen concrete improvement <strong>int</strong>heir activities.41 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Secretary of State and Governor of Jalisco <strong>with</strong> other delegatesFocus on the State ofJaliscoThe State of Jalisco <strong>int</strong>ensified itsalready committed informationcampaign to promote voluntary,non-remunerated blood donation.With the Department ofCommunication and under theauspices of the Secretary for<strong>Health</strong>, a variety of materials suchas posters, documents and leaflets<strong>with</strong> poignant visual images andmessages were distributedthrough the State health medianetworks.On 6 April, a press conferencetook place <strong>with</strong> the Director-General of <strong>Health</strong> Services, DrHéctor Gallardo Rincón and otherkey personnel from healthlegislation and transfusionmedicine. The importance ofaltruistic blood donation formedthe basis of a press release, madeavailable to all communicationsmedia.An official ceremony in theAuditorium of the HospitalGeneral de Occidente on 7 Aprilwas highly mediatised andhonoured by the participation ofthe State Governor and the UnderState Secretary for <strong>Health</strong>, amongother notable dignitaries. To thebackdrop of key blood safetyimages, participants heardmessages from WHO and apersonal message from the StateGovernor, an extract of which isrelated below.“Today, we must double our effortsto move gradually from family tovoluntary blood donations.Hopefully, in a not too distantfuture, all Jalisciens in a positionto do so will give blood regularlyso that others, less fortunate, willlive or benefit from treatment thatonly this noble and altruisticgesture of life blood can makehappen. Our deepest thanks go toall <strong>who</strong> give blood, to the mediathat support us, and to all healthprofessionals <strong>who</strong> care about theoptimal use of this preciousresource—a real gift of life.”The Governor then set theexample for all his colleagues bybeing the first voluntary blooddonor of the podium.Focus on the State ofCoahuilaThe State <strong>Blood</strong> TransfusionCentre (CETS) was inaugurated in1990 as a blood bank for thequality control of centresmanaging blood components andthe supply of these around theclock. It also regulates bloodbanks and transfusion servicesthrough periodic controls to verifythat safety procedures areasurred. The State’s goal is toincrease altruistic and autologousdonors and minimize transfusionrisks and counts, today, 75 publicand private organizations relatedto bloodtransfusion.“... theCentre isopen toblooddonors 24hours/day”<strong>World</strong> <strong>Health</strong>Day 2000means “GiveLife”. <strong>Blood</strong>has always hada special placein the historyof localcultures, representing differentemotions: symbolism, mysticism,colour, fear, terror, sadism, alifeline, pain, love, racism,42 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Laboratory in Coahuilatragedy, or pure gold. Mysteriousand fascinating, the Egyptiansused it to rejuvenate their eldersand to cure illnesses, and theRomans to acquire strength.A ceremony took place at theState Hospital for Women in thepresence of the Secretary of Statefor <strong>Health</strong>, the Director of <strong>Health</strong>Services and many other healthpersonnel of Coahuila, highlightingthe activities of the CETS and thefact that the Centre is open toblood donors 24 hours a day.Potential donors pass three stagesto ensure safe blood transfusion:first, completion of an autoexclusionform, which explains therisks of unsafe blood; second, amedical visit to establish a clinicaldossier; and finally a laboratoryanalysis of a preliminary bloodsample. Last year, 1946 units ofblood were collected andunderwent 12,845 tests for majortransfusion transmissibleinfections.Focus on the State ofHidalgoThe concerted efforts—day afterday—in Hidalgo go towards blooddonation as an altruistic and nobleact and, in parallel, discouragingpaid or replacement donors.Altruistic donors should thereforehave a comfortable and cleanplace where they are welcomed bycompetent health servicespersonnel. All blood fortransfusion should be safe and istested for known infections.With unconditional support fromthe State health authorities, thefollowing activities were organizedfor WHD:An “on site” course in transfusionmedicine for physicians took placeon 3–7 April, conferring a diplomarecognized by the <strong>Me</strong>dical Schooland the <strong>Me</strong>dical College ofHidalgo. Ten medical specialiststaught the basic legal conceptsrelated to blood donation torepresentatives of bloodtransfusion services, blood banksand various health organizations.The course was based on theGeneral <strong>Health</strong> Law and inparticular articles related to thedonation of organs, tissue andother human parts, and official<strong>Me</strong>xican norms for the provisionof blood and blood components fora wide range of clinical andtherapeutic purposes. One of themost important themes of thecourse was quality assurance. Itwas agreed that quality normsshould be assured through healthcontrol visits, as well as follow-upmeetings, and that the courseshould be incorporated <strong>int</strong>o theDistance Learning Programme.An information meeting betweenthe National and State <strong>Blood</strong>Transfusion Centres and WHO/PAHO agreed that the State <strong>Blood</strong>Banks should be strengthened.The media was encouraged topromote altruistic blood donation.TV programmes compared thevalue of voluntary, nonremuneratedblood donationagainst paid donation, and invitedthe general public to donate bloodfor the anonymous patient <strong>who</strong>selife they may save, at least threetimes a year. Radio <strong>int</strong>erviewsfocused on motivating andsensitizing listeners to thedifferent functions of bloodcomponents. The correct answersto key questions were rewarded<strong>with</strong> safe blood prizes (caps,T-shirts, etc.)The safe blood theme wasenthusiastically promotedthroughout all strategic places inhealth sector hospitals and publicthoroughfares.Educational establishments suchas the Institute of Social Sciences,the Institute of Economic Sciencesand the School of <strong>Me</strong>dicine weretargeted <strong>with</strong> a mass informationcampaign, reaching a total of 800students. They learnt why we needblood and why it must be safe.Also of the responsibility they43 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
For further information on bloodsafety activities in <strong>Me</strong>xico,contact:Dr Antonio Marin LopezDirector of the National <strong>Blood</strong>Transfusion CentreAvenida Othón de <strong>Me</strong>ndizabal No.195Col. ZacatencoDelegación Gustavo A. Madero C.P.07360Tel/Fax : +51193976, 51191008E-mail: amarin@mail.ssa.gob.mxInternet: www.ssa.gob.mx/unidades/cntsDrawing competition in Hidalgohave to help make blood a qualityproduct for the patient in need,and the confidentiality and carereserved for them as donors.Students received promotionalmaterial reinforcing the safe bloodcampaign.Convinced of the importance ofearly education to improve thesafety of blood transfusion, elevenelementary schools were invitedto participate in a drawingcompetition on altrustic blooddonation, to be exhibited in theState BTC. The principal messagecoming from the 500 entriesreceived was that of solidarity, 12of which will adorn the calendarproduced by the State BTC.Moreover, these schools mounteda one-month informative muralexhibition to encourage theconcept of our future as one ofvoluntary, non-remunerateddonors. ▲In particular, note that a specialproject has been created in <strong>Me</strong>xicocalled the “Guia Roja” (the RedRoute). The project consists of aseries of maps, where you candiscover all the informationavailable on where to find bloodservices throughout the country.Go to the above web site and clickon “mapa virtual”.44 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESNicaraguaHistoryNicaragua, situated in the heart ofCentral America, has a populationof five million. Its health systemfaces similar budgetaryconstra<strong>int</strong>s to that of otherdeveloping nations. The bloodprogramme falls under theresponsibility of the Ministry of<strong>Health</strong> and the Nicaraguan RedCross (NRC). For a long time,blood donations were paid,Second National Congress of <strong>Blood</strong> Bankshospital needs difficult to meetand access to transfusion therapylimited and costly.Then in 1975, the <strong>World</strong> <strong>Health</strong>Assembly urged governments toestablish blood transfusionservices based on voluntary, nonremuneratedblood donation, thusavoiding the commercialisation ofblood and exploitation of donors. Ayear later, the NRC founded theCentral <strong>Blood</strong> Bank <strong>with</strong> a view tocollecting blood tomeet the needs ofthe entire country.To assure maximumquality and safety,blood was thereafteronly collected fromvoluntary, nonremunerateddonors.The National <strong>Blood</strong>Programme (PNS)collects, processesand supplies bloodand blood products to all publicand private hospitals and clinicsin Nicaragua. The programmecomprises four blood bankssituated in Managua, Juigalpa,Matagalpa and Estelí. TheProgramme also includes Centresfor the Promotion of Voluntary<strong>Blood</strong> Donation throughout thecountry. The PNS collects twothirdsof the blood donated inNicaragua and produces 80% ofblood products for transfusion.Provision for the other third is theresponsibility of the Ministry of<strong>Health</strong> through its 18 blood banksdotted around the country.Second National Congressof <strong>Blood</strong> BanksWithin the framework of <strong>World</strong><strong>Health</strong> Day 2000, Nicaraguaorganized its Second NationalCongress of <strong>Blood</strong> Banks. Theevent, which took place inManagua from 30 March to 1 April2001, was in memory of DrErnesto López López, Director ofthe NBC <strong>who</strong> passed away inSeptember 1999. The objectives ofthe Congress were to ensure abetter service for donors and forthose in need of blood, usingqualitycontrols at“Of notewas thepresence ofJehovahWitnessesat theCongress.”every level tominimize risks.165 specialistsattended theevent,includingphysicians,nurses,experts inbioanalysis, laboratorytechnicians, safe blood advocatesand students. Also invited werestaff from hospitals, universitiesand clinics, and officials from theMinistry of <strong>Health</strong>, including the45 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Minister, <strong>Me</strong>mbers of the NationalAssembly, WHO and NGOs. Ofparticular note was the presenceof Jehovah Witnesses at the event.Modernization of National<strong>Blood</strong> CentreAt the opening ceremony, MrsEsperanza B. de Morales,President of the NRC, underlinedthe promise of the <strong>Organization</strong> tocontinue to strive to develop thenational <strong>Blood</strong> Programme basedon voluntary, non-remuneratedblood donation. This was also theideal occasion to announce therestructuring and refurbishing ofthe National <strong>Blood</strong> Centre, fundedby the American Red Cross.National ForumRitha Fletes, President of the<strong>Health</strong> Commission at the NationalAssembly, announced the creationof a National Forum to discuss thedraft bill on transfusion safety<strong>with</strong> the different sectorsconcerned <strong>with</strong> the issue. The newPAHO/WHO Representative inNicaragua, Dr Patricio Rojas,assured participants of WHO’stechnical and financial assistancein strengthening blood banks <strong>int</strong>he country. The representative ofthe Minister of <strong>Health</strong> said that, inconjunction <strong>with</strong> the NRC, theywould promote the development ofappropriate policies to improveblood banks in the country.WorkshopsOn the first day of the Congress,practical workshops took place onthe promotion of voluntary blooddonation, the selection of donorsand special studies onimmunohaematology. In addition,participants in the DistanceLearning Programme on <strong>Safe</strong><strong>Blood</strong> and <strong>Blood</strong> Products hadtheir fourth meeting. A total of 55people participated in thesesimultaneous workshops.All participants expressedtheir gratitude to thehumanitarian actions ofvoluntary blood donorsConferencesOn day two and three of theCongress, major conferencesfocused on topics related to theModernization of <strong>Blood</strong> Banks, e.g.transfusion risks, serologicalstudies, quality controls, nationalstrategic plan on HIV/AIDS, viralhepatitis, molecular biology inblood banks, etc. The objectivewas to address the most urgentlearning needs inimmunohaematology.All invited lecturers were eminentprofessionals in their field<strong>int</strong>ernationally. These included DrJosé Ramiro Cruz from PAHO inWashington, Dr BenjaminLichtiger from the UTMDAnderson Cancer Centre, DrGraciela León from the Municipal<strong>Blood</strong> Bank in Venezuela (picturedfrom right to left in the officialphotograph), and Drs KirsténVisoná and Dr Lizeth Taylor of theLSU-ICMRT Costa Rica. Lecturersalso included national specialistsin transfusion medicine, <strong>who</strong>covered various issues ofparticular relevance to bloodsafety in Nicaragua.The event was a success both fromthe organizational perspective, aswell as the attendance, quality ofpresentations, educationalmaterial available and theexchange of experiences betweenparticipants during all the variousactivities.Rhesus Negative ReunionAnother event that took place<strong>with</strong>in the framework of <strong>World</strong><strong>Health</strong> Day celebrations was theFirst <strong>Me</strong>eting of Rhesus NegativeVoluntary <strong>Blood</strong> Donors. This wasorganized jo<strong>int</strong>ly between theNicaraguan Red Cross and thePanamerican <strong>Health</strong> <strong>Organization</strong>on 7 April for 150 rhesus negativeblood donors. The Minister of<strong>Health</strong>, the President of the RedCross, the PAHO/WHORepresentative and the Presidentof the Commission on <strong>Health</strong> andWell-being were among the invitedguests at the occasion. Allparticipants recognized andexpressed their gratitude to thehumanitarian actions of voluntaryblood donors.46 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
During the event, diplomas andT-shirts <strong>with</strong> the official safe bloodlogo were issued to all 150donors. In addition the officialWHO safe blood pin was awardedto 10 voluntary donors <strong>who</strong> hadexceeded 50 donations.CreditsSpecial thanks go to all those <strong>who</strong>supported us, nationally and fromoverseas, in our efforts to makeblood safe in Nicaragua, but notleast our voluntary, nonremuneratedblood donors. ▲For further information on bloodsafety activities in Nicaragua,contact:Dr Rene Berríos CruzDirector of the National <strong>Blood</strong>ProgrammeNicaraguan Red CrossManaguaTel/Fax: +505 2651 406E-mail: rbc20@ibw.com.niResearch andprogress in bloodproductsTo date, there is no available man-made substitutefor red blood cells. Although considerableprogress has been made in both preventive andcurative blood-derived products, red blood cellsremain a rare commodity.Progress in technology has made it possible toseparate all the components of blood and to storethem at temperatures which are best suited toma<strong>int</strong>ain their viability. Biotechnology research hasincreased our knowledge and enables some of thedifferent components of blood to be identified andpurified. Research is continuing <strong>int</strong>o new blood-derivedproducts and technologies.<strong>Blood</strong> tests have become more sophisticated and arefaster and more cost-effective, yet in many countriesblood is still not screened systematically. Moreresources have to be identified and allocated to ensurecontinuous screening programmes. ▲47 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
BLOOD SAVES LIVES IN WHO’S REGIONAL OFFICE FOR THEEastern <strong>Me</strong>diterraneanWHO Regional OfficeactivitiesTo mark <strong>World</strong> <strong>Health</strong> Day 2000on blood safety, the WHO RegionalOffice for the Eastern<strong>Me</strong>diterranean (EMRO) startedcontacting <strong>Me</strong>mber States at avery early stage, and undertookthe following arrangements:The official theme and slogan weretranslated <strong>int</strong>o Arabic and sent toall <strong>Me</strong>mber States.Letters were sent from Dr HusseinGezairy, Regional Director toMinisters of <strong>Health</strong> briefing themon the importance of the eventand explaining the need tomobilize all walks of life in theircountries for blood donation. Theneed to enhance blood services asa part of the health system wasalso underlined. This lettersuggested activities that could beimplemented locally to mark theHussein A.Gezairy, M.D., F.R.C.S.,event based on the WHD theme,such as:— celebrations and specialevents, e.g. sports matches;— issue of stamps;— seminars and discussions onblood safety and health incultural and social centres;— blood donation campaigns inclubs and universities <strong>with</strong> keyfigures from the arts andsports fields;— urging NGOs to participate <strong>int</strong>he event;— coordinating <strong>with</strong> the Ministryof Education to allocate thefirst lesson of 7 April 2000 inall elementary, preparatoryand secondary school todiscuss blood safety;— arranging <strong>with</strong> the Imams ofMosques and priests ofchurches to allocate the Fridayand Sunday speeches of 7 and9 April to talk about theimportance of blood safety andblood donation;— participating in the annual artcompetition organized byEMRO on the WHD theme;— urging media personnel to takeup their role in assuring theimportance of blood safety.Simultaneously, contacts weremade <strong>with</strong> all WHORepresentatives and Focal Po<strong>int</strong>sin the Region to coordinatesupport for the maximum andeffective involvement of <strong>Me</strong>mberStates.Preparation of informationmaterialsThe official <strong>World</strong> <strong>Health</strong> Day kitwas translated <strong>int</strong>o Arabic andpr<strong>int</strong>ed in three languages. Locallanguage versions such as Persianand Ardu were also produced.Information on blood safety andblood services in the Eastern<strong>Me</strong>diterranean Region was addedto the main kit. Together <strong>with</strong>specially pr<strong>int</strong>ed stickers andposters, these information kitswere then disseminated to anextensive mailing list <strong>with</strong>in EMRcountries, including all mediacontacts.The Regional Office produced its48 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
own video film on blood safety,using shots and footage from manycountries of the Region. Inaddition, a videotape <strong>with</strong> themessage from the RegionalDirector on blood safety wasproduced for the occasion. Thesetwo audiovisuals were broadcaston television channels in all<strong>Me</strong>mber States.Art competitionThousands of entries werereceived from school children inresponse to an Art Competitionlaunched by WHO/EMRO.Submissions were judged at theWHO Regional Office and winnersawarded their prizes during localcelebrations held on 7 April.<strong>Me</strong>dia dayPrior to <strong>World</strong> <strong>Health</strong> Day, theRegional Director held a mediaday during which he gave<strong>int</strong>erviews and held discussions<strong>with</strong> representatives of the pressand television and radio channels.The Head of the Egyptian RedDr Gezairy <strong>with</strong> staff and guests during the WHD 2000 receptionCrescent Association participatedin this media day.On the eve of 7 April, the RegionalOffice held a reception, attendedby high-level officials in thehealth, political and media arenas.All attendees wore safe blood pinsand admired the display ofmaterials on blood safety.EvaluationThe reports received from<strong>Me</strong>mbers States after the mainevents reflect successfulimplementation of the activitiesrecommended by WHO and others,to mark <strong>World</strong> <strong>Health</strong> Day 2000“<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>”. ▲For more information on bloodsafety activities at the WHORegional Office for the Eastern<strong>Me</strong>diterranean, contact:Dr Nabila <strong>Me</strong>twalliRegional Adviser for <strong>Blood</strong> <strong>Safe</strong>tyLaboratory & ImagingWHO Regional Office for theEastern <strong>Me</strong>diterraneanAbdul Razzak Al Sanhouri StreetP.O.Box 7608, Nasr CityCairo 11371Tel: +202 670 5314Fax: + (202) 670 24 92E-mail: metwalin@emro.<strong>who</strong>.<strong>int</strong>Internet: www.emro.<strong>who</strong>.<strong>int</strong>49 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESBahrain“Festival kicked off on ahealthy note”Under this headline, the DailyNews—Voice of Bahrain waspleased to announce that <strong>World</strong><strong>Health</strong> Day 2000 was markedearly in Bahrain. Indeed, a threedayfestival in honour of WHD2000 was organized by the <strong>Health</strong>Ministry’s health educationsection from 2 to 4 April at the AlA’ali Shopping Complex main hallunder the patronage of <strong>Health</strong>Under-Secretary AbdulrahmanBu’ali. Several governmentschools, societies and Bahrainiactors were involved in theexhibition, notably 11<strong>int</strong>ermediate and secondaryschools, said senior healtheducation specialist Aneesa SaadAlhuwaihei.Students displayed drawings atthe exhibition to express theirviews on the theme “<strong>Safe</strong> <strong>Blood</strong> isIntermediate andSecondary Schools involvedin the festivalAbdulrahman Al Dakhil Int.School for BoysGudaibiya Int. School for BoysKhadija Al Kubra Int. Schoolfor GirlsZanoubia Int. School for GirlsAisha Umm Al Moamineen Int.School for GirlsKhawla Sec. School for GirlsAl Esteqlal Int. Sec. Schoolfor GirlsManama Sec. School for GirlsMuharraq Sec. School for GirlsHoora Sec. School for GirlsMuharraq Sec. CommercialSchool for GirlsEveryone’s Responsibility—<strong>Safe</strong><strong>Blood</strong> Saves Lives”. The bestdrawings won valuable prizes. Thefollowing students were awardedfor their outstanding work: RashidAbdulrahman Al Aufi, Maha Ali AlMahmeed, Mooza Al Benali, WisalEbrahim Haji, Naseema Hassan AlShaikh, Noora Yousef Mohammedand Maha Abduljalil Abdullah.The Islamic Society, the <strong>Blood</strong>Bank, Bahraini actors Jaman AlRuwai’ee, Ali Al Ghurair andAhmed Al Majli also supported theevent along <strong>with</strong> manycontributors from the privatesector. A drawing competition forchildren between six and 10 yearswas held under the supervision ofthe Islamic Society and SalmanCultural Centre for Children.Another hands-on pa<strong>int</strong>ing contestwas held, <strong>with</strong> instant prizesdonated by the Islamic Society tothe most innovative artists. Theseart pieces, posters related tovarious health issues, along <strong>with</strong>information booklets to raiseawareness among the generalpublic, were also exhibited.Further prizes went to winners ofa competition on general healthduring the evening of 3 April, <strong>with</strong>live entertainment from the localmusical group, Al Dabdoob.The Islamic Society also producedan explanatory newsletter for theoccasion, and the Al Eslah Societyhad two educational stickersspecially designed for distribution.Hands on healthA keen po<strong>int</strong> of <strong>int</strong>erest was thefree blood tests carried out by theblood bank during the festival. Tocomplement this, the BahrainNursing Society carried out freeeye tests and offered to checkyour weight, height and blood50 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
pressure. The Bahrain DiabetesSociety also took the opportunityto offer diabetes tests and carryout awareness building among thepublic.Honours for festivalpromoters and participantsThe Assistant Under-Secretary forPrimary and Public <strong>Health</strong>, DrAbdulwahab MohammedAbdulwahab andthe Chief ofNot oneperson woulddispute thevitalrelationshipbetween bloodand health<strong>Me</strong>dical Stafffor PrimaryCare, Dr FawziAmin, presentedhonours topeople <strong>who</strong>made <strong>World</strong><strong>Health</strong> Day sucha success.Those honoured included students,teachers, schools, societies, themedia, companies, healthpersonnel and other individuals.The ceremony was organized bythe health education directorate topass a special message of thanksto all <strong>who</strong> supported the day’scelebration from the <strong>Health</strong>Minister and Under-Secretary for<strong>Health</strong>. Dr Abdulwahab said thatthe support from outside thehealth and medicine field was animportant asset and key to thesuccess of any health strategy. “Ithelps reinforce the close tiesbetween the health sector and thepublic” he continued. This joininghandswas also testimony to acooperative society that is wellaware of the need for sharedresponsibility and solidrelationships between the publicand private sectors.Not one person would dispute thevital relationship between bloodand health. “Our role to providenecessary health services to thepeople is a crucial strategy forBahrain’s leadership, which hasleft no stone unturned to achievethe plans and programmes of thehealth ministry” added Dr AlMousawi.New drive aims at safeblood donationThe nursing community in Bahrainmade a concerted effort toincrease people’s awareness ofsafe andBahrain’sleadership hasleft no stoneunturned toachieve theplans andprogrammesof the healthministryvoluntaryblooddonation.BahrainNursingSocietyPresident,BeemaSultan, saidthe worldrelied onsafe bloodto save people’s lives, yet sadlyonly 20 to 30 per cent of healthsystems around the world providethe necessary facilities for a safeand adequate blood supply.At the beginning of this newmillenium, said Ms Sultan, we as asociety would like to emphasizethe importance of managing bloodproperly. People need to know thevalue of safeguarding their healthand the precious life source whichis our blood. Good nutrition, ahealthy lifestyle and properprevention and early treatment ofdiseases will contribute to healthyblood. The BNS reaffirmed itscommitment to the community onthe occasion of <strong>World</strong> <strong>Health</strong> Day,and made a tremendous effort topromote public awareness of safeblood donation. These efforts, saidMs Sultan, should be promotedright from primary schools todevelop a positive attitudetowards voluntary and nonremuneratedblood donation.Special appreciation was given bythe BNS to the blood donors inBahrain <strong>who</strong> receive noremuneration for this altruisticact. But many more such donorsare needed to fulfil ourrequirements for blood. Dr AmalAl Jowder, Head of the <strong>Health</strong>Education Department in theMinistry of <strong>Health</strong>, said that manypeople all over the world are indesperate need of blood every day,especially those <strong>with</strong> thalassemia<strong>who</strong> need blood regularly, and inemergency operations.51 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
<strong>Blood</strong> represents eight per cent ofbody weight, and a person <strong>with</strong>average height and weight carriesblood <strong>with</strong> 25 billion red bloodcells. WHO statistics were cited <strong>int</strong>he press to show that half amillion women die each year frompregnancy-related causes, manydue to lack of blood. Dr Al Jowdertold the media that healthy adultscan handle losing 20 per cent oftheir blood and that the averageamount of blood being pumpedthrough the heart is five litres perminute.Combining religion andhealth: a truly outstandingachievementTraditionally, the 10th day of theIslamic New Year is a time whenMoslems make themselves bleed,<strong>with</strong> a view to sharing the agony ofthe murder of the son of theprophet. With tremendous supportfrom the media, new legislationwas passed whereby those <strong>who</strong>wish to pay homage in this wayshould do so at the local bloodbank. In this way, Shee’etMoslems have successfullyretained an important element oftheir culture as well as ensuringthat many others in need willbenefit from the gesture. This ideahas been proposed in othercountries, but has only beensuccessfully implemented inBahrain. A success story worthcopying.ConclusionThe urgency to develop safe andeffective blood transfusionservices has been highlighted bythe serious threat of infection byHIV and hepatitis B viruses. Of the33 million HIV/AIDS patientsworldwide, five per cent arereported to have contracted thevirus through blood transfusion.<strong>World</strong> <strong>Health</strong> Day 2000 on <strong>Safe</strong><strong>Blood</strong> provided Bahrain <strong>with</strong> atimely opportunity to bring thishome to its people. The nationalhealth authorities spotlighted, onthe one hand, the need torecognize those <strong>who</strong> support safeblood initiatives and, on the other,the need to increase voluntary,non-remunerated blood donation.The Arab <strong>Health</strong> Ministers Councilhas established a <strong>Blood</strong> TransfusionScientific ConsultancyCommittee and formulated aholistic plan to increase awarenessof the key issues in thisfield. ▲For further information on bloodsafety activities in Bahrain, contact:Mrs Fakhreyya Ali DarwishSupervisor <strong>Me</strong>dical TechnologistSalmaniya <strong>Me</strong>dical ComplexCentral <strong>Blood</strong> BankMinistry of <strong>Health</strong>Government of BahrainP.O. Box 12, ManamaTel: +973 289 454Fax: +973 289 46752 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESEgyptChallenges facing theblood programmeHistorically, blood transfusionservices (BTS) have always had alow priority <strong>with</strong>in the Egyptianhealth care system. Lack ofgovernmental attention andsupport, and no centralized—orregionalized—programme meantthat the BTS were primitive andfragmented. Few blood centrescould meet the needs for blood,either quantitatively orqualitatively and blood was onlydonated in a patient-basedemergency, 90% of which camefrom family relatives. Thissituation was exacerbated by thegrowing commercialisation ofblood. The scope of vision and acompetent and credible nationalblood service that could equalother medical disciplinesremained a pipe dream for quitesome time.Egyptian-Swissturning po<strong>int</strong>In 1997, the Minister of <strong>Health</strong>and Population spearheaded arevolution in blood transfusionservices <strong>with</strong> a view to <strong>int</strong>egratingthis vital facility <strong>int</strong>o the emerginghealth care system. A turningpo<strong>int</strong> was the agreement, signedNational <strong>Blood</strong> Transfusion Centrein this year, between the EgyptianMinistry of <strong>Health</strong> and the Swissgovernment to implement aproject to restructure and upgradethe BTS as a priority.Centralization of the BTS was thefirst objective of the Egyptian-Swiss project. The plan was toestablish one central, or national<strong>Blood</strong> Transfusion Centre, eightregional centres and 30 districtblood banks that would graduallyreplace the old fragmented system<strong>with</strong> a viable blood programme. Toachieve this ambitious objective,the Ministry of <strong>Health</strong> andPopulation is implementing thefollowing strategy:— the National <strong>Blood</strong> TransfusionCentre, supported by theGeneral Directorate of <strong>Blood</strong>Affairs of the Ministry is thecentral body responsible foroverseeing the bloodprogramme. As a centre ofexcellence, it acts as a nationalreference, training anddevelopment centre;— safe blood and blood productsfor transfusion must beavailable to all in need;— paid blood donation wasabolished by Ministerial53 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Decree No. 25 in 1999 andreplaced accordingly <strong>with</strong>voluntary, non-remuneratedblood donation;— the highest <strong>int</strong>ernationalstandards and criteria arefollowed for the testing of everyunit of blood to avoidtransfusion transmissibleinfections;— the appropriate clinical use ofblood and blood components isencouraged;— quality managementprogrammes have beenestablished for the bloodcentres;— various training programmesfor staff at all levels have beendefined; and— an information technologydepartment and communicationnetwork are being created.National <strong>Blood</strong> Programmeactivities during 2000This strategy has proved verysuccessful and enormous progresshas been made in safe bloodtransfusion services in thecountry. The following list ofactivities carried out during theyear 2000, dedicated to bloodsafety, pays tribute to theseefforts.Donor recruitmentprogramme— blood donation status assessedall over Egypt;— training module preparedbased on WHO DistanceLearning Material and used aseducational material for bloodcollection teams and donorrecruiters in the national BTCand different regional centres;— trained donor recruitment staffallocated to NBTC andoperational RBCs;— project for voluntary bloodcollection initiated in NGOssuch as the Sunrise RotaryClub;— several workshops <strong>with</strong> WHOand Family <strong>Health</strong>International, proposingstrategy for six-month actionplan;— educational materials(brochures, posters, etc.) toraise public awareness onvalue of safe blood donationdisseminated;— standard operating proceduresand manual for donorrecruitment programmeproduced by NBTC;— Alexandria RBC pilotedimplementation of a donorrecruitment programme <strong>with</strong>technical assistance from FHI;and— national guidelines and basicinformation leaflet in use.Serological testing— in the NBTC and operatingRBCs, serological departmentshave two laboratories forroutine testing of transfusiontransmissible infections andred cell grouping;— standard operating proceduresavailable;— technical manuals inpreparation— all personnel trained on properuse of new equipment andtechniques;— several seminars andworkshops held.<strong>Blood</strong> processing— different blood components(packed red cells, fresh frozenplasma), platelet concentrate,cryoprecipitate, etc., now allprocured;— logistics—quality control,appropriate storage conditions,proper labelling and disposal ofinfected or out-of-date blood—all in place;— leucodepleted blood andirradiated componentsavailable;— apheresis blood collectionexists.54 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Quality management— quality department in NBTChas three related laboratories:• confirmation lab: provides aconfirmation service for alltesting parameters relatedto blood transfusion;• quality control lab: providesexternal proficiency testingpractice for all blood banksand supervises and controlswork performance. Alsoinvestigates blood transfusionincompatibility issuesdue to presence of red cellantibodies.N.B. To test this lab, the NewJersey External QualityControl Department sent twoproficiency samples, theresults of which were 100%accurate.• validation lab: providesadvice on validity ofreagents and consumablesrelated to blood testing onthe market. Also tests bloodcomponents for contamination.— standard operating proceduresbeing elaborated;— bar code labels in use;— continuous training to buildnew attitudes forimplementation of goodlaboratory practice.Human resourcesdevelopment— several scientific activities heldrepeatedly, e.g. trainingcourses, workshops andseminars <strong>with</strong> educationalmaterial;— guidelines published anddistributed;— training and education policyformulated and implemented;— programme of TOT (trainingthe trainers) established <strong>with</strong>five national cascade trainersalready implementing aschedule of GLP training in theRBCs.Information technology— communications network forthe national, regional anddistrict blood banks being setup— web site for the NBTSavailable: www.nbtsegypt.orgAppropriate use of blood— routine use of bloodcomponents encouraged;— hospital transfusioncommittees established inseveral hospitals— national guidelines distributedto all clinicians for use.Future goalsImmediate goals for the National<strong>Blood</strong> Transfusion Centre are tocomplete the centralized andregionalized network of bloodbanks so that safe and adequateblood may be provided to theentire country.A system that can register andfollow reliable repeat blood donors<strong>who</strong> are committed is a highpriority.Other priorities are to have theNBTC accredited as an<strong>int</strong>ernational operating body, to<strong>int</strong>roduce a complete ExternalQuality Assessment Scheme, andthe creation of a medical andtechnical postgraduate course <strong>int</strong>ransfusion medicine.Consideration is also being givento <strong>int</strong>roducing novel assays todetect viral nucleic acid bygenomic amplificationtechnologies. ▲For further information on bloodsafety activities in Egypt, contact:Dr Faten MoftahDirectorNational <strong>Blood</strong> Transfusion CentreP.O. Box 146, CairoTel: +20 2 355 3708Mobile phone: +201 221 74488Fax: +20 2 355 3756E-mail:faten@moftah.comInternet: www.nbtsegypt.org55 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESJordanPlanning for blood safetyin JordanThe <strong>Health</strong> Education Departmentof the Ministry of <strong>Health</strong>, incollaboration <strong>with</strong> the National<strong>Blood</strong> Bank, set up a SteeringCommittee to plan and conductactivities for <strong>World</strong> <strong>Health</strong> Day2000 “<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>”.Representatives fromgovernmental andnongovernmental organizationsoffered their full support to theactivities, a summary of which isoutlined below.Official ceremonyThe main celebration ceremonytook place on 10 April 2000 at theMarriott Hotel in Amman underthe patronage of Her RoyalHighness Princess Basma B<strong>int</strong>Talal. The event, which wascaptured on video, comprised:<strong>Safe</strong> blood donation poster— an art exhibition;— a song about the importance ofblood, sung by the Al MashreqInternational schools coral. Thesong was written by Mrs MunaHamzeh, Head of the <strong>Health</strong>Education Department andcomposed by one of thestudents—Tareq Abu Qura;— Jordan received prizes for 2nd,3rd, 4th and 5th place from theregional art competition, underthe auspices of <strong>World</strong> <strong>Health</strong>Day, in the presence of theMinister of Islamic Affairs andthe WHO Representative ofJordan;— four papers were presented onthe importance of safe blooddonation.Significant momentsA seminar was organized in theMadabah governate for thegeneral population under thepatronage of the Minister of<strong>Health</strong>, Dr Mosleh Al Tarawneh,during which rewards were givento faithful donors.Religious leaders were able toassist in a specially-designedworkshop in the King AbdullaMosque on 23 March 2000 on therole of religion in encouragingsafe blood donation. The followingFriday, the speeches in all themosques of the nation focused onthis subject and were broadcastover television and radionetworks.The national blood bank alsohosted a workshop for numerousparticipants from nongovernmentalorganizations and allJordanian universities. Thepurpose of this event was todiscuss their role in encouragingblood donation and theorganization of regular blood56 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
donation campaigns. The specificobjective was to increase regular,voluntary, nonremunerated blooddonation in Jordan.A one-hour seminar was hosted byMr Gunnar Lofberg, Director ofthe United Nations Relief andWorks Agency for PalestineRefugees in the Near East(UNRWA) for operations in Jordan.The seminar was a jo<strong>int</strong>collaboration <strong>with</strong> the <strong>Health</strong> andEducation Department of theMinistry, under the theme <strong>Safe</strong><strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>.A blood donor award ceremonywas held in May-June 2000 underthe patronage of the royal family.The objective was to reward andcertify committed blood donororganizations that raiseawareness of the community ofthe need for adequate and safeblood. Regular blood collectioncampaigns fall also under thepurview of this association.Educational activitiesA muppet show was staged,since this was considered anexcellent medium to reflect to awide audience the many ideasthrough songs, and tell childrenabout the importance of blood andblood safety. The different roles ofblood components in saving liveswas the focus of the show, held atthe Haya Cultural Centre.A technical team for the muppetshow included Dr Janiet <strong>Me</strong>rza,responsible for Information; MrsMuna Hamzeh for Supervision;Abdel Jaber Hassan, Writer andDirector; and Hanan Hinatti,Mupper Designer and Producer.Issam Abu Fara and Naoomy werethe actors and muppet movers.Schools had a general knowledgequiz, art exhibitions and songs onthe importance of voluntary, nonremuneratedblood donation.MaterialsTwo posters and a brochure werewidely distributed to the generalpopulation during face-to-faceYour blood—for the loveof lifeSeeking for it ... Seeking for itwhere we can find ... wherewe can findimpossible ... impossible everto reach it from the treethe secret of our lifeto find it from the rocksor from the depth of the earthit is <strong>with</strong>in us ... one drop of itsaves our souls ... createshopewe volunteer happilyto protect soulsto save human livesfor ever ... and ever bloodbanksopen the doors of hopego ahead ... don’t hesitatego ahead ... save livesdonate your blood ... savelivesextract byMuna HamzehHead, Dept. of <strong>Health</strong> Educationsessions at all governates, ashealth education materials.Mass media eventsThirty-six representatives fromthese media also participated in aworkshop to sensitize them tosafe blood issues, and in this wayafford maximum impact of theblood safety media campaign.Activities took place over a <strong>who</strong>lemonth on television, radio and innewspapers. In particular, 16television spots were shown toraise awareness among the publicof the need for their support indonating blood in an altrusticmanner. The television and radioprogrammes included <strong>int</strong>erviews<strong>with</strong> physicians, current blooddonors and patients that havebenefited from blood donation.Of the dozens of newspaperarticles that appeared in theAl-Rai, Al-Dustoor and Al-Aswaqnewspapers, one was a comicstrip that appeared on 6 April tosensitize youth to exactly whatvoluntary blood donationmeans. ▲57 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
For further information on bloodsafety activities in Jordan, contact:Dr Janiet <strong>Me</strong>rza NiqurDirectorNational <strong>Blood</strong> BankMinistry of <strong>Health</strong>P.O.Box 10058Al AshrafiehTel: +962 64 749121/2/3Fax: +962 64 749123E-mail: nbbam@moh.gov.joComic strip on voluntary blood donation58 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESSyriaThe following is a snapshot ofactivities undertaken under theauspices of the health authoritiesin Syria:— The Ministry of <strong>Health</strong> and theGeneral <strong>Blood</strong> Institute and<strong>Me</strong>dical Industries translatedand pr<strong>int</strong>ed the WHO posterand distributed it to all <strong>Blood</strong>Transfusion Centres and healthestablishments in Syria.— A television symposium wasorganized by the Ministry ofPreparing a blood donorInformation, led by theMinister of <strong>Health</strong> <strong>with</strong>physicians and specialists inblood transfusion medicine.The broad discussions on avariety of aspects of bloodsafety were put <strong>int</strong>o context bythe WHO official blood safetyvideo that was shown duringthe symposium.— The Ministry of <strong>Health</strong> prepared,pr<strong>int</strong>ed and distributedseveral manuals describing themajor topics related to bloodtransfusion. These were on<strong>Me</strong>dical History and PhysicalExamination of <strong>Blood</strong> Donors,Voluntary <strong>Blood</strong> Donation,<strong>Blood</strong> Collection and StoragePrinciples and <strong>Blood</strong> Groupsand <strong>Blood</strong> Group Testing.— The National Committee of<strong>Blood</strong> Transfusion held threemeetings during which keytopics related to blood<strong>Blood</strong> donor registrationtransfusion were discussed.— The Committee on Informationand Voluntary <strong>Blood</strong> Donation,and the Committee ofContinuous <strong>Me</strong>dical Educationalso took the opportunity toraise issues of mutual concernrelated to blood safety.— Moreover, the Continuous<strong>Me</strong>dical Education Committeeis preparing multiple trainingactivities for technical healthassistants on various aspectsof blood transfusion.— <strong>Me</strong>dia coverage was assured.In particular, the local pressauthorities <strong>int</strong>erviewed DrEmad Abo Khamis, Chairman ofthe <strong>Blood</strong> Transfusion Centre inEl Moasat Hospital, DamascusUniversity. His remarksfocused on the importance ofthe quality and safety of theblood collected, and on thevalue of voluntary donation.The <strong>int</strong>erview was published <strong>int</strong>he local El Ba’ath newspaperon 6 April. A further <strong>int</strong>erviewwas published in the Techreendaily newspaper on 8 April,focusing broadly on all aspectsof blood transfusionmedicine. ▲For further information on bloodsafety activities in Syria, contact:Dr A.S. Assa’ediThe <strong>World</strong> <strong>Health</strong> <strong>Organization</strong>RepresentativeMinistry of <strong>Health</strong> BuildingSalhieh Parliament StreetAl Najmeh Sq., DamascusTel: +963 11 332 9315Fax: 963 11 33 0298E-mail: <strong>who</strong>@net.sy59 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESTunisiaSteering Group on <strong>Blood</strong><strong>Safe</strong>ty in TunisiaTunisia joined all other countriesto celebrate <strong>World</strong> <strong>Health</strong> Dayunder the theme “<strong>Safe</strong> <strong>Blood</strong><strong>Starts</strong> With <strong>Me</strong>—<strong>Blood</strong> SavesLives”. A Steering Group wasformed on the decision of theMinistry of <strong>Health</strong> several monthsin advance. <strong>Me</strong>mbers of the groupincluded representatives of theTransfusion Unit, the National<strong>Blood</strong> Transfusion Centre, theRegional Centres, the <strong>Blood</strong>Transfusion Military Centre, theRed Crescent Association, the<strong>Health</strong> School Board and thePrimary <strong>Health</strong> Care Board. Theobjective of the Steering Groupwas to propose activities thatcould take place on 7 and 8 April2000.<strong>World</strong> <strong>Health</strong> Day joinsNational <strong>Blood</strong> DonationDay<strong>World</strong> <strong>Health</strong> Day falls the daybefore National <strong>Blood</strong> DonationDay, which has been celebrated inTunisia every 8 April since 1988.This year’s focus of WHD on safeblood made it a doublecelebration, and many activitieswere planned for these two days.Some of these are described in thefollowing pages.Important <strong>Me</strong>ssagesA brochure was written in Arabicon <strong>World</strong> <strong>Health</strong> Day by membersof the Steering Group. Using theinformation kit provided, the textswere adapted to the Tunisiacontext and carried the followingmessages:— what is blood?— what issafe blood?— what is thegovernmentdoingto providesafe blood?And finally,— Tunisianeedsmore blood.A noble gestureThis brochure was circulatedextensively to the general public.Promoting public awareness of theneed for voluntary nonremuneratedblood donation wasanother major message, passedthrough articles in Arabic andFrench in Tunisian newspapers,and through television and radiocampaigns.The media campaign could be seenas an aide-mémoire of the bloodtransfusion situation in Tunisia,both in achievements andchallenges. The successesincluded: national legislation onblood safety; a network comprisinga newly built national bloodtransfusion centre <strong>with</strong> fiveregional centres that cover theentire country; national screeningpolicies <strong>with</strong> directives updated tothe end of 1996 and related todonor recruitment and selection;and laboratory testing includingscreening for the infectious agentsHIV, hepatitis B and C, andsyphilis. The challenges wereperceived as the need to replacefamily donors <strong>with</strong> voluntary, non-Mobile blood collection unit60 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
emunerated donors and toincrease the number of thesealtruistic donors.the current President Ben Ali, indeference to the circumstances,also made his annual blooddonation later than usual.<strong>Blood</strong> collectionPlanned mobile blood collectionsessions were organized on 7 and8 April 2000, in collaboration <strong>with</strong>the Red Crescent Association. It isimportant to note that a specialblood collection session isorganized every year in theMinistry of <strong>Health</strong> on this date.Promotional activitiesBanners were suspended in themajor thoroughfares of big cities,carrying slogans promoting bloodAnnual blood donation at Ministry of <strong>Health</strong><strong>Safe</strong> blood bannerdonation. An exhibition took placein the show room of the Ministryof Information in Tunis on 7 and 8April, organized in collaboration<strong>with</strong> the <strong>Blood</strong> TransfusionMilitary Centre, the Red CrescentAssociation, the TransfusionCentral Unit of the Ministry of<strong>Health</strong> and the Board of the<strong>Me</strong>dical School. Posters reflectedthe accomplishments in the fieldof blood transfusion. Thesefocused on the goals and evolutionof blood donation and transfusionsafety and included both generaland specific information, such asthe blood fractionation centre.Tunisia participated in thedrawing competition organized bythe WHO Regional Office for theEastern <strong>Me</strong>diterranean, andexhibited the best entries,including one that was awarded6th place in the Region.During the two days, documentswere distributed and anaphaeresis machine displayed forvisitors <strong>who</strong> received hands-onexplanations as to its use. Schoolhealth club members could alsotake advantage of guided visits tothe different blood transfusioncentres.The Presidential AwardIn 1999, the President award wascreated to reward the region inTunisia collecting the most blooddonations and to promotecompetition between the 23regions. This year, the award waswon by the Jendouba region in thenorth-west of the country.However, due to the death of theformer President of Tunisia, theofficial ceremony was postponeduntil later in the month. Similarly,<strong>Blood</strong> Donor AwardIn line <strong>with</strong> the legislation, agraduation ceremony took place inall regions on 7 April, except forTunis where the ceremony waspostponed to 23 May, <strong>World</strong>Donation Day.Transfusion in Tunisia:LectureIn the afternoon of <strong>World</strong> <strong>Health</strong>Day, members of school healthclubs in the Tunis region wereinvited to attend a meeting in theampitheatre. Four lectures weregiven on blood and its functions,blood safety, transfusion inTunisia, and on albuminproduction.ConclusionThe celebration of <strong>World</strong> <strong>Health</strong>Day gave us the opportunity to61 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
launch a far-reaching mediacampaign to promote voluntary,non-remunerated blood donation,which remains an importantchallenge in Tunisia. ▲For further information on bloodsafety activities in Tunisia, contact:Professor Dr Kamel BoukefDirectorNational <strong>Blood</strong> Transfusion Centre13 Rue Djebel Lakhdar-BabSaadoun, 1006 TunisTel: +216 1 562 957 lFax: +216 1 562 957E -mail: kamel.boukef@rns.tn62 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
BLOOD SAVES LIVES IN WHO’S REGIONAL OFFICE FOREurope<strong>Safe</strong> blood, used safely,saves lives!Inadequate supplies of safe blood,the lure of cash payments forblood donation and theinappropriate use of availablesupplies are putting people’s livesat risk, warned WHO in a series ofreports issued in conjunction <strong>with</strong><strong>World</strong> <strong>Health</strong> Day 2000.“This year’s <strong>World</strong> <strong>Health</strong> Daytheme, ‘<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> <strong>with</strong><strong>Me</strong>’, is about public health rightsand responsibilities,” said DrMarc Danzon, WHO RegionalDirector for Europe. “Peopleeverywhere have the right toexpect that their governments willtake all steps necessary to ensureaccess to an adequate supply ofsafe blood when and where it isneeded, and that their healthprofessionals will be properlytrained to use blood only whenappropriate and when otherDr Marc Danzonalternatives will not answer. Atthe same time, WHO calls on allpeople to protect their own blood,to avoid high-risk behaviour, suchas unsafe sex and <strong>int</strong>ravenousdrug use, and to come forth asvoluntary, unpaid donors tocontribute to the health of theirfellow human beings.”“The key blood safety priority forWHO in the European Region is toassist countries, where necessary,to establish health policies thatwill increase the number of lowrisk,unpaid voluntary donors,especially in countries <strong>with</strong> highlevels of HIV, hepatitis, syphilisand malaria, and to ensure mechanismsto improve the quality ofcare by reducing inappropriateblood transfusions and promotingthe use of alternatives.”Most transfusions are given topeople injured in accidents,children <strong>with</strong> severe anaemia,surgical and cancer patients andwomen <strong>who</strong> lose large quantitiesof blood as a complication ofpregnancy.Countries in the eastern half ofthe European Region have specialproblems. In many easternEuropean countries, the incidenceof infectious diseases such assyphilis has risen twenty- to fortyfoldduring the last few years,reaching a rate of 150–300 casesper 100 000 population (inwestern Europe the average rateis 1.5 per 100 000). Thesecountries are also seeing manynew cases of HIV. In some,donations of HIV-infected bloodwere up to 64 per 100 000 in1998; in most other countries ofthe Region, the figure is 0.5 per100 000 donations or below.“Many of these countries stilldepend on paid blood donors.Financial and other ‘rewards’ fordonation attract high-riskpopulations such as drug abusersand sex workers,” noted Dr AlexGromyko of the WHO RegionalOffice for Europe. “This meansthat screening out unusable blooduses up scarce and expensiveblood-testing resources. Also,since donors may have acquiredHIV but may not have developedthe antibodies to the virus, therisk of undetected infections isgreat.”63 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
<strong>World</strong>wide, 5–10% of cases of HIVinfection are transmitted throughthe transfusion of infected bloodand blood products. Other majordiseases that can be transmittedinclude viral hepatitis B and C,syphilis, malaria and Chagasdisease. Globally, each yearunsafe transfusion and injectionpractices cause an estimated8–16 million hepatitis virus Binfections, 2.3–4.7 millionhepatitis virus C infections and80 000–160 000 HIV infections.WHO is working <strong>with</strong> nationalauthorities and clinicians topromote blood safety and toreduce the spread of HIV andother infections through bloodtransfusion in all countries,especially those most in need, byadvocating and assisting in thedevelopment of policies andinfrastructures and the training ofpersonnel. For example, a new setof Russian-language distancelearningmaterials on blood safetyand the clinical use of blood was<strong>int</strong>roduced to high-levelministerial representatives in 14of the newly independent statesof the former USSR last month.Transfusion medicine specialistsand clinicians <strong>with</strong> an <strong>int</strong>erest <strong>int</strong>ransfusion practice from acrossEurope gathered on 6–7 April2000 in London, United Kingdom,under the auspices of the WHOCollaborating Centre at theNational <strong>Blood</strong> Service(Birmingham), to agree on andissue recommendations to assistall European <strong>Me</strong>mber States indeveloping their own policies, inline <strong>with</strong> WHO guidelines, toreduce inappropriate bloodtransfusions and to promote theuse of alternatives.“Encouraging physicians to stopand think whether a transfusion isthe best option is fundamental,”said Dr Gamal Gabra, head of theWHO Collaborating Centre and theprincipal coordinator of themeeting. “We want to alertgovernments to the need to lookcarefully at using blood, to have anational policy in place and tomonitor quality and outcomes on aregular basis, making sure thatthe right product goes to the rightpatient at the right time <strong>with</strong>outunnecessary overuse orunderuse.”“Experts discussed a variety ofrecommendations” noted Dr IsufKalo, WHO Regional Adviser forQuality of Care and Technology.“For example, the most seniorperson in the treatment teamshould make the decision to useblood and blood products.Clinicians should be encouraged toreview and update their clinicalprinciples on the use of blood, tominimize its use and to encouragealternatives or replacements, aspart of a national policy on bloodtransfusion. Patients should beassessed carefully and on anindividual basis, and all availablealternative therapies exploredbefore a decision is made. Inaddition, the experts madespecific recommendations fortransfusion practice during andafter childbirth and inemergencies.”The final recommendations of theexpert group were forwarded tothe WHO Regional Committee forEurope which met in September2000 in Copenhagen. ▲(Adapted from WHO Press ReleaseEURO 05/00, Copenhagen, 7 April2000. Available in English,French, German and Russian.)For further information on bloodsafety activities in the EuropeanRegion, contact:Dr Isuf Kalo, Regional AdviserQuality of Care and TechnologiesWHO Regional Office for EuropeScherfigsvej 8, DK-2100Copenhagen Ø, DenmarkTel.: +45 39 17 12 65Fax: +45 39 17 18 80E-mail: ika@<strong>who</strong>.dkInternet: www.<strong>who</strong>.dk/64 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESCroatiaLandsteiner linkTransfusion medicine got underwayin Croatia at the turn of the20th century, shortly after thediscovery by Karl Landsteiner ofABO blood typing. Landsteiner infact co-published a number ofscientific papers <strong>with</strong> Dr Prasek, aCroatian scholar of immunohaematologyand microbiology.Yet, attempts to institute a systemof non-remunerated blooddonation failed, and blood donorswere largely limited to familymembers. Transfusion therapyremained rare until the end of<strong>World</strong> War II, when a transfusionteam was established <strong>with</strong>in thearmy, later to become a transfusionservice.In 1998, as much as 92%of blood donationswere non-remuneratedThe transition frompaid to non-remunerateddonationIn 1945, the blood supply wasinsufficient to meet the greatdemand for blood components.The number of voluntary, nonremuneratedblood donors grewsteadily however until, in 1953,Parliament outlawed the sale ofblood. On 25 October that year,the Red Cross organized the firstever blood donation campaign inCroatia, and this date has beendedicated to voluntary, nonremuneratedblood donors eversince. The transition from paid, orfamily donors to voluntary, nonremunerateddonors was not easy.By the end of the 1960s, paiddonation was only tolerated inexceptional circumstances, suchas emergencies and scarcities.The responsibility for blooddonation remains <strong>with</strong> the RedCross, although blood collectionand the preparation of componentsis under the care of theblood banks.TrainingThe first Croatian specialists <strong>int</strong>ransfusion medicine wereeducated in Glasgow and Paris, ata time when transfusion therapywas only accessible at majorhospitals. In 1958 Zagreb <strong>Me</strong>dicalSchool <strong>int</strong>roduced the first threeyearcourse in transfusionmedicine, comprising laboratoryand clinical practice and by theearly 1960s, the first generationof Croatian specialists was born.This had a positive and immediateimpact on the number of blooddonations in Croatia.The 1960s also saw many othertransitions. For example, glassbottles to collect blood wereBTS staffreplaced <strong>with</strong> plastic bags; andplasma was first locally produced,then lyophilized for later use. Thevolume of fractionated plasma andthe number of products increasedover the years and today thecountry produces albumins,<strong>int</strong>ramuscular and <strong>int</strong>ravenousgammaglobulins and variousspecific gammaglobulins. From65 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
1987 to the mid 1990s, cryoprecipitatevirally inactivated at 60° for62 hours was used for the treatmentof haemophiliacs. Thisexplains the relatively low rate ofHIV infections in this population(2%), which is attributed to thenon-inactivated factor VIIIconcentrates imported at thattime.Solidarity in adversityStrangely enough, it was theHomeland War in the 1990s thatgave blood donation a big boost: inone year, the number of blooddonors increased by over 20%,ending the blood componentshortages at the time. People justcame and offered their blood as agesture of goodwill and support totheir fellow citizens in times ofconflict. The fact that—evenduring war times—no bloodproduct is transfused <strong>with</strong>outtesting for viral markers, is agreat achievement of the bloodtransfusion services, and theCroatian health system in general.Testing<strong>Blood</strong> transfusion safety hasalways been a priority for the RedCross and transfusion services aswitnessed by mandatory testing <strong>int</strong>he country. Testing for syphiliswas <strong>int</strong>roduced at the end of the1940s, for hepatitis B in 1972,HIV in 1987 and hepatitis C in1992. And by the end of 1998,small-pool RNA-HCV NAT testingbecame mandatory. Only testsapproved by the Paul EhrlichInstitute or the Agence françaisedu Sang are authorized in Croatia.Quality controlThe fast growth of the transfusionservices in the 1990s ledspecialists to focus on the settingof standards and quality control.External Quality Control was theninitiated for immunohaematologyand viral serology. A reorganizationof the blood transfusionservices will also allow greaterquality and safety controlmeasures, through more centralizedproduction and testingfacilities. Implementation of thisdecision, however, has beendelayed due to a lack of financingand a concern over the implicationsof such restructuring,particularly for blood transfusionpersonnel. Nonetheless, it ishoped that the reorganization willbe completed <strong>with</strong>in five years.Challenges facing thetransfusion servicesFor a population of around fourand a half million, Croatia has fourregional <strong>Blood</strong> TransfusionCentres and 20 hospital-basedblood banks. In 1999, an averageblood bank collected 7,000 unitsof <strong>who</strong>le blood and prepared15,000 blood components. Thedisproportionate number of bloodbanks in Croatia performinglaboratory donor screening andproducing relatively smallquantities of blood means that it isdifficult and expensive to<strong>int</strong>roduce a new test and tocomply <strong>with</strong> current GMP.One of Croatia’s many blood donors on <strong>World</strong> <strong>Health</strong> Day66 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
<strong>World</strong> <strong>Health</strong> Day 2000In promoting blood transfusionservices, Croatia’s message was tofocus on the fact that manypatients need treatment based onblood products. It was importantto refute the unjustified stigmathat blood transfusion was notsafe, although no modernmedicine could be guaranteed100% risk-free.Most events were planned to takeplace on or around 7 April. Newspaperarticles explained the basicconcepts of blood transfusion andresponded to frequently askedquestions: is blood tested? howoften can you give blood? what arethe greatest risks?A drop of blood to save a lifeWHO promotional literature weredisplayed everywhere that bloodwas collected. The responsibilityof the donor was emphasized tominimize risks.<strong>Safe</strong> blood messages<strong>Blood</strong> transfusion staff took part ina series of phone-in programmes.The central event was a one-hourtelevision show, in which theMinister of <strong>Health</strong>, and theDirectors of the Red Cross andCroatian Institute of Transfusion<strong>Me</strong>dicine discussed transfusiontherapy, blood donors, safetymeasures and the reorganizationof the Transfusion Services. Inbetween answering questions fromviewers, a film showed—vein tovein—all phases of the preparationof blood components from thearrival of the blood donor, thedonation, testingof the blood,preparation ofthe componentsto the transfusionof apatient. A secondfilm showed the<strong>int</strong>roduction ofquality control ina hospital.The aim of thiscampaign was tosensitize the public to the factthat, although absolute safety waswishful thinking, blood safety canbe increased through the jo<strong>int</strong>efforts of all involved in theprocess: the donor, thetechnicians collecting andlabelling blood, and the healthworker administering thetransfusion.The key message was thatvoluntary, non-remunerated blooddonors are an extremely valuablegroup in our society, and that theyare recognized as such. At thesame time, the responsibilities ofblood donors are changing as theyare asked to provide more<strong>Blood</strong> transfusion staff and donorsinformation, solidarity andcooperation.The campaign was considered agreat success, judging from thenumber of callers to the phone-<strong>int</strong>elevision programme. The numberof spontaneous donors alsoexceeded all expectations. ▲For more information on bloodsafety activities in Croatia, contact:Damir Grgicevic, MD, PhD, FRCPEdin, DirectorCroatian Institute of Transfusion<strong>Me</strong>dicinePetrova ul 3, 10000 ZagrebTel: +385 1 46 00 333Fax: +385 1 46 33 286E-mail: damir.grgicevic@hztm.tel.hrInternet: www.hztm.hr67 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESEstoniaEstonia in EuropeEstonia’s <strong>int</strong>egration <strong>int</strong>o theEuropean Union reflects thenation’s firm commitment to thevalues and principles of democracy,the rule of law, respect forhuman rights, security and amarket economy. The reformsunderway are an active attempt tobuild a stable and prosperoussociety based on these values.The cost of nonremunerationWHO, the European Union andother authorities rightly place highstandards on blood donations andblood products. Countries applyingfor <strong>int</strong>egration <strong>int</strong>o Europe musthave appropriate legislation and anational blood programmecompliant <strong>with</strong> quality standards.One of these blood safetymeasures recommends that blooddonations should be voluntary andnon-remunerated.Estonia likes to keep in step <strong>with</strong>our world and, in 1996–1997,moved from donations which weremostly paid, towards thepromotion of non-remuneratedCoffee offered to blood donors andstaff by a local sponsorblood donations. This was a verydifficult change in people’s beliefs.On the good side, 92% of blooddonations were non-remuneratedin 1998, rising to over 98% at theturn of the century. But thissuccess had its negative side, andthe number of donations plummeted,falling from over 70 000 in1996 to only 44 000 a year later.Luckily this trend was thenreversed and, in 1998, 47 000blood donations were collectedfollowed by 50 300 in 1999.A spring dayThe 7 April 2000, in SpringtimeEurope, Estonia celebrated safeblood donations. A small exhibitionwas opened in the Estonian<strong>Health</strong>care Museum in Tallinn,comprising materials and photosfrom earlier years and contemporarytimes alike, which alloweda review of the developments <strong>int</strong>he national blood service, and anopportunity to advocate forvoluntary, non-remunerated blooddonations. The opening of theexhibition was attended by councillorsof the donation department,the Chairman of the Board of theEstonian <strong>Blood</strong> Donors Association,and the Head of the DonationDepartment of the North Estonian<strong>Blood</strong> Centre.Earlier in the day, 31 donations ofblood were collected at theMuseum, which is more than twicethe usual collection. Schoolchildren and teachers wereparticularly excited to witnessfirst-hand a “live” blood donation.Every donor received a smallsouvenir to remember the day, andfresh coffee was offered to all bythe sponsor of the Day, “LöfbergsLila”.In addition, 43 donors attendedthe North Estonian <strong>Blood</strong> Centre,68 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
and the mobile-team sessionrecorded 102 visits. This wasconsidered an excellent result!Avian advocacyEstonia’s two biggest newspapers—“Postimees”and “EestiPäevaleht”—published articles onvoluntary, non-remunerateddonations and expressed gratitudeto blood donors for their regularand safe donations.<strong>Blood</strong> donors were <strong>int</strong>roduced tothe legend, virtually unknown <strong>int</strong>he country, of the first donor <strong>int</strong>he world—a pelican! For theuninitiated, mediaeval legend hasit that the pelican pecked herThe frst blood donor … a pelican<strong>Blood</strong> donation counsellors Mare Kaarus, Monika Huum and Olga Kalabreast to feed her starvingoffspring <strong>with</strong> her own blood. Indays long past, an example ofmotherly love and unselfishness,the pelican nowadays symbolizesthe altruism of voluntary blooddonation in Estonia.Altruism—the safest wayDonated blood is only consideredsafe in Estonia once the “window”period—during which infectiousdiseases may be transmitted tothe recipient—has passed.Not<strong>with</strong>standing, potential donorsfill in a questionnaire, and it is feltthat provided donations are nonremuneratedand voluntary, thereis no reason that the informationwould not be as honest andaccurate as possible, and the riskof unsafe blood at its lowest. ▲For more information on bloodsafety activities in Estonia, contact:The Manager, Donation DepartmentNorth Estonian <strong>Blood</strong> CentreAdala 2, EE0006, TalinnTel: +372 697 40 22Fax: +372 697 40 03E-mail: doonor@nebc.ee69 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESPolandPolish policies<strong>Blood</strong> Transfusion Services (BTS)have been an <strong>int</strong>egral part ofPolish public health services since1 January 1999, when a lawadopted by Parliament came <strong>int</strong>oeffect. The National Centre forTransfusion <strong>Me</strong>dicine incooperation <strong>with</strong> the Institute ofHaematology and <strong>Blood</strong>Transfusion is responsible for theBTS and all issues related totransfusion medicine.For a population of 38 million,Poland has 21 Regional <strong>Blood</strong>Transfusion Centres (RBC) and253 blood banks located inhospitals. About 1 million units ofblood and plasma are collectedevery year, equivalent to over 26donations per 1000 inhabitants.The policy in Poland is based onvoluntary, non-remunerateddonors, and the number of donorsrecruited by the Polish Red Cross,in conjunction <strong>with</strong> the BTS, hasbeen constant over the last fiveyears. Mobile units, used for thefirst time in some Polish cities on<strong>World</strong> <strong>Health</strong> Day 2000, will beused increasingly to collect blood.Facts and figuresSince 1991 blood has beencollected in plastic bags. Poland isself-sufficient in red blood cellconcentrates and platelets and isconsistently improving thehandling of blood: in 10 years, thepercentage of blood discarded wasreduced from 18% to just 6% in1999. Over the same period, theproduction of fresh frozen plasmaincreased significantly from56 000 litres to 241 000 litres in1999 through implementation ofmanual and automaticplasmapheresis.Standard operatingproceduresMandatory procedures for bloodtransfusion are issued in manualsedited by the National Centre forTransfusion <strong>Me</strong>dicine and theInstitute of Haematology and<strong>Blood</strong> Transfusion. Theseprocedures are periodicallyrevised following therecommendations of the Council ofEurope and WHO. A QualityAssurance System, for example,was implemented based on theserecommendations in 1995, and anAABB manual translated <strong>int</strong>oPolish in order to raise the level ofknowledge on current transfusionmedicine.These same two Polish institutionsorganize several individual andgroup training courses forpersonnel in blood transfusioncentres each year. RBCs areresponsible for the training andeducation of blood bank staff, aswell as for blood grouping andcarrying out all pre-transfusiontests in blood banks and hospitallaboratories.<strong>Safe</strong>ty measuresAdverse transfusion reactions areregistered and analysed by theRBC and the supervisoryorganization. External audits arecarried out yearly by experts inblood collection and processing,quality assurance, immunohaematologyand viral markerdiagnostics. BTS is involved in theserological diagnosis of foeto–maternal incompatibility and inRhD prophylactics. Serologicaltests are performed on everyblood and plasma collection. In1999 the prevalence of HIVantibodies was 0.016%; 0.13% forHCV and 0.04% for the HBs70 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
antigen. Six post-transfusion HIVinfections in the window periodhave been detected since 1987.PlasmaIn line <strong>with</strong> European recommendations,HCV–RNA NAT testingfor plasma for fractionation was<strong>int</strong>roduced in April 2000. Atpresent Poland is not selfsufficientin plasma derivatives. In1999 there was 1.1units of FactorVIII per capita in Poland, obtainedfrom two sources: the Polishplasma fractionation programmein ZLB (Switzerland), and thecentral programme funded by theMinistry of <strong>Health</strong>.“<strong>World</strong> <strong>Health</strong> Day 2000” inPoland: regional focusThe National Centre forTransfusion <strong>Me</strong>dicine briefed allRegional <strong>Blood</strong> Centres about theneed to organize events toeducate, motivate, recruit andretain safe blood donors on theoccasion of <strong>World</strong> <strong>Health</strong> Day2000. They all received the WHOposter “<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> <strong>with</strong><strong>Me</strong>” in Polish to support their safeblood activities around 7 April,which focused on young people,and the message that blooddonation is fast, safe and easy.Many and varied events took placein all corners of the country,including organized tours of BTSfacilities for students, lectures onsafe blood collection, processingand storage and media awarenesscampaigns. Notable eventsinclude:Kielce unveiled its first everblood-collecting ambulance,commissioned to commemoratethis day and complement theRegional <strong>Blood</strong> Centre where highschoolstudents also donatedPoster displayKatowice Regional <strong>Blood</strong> Centreblood. In Poznan (the old heartlandof Poland), 99 universitystudents donated blood. The citytransit commission of Opole kindlylent one of its buses for thecollection of blood from the localpopulation, and candy factoriesfrom the surrounding areaprovided small gifts for the—mainly young—donors.In Katowice and the entire coalmining region of Slask, thecelebrations spanned three days.A well-organized media campaignmeant that citizens of Slask joinedin numerous events promotingvoluntary, non-remunerated blooddonations. For example:● 182 persons had their haemoglobinlevels tested free of charge● 312 persons discovered theirblood group type● Over 300 people got freemedical advice.Also on offer were first-aidtraining sessions, and lecturesand demonstrations in the71 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
marquee on “how do we testblood?”, “how do we collectblood?” and “<strong>who</strong> can be a bloodor bone marrow donor?” In all,817 donors gave blood in Katowiceand its regional blood banks <strong>with</strong>excellent press, radio and TVcoverage.In downtown Lodz, citizens gaveblood in an ambulance and learntfrom talks and flyers theimportance of safe blood. <strong>Blood</strong>donations in the Radom area werefilmed by local TV stations andbroadcast in the afternoon news.In Cracow, the Red CrossDemonstrations in the marqueeorganized a press conference <strong>with</strong>the RBC employees, the voluntaryblood donors club, journalists,high school students and thegeneral public.Employees of Polish publictelevision gave blood at theNational Centre for Transfusion<strong>Me</strong>dicine/Institute of Haematologyand <strong>Blood</strong> Transfusion, whichnaturally got good coverage.Before the event, the RBC inLublin asked all local radio and TVstations and newspapers tosupport campaigns to promotevoluntary blood donation and BTSactivities. Themessages weregleaned from anofficial letter fromWHO’s Director-General to the lateMrs FranciszkaCegielska, Poland’sMinister of <strong>Health</strong>.Editorials on thesubject werethereforeprepared,<strong>int</strong>erviews <strong>with</strong> the employees ofthe RBC broadcast, and on 6 April,Lublin TV transmitted “Talk of theDay” <strong>with</strong> the Managing Directorof the Regional Centre.During the <strong>who</strong>le month of Aprilthe RBC in Kalisz ran acompetition for 40 high schoolscalled “The Vampiriade”, duringwhich 835 students donated blood.The project aimed to promote“voluntary blood donation” andspread awareness of how uniqueand irreplaceable blood is, andhow safe it is to donate blood inPoland. Local businesses providedvaluable prizes (TVs, CD players,sporting equipment), and theevent led to many studentsbecoming regular blood donors.Cracow organized 13 mobilecollections under the banners“<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> <strong>with</strong> <strong>Me</strong>” and“<strong>Blood</strong> Saves Life” which attracted419 donations. Two collectionsorganized in high schools for thefirst time saw 154 graduatingstudents give blood. At the end ofApril, the RBC employees tookpart in a two-hour live radioprogramme on safe blood,answering many calls from thepublic.The success of the mobile bloodcollections in Bialystok—aselsewhere in Poland—can beattributed in part to mediasupport and lectures given prior tothe event advertising voluntaryblood donation. Together <strong>with</strong> thehospital blood banks, informationmaterials were distributed andblood collection sessions held atuniversities, high schools,manufacturing companies, etc. bythe RBC and a lecture on “<strong>Safe</strong>blood and modern transfusionmedicine” delivered to nurses. Insmall towns visited by RegionalCentre employees for the firsttime, special posters weredisplayed.In townThe National <strong>Blood</strong> TransfusionCentre/Institute of Haematologyand <strong>Blood</strong> Transfusion in Warsawjoined <strong>with</strong> a city businesssponsor to organize a blood72 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
collection on 5 April on thepremises of the Polish Radio. Thisevent tied in <strong>with</strong> the pressconference described below.Activities spanned from 3 to 16April, and included mobile bloodcollections at the University ofWarsaw and other colleges.<strong>Me</strong>dia coverageThe afternoon and evening news ofall the central radio and TVstations, and newspapers carriedinformation on safe practices forthe collection, processing andtransfusion of blood and bloodcomponents.The highlight of the day was apress conference organized by thePolish Ministry of <strong>Health</strong>, extractsof which were used by radiostations, news announcementsand other broadcasts throughoutthe day. Among the participantswere: Maciej Pirog, Deputy <strong>Health</strong>Minister, Jan Sablinski, ManagingDirector of the National Centre forTransfusion <strong>Me</strong>dicine, DrMagdalena Letowska from theInstitute of Haematology, DrHanna Skalisz, Managing Directorof the Regional <strong>Blood</strong> Centre inPoznan and Mrs WieslawaKaczorowska, a transfusionmedicine specialist from theMinistry of <strong>Health</strong>.ConclusionPolish citizens across the <strong>who</strong>lecountry got involved in <strong>World</strong><strong>Health</strong> Day 2000—and learnt allthe whys and wherefores of safeblood—thanks to the NationalCentre for Transfusion <strong>Me</strong>dicine incooperation <strong>with</strong> the Institute ofHaematology and <strong>Blood</strong>Transfusion, and the Regional<strong>Blood</strong> Centres. ▲For more information on bloodsafety activities in Poland, contact:Institute of Haematology and <strong>Blood</strong>Transfusionul. Chocimska 5, 00957 WarsawTel: +48 22 849 57 81Fax: +48 22 848 89 70E-mail: letowska@cdit-aids.med.plRegions of Poland73 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESRomaniaBackground<strong>World</strong> <strong>Health</strong> Day 2000 was atimely opportunity for Romania tofocus on blood transfusion as aquality process that dependsprimarily on individual awarenessand civic sense. Sustained effortsto implement the NationalProgramme of <strong>Blood</strong> Transfusion,initiated in 1991, haveconcentrated on improving theentire blood safety network,including organization, testing andbudgeting, to align the country’sblood transfusion services <strong>with</strong><strong>int</strong>ernational recommendations.The success of these efforts—theresult of dedicated people, blooddonors and medicalprofessionals—was celebrated on7 April 2000.<strong>World</strong> <strong>Health</strong> Dayactivities<strong>Blood</strong> donation at theMinistry of <strong>Health</strong>First and foremost, the Minister of<strong>Health</strong> himself gave blood as aclear statement of support tovoluntary blood donation,declaring this to be “a noblegesture and the first prerequisitefor safe transfusion practice”.Other members of the Ministryjoined him, reiterating that givingblood is both a moral duty and asocial right. The early morningevent was featured on radio andtelevision and in the press.Press conference at theHouse of ParliamentHigh level officials from thegovernment and invitednongovernmental organizationswere present at a well mediatizedpress conference at the House ofthe Parliament. Here it wasunanimously declared that safeblood<strong>Safe</strong> bloodis vitalto overall health,not just theabsence ofdiseaseplays an<strong>int</strong>egralpart ofouroverallstate ofwellbeing,and notjust a tool to reduce the mortalityor morbidity of a given disease.Romania is pursuing constantefforts to comply <strong>with</strong> WHOrecommendations in terms ofblood safety and stresses theimportance of individualcommitment in this debate.A healthy society leads to a safeblood supply, but the appropriateuse of this blood supply must alsobe considered. The therapeuticuse of blood products requiresconsideration of alternatives,where possible, and a commitmentto quality which has fullgovernmental support. The goalsof the National Programme of<strong>Blood</strong> Transfusion are to increaseblood safety and reducetransfusion risk through voluntaryblood donation (from low-riskdonor populations), compliance<strong>with</strong> <strong>int</strong>ernational recommendationsfor donor selection anddeferral, blood testing, anddistribution and appropriateMicrobiology laboratory at the <strong>Blood</strong>Transfusion Centre74 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
clinical use of blood products.Special attention has been givento continuous training, access toup-to-date information andguidelines. Accurate standardoperating procedures and goodmanufacturing practices at everylevel of the blood transfusionchain will make blood safer.National debatefocuses on qualityThe National Institute of TransfusionHaematology in conjunction<strong>with</strong> the <strong>Blood</strong> Transfusion Centreof Bucharest organized a specialevent on “<strong>Safe</strong> blood starts <strong>with</strong>me”. Public acknowledgement anddiplomas honoured the efforts ofeach <strong>Blood</strong> Transfusion Centre forits work over the last 50 years.This was followed by an open andfriendly scientific discussion onissues related to bloodtransfusion.Participants, in recognizingRomania’s progress, agreed tofocus in the future on the unmetagenda: self-sufficiency in bloodproducts; increased resources;Step-by-step explanation of the bloodtransfusion chain in Romaniaand sustained and well-definedresponsibilities in the bloodtransfusion system. <strong>Safe</strong> blood fortransfusion is now an essentialprerequisite of human and medicalnature—quality people leading toquality results—rather than of atechnical and economic nature. Inother words, the more involvedthe players, the more performantand rapid the results.Participants received a booklet ofthe presentations, covering eachstep of the blood transfusionchain.The voluntary, non-remuneratedblood donor—cornerstone of bloodtransfusion safety—needs to bemade aware from early childhoodof the impact of his gesture.Extensive mass media campaignsand raising a positive image of<strong>Blood</strong> Transfusion Services areimportant ways to increase thenumber of low-risk, regulardonors.Distribution of materialsWHO “safe blood starts <strong>with</strong> me”materials were distributed all overthe country through the bloodtransfusion network and youngvolunteers, spreading the messagethat donating blood is a moralobligation and a civic right.Special teams visited schools toinstil the fact that giving bloodmust be an altruistic gesture, anexpression of commitment tomankind.One-to-one broadcast onnational radioA live programme on RadioRomania gave listeners nationwidethe opportunity to ask questionson the safety of procedures in theblood chain. They thereby learntall the basic why-when-howinformation on blood donation andtransfusion, and heard first-handfrom regular, voluntary blooddonors <strong>who</strong> shared theirexperiences and explained their<strong>int</strong>rinsic motivation to help thosein need. A retired Red Crossassistant, for example, related hermemories of the Second <strong>World</strong>War and the powerful feeling ofhuman solidarity in the bloodtransfusion services in the face ofadversity. Many young people,moved by her story, turned up thefollowing day to donate blood.Benevolent <strong>Blood</strong>Donor FoundationThis recently created foundationorganized a special event forhonorary voluntary, nonremunerated,regular blooddonors (those <strong>who</strong> have givenblood for more than five years).Their gesture of human solidarityand civic sense and their personalcontribution to health were75 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
publicly recognized <strong>with</strong> diplomasof merit and a pin, representing asimple, single drop of blood. A bustrip took participants to theoutskirts of Bucharest for a welldeservedpicnic.Romanian Red CrossRepresentatives of the RomanianRed Cross were active at thecommunity level in a campaign toattract and educate voluntaryblood donors, armed <strong>with</strong> theinformation kit produced by WHO.Beyond <strong>World</strong> <strong>Health</strong> DayA series of activities wereprogrammed to ensure that bloodsafety remained a priority wellbeyond <strong>World</strong> <strong>Health</strong> Day, 7 April2000.Educating blood donorsLeaflets on blood donation andtransfusion will be distributed atall blood donation sites.Videotapes presenting the bloodtransfusion chain as well asapheresis collection procedureswill be available for donorinformation. Extensive work isunderway to improve existingfacilities so that blood collectiontakes place in a pleasantatmosphere, in convenientsurroundings and under thesupervision of attentive staff.Regular blood donorrecognitionActivities to publicly recognizedonors will continue. Sustainedadvocacy and active education willbe focused on moral awareness,the notion of solidarity betweenindividuals and a sense of socialpride, in order to increase thenumber and commitment ofexisting and potential blooddonors.Increasing public awarenessand informationMass media support is vital to getclear and updated information tothe public on what blood safetymeans. National Television is<strong>Blood</strong> Transfusion CentreProduction Unitpreparing a hands-on tape showingthe steps involved in blooddonation. Two panel discussionsdedicated to blood transfusionhave already been presented.Given the impact of the radioprogramme on <strong>World</strong> <strong>Health</strong> Day,several radio stations arecollaborating in a plan to continuelive broadcasts on blood safetyand low-risk donors to generate anactive dialogue <strong>with</strong> immediateimpact. Major journals willpublish short information textsunderlining the importance ofvoluntary regular blood donation,quality management and theoptimum use of blood.Activities in schools and the workplace will be carried out inparallel to the media campaign. Aseries of health educationconferences is already underwayto explain the basic notionsrelated to viral transmissibledisease, the significance andnecessity of voluntary blooddonation and low-risk donors.Leaflets, booklets and posterscontaining information on blooddonation and transfusion will becrafted from both localexperiences and data from theWHO information kit.Transfusion medicine coursefor <strong>Blood</strong> Transfusion Servicestaff and cliniciansContinuous training programmeshave now been organized on amodular basis to enablespecialists to focus on theirparticular field of <strong>int</strong>erest.Transfusion medicine courses andworkshops on the clinical use ofblood, targeting clinicians andgeneral practitioners, are madeavailable periodically by theNational Institute of TransfusionHaematology.76 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
ConclusionThe national authorities inRomania are committed toattaining the maximum <strong>int</strong>ernationalstandards of quality <strong>int</strong>ransfusion medicine. With thisgovernmental support and a legalframework in place, the bloodtransfusion services can beassured of a healthy development.Sustained collaboration <strong>with</strong>national and <strong>int</strong>ernationalorganizations is an essentialprerequisite to such <strong>int</strong>egrateddevelopment for blood safety. ▲For more information on bloodsafety activities in Romania,contact:Director, National Institute ofTransfusion Hematology<strong>Blood</strong> Transfusion Centre ofBucharestStr. Constantin Caracas Nr 2-8Sector 1, 78156-BucharestTel +401 650 7410Fax: +401 659 6990E-mail: vhafner@dial.kappa.ro.Vector-borne diseases,parasites and bloodMany parasites and viruses which affect hundreds of millions ofpeople worldwide are transmitted from person to person bybloodsucking insects (vectors), and are then transported in the bodyvia the blood. These diseases include malaria, filariasis, dengue fever,Chagas disease, leishmaniasis and African sleeping sickness. Someof these diseases cause severe anaemia or blood loss and may requirethe use of blood products or transfusion in order to save lives. Malaria,which affects some 300 million people a year, may cause miscarriages,stillbirths or underweight, anaemic children.Simple preventive measures such as sleeping under a bed net canprovide protection against night-biting malaria mosquitos and fromcarriers of certain other insect-transmitted diseases. Appropriateinsecticides, good environmental sanitation to reduce vector breedingplaces, and biological control methods are commonly used to combatthese diseases.Schistosomiasis and the hookworms are worm infections, affectingsome 1400 million people worldwide. Both diseases cause blood loss,resulting in damage to tissues and anaemia. Cost-effective drugs existto treat these infections effectively and safely, thereby reducing theneed for blood and blood products. It has been demonstrated thatregular treatment of women and children <strong>with</strong> anthelm<strong>int</strong>hic drugsin endemic areas increases their haemoglobin levels. ▲77 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESSloveniaA young countrySlovenia is a small, new Europeancountry <strong>with</strong> an ethnically homogenouspopulation, 90% of <strong>who</strong>mare Slovenes. The populationgrowth is expected to stagnateover the coming years, <strong>with</strong> theproportion of children continuingto decrease, and the percentage ofpeople over 65 on the increase.Soon after its independence in1991, Slovenia was granted<strong>int</strong>ernational recognition by theEuropean Community andadmitted to leading <strong>int</strong>ernationalorganizations such as WHO. Thecountry has a well-developed,mandatory health insurancesystemThe typicalSlovenian blooddonor is a 35- to45-year-oldmale.and,althoughhealthindicatorsplace itsomewhatbehind the leaders, Sloveniaremains ahead of most othercountries in the central andeastern European region.History of the <strong>Blood</strong>Transfusion Servicesin SloveniaThe first bottles of blood werecollected in the new <strong>Blood</strong>Transfusion Services of Slovenia atthe end of <strong>World</strong> War II. <strong>Blood</strong>donors were paid <strong>with</strong> oil, sugaretc., in line <strong>with</strong> local custom. In1953, blood donation became nonremunerativeand voluntary andthe number of blood donors grewunder the direction of theSlovenian Red Cross, reaching125,000 in 1984—5.6% of thepopulation.Today, the National <strong>Blood</strong>Transfusion Centre (NBTC),closely connected <strong>with</strong> the ClinicalHospital inLjubljana, has eightdepartments locatedin regional hospitalsunder thesupervision of atransfusionist. TheNBTC collectsnearly half of the100,000 units ofblood donated each year. Mobileunits operate 170 days a year atdifferent places in Slovenia and onthe remaining days, blood iscollected at the TransfusionCentre or other Transfusiondepartments. <strong>Blood</strong> donors arealso called in daily for theplasmapheresis programme andfor collecting fresh <strong>who</strong>le blood forthe citopheresis programme.Whether voluntary or targeteddonors, no-one gets remunerated.My blood—safe blood. For me, for you, for everyone.The processing of blood<strong>Blood</strong> is mainly collected bymobile units in triple bags <strong>with</strong>SAGM and processed <strong>int</strong>o redblood concentrate, fresh frozenplasma or platelet concentrate. Asmall amount is used as <strong>who</strong>leblood for open-heart surgery, livertransplants or bone marrow forexample, for which there is aspecial transplantation team.Plasma and platelets areadditionally collected byaphaeresis from voluntary,unremunerated donors.78 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Given the relatively short storagelife for all blood cellcomponents—from six weeks forred blood cells down to only oneday for granulocites—it isimportant to focus on qualitycontrol and cost benefit whenchoosing a preparation method.Some special components areprepared only in the larger <strong>Blood</strong>Transfusion Centres beforedelivery to the smaller hospitals.Slovenia is still developing itspolicy on self-sufficiency for bloodderivatives. The country has noeconomic reason to have its ownfractionation plant since itspartners fractionate the greatmajority of collected plasma foralbumin, Factor VIII, IXconcentrate and gamma globulin.Slovenia is, however, selfsufficientfor all blood componentsand products <strong>with</strong> the exception ofFactor VIII, for which half of the6 million units used per year areimported.ScreeningAll units are tested for syphilis,HIV 1/2, hepatitis B and C, thelatter using PCR. Testing, groupingand cross matching of donatedblood is carried out beforetransfusion. The functions of the<strong>Blood</strong> Transfusion Service alsoinclude antenatal screening andcoordination of anti-D protection,a tissue typing laboratory and anauto transfusion unit foroutpatients.Quality ManagementProgrammeTo reinforce a strong Researchand Development team, thepriority is to <strong>int</strong>roduce effectivequality control and build a uniquequality assurance system for the<strong>who</strong>le country.Training in the field of bloodtransfusion is high on the agenda.Administrative errors are one ofthe most common sources in theblood transfusion service which iswhy fifteen years ago, Sloveniaadopted a special automatedprogramme to make routinedecisions, guide procedures andproduce reports, statistics andanalyses, all of which has madeblood transfusion safer. A networkconnects all transfusion departmentsto the Slovenian register ofblood donors, although a datalinkbetween clinics and blood transfusionservices would improvesupervision of the clinical use ofblood and blood derivatives, andalso form the basis for an effectivehaemovigilance system.<strong>World</strong> <strong>Health</strong> Day—A Red Flag<strong>World</strong> <strong>Health</strong> Day, <strong>with</strong> its slogan“<strong>Safe</strong> blood starts <strong>with</strong> me—bloodsaves lives” was a challenge tothis nation, in the midst oftransition and reorganization of itsblood transfusion and donorrecruitment system. The challengewas to increase public awarenessand understanding of blood safetythrough voluntary, nonremuneratedblood donation fromlow risk populations. Gaininginformation on the behaviouralcharacteristics of present andpotential donors was considered avital starting po<strong>int</strong>.Several manifestations andactivities took place on 7 Aprilfocusing on donor recruitment andhealth professionals. Key playersin the public informationcampaign for safe transfusionwere the President of Slovenia,the Minister of <strong>Health</strong>, representativesof the Red Cross andhealth care personnel.Manual for blood donor andrecruitment personnel79 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
<strong>Health</strong> Care CouncilThe <strong>Health</strong> Care Council is thehighest scientific body in Sloveniaand advises the Minister of <strong>Health</strong>on health policy. A meeting of theCouncil coincided <strong>with</strong> the safeblood campaign, presided by theMinister of <strong>Health</strong>. Majoroutcomes of the meeting were:● the Law on <strong>Blood</strong> Supply,compatible <strong>with</strong> Europeanguidelines, will be key to transformingthe current system <strong>int</strong>omodern blood transfusionmedicine.● there were many reasons to becontent: 5% of the population areblood donors, and the bloodprogramme itself is largely selfsufficient.Yet the occasional bloodshortage or surplus still need tobe addressed.● further development of theexisting quality assurance systemmeans new investment and moreexpensive blood and bloodderivatives, so the first priority isto prepare strict directives for therational clinical use of blood. Thedecision to transfuse must bebased on a careful assessment ofthe clinical situation supported bylaboratory data, <strong>with</strong> a clearindication that the transfusion willsave a life or reduce morbidity.● the automated network providesgood support, but should be linkedto the clinical systems. The aim isto have a unique patient identificationnumber in every hospital,like a social security number, toenable the rapid management ofdata and decision-making.● practical experience should beshared regularly between hospitaltransfusion committees. Followingup on the results of transfusiontherapy—positive as wellnegative—is crucial.Dedicated to donorsOf special note was the presentationof a book written especiallyfor blood donors and recruitmentpersonnel. The President ofSlovenia—a blood donor himself—along <strong>with</strong> the President of theRed Cross and the Director of the<strong>Blood</strong> Transfusion Centre, eachwrote a preface. Twenty-sixarticles by different authorsaddress all issues related todonation from the past to present,and answer the most frequentlyasked questions.Illustrative activitiesAn exhibition was openedcombining WHO materials <strong>with</strong>Slovenian data. Future exhibitionsand promotional activities willArtwork from the fifth Sloveniansecondary medical scholars contestbenefit from the remarkablepictures, articles and othermaterial gleaned from the medicalschool scholars on “safe bloodstarts <strong>with</strong> me”.Donor profile surveyA public survey was carried out bytelephone to collect data using aspecially designed questionnaire.The main goals were:i) to verify the motivation of thepopulation to give blood; andii) improve understanding of thetypical blood donor profile.Results showed that a staggeringtwo-thirds of the Slovenianpopulation are potential donorsand that the most frequent reasonfor people not to donate is relatedto health. At least 25% of thepopulation has had some personalexperience <strong>with</strong> giving blood.<strong>Me</strong>dia supportSeveral public media, includingradio and television companies,supported the campaign. A half-80 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
… a staggering two-thirdsof the Slovenian populationare potential donors.page article in the main nationalnewspaper compared blood safetyin Slovenia to that in otherEuropean countries.ConclusionThe decision to devote <strong>World</strong><strong>Health</strong> Day 2000 to blood safetyoffered this budding nation theperfect opportunity to consolidateand build on its blood transfusionservices. ▲For more information on bloodsafety activities in Slovenia,contact:The <strong>Blood</strong> Transfusion CentreSlajmerjeva 6, 1105 LjubljanaTel: +386 1 5438 110Fax: +386 1 2302 224E-mail: Ljubisa.lukic@mf.uni-lj.siInternet: www.zrs-tk.siGenetically determineddiseases and bloodSome genetic diseases affect the blood, such as hemophilia, thalassaemiaand sickle-cell disorder. Persons <strong>with</strong> these diseases require supplies of safeblood to replace their deficient blood.Haemophilia, which affects mainly men and occurs in about 1 in 5000 male births,is caused by shortage of clotting factors: when a person is injured, there is a riskof bleeding. Accurate identification of haemophilia is made by measuring thelevels of specific clotting factors in the blood. <strong>Blood</strong> tests need to be carried outin a laboratory which has appropriate facilities and experience <strong>with</strong> these tests.To date, <strong>with</strong> comprehensive care and by using products containing the missingclotting factors, made from blood donations or biotechnology, even people <strong>with</strong>severe haemophilia lead nearly normal lives. In most developing countries, bloodis the only source of treatment available.In sickle-cell disorder and thalassaemia the red blood cells are unable to carryenough oxygen. Thalassaemia may lead to mild or severe anaemia and prematuredeath. <strong>Blood</strong> transfusion is currently the main treatment for thalassaemia, whichgives the person optimal chances of survial; blood is also needed for patients<strong>with</strong> sickle-cell disorder.A strong health service infrastructure is essential to ensure continued monitoringof populations for the early detection and treatment of these diseases. If everycapillary, vein and artery in a person’s body were lined up end to end, they wouldcover a distance of 150 000 kilometres. All the iron in a average person’s bloodcould make a 5-centimetre nail; two-thirds of this iron is in the red blood cells. ▲81 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
BLOOD SAVES LIVES IN WHO’S REGIONAL OFFICE FORSouth-East AsiaDr Uton Muchtar Rafei<strong>Me</strong>ssage from theRegional DirectorThe Regional Director for WHO’sSouth-East Asian Region (SEARO),Dr Uton Muchtar Rafei passed aspecial message to membercountries on the occasion of <strong>World</strong><strong>Health</strong> Day 2000 highlighting anurgent need to develop nationalstrategies for safe bloodtransfusion and to ensure theirefficient implementation. Hismessage covered the importanceof phasing out replacement andprofessional blood donors in allcountries in the region besidesscreening of all donated blood andits rational use.The example set by his message,the extensive materials developedand shared <strong>with</strong>in the South-EastAsia Region, and the activities thattook place, are summarized below.Preparation ofinformation kitsKits containing two booklets wereprepared by SEARO, namely— a booklet on information andanswers to basic questions forpotential blood donors; and— a booklet on information forclinicians on appropriate use ofblood.Car sticker and a poster on“<strong>Safe</strong> blood starts <strong>with</strong> me” wereincluded in these kits, that weredistributed to all <strong>Me</strong>mberCountries much ahead of 7 Aprilfor translation <strong>int</strong>o regionallanguages.New Year greeting cards werepr<strong>int</strong>ed and distributed to all<strong>Me</strong>mber Countries well inadvance.A calendar on the theme wasprepared, pr<strong>int</strong>ed and distributedto all <strong>Me</strong>mber Countries.Posters depicting variousstrategies on blood safety wereprepared and displayed in thelobby of the SEARO building.A website on safe blood wascreated which covered all technicalpublications and activities on<strong>World</strong> <strong>Health</strong> Day and beyond.Dr Uton Muchtar Rafei, Regional Director SEARO and Dr Geoffrey Dennis,Representative of the IFRCRCS, addressing press conference82 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Press conferenceA press conference was held onthe eve of <strong>World</strong> <strong>Health</strong> Day on6 April 2000 at WHO House, NewDelhi.Dr Uton Muchtar Rafei addressedthe large gathering of mediapersonnel from differentnewspapers and televisionchannels. The representative ofthe International Federation ofRed Cross and Red CrescentSocieties (IFRCRCS), Dr GeoffreyDennis, Dr P. Abeykoon, Directorof <strong>Health</strong> Technology andPharmaceuticals, SEARO and DrNeelam Dhingra, <strong>Me</strong>dical Officerfrom WHO/HQ, took part in thepress conference.The Regional Director highlightedthat 80% of the global populationliving in the developing world hasaccess to 20% of the global supplyof safe blood. The requirement forblood in the region is 15 millionunits whereas the total number ofblood units donated is about onehalf of that.He stressed the need to takeurgent action on two crucialissues related to bloodtransfusion: the lack of availabilityof blood when needed, and theassociated risk of transmission ofinfection. He po<strong>int</strong>ed out threeprinciples to ensure blood safety.Firstly, ensuring that100% ofblood for transfusion is obtainedfrom voluntary, non-remuneratedlow risk donors. It has beencalculated that 1% of the eligible<strong>Safe</strong> blood posterpopulation of any country needs toregularly donate blood to meet theneeds of that country. It isimportant to inform people,particularly the youth, about theimportance of blood safety and theneed to become regular blooddonors. Secondly, to formulatenational blood policies andregulations to ensure screening ofall blood before transfusion <strong>with</strong>reliable quality reagents; andthirdly, to educate the clinicians touse blood judiciously andappropriately.Dr Neelam Dhingra emphasizedthe role of WHO to assistcountries to strengthen theirnational blood programmesthrough advocacy and technicalassistance, through wellformulatednational blood policiesand plans, effective regulatorymechanisms, training andeducation.Dr Geoffrey Dennis, Head of theIFRCRCS for the South East AsiaRegion, stated that they wereinvolved in blood services in 113countries, ranging fromrecruitment of blood donors to theprovision of blood services,in global partnership <strong>with</strong> WHO.News highlights of <strong>World</strong> <strong>Health</strong>Day were carried in all nationalnewspapers and covered bytelevision on 6 and 7 April 2000.Cocktail and receptionA reception was hosted by WHOon 7 April 2000 invitingrepresentatives from the press,the Ministry of <strong>Health</strong> and FamilyWelfare of India, blood programmemanagers, the Indian Red CrossSociety and the IFRCRCS. ▲For more information on bloodsafety activities in the WHORegional Office for South-East Asia,contact:Dr Sudarshan Kumari<strong>Blood</strong> <strong>Safe</strong>ty and ClinicalTechnologySEARO, Indraprastha EstateMahatma Gandhi RoadNew Delhi 110002Tel: 91 11 337 0804Fax: 91 11 337 9507E-mail kumaris@<strong>who</strong>sea.orgInternet: www.<strong>who</strong>sea.org83 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESBangladeshSetting the sceneBangladesh observes <strong>World</strong> <strong>Health</strong>Day each year <strong>with</strong> due solemnityand enthusiasm, expressing in thisway its political commitment tothe health and well-being ofmankind. The theme for the year2000 “<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>”was welcomed by the world atlarge, the South-East Asian regionH.E. Minister for <strong>Health</strong> and Family Welfare Mr Fazlul KarimSelim addressing the press conferenceand, of course, the Bangladeshiauthorities, in particular throughthe following activities.A press conference wasarranged on 6 April at the HotelSheraton to spread the theme ofsafe blood <strong>with</strong> the media. All citybasednewspapers were invited,as well as foreign news agenciesand television. The Minister for<strong>Health</strong> andFamily WelfareMr Fazlul KarimSelim and theState MinisterDr M. Amanullahattendedthe event, whichwas given goodcoverage onBangladeshTelevision.BangladeshTelevision andRadio activelytook part by airing<strong>int</strong>erviews fromthe eminentMinister of<strong>Health</strong>, the StateMinister for<strong>Health</strong> and FamilyWelfare, theChairman of theBangladesh RedCrescent Society,the WHORepresentative,the DirectorGeneral of <strong>Health</strong> Services andthe Director General of FamilyPlanning. Topics illuminated thepublic on a variety of vital issuesrelated to blood transfusion safety.View of the WalkathonThe 25-minute programme wasbroadcast live on television andsimultaneously on radio on7 April.A colourful walkathon was heldon 7 April, starting from theNational Museum and ending atthe National Press Club.Numerous organizations—theNursing College, Boy Scouts andGirl Guides, SwanirvarBangladesh, Bangladesh ProbinHitoishi Sangha, Pre-CadetSchool, Directorate of <strong>Health</strong>Services, Directorate of FamilyPlanning, Dhaka <strong>Me</strong>dical College,among others—all participateddisplaying banners and festoons84 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
<strong>with</strong> messages on the theme of theday. <strong>Health</strong> messages highlightingthe prevention and control ofblood related diseases wereconsistently announced over themegaphone.An essay competition waswidely advertised in importantdaily newspapers and announcedon radio and television to ensuremaximum participation. Nineprizes were distributed among thenational winners, that includedcertificates, prize bonds and acrest.Honourable Minister congratulatingwinners of pa<strong>int</strong>ing competition<strong>World</strong> <strong>Health</strong> Day function in the districtA pa<strong>int</strong>ing competition wasarranged on 30 March 2000 in theShishu Academy for 500 childrenaged 6–18 years, presided bymany notable dignitaries includingthe State Minister for <strong>Health</strong> andFamily Welfare Dr Amanullah,many other important dignitariesand a large number of parents.An inaugural ceremony washeld on 7 April in the auditoriumof the Bangladesh College ofPhysicians and Surgeons. TheMinister for <strong>Health</strong> and FamilyWelfare was the guest of honour,accompanied by the State Ministerand Chairman of the BangladeshRed Crescent Society. TheAdditional Secretary, <strong>Health</strong> andFamily Welfare, presided over thefunction. The major focus of thediscussion was the importance ofblood safety and the need tostrengthen transfusion services <strong>int</strong>he country.The Government underlined itscommitment to implementappropriate programmes atdifferent levels of health care toensure safe blood transfusion.<strong>Health</strong> EducationExhibitionA colourful and attractive healtheducation exhibition was mountedin the Bangladesh CollegePhysicians and Surgeons lobby on7 April, during which variousmaterials were displayed anddistributed. The exhibition wasinaugurated by the Minister for<strong>Health</strong> and Family Welfare, amongother distinguished guests.Road Island DecorationTo publicize the theme of the<strong>World</strong> <strong>Health</strong> Day, 20 road islandsand three bridges in Dhaka Citywere decorated <strong>with</strong> framed wood,hardboards and attractive cloths.Activities at districtsand UpazilaThe national authorities gave thegreen light for DeputyCommissioners and Civil Surgeonsof all districts to observe <strong>World</strong><strong>Health</strong> Day in a befitting manner.Guidelines were provided as to85 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
<strong>Health</strong> Education Exhibitionpotential programmes, that weresubsequently elaborated <strong>with</strong> thesupport of the Bureau of <strong>Health</strong>Education in the form of posters,leaflets, stickers and caps. ▲For more information on bloodsafety activities in Bangladesh,contact:Programme CoordinatorNational <strong>Blood</strong> Transfusion CentreDhaka <strong>Me</strong>dical College HospitalAnnex Building, DhakaTel: +88 02 966 8781Fax: +88 02 988 6415Emergency,conflict andhealthThe need for an effective health service is feltmost during emergencies of any kind,whether war, natural disasters, large-scaleaccidents or human conflicts. Yet it is at suchtimes that the system often breaks down, beingunable to cope <strong>with</strong> the magnitude of thedemand. Internal conflicts or war may destroyhospitals and clinics, while power shortage oftendisrupt their work and can ruin medical stocksthat require refrigeration, including blood. Caringfor large numbers of wounded people puts anadded burden on already strained systems.Whenever such events occur the need for blooddonation and transfusion services increases.Many people spontaneously donate blood duringa crisis, but when the crisis is over, the countriesare left <strong>with</strong>out a sustainable blood supply.Such situations can be avoided by setting upsystematic efficient blood services <strong>with</strong> lists ofregular donors. ▲86 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESBhutanAn Organized AffairBhutan joined all other <strong>Me</strong>mberStates of the United Nations inobserving <strong>World</strong> <strong>Health</strong> Day(WHD) on 7 April 2000. The theme“donate blood—save life” wasused by this nation to raiseawareness of the need andimportance of altruism in donatingblood and saving lives.The Royal Institute of Management(RIM) was invited by theInformation, Education andCommunication for <strong>Health</strong> (IECH)Royal Institute of Managementcelebrates <strong>World</strong> <strong>Health</strong> Day 2000Division of the <strong>Health</strong> Departmentto develop a programme ofactivities for the occasion. Incollaboration <strong>with</strong> a multitude ofpartners (see end), the followingactivities were implemented.Chief Guestaddressing theaudience duringSymposium on<strong>Safe</strong> <strong>Blood</strong>Seminar on“donateblood—savelife”The guestspeaker at thisimportantseminar,Dr OrapinSingadheji,WHO Representative,highlighted thesignificance ofWHD 2000 dedicated to bloodsafety, and the need for the youthof Bhutan to get involved in thevoluntary blood donationprogramme. The WHO Representative,faculty and staff from theRIM, personnel from the RoyalBhutan Police and all otherparticipants agreed to lend theirsupport to this plea.Fun runA fun run was organized by theRoyal Institute of Management. Allthe trainees and <strong>int</strong>erested facultystaff members of the Instituteparticipated, starting from theRIM campus, Semtokha, to theFun RunJigmi Dorji Wangchuck NationalReferral Hospital (JDWNRH)Campus, about 5km away. Thefirst three men and women wereawarded T-shirts pr<strong>int</strong>ed <strong>with</strong> thetheme of <strong>World</strong> <strong>Health</strong> Day 2000.Those <strong>who</strong> fell behind decided toform a group and walk through thestreets of Thimphu shouting antitobaccoslogans.Recognition awardThe prize for the donor <strong>who</strong> hadgiven the most units of blood inBhutan wasawarded to MrKesang Jigme,a laboratorytechnician atJDWNRH. TheMinister of<strong>Health</strong> andEducation,Lyonpo SangayNgedup,87 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
awarded him a certificate ofappreciation from the <strong>Health</strong>Department for his 32 donations.DebateA debate was organized for thetrainees of the Royal Institute of<strong>Health</strong> Sciences in support of asafe blood campaign, under theslogan “Donate blood—Save life”.Certificates and prizes wereawarded to the best speaker andthe team that won the debate.Donors lined up to donate bloodCultural programmeCultural programmes were put onin schools and institutes,spreading the “Donate <strong>Blood</strong>—Save Life” message. Short skitswere followed by songs anddances in the evening.Guest lectureThe Chief Guest Speaker forDechenphodrang Monastic Schoolwas a senior Buddhist Lama. Hehighlighted the importance ofdonating blood voluntarily, and theinvolvement of the <strong>who</strong>lecommunity in such a noble cause.In his speech he made severalreferences to the sacrifices of theLord Buddha in order to helpothers.SymposiumA symposium on safe blood washeld at JDWNRH on 8 April aspart of the WHD 2000celebrations, and included thefollowing topics:— <strong>Safe</strong> blood transfusion— <strong>Blood</strong> usage in JDWNRHstatistics— <strong>Me</strong>dical indication of bloodtransfusion— <strong>Blood</strong> transfusion in theoperating theatre/<strong>int</strong>ensivecare unit— Use of blood in obstetrics/gynaecological practice— Transfusion-transmittedinfections— Rational use of blood and bloodproducts.Participants of the symposiumincluded doctors from Indo-BhutanFriendship Hospital, Lungtenphuarmy hospital and doctors,Assistant Clinical Officers, wardin-charges and laboratorytechnicians of JDWNRH.<strong>Blood</strong> donor enrolmentA blood donor enrolment andmobile blood banking camp washeld on 8 April 2000. Fifty donorsgave blood and many more wereregistered after confirming theirblood groups.Video show “Donateblood—Save a life”The IECH Bureau prepared twovideo films of 20 minutes each onsafe blood, which were shown tothe RIM trainees and otherparticipants in the Institute’sauditorium.AcknowledgementsGroups that carried out activitieson WHD 2000 included: the RoyalInstitute of Management (RIM),the Institute for Language andCultural Studies Semtokha, theRoyal Institute of <strong>Health</strong> Sciences,Dratsang Lentshog (Secretariatfor Monk Body), Motithang HighSchool, the Police, DechencholingJunior High School, ChangangkhaJunior High School, Choden JuniorHigh School, JDWNRH and ChukhaDzongkhag. The IECH Bureau andthe WHO Country Office were thekey coordinators. ▲For more information on bloodsafety activities in Bhutan, contact:Dr Krishna Prasad SharmaPathologistJigme Dorji Wangchuck NationalReferral HospitalThimphuTel: +975 2 322497/322 496Fax: +975 2 323 812E-mail: DRKPSharma@yahoo.com.88 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESIndiaSetting the ToneDelhiDr Uton Muchtar Rafei, RegionalDirector of WHO’s South-East AsiaRegional Office (SEARO),highlighted an urgent need todevelop national strategies forsafe blood transfusion and toensure their efficient implementation.His message set the tonefor activities in the Region, andthis article provides just a glimpseof the wealth of activities carriedout to address blood safety issuesin States and cities all over India.Inaugural function of SeminarA Seminar on the RationalUse of <strong>Blood</strong> was organized bythe All India Institute of <strong>Me</strong>dicalSciences on 7 April 2000 at theIndia Habitat Convention Centre.The objectives of the seminarwere to train clinicians inGovernment and private hospitalson the risks of blood transfusion,the need for safe, voluntary blooddonations and judicious use ofblood and blood components.Around 150 clinicians fromdifferent specialities, i.e.gynaecology and obstetrics,anaesthesia, surgery, paediatrics,cardiothoracic and vascularsurgery, physicians, andorthopaedic surgery hospitaladministration, participated in theseminar.The Minister of Information andBroadcasting, Shri Arun Jaitely,inaugurated the event, that wasMiss <strong>World</strong> on the podiumchaired by the Dean of the AllIndia Institute of <strong>Me</strong>dicalSciences. Topics covered by theeminent speakers from differentspecialities were:— red cell conservation in cardiacsurgeries— autologous blood transfusion— blood component use: currentneeds— ensuring blood safety: WHOstrategiesA panel discussion on blood safetyincluded distinguished guests fromthe media, the blood regulatoryauthority, transfusion services,general surgery and microbiology.Participants left the seminarstimulated to reflect carefully onhow to make blood transfusion assafe as possible.A public function in honour ofvoluntary blood donors wasorganized in the auditorium of the89 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
All India Institute of <strong>Me</strong>dicalSciences to honour voluntaryblood donors from Delhi <strong>who</strong> haddonated blood at least 50 times.This tribute was reinforced <strong>with</strong>an entertainment programme forthe youth that had come to watchthe function. Fourteen blooddonors <strong>who</strong> had donated morethan 50 times (range between50–150 times) were givenmementoes based on the <strong>World</strong><strong>Health</strong> Day 2000 logo. Thesesouvenirs were presented by thereigning Miss <strong>World</strong>, Ms YuktaMookhey <strong>who</strong> was the specialguest of the occasion. The ChiefGuest of the occasion was theState Minister for <strong>Health</strong> & Family Welfare <strong>with</strong> WHO AdviserUnion Minister of State for <strong>Health</strong>and Family Welfare, Mr N. T.Shanmugham. Many other seniorofficials were also present tohonour Delhi’s prolific blooddonors.After the felicitation ceremony, acultural function was staged,during which popular artists likeMs Shivani Kashyap and VipinAneja and the Bhangra Pop Star“Jassi”, gave star performances.The Nehru Yuva KendraSangathana organized a massiveblood donor enrolment drivein 500 districts of the country. Onthis day, the organization enrolled100 000 potentialblood donors in500 camps afteroffering them theservices of bloodgroup determination.On 8 March, aseminar entitled“Steps Towards a<strong>Safe</strong> <strong>Blood</strong>TransfusionService” was heldto mark <strong>World</strong><strong>Health</strong> Day 2000.It was inaugurated by the DelhiState <strong>Health</strong> Minister Mr A.K.Walia. SEARO’s Regional Adviseron <strong>Health</strong> Laboratory Services, DrSudarshan Kumari, addressed thegathering. The seminar was wellattended by blood bank experts,hospital administrators, personnelfrom the drugs control authorityand technical staff members.MumbaiAs part of the <strong>World</strong> <strong>Health</strong> Daycelebrations, the Federation ofBombay <strong>Blood</strong> Banks focused on<strong>Blood</strong> collection at Governor’s bungalowthe vital role of voluntary blooddonors and organized the followingactivities:A Seminar on <strong>Safe</strong> <strong>Blood</strong> TransfusionPractices was held at theGrant <strong>Me</strong>dical College and Sir JJGroup of Hospitals on 6 April. Itwas inaugurated by theMaharashtra State <strong>Health</strong>Minister and was well attended bymore than 100 clinicians, bloodbankers and administrators.On 7 April, the city offered:—a blood collection drive atRaj Bhavan, the Governor’s90 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
ungalow. Six blood bankscollected 981 units of blood;— a <strong>World</strong> <strong>Health</strong> Day function atthe Y.B. Chavan auditorium toapplaud “100-time”voluntary donors. The ChiefMinister, <strong>Health</strong> Ministers andother Government officialswere present, along <strong>with</strong> alarge gathering of voluntaryblood donors, youths fromcolleges and socialorganizations;Voluntary blood donor cricket tournament—a poster competition andseminar by the Seth G.S.<strong>Me</strong>dical College at K.E.M.Hospital;— an information booklet onblood donation for distributionto various colleges, schools andthe general public.An event was held to announceinformation systems for supplyof safe blood to the citizens ofMumbai from member bloodbanks. The Honourable Minister of<strong>Health</strong>, Government ofMaharashtra was the Chief Guest.The <strong>Health</strong> Secretary, Chairman ofthe Maharashtra State <strong>Blood</strong>Transfusion Council and the FDACommissioner of Maharashtra,were guests of honour.A cricket tournament <strong>with</strong> aview to motivating voluntary blooddonors was held from 9 to 16April. Twenty teams comprisingvoluntary blood donors fromdifferent organizations in Mumbaiparticipated in the tournament,supported by film starts and otherpersonalities All participantsreceived a T-shirt, a cap, a bagand a Certificate of Participation.West BengalThe Association of Voluntary<strong>Blood</strong> Donors, West Bengal(AVBD) is a collaborative effort ofthose <strong>who</strong> are not only willing togive their blood, but also theirsweat and tears for the cause.Established in 1980, theAssociation today has a fraternityof over 5 million blood donorsfrom all walks of life. Their sharedmission: to bridge the woeful gapbetween the supply and demand ofthe life saving fluid in WestBengal.The AVBD believes that the mosteffective way to fill the bloodbanks is to bring the bank to thedonors, rather than wait for themto come forward. To this end,many activities were organized onWHD 2000, including a colourfulCycle Rally of 500 youngvoluntary blood donors fromRaktadan Bhawan, Barasat to theCentral <strong>Blood</strong> Bank in Calcuttaand back. A Year Long StateLevel Programme on <strong>Safe</strong>Donor Motivation was alsolaunched amid seminars andlectures on issues related to therational use of blood.Distinguished guests werecordially invited to make theevents a success.The Indian Society of <strong>Blood</strong>Transfusion and Immunohaematology(ISBTI) also cheeredthe occasion in a befitting manner.All State Level Chapters of theorganization, invited to celebrate“<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>”,produced thousands of posters91 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
and information leaflets that weredistributed at all ends of thecountry. Of particular note is theSpecial Issue of ISBTI News inhonour of <strong>World</strong> <strong>Health</strong> Day 2000and the All India Voluntary <strong>Blood</strong>Donation Day Celebration 2000illustrating the enthusiasm andcommitment of Governmentofficials and the general publicalike to a safe and sufficient bloodsupply. The poem below isreproduced from thisNewsletter. ▲For more information on bloodsafety activities in India, contact:Dr P. SalilJt. Director (BS)National AIDS Control <strong>Organization</strong>(NACO)9th Floor, Chanderlok BuildingJanpath LaneNew Delhi 110 001Tel: +91 11 373 1805Fax: +91 11 373 1746E-mail:salilpanakadan@hotmail.com<strong>Safe</strong> blood starts<strong>with</strong> me…I want to help others whatever it beBut show me the path, listen to me thee.Suddenly a voice came “<strong>Safe</strong> blood starts <strong>with</strong> me”And I realised what God wanted of me.From each one of us he wants the same:Donate blood and save the bodies which may be put to flame.So come forward and stretch out your handNo one is taking out your organ or glandJust sit and give a thought for a whileYour donated blood may save a smileFor want of blood we see many people dyingThey leave their families mourned and children crying.I hope you understand what I meanCome forward and help WHO and ISBTI in improving this scene.<strong>Me</strong>gha Gupta92 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESIndonesiaOrganizing CommitteeThe Directorate General of<strong>Me</strong>dical Care was the focal po<strong>int</strong>for activities related to <strong>World</strong><strong>Health</strong> Day 2000, supported by anOrganizing Committee of membersfrom the International Federationof Red Cross and the Red CrescentSocieties, the Ministry of <strong>Health</strong>,the Indonesian Red Cross Societyand NGOs. Highlights were asfollows.Minister of <strong>Health</strong> Dr Achmad Sujudi,mingling <strong>with</strong> the communityPress conferenceA press conference was held on30 March 2000 chaired by theMinister of <strong>Health</strong>, Dr AchmadSujudi, President of the InternationalRed Cross, Mar’ieMuhammad, Director General ofEnvironmental <strong>Health</strong>, Prof. DrUmar Fahmi and Director Generalof <strong>Me</strong>dical Services, as well as theWHO <strong>Health</strong> Promotion Officer forIndonesia.The Minister of <strong>Health</strong> advocatedsafe blood policies as an <strong>int</strong>egralpart of a successful healthdelivery service from both agovernmental and communityperspective. The Minister po<strong>int</strong>edin particular to GovernmentDecree. No. 18/1980 wherebyblood transfusion activities are tobe executed by the Indonesian RedCross Transfusion Unit, includingthe selection, safety, processing,storing and distribution of blood. Astatistical description was given tothe press by the President of theRed Cross on the demand andsupply of blood.The information kit provided bythe WHO Regional Office forSouth-East Asia, and a pressrelease from WHO Indonesia wasdistributed to the mass media. TheRegional Director’s <strong>Me</strong>ssage for<strong>World</strong> <strong>Health</strong> Day wasshared <strong>with</strong> RadioRepublic Indonesiaand other privatestations.WorkshopThe Ministry of <strong>Health</strong>organized a workshopon 7 April on “<strong>Safe</strong>blood comes from ahealthy body” forparticipants fromdifferent sectors ofsociety, including laboratorytechnicians and paramedicaltrainees. Given that nationalawareness of the need for safe,voluntary blood donation is weak,the workshop included aquestionnaire survey based onperception of voluntary blooddonation in local communities. Ithighlighted the need to change theWHO Representative addressing the audience93 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
prevailing system of replacementblood donation by voluntary blooddonation in a phased manner.<strong>Blood</strong> donation<strong>Blood</strong> donation camps were set upby the Ministry of <strong>Health</strong> incollaboration <strong>with</strong> the Jakarta<strong>Blood</strong> Transfusion Service on thesame day, attracting an estimated150 donors. The Minister of<strong>Health</strong> awarded recognitioncertificates to blood donors <strong>who</strong>had donation 100 times. Prof. DrS. Musilihan expressed concernthat the high number ofhaemophiliacs in the country didnot have adequate access toFactor VIII, and were also at highrisk of transmissible infections.A special workshop was held on<strong>World</strong> Haemophiliacs Day, 17April 2000.<strong>Me</strong>dical devicesAn exhibition of medicalinstruments and devices used inblood transfusion was alsoLocal community invited to participate in Roll-back Malaria launchorganized by the Ministry of<strong>Health</strong>.<strong>Safe</strong> <strong>Blood</strong> andRoll Back Malaria inEast Timor-KupangThe Minister of <strong>Health</strong>, on 8 April2000, in declaring the officiallaunch of Roll Back Malaria inEast Timor, essentially linked it tothe theme of safe blood and theneed to improve quality assuranceprogrammes for blood banks. TheMinister reassured the audienceof his strong commitment tosupport measures to ensure bloodsafety, and highlighted the need toscreen each and every unit ofblood for HIV, Hepatitis, malaria,and syphilis. ▲For more information on bloodsafety activities in Indonesia,contact:DirectorGeneral <strong>Blood</strong> Transfusion ServiceTel: +62-21 781 5464Fax: +62-21 781 5470.94 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESSri LankaThe Seat of a SpecialRegional ImpetusThe Ministry of <strong>Health</strong> andIndigenous <strong>Me</strong>dicine of theGovernment of Sri Lanka incollaboration <strong>with</strong> the National<strong>Blood</strong> Transfusion ServiceMinister of <strong>Health</strong> and Indigenous <strong>Me</strong>dicine, Mr Sirpala de Silvacommemorated <strong>World</strong> <strong>Health</strong> Day2000 by convening an <strong>int</strong>erregionalconference on the themeof “<strong>Safe</strong> <strong>Blood</strong> TransfusionPractices—Year 2000”. This majorevent took place on 7 and 8 Aprilat Bandaranayake <strong>Me</strong>morialInternational Conference Hall inColombo. Participants includeddelegates from India, Pakistan,Bhutan and Bangladesh and 150staff members of National <strong>Blood</strong>Transfusion Services from all overSri Lanka. Consultants (bloodusers), haematologists, mediapersonnel, blood donors, donororganizations, clergymen andstudents also participated.Technical sessions were held onstrategies for safe blood whichincluded:— organization and managementof blood programmes— motivation and recruitment ofvoluntary blood donors— screening blood for infectiousmarkers— appropriate clinical use ofblood; and— quality assurance programmesin transfusion services.During the <strong>World</strong> <strong>Health</strong> Daycommemoration, the contributionof voluntary non-remuneratedblood donors was acknowledged byawarding gold medals andcertificates to those <strong>who</strong> donatedblood more than fifty times.Organizers of annual blooddonation campaigns were alsoawarded certificates and theircontribution to the National <strong>Blood</strong>Programme was appreciated bythe Hon. Minister of <strong>Health</strong>. <strong>Safe</strong>blood pins sent from WHO/HQwere awarded to donors <strong>who</strong> haddonated more than ten times.WorkshopIn the scientific session, various<strong>int</strong>ernational experts covereddifferent technical aspects ofblood banking such as blood groupserology, blood componentpreparations and infectious95 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
markers screening. Around 150staff of the National <strong>Blood</strong>Transfusion Services—includingmedical officers, public healthinspectors, nurses and medicallaboratory technicians—participated in this scientificsession. A post conferenceworkshop was held at the <strong>Me</strong>dicalResearch Institute of Colombo forpostgraduate students <strong>int</strong>ransfusion medicine and medicaltechnologists of the NBTS.Press conferenceA press conference, presided bythe Honourable Minster of <strong>Health</strong>Audience at press conferenceand Indigenous <strong>Me</strong>dicine andattended by other officials of theMinistry, alerted media personnelfrom a wide range of pr<strong>int</strong> andelectronic media of the virtues ofvoluntary blood donation.Information on the <strong>int</strong>er-regionalconference was also accessible todelegates on web site pages.Television programmesA television programme on bloodsafety was prepared in which theMinister of <strong>Health</strong> and Indigenous<strong>Me</strong>dicine, the Director General of<strong>Health</strong> Services and the AdditionalSecretary, Ministry of <strong>Health</strong>participated. This programme wastelecast several times.Press coverageTwo of the largest circulatingnewspapers in the country carrieda full-page supplement on <strong>World</strong><strong>Health</strong> Day 2000.Hon. Minister inaugurating workshop for media personnelWorkshop for mediapersonnelA workshop was held for mediapersonnel on 5 April 2000 <strong>with</strong>the assistance of the <strong>Health</strong>Education Bureau, on the theme“<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>”. TheMinister of <strong>Health</strong>, DirectorGeneral <strong>Health</strong> Services,inaugurated the workshop, whichincluded a technical session onblood transfusion services in SriLanka. A draft of a national policyon blood transfusion was releasedto the media on this occasion.Donor organizers meetA gathering of the variousorganizations involved inmotivating blood donors andholding blood donation camps washeld on 3 April at Suwa <strong>Me</strong>dura,Narahenpita. It was addressed bythe Minister of <strong>Health</strong> andattended by the AdditionalSecretary to the Ministry of<strong>Health</strong>, the Director of the NBTSand members of various religiousorganizations.The aim of the meet was to96 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
express gratitude to theorganizers and persons involved inpromoting the role of voluntaryblood donation and at the sametime to encourage moreorganizations to get involved <strong>int</strong>he noble cause. The need for100% voluntary blood donationwas highlighted, and the importantcontribution of Buddhist monks inSri Lanka in the promotion of thevoluntary blood donationmovement was recognized.As a new step to improve thesystem for voluntary blooddonation, the Lions Club of SriLanka donated a multimediaprojector for the donor awarenessprogramme, and five computers toupdate the donor database.A conference souvenir waspublished by the NBTS, comprisingarticles prepared by the staff ontheir experiences in the field ofblood transfusion.ConclusionThe <strong>int</strong>er-regional conferencesignificantly increased awarenessamong the public on theimportance of governmentcommitment for a National <strong>Blood</strong>Programme in order to ensureblood safety in Sri Lanka. Thisalso opened the way for all SAARC(South Asian Association forRegional Cooperation) countries toshare resources for blood safetythroughout the region. Thefollowing outcomes of theconference were welcomed :— SAARC Association ofTransfusion <strong>Me</strong>dicineformulated— National <strong>Blood</strong> Programme forvoluntary donation formulated— Draft National <strong>Blood</strong> Policyforwarded for approval— Project identified to establishdatabase for voluntary donors.For the development of bloodtransfusion services in Sri Lanka,it was considered appropriate toplace immediate focus on thefollowing:— <strong>int</strong>roduce a postgraduatedegree course (MD inTransfusion <strong>Me</strong>dicine)— rigid enforcement of voluntary,non-remunerated blooddonation programmes acrossthe country— no privatization of bloodservices by nursing homes— disaster management andcomputerized links between allcentres. ▲For more information on bloodsafety activities in Sri Lanka,contact:Dr (Mrs) R.M. BindusaraDirectorNational <strong>Blood</strong> Transfusion ServicesKynsey RoadColombo 8.Tel/Fax: + 94 1692 31797 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
BLOOD SAVES LIVES IN WHO’S REGIONAL OFFICE FOR THEWestern PacificSynopsis of <strong>Me</strong>ssage fromthe Regional Director<strong>Blood</strong> saves lives. However, manypeople do not have access to safeblood. Studies show that only 20%to 30% of the world’s healthsystems are able to provide safeand adequate blood supplies.Many people therefore run therisk of receiving contaminatedblood.To raise awareness of the need forsafe blood, WHO dedicated <strong>World</strong><strong>Health</strong> Day 2000, on 7 April, toDr Shigeru Omiblood safety. The theme, “<strong>Safe</strong><strong>Blood</strong> starts <strong>with</strong> me”, urgespeople to look after their health bycaring for that precious lifesource: their blood. It alsoemphasizes the blood donor’sresponsibility towards therecipient.Although over 75 million bloodunits are collected from blooddonors every year, millions moreare needed to meet the globalrequirements for safe blood. Tosave more lives, we need toensure the availability of safeblood when and where it isneeded.WHO seeks to work closely <strong>with</strong><strong>Me</strong>mber States to ensureadequate supplies of bloodthrough voluntary, nonremunerateddonations. In theWestern Pacific Region, the targetof 100% voluntary unpaid donorshas been reached in Australia,Hong Kong (China), Japan,Malaysia, New Zealand, Republicof Korea and Singapore. However,many countries in the Region stillrely on paid donors, <strong>who</strong>sometimes give blood for money tosupport unhealthy habits, such astaking drugs. Others areundernourished and therefore atrisk of passing on infectionsthrough blood transfusions. WHOtherefore seeks to promote blooddonations from voluntary, nonpaiddonors <strong>who</strong> are at low risk.Moreover, there is also a need toensure the effective clinical use ofblood and blood products. Inhealth facilities, alternativetreatments should be sought whenblood transfusion is not the mostappropriate choice.WHO encourages <strong>Me</strong>mbers Statesto support national bloodprogrammes to ensure theavailability of safe blood. Strong“perhaps the most importantreason is that most people haveprobably never been asked todonate blood”government commitment isnecessary to ensure a safe andadequate supply of blood, whichincludes screening of blood forcertain viruses.“People are often reluctant to giveblood. Some people do not realizehow their blood could save others’lives. Perhaps the most importantreason is that most people haveprobably never been asked todonate blood”, said Dr Omi in avideo <strong>int</strong>erview.“People need to be given positiveencouragement to give blood.Education is a crucial part of anydonor recruitment strategy. Before98 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
“we owe it to ourselves tohave healthy blood”people can be motivated to donateblood for the benefit of others,they must understand how they, asindividuals, can play an importantpart in contributing to the healthof others.”Help save a life. Give safe blood.Dr Shigeru OmiRegional DirectorActivities in the WesternPacific RegionThe WHO Regional Office for theWestern Pacific publishedcolourful articles in Volume 1,Nos. 3 and 4 of its newsletter“WHO In Action” (seewww.<strong>who</strong>.wpro.<strong>int</strong>/).A NewsBrief in the March 2000Issue No. 3 announced the themeand slogan of WHD 2000 “<strong>Safe</strong>blood starts <strong>with</strong> me”, and invitedthe global community to careabout this common life source anddonate voluntarily this preciousproduct. The message was broughthome that we owe it to ourselvesto have healthy blood. Goodnutrition, a clean and healthylifestyle, proper prevention andearly treatment of disease, allcontribute to this.The WHO Western Pacific Regionorganized an exhibit at Robinson’sPlace in Manila (see photo),encouraging healthy lifestyles forsafe blood. <strong>Me</strong>mber States of theExhibition organized by WPRO inpopular shopping mallWestern Pacific Region preparedactivities to raise publicawareness on the importance ofsafe blood based on informationcontained in press releases, videomessages and other publicrelations materials from WHO.These materials were either usedon WHD 2000 or incorporated <strong>int</strong>oother notable events, such as the<strong>Health</strong> Expo (6-7 May 2000) inPapua New Guinea, wherethousands of young people witnessedthe theme of safe blood on TV.Other examples included theSolomon Islands, where there isno television station, but wherethe video recording of Dr Omi wasplayed on VHS at the HoniaraCentral Market to a largegathering on 7 April. Audiovisualmaterial prepared by WHO/HQwas used by the Red Cross in theiractivities throughout the year2000.In the next issue of NewsBrief(July 2000) a dozen full colourphotographs illustrated othernational events in commemorationof <strong>World</strong> <strong>Health</strong> Day 2000. Theseincluded the Papua New GuineaMinister of <strong>Health</strong> honouringveteran blood donors in a ruralsetting, a Philippine Red Crossceremony in a local shopping mall,school children visiting ahaematological laboratory inVanuatu, a blood safety seminar inLaos chaired by the Vice-Ministerof Labour and Social Welfare andstudent poster displays fromBokona Primary School in theSolomon Islands. ▲For further information on bloodsafety activities at the WHORegional Office for the WesternPacific, contact:Dr Ken Chen, <strong>Me</strong>dical OfficerTraditional <strong>Me</strong>dicine, orDr Oscar Barreneche<strong>Blood</strong> <strong>Safe</strong>ty<strong>World</strong> <strong>Health</strong> <strong>Organization</strong>Regional Office for the WesternPacificUnited Nations AvenueP.O. Box 2932, 1000 ManilaTel: +63 2 528 8001Fax: 63 2 521 1036E-mail:barrenecheo@cam.wpro.<strong>who</strong>.<strong>int</strong>Internet: www.<strong>who</strong>.org.ph.99 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESCambodiaIntroductionIn Cambodia, <strong>World</strong> <strong>Health</strong> Day2000 celebrations were a uniqueopportunity to raise generalawareness of blood safety issues.It was also an opportunity toacknowledge the efforts of theMinistry of <strong>Health</strong> (MoH) and theNational <strong>Blood</strong> TransfusionServices (NBTS) to address dailychallenges such as the shortage ofblood due to very low levels ofvoluntary donation. WHD 2000was therefore an important<strong>Safe</strong> blood seminarstimulus to create a blood donorrecruitment programme, inpartnership <strong>with</strong> the CambodianRed Cross (CRC). This articledescribes activities developed forthe occasion.Historical settingBefore the fall of Phnom Penh in1975 to the Khmer Rouge regime,the blood transfusion serviceswere the responsibility of the CRC.The system was completelydisrupted during the war, and onlybecame functional again in 1980,under the supervision of the MoH,<strong>with</strong> partial and temporarysupport from external sources,including the ICR and theInternational Federation of theRed Cross and Red CrescentSocieties. During this period,hospitals collected most of theblood needed from paid donorsand only basic compatibilitytesting was regularly carried out.No screening for communicablediseases was performed.In 1991, a decree issued by theMoH reinvested the NBTS <strong>with</strong>official responsibility fororganising and supervising thecollection and supply of bloodthroughout the country. At thesame time, also by governmentdecree, payment for blooddonation was prohibited.Over the next sevenyears, the NBTS wascompletely reorganized,to become largely how itexists today, coveringapproximately 80% ofthe population. Thisincluded physicalrehabilitation of theNBTC in Phnom Penhand 13 provincialtransfusion centres,<strong>with</strong> the relevant financial andtechnical support and trainingneeded to operate the centres.Voluntary blood donation and theorganization of external bloodcollections were also heavilypromoted.However, <strong>with</strong> the <strong>with</strong>drawal ofICRC support in December 1997,activities developed to increasevoluntary blood donations fell to abasic level. Spontaneous voluntarydonors almost disappeared, andreplacement “family” donors100 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
(which in reality includes aproportion of “professional” illegaldonors) passed from 66% to 90%of total of blood donors. Stocks ofblood fell to critically low levels,exacerbating the illegal trade ofblood. As a consequence of morepaid donors, during the sameperiod, the prevalence of units ofblood collected in Phnom Penhtesting HIV positive rose from3.5% to 5.6%, the highestprevalence in the Asian andWestern Pacific Region (seegraph).Partnerships were needed todevelop a sustainable programmefor the recruitment of safe blooddonors. The CRC, <strong>with</strong> its nationalnetwork of volunteers, wasperceived as an ideal partner, butsubject to lengthy negotiations,and in August 1999 WHO’sWestern Pacific Regional Office(WPRO) initiated an assessment ofthe situation to try to solvepriority problems, especially therecruitment of voluntary blooddonors and the critical shortage ofblood. This collaboration providedimmediate results, <strong>with</strong> thepercentage of voluntary donationsthrough mobile blood collectionsincreasing substantially during thelatter half of the year, and amarked reduction in theprevalence of HIV among blooddonations (especially in PhnomPenh).<strong>World</strong> <strong>Health</strong> DayWithin this context, thecelebration of <strong>World</strong> <strong>Health</strong> Daywas particularly opportune tostrengthen visibility of theseefforts, especially among officialsat the MoH, policy makers andpotential partners like CRC.A mass campaign was designedand launched at the end of 1999.<strong>Safe</strong> <strong>Blood</strong> Started With Dr Hong SunHuot, Minister of <strong>Health</strong> of CambodiaA special working group <strong>with</strong> staffof the NBTC participated in allphases of the campaign, thepriority objectives of which were:— To prepare the celebration of<strong>World</strong> <strong>Health</strong> Day 2000;— To increase the number ofblood units collected fromvoluntary donors at the NBTC;— To raise awareness amongdecision and policy makers atthe MoH and other ministriesof the importance of bloodsafety issues in the provision ofgood quality health services;— To raise awareness among thegeneral population of issuesrelated to the lack of blood,voluntary blood donations, andthe risks linked <strong>with</strong> theutilization of paid donors;— To promote voluntary blooddonation among identified lowriskpopulations;— To re-open negotiations <strong>with</strong>the IFRC and the CRC in apartnership programme forblood donor recruitment.Minister awards safe blood donorIn February 2000, the IFRC andthe CRC joined the working group,which was a huge boost for theNBTC team and enlarged thescope of potential activities. Thefollowing summarizes some of themajor events that spanned WHDand well beyond.A ceremony held on 7 April atthe Ministry of <strong>Health</strong> waspresided by His Excellency DrHung Sun Huot, Minister of <strong>Health</strong>and attended by high rankinggovernment officials. In theirpresentations, WHO, IFRC andCRC representatives stressed theurgency of blood safety. For thefirst time in Cambodia, regularvoluntary blood donors werepublicly congratulated and issued<strong>with</strong> a certificate signed by theMinister of <strong>Health</strong>. These101 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
voluntary donors represented thefirst step towards the creation ofthe Association of Voluntary <strong>Blood</strong>Donors. A video documentary producedin Cambodia on bloodsafety, entitled “blood and life”was shown during this ceremony.With the active support ofMédecins Sans Frontières, otherNGOs and the local healthauthorities, a regional eventwas held the same day in thenorthern Province of Battambang,which has the second largestRegional Transfusion Centre afterthe NBTC in Phnom Penh.Local and foreign journalistswrote newspaper articlesconcerning blood safety issues inCambodia. published in two localnewspapers in French and inKhmer in late November 1999.The article raised issues related tothe lack of blood and the imbalancein donor types, especiallythe dependency on replacement/family donors and the lack ofvoluntary donations. This drewattention to the issue of safe bloodat an early stage of the campaign.Several articles were alsopublished in national circulationnewspapers in the days precedingWHD. The message of the RegionalDirector for WPRO, Dr ShigueruOmi, also appeared in Khmer.Two Karaoke video clipsfeaturing different aspects ofblood safety and voluntary blooddonations were produced starringwell-known Cambodian celebritiesand students getting together forexternal blood collections.Moreover, the sound track of thesekaraokes was very successful onlocal radio.Two spots were broadcast onnational television in February2000, and were still beingbroadcast months later.— The first spot features studentsreticent to give blood. A heatedconversation on buying blood isgradually cooled down by thedoctor of an external bloodcollection team, <strong>who</strong>underlines the risks linked <strong>with</strong>paid donors and teaches themabout voluntary blood donation.— Spot number 2 showsfishermen in a rice paddy,having received a leafletfrom the mobile van andarguing over whetherthey should give blood.The daughter of thefisherman opposed togiving blood announcesthat his wife is inhospital <strong>with</strong> postdeliverycomplicationsand urgently needsblood, leaving him faced<strong>with</strong> his lack of altruism.A special budget was allocated toproduce a 26-minutedocumentary on the activities ofthe NBTC and safe blood issues inCambodia, timed for the openingceremony on 7 April. 50 copies ofthe film were distributed to theCRC and Provincial TransfusionCentres.The documentary was supportedby an additional set of 200 videocovers and 200 educationalposters, using the film’sbackdrop of images and theeducational message “<strong>Blood</strong> isLife—Go give <strong>Blood</strong>”.Official <strong>Safe</strong> <strong>Blood</strong> PosterThe <strong>int</strong>roduction of the TVdocumentary served to produce anextra one-minute Public ServiceAnnouncement spot on theserious need for blood in relationto traffic accidents. The spotfeatures the emergency rescueambulance and an <strong>int</strong>erview <strong>with</strong>of one of its doctors.Using the TV scripts, two radiospots were distributed to localbroadcasting stations,emphasizing WHD 2000 andaccompanied by supporting pressreleases.Two thousand T-shirts featuringthe NBTC and WHD 2000 logoswere widely distributed102 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
throughout the campaign, eitheras gifts for voluntary andspontaneous blood donors, orthose from mobile teams.Based on the need to target youthas a low-risk group of blooddonors, a high quality poster wasproduced featuring a group ofsmiling students in front of theRoyal University of Phnom Penh.With the slogan “To give blood isan honour for youth—become aregular voluntary blood donor atthe NBTC”, the poster was sosuccessful in high schools andfaculties that repr<strong>int</strong>s areforeseen.Drawing directly on official WHD2000 graphics, thousands ofposters were also pr<strong>int</strong>ed anddistributed to all provincialtransfusion centres, differentdepartments and ministries, highschools and pagodas.A third, large-scale poster wasalso produced and framed in 500copies for distribution to allhospitals in the country. Thisposter describes the basicfunctions of blood centres and theethics and altruism of blooddonation, and aims to warn thefamilies of patients in need ofblood of the risks inherent in usingpaid blood donors.A brochure was pr<strong>int</strong>ed inKhmer, adapting informationproduced by WHO/HQ to theCambodian blood safety contextand using local photos. This highquality document, along <strong>with</strong> theYouth Poster, is one of the majorachievements of the campaign.Copies of the brochure weredistributed among MoH officialsand other ministries, as well as<strong>Safe</strong> blood stickersreligious authorities andrepresentatives of the Cambodiancivil society.Two different stickers wereproduced for the campaign, thefirst representing the campaignlogo <strong>with</strong> the educational message“thank you for your blooddonation”, and the second <strong>with</strong> theWHD logo and message “safeblood starts <strong>with</strong> me—blood saveslives”.A quiz show was broadcast on6 April featuring competingstudents from three different highschools, and famousCambodian stars.NBTC doctors actedas the jury. The quizshow is always asuccess formula toreach familyaudiences and wastherefore repeatedat peak familyviewing timepassing keymessages on bloodsafety.In honour of WHD2000, a series of workshops onthe rational use of blood wereorganized in Phnom Penhthroughout the year for cliniciansfrom public and private hospitals.Conclusions<strong>World</strong> <strong>Health</strong> Day 2000 wassuccessful in Cambodia. Theceremony held at the MoH was animportant opportunity tocongratulate the small group ofregular voluntary blood donorsand initiate a <strong>Blood</strong> DonorsAssociation in Cambodia. Similarceremonies should be held everyyear.The mass campaign was veryuseful in raising awareness andpreparing the ground for thecelebration of WHD 2000.The initial concrete outcome of thecampaign is the increased numberof donated blood among safe blooddonor groups. The number of bloodbags was tripled, probably due tothe efficient mobile bloodcollection activities. The impact ofIEC activities on blood donors willneed a longer period to evaluate.103 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
An undeniable impact of the mediacampaign can be observed amonggovernment officials and policymakers, <strong>who</strong> are starting tounderstand that blood safety is notonly a laboratory issue. The MoHexpressed its <strong>int</strong>erest in puttingblood safety high on the policyagenda, and a draft NationalPolicy on <strong>Blood</strong> TransfusionServices was submitted by theNBTC for approbation.One of the major successes ofWHD 2000 was the creation of apartnership between the MoH/NBTC and the IFRC/CRC. Thispartnership is an encouragingstep towards the greaterinvolvement of the CRC in avoluntary blood donor recruitmentprogramme and, thereby, ne<strong>who</strong>pe for improved transfusionservices and availability of safeblood and blood products inCambodia. ▲<strong>Blood</strong> donor recognitionFor more information on bloodsafety activities in Cambodia,contact:<strong>Me</strong>dical OfficerInternational Committee of the RedCross81 Boulevard Sothea-Ros(ex Boulevard Lenine)Phnom PenhTel: (855 23) 426 160/ 360 071Fax: (855 23) 362 071/ 426 275E-mail: icrcphnkh@pactok104 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESPeople’s Republic of ChinaMore donors meansafer supplyHeading an article published bythe China Daily on 8 April 2000, aphotograph shows the Minister of<strong>Health</strong> and the WHO Representativein China visiting a mobileblood donation unit in Beijing,supporting the theme of this year’s<strong>World</strong> <strong>Health</strong> Day dedicated toblood safety. The essence of thisarticle is related below.People urged todonate blood(China Daily, 8 April 2000)China needs more voluntary blooddonors to ensure a safe bloodsupply, it was reported by topofficials at a seminar in Beijing tomark <strong>World</strong> <strong>Health</strong> Day 2000.Everyone can donate blood, andeveryone may need a blooddonation, said the WHORepresentative in China. Everyoneshould therefore be concernedabout the safety of blood supplies.The Minister of <strong>Health</strong> expressedhis appreciation to all blooddonors and said that a largenumber of blood donors is neededif China is to have a safe andadequate blood supply.<strong>Blood</strong> transfusions can save lives,but contaminated blood can alsotransmit diseases such ashepatitis and HIV/AIDS. Indeveloping nations, as much as5% of all cases of the HIV virusare transmitted through bloodtransfusions.Voluntary blood donations wherethe donor is not paid substantiallyreduce the risks of transfusiontransmissible infections, said theWHO Representative. Threemillion people have donated theirblood voluntarily since the <strong>Blood</strong>Donation Law took effect on1 October 1998, This laweliminated the practice of payingfor blood donations and instituteda system of unpaid, voluntarydonation.China still needs to build a nonremuneratedblood donationsystem, said State Councillor PengPeiyun. Many people still havemisgivings about donating blood,believing blood loss can damagetheir own health. But blooddonation is not harmful, statesDr Lu Daopei as blood is alwaysregenerating.<strong>Health</strong> workers were on severalBeijing streets to encourage blooddonation. “Our station receivedhundreds of people this morning”said a health worker at a bloodeducation station of WangfujingStreet.Mr Wang Bin, champion blood donorThe Number One blood donor, 50year-old Mr Wang Bin, a cadre atthe <strong>Health</strong> Division of the CentralParty School of the CommunistParty of China, donated a total of11 200 millilitres of bloodbetween 1988 and 1999. He wasawarded “the Golden Cup forVoluntary <strong>Blood</strong> Donation” and“the <strong>Me</strong>dal for the Advancement ofthe Capital’s Spiritual Civilization”(see photo).105 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Let’s Participate in<strong>Safe</strong> <strong>Blood</strong> ActionMinisterial meeting on <strong>World</strong><strong>Health</strong> Day 2000(extract from Chinese <strong>Health</strong>Pictorial)On 7 April 2000, a meeting on thetheme of this year’s <strong>World</strong> <strong>Health</strong>Day—“<strong>Safe</strong> blood starts <strong>with</strong>me”—was organized by theMinistry of <strong>Health</strong> in the People’sGreat Hall of Beijing. The meetingcalled upon society to support themovement for increased blooddonations from voluntary, nonremunerateddonors, and urgedthe general public to participateactively in this challenge.Madam Peng Peiyun, Vice Chair ofthe Standing Committee of thePeople’s Congress and Presidentof the Chinese Red Cross said thatsince the establishment of the<strong>Blood</strong> Donation Law, initialprogress had been made inincreasing the numbers ofvoluntary, non-remunerated blooddonors. However, arduous effortsneed to be made to establish amechanism for promoting suchdonations throughout China. Shecalled on government leaders atall levels to raise awareness of theneed to implement the <strong>Blood</strong>Donation Law <strong>with</strong> a sense ofresponsibility and urgency.Madam Peng said that thePeople’s Congress at all levelswould play their role in thisendeavour, and that the Red Crossshould to be closely involved inmobilizing healthy, eligible peopleto participate, voluntarily, in theblood donation movement. It wasimportant, she concluded, toincorporate the concept ofaltruistic blood donation <strong>with</strong><strong>int</strong>he context of health education foradolescents.In his speech, <strong>Health</strong> MinisterZhang Wenkang invited the healthsector nation wide to respondactively to WHO’s appeal, toeducate the public on bloodrelatedknowledge, and build up anew concept that safe blooddonation does you no harm. TheMinister added his support toincreasing the numbers ofvoluntary, non-remunerated blooddonors in China. <strong>Me</strong>anwhile, thelegislation and regulations for safeblood management, blood testingcapacity, and the scientific andrational use of blood for clinicalpurposes, still needed to beperfected.Many other presentations weremade at the meeting, which waschaired by Dr Wang Longde, ViceMinister for <strong>Health</strong>.Following the meeting,government leaders and the WHORepresentative visited thecounselling and advocacyactivities taking place in thecommercial streets of Wang Fujingand Xidan in Beijing. ▲For further information on bloodsafety activities in China, contact:Dr Feng GaoVice DirectorShanghai <strong>Blood</strong> Centre (WHOCollaborating Centre)1191, Hong Qiao RoadShanghai 200051Tel: +86 21 6278 1789Fax: +86 21 62958414E-mail: shblood@public.sta.net.cnInternet: www.sbc.org.cn106 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESJapanAltruism starts at homeThe Japanese authoritiessupported <strong>World</strong> <strong>Health</strong> Day 2000in many ways, not least inproviding financial and technicalsupport that enabled other, lessfortunate countries to commemorateblood safety as well.<strong>Safe</strong> <strong>Blood</strong> Symposium:nucleic acid amplificationtestThe main activity of the Day was asymposium organized in Tokyo on“<strong>Safe</strong> <strong>Blood</strong>”. Mr Shoichi Fujimori,President of the Japanese RedCross Society, welcomed thedistinguished speakers. Heproudly noted that, through theclose collaboration of allstakeholders—especiallyvolunteers—100% of the bloodneeded for transfusion has beenobtained from voluntary, nonremuneratedsources since 1974,although this target has yet to bereached for plasma derivedproducts.Japan has a proud history ofkeeping abreast of medicalscience and social needs. Since1997, nucleic acid amplificationtests (NAT) have been used toscreen for hepatitis B and C virusand HIV-1 for source plasma ofplasma derived products, and allvoluntary blood donations are nowscreened before transfusion <strong>int</strong>hree NAT centres. Today, concernfocuses naturally on the health ofblood donors themselves. Japan’sblood programmes took the theme“<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>” as astart, and continue efforts topromote this message, <strong>with</strong> thehope that as many people aspossible will think about their ownhealth and realize that donatingblood is an altruistic act.Mr Fujimori paidspecial thanks toDr Brundtland for hermessage for bloodprogrammes in Japan.Dr Omi, Director ofWHO’s Regional Officefor the WesternPacific, recalled hisdays in Dr Mayumi’slaboratory in Japanwhen the PCRtechnique was<strong>int</strong>roduced, which hassince progressed from theexperimental stage to becomeroutine for screening, enhancingthe safety of blood transfusions.On the other hand, he lamentedthat most Asian countries still relyon a paid donor system <strong>with</strong> theconcomitant high risk of posttransfusionHBV, HCV and HIV-1.He hoped that these countriesTokyo NAT Centre and host to memorial meetingmay be able to benefit fromcollaboration <strong>with</strong> Japan.Dr Nakajima of the Ministry of<strong>Health</strong> and Welfare concurred<strong>with</strong> the previous speakers andassured the congregation of thefull cooperation of the JapaneseRed Cross Society in contributingto the improvement of global bloodsafety.107 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Inside NAT CentreNAT TourAfter the symposium, where many<strong>int</strong>ernational and nationalperspectives were debated,delegates were treated to a tour ofthe pristine NAT centre laboratoryin Tokyo. Between November 1997and November 1999, 5.6 milliondonations, screened serologicallynegative, were tested manually byNAT <strong>with</strong> a view to reducing theviral load from source plasma forplasma derived products. 78positive donations were found forHBV (1:72,000), 10 for HCV(1:560,000) and 2 for HIV-1(1:2,800,000), the highest windowdonation risk being HBV. Thesedata show that blood transfusionin Japan has become safer thanever through 100% voluntaryblood donations and serologicalscreening, although a residual riskmay still occur in later stages <strong>with</strong>virus mutants or viral load <strong>with</strong> anundetectable level of currentserological screening.Because of the need to containcosts, tests are currently carriedout on pool, as rapidly as possibleto enable transfusion of cellularcomponents. As HBV genomeswere quantified in 6 hepatitis Bseroconversion panels in the earlystages of infection, the virusgrowth curve showed anexponential straight line againstthe date of bleeding. Doubling timewas 2 days and log time was 6.5days. Therefore, a highly sensitiveNAT assay <strong>with</strong> the appropriatepool size could narrow the windowperiod of HBV resulting inexponential reduction of the virusload not detected in the presentserological screening.In late 1998, a highly sensitivemultiplex HBV/HCV/HIV-1 (MPX)reagent was developed for NATthat can reduce the test cost andtime as compared to the reagentsfor individual viruses. In July1999, thanks to technologicaladvances, nationwide serologicalNAT screening of negativevoluntary donated blood wasinitiated. After resolution of MPXpositive samples <strong>int</strong>o individualvirus, each blood centre informeddonors of the results and followedup NAT-positive cases todifferentiate between transient orchronic infections, <strong>with</strong> the aim ofreducing positive donors andimproving the health care ofvoluntary blood donors. Over twomillion units were tested by 500pools and 19 HBV and 8 HCVcases were identified. SinceFebruary 2000, NAT screening hasidentified 18 HBC, 5 HCV and 2HIV-positive cases from the 1.3million units tested.Cost-benefit analysis<strong>Blood</strong> donations must bevoluntary, yet funds are stillrequired to ma<strong>int</strong>ain an organizedsystem and to research andbenefit from technology to assuresafety. A cost-benefit analysisshould therefore not be basedalone on the cost of an individualtransfused patient, since unsafeblood transfusion results in healthcare expenditure and, moreseriously, a threatened life. Soinvestment in technology such asNAT screening, if expensive,becomes cost-effective and to beencouraged.108 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
An altruistic IssueIt is not only in donating bloodthat we must think of others.Japan realizes that helping othersinvolves training, blood safetypractices and technology transfer.Moreover, <strong>int</strong>ernationalstandardization needs to take thedeveloping world’s epidemiologicaland socio-economical situation<strong>int</strong>o account if it is to fulfil real<strong>int</strong>ernational harmonization.The Japanese challengeAs stated above, self-sufficiencymay have been achieved for bloodtransfusion, but remains an unmettarget for plasma-derivedproducts emanating fromvoluntary, non-remunerateddonors. To achieve this safetylevel, increased efforts will be putto recruiting and retaining suchdonors at the individual, socialand governmental level. Thismulti-tiered approach is based onthe premise that, although safeblood starts <strong>with</strong> me, it cannot bethe sole responsibility of theindividual to assure the success ofa safe blood system. Together,however, we can succeed.In conclusion, Japan has identifiedfour clear areas of focus over thenext five years:— clarify the roles andaccountability of centralgovernment, local authoritiesand the Japanese Red Cross— elucidate the policy of selfsufficiency of blood productsfor the general public— set up a concrete strategy toensure blood safety andDr Nishioka reads message fromWHO Director-Generalimplement national bloodlegislation— take administrative measuresfor compensation forunavoidable accidents in bloodtransfusion.As Dr Brundtland states in hermessage, this is but the beginning,and Japan stands ready tocollaborate in the WHO five-yearplan to reinforce global bloodsafety. ▲For more information on bloodsafety activities in Japan, contact:The DirectorCentral <strong>Blood</strong> CentreJapanese Red Cross Society1-31 Hiroo, 4-Chome, Shibuya-kuTokyo 150 0012Tel: +813 343 81311Fax: +813 3343 58509E-mail: rcjpn@ppp.bekkoame.or.jpInternet: www.jrc.or.jp/english109 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESMongoliaMongolia paysconsiderable attentionto blood safetyThe provision and safety of bloodand blood products is of greatpublic health concern to theGovernment of Mongolia. Thetheme of <strong>World</strong> <strong>Health</strong> Day 2000“<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>—<strong>Blood</strong> Saves Lives” followedimmediately the adoption of theLaw on Donors, an initiativedeveloped by President N.Bagabandi. This contributed in nosmall way to the success of thePresident Bagaband (second from right)visiting the <strong>Blood</strong> Centrepublic promotion campaign andimprovement in the quality ofblood and blood products inMongolia.On receiving the official letter ofDr Gro Harlem Brundtland,Director-General of WHO, thePresident issued an appeal to thecitizens of Mongolia. The Ministryof <strong>Health</strong> and Social Welfare <strong>with</strong>the Red Cross Society of Mongoliadeveloped an action plan insupport of this appeal.The initiative of the Presidentgained the full support of thenation, especially from universitystudents, high schools andcolleges. For instance, theMongolian National <strong>Me</strong>dicalUniversity, the key educationalinstitution that preparesMongolian doctors and healthrelatedprofessionals, keenlyaccepted this challenge.In the central aimak, theentire local governmentstaff donated bloodDonate blood: settingan exampleDr Sh. Batbayar, Parliament<strong>Me</strong>mber, Dr S. Sonin, Minister of<strong>Health</strong> and Social Welfare andDr R. Salmela, Acting WHORepresentative, took part in aspecial meeting on blood safety. Atthis meeting, students of theMongolian National <strong>Me</strong>dicalUniversity donated their blood,appealing to all students ofMongolia to participate actively <strong>int</strong>he movement for voluntary, nonremuneratedblood donorrecruitment. Many studentsfollowed the example of the WHORepresentative in publiclydonating blood.Efforts to promote blood donationwere not only initiated inUlaanbaatar, capital city ofMongolia <strong>with</strong> one third of thetotal population, but in all aimaks(provinces). For example, in thecentral aimak, the entire staff ofthe local government andorganization of citizensrepresentative meeting donatedtheir blood.Information, educationand communicationAn important aspect of WHD 2000was that very broad activitiesrelated to information, educationand communication wereundertaken. The brochure andposters provided by WHO weretranslated <strong>int</strong>o the Mongolianlanguage and pr<strong>int</strong>ed anddistributed to all aimaks andsoums (villages). The Ministry of<strong>Health</strong> also translated <strong>int</strong>o the110 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Mongolian language anddistributed, <strong>with</strong> WHO support,several manuals on blood safetyand the appropriate use of bloodproducts to all hospitals.Various advertisements on theprovision and safety of blood andblood products were broadcastthrough television and radiochannels. The biggest channel ofMongolian TV prepared a specialprogramme entitled “Sacred deedsof blood donors and blood safety”.In this programme, the WHORepresentative and the Minister of<strong>Health</strong> and Social Welfareaddressed the Mongolian people.The greeting from Dr Omi, WHODirector for the Western Pacific,as well as a programme aboutblood safety, were presented.Doctors and specialists of the<strong>Blood</strong> Centre played a key role inall activities organized on thestudents worked in trolleybuses, distributing leaflets andthe President’s appealoccasion of WHD 2000. Theydelivered lectures and highlightedtheir own actions at more than 10organizations involving around2000 people. Students ofuniversities, high schools andcolleges also participated inpromoting <strong>World</strong> <strong>Health</strong> Day byworking in buses and trolleybusesand distributing leaflets and thePresident’s appeal.Press conferenceThe press conference was animportant event to promote theLaw on Donors, <strong>World</strong> <strong>Health</strong> Day2000 and the President’s appeal.Dr P. Nyamdawa, Social PolicyAdviser to the President, Mr L.Odonchimed, President of theMongolian Red Cross Society, MrsB. Tsetsegdari, Chief of the <strong>Health</strong>Divison of the Ministry of <strong>Health</strong>and Dr D. Ulaankhuu, Director ofthe <strong>Blood</strong> Centre, took part in thepress conference. They deliveredspeeches and gave detailedanswers to questions from themedia on the provision and safetyof blood and blood products.Scientific seminarsTwo seminars, one on the“Rational use of blood and bloodproducts” and another on the“Provision of blood safety” wereconducted <strong>with</strong> support fromWHO. The first involved directorsand deputy directors of cities andaimaks clinical and jo<strong>int</strong> hospitals,whilst the second was conducted<strong>with</strong> the participation oflaboratory doctors of all aimaks.The training of doctors andthe renewal of basicequipment were also highon the President’s agenda.Presidential supportThe presidential visit to the <strong>Blood</strong>Centre <strong>with</strong> state andgovernmental high level officialswas a significant event in supportof <strong>World</strong> <strong>Health</strong> Day. ThePresident, familiar <strong>with</strong> theactivities of the <strong>Blood</strong> Centre,addressed the staff and awardedHonoured Donors <strong>with</strong> certificatesand badges. In his speech, heexpressed deep thanks to allcitizens of Mongolia for theiractive and broad acceptance of hisappeal. He also emphasized theimportance of the adequateprovision and safety of blood andblood products, especially inemergency cases during naturaldisasters, certain accidents andserious diseases that could affectlarge groups.Improvement in productiontechnologies of blood and bloodproducts through the training ofdoctors and production specialistsand the renewal of basicequipment were also high on hisagenda, as was the need forfinancial assistance to developblood transfusion services in thiscountry.Conclusion“<strong>Safe</strong> blood starts <strong>with</strong> me. <strong>Blood</strong>saves lives”—initiative of WHOand the International Federationof the Red Cross and Red CrescentSocieties—was an important step111 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Brief <strong>int</strong>roduction to theMongolian Humane Association of <strong>Blood</strong>The MHAB is a nongovernmental humane organization that services the <strong>int</strong>erests ofblood donors. The association was registered by the Ministry of Law in May 1999 <strong>with</strong>the objective to protect people’s health during national health care reform. The associationunites 25,000 members including 200 veterans of donor movements and 1,850 honourabledonors. Our supreme goal is to develop the life saving charitable activity of blood donors inMongolia and to supply hospitals <strong>with</strong> guaranteed safe blood from certified donors.<strong>Me</strong>ssage from the Association to WHO Director-General“We should like to congratulate you on behalf of thousands of Mongolian donors, andinform you that the Mongolian Humane Association of <strong>Blood</strong> is sustaining its activities <strong>int</strong>he blood service field of health care. <strong>World</strong> <strong>Health</strong> Day 2000 was widely observed in ourcountry this year. And on that day, the Mongolian President N. Bagabandi visited the <strong>Blood</strong>Centre in Ulaanbaatar. In his speech he advised us to extend cooperation <strong>with</strong> similarexternal organizations and recruit more people <strong>int</strong>o our donor movement throughacknowledgement of the importance of this movement.We are using this material in health education programmes. There are 15,300 voluntarydonors in Ulaanbaarar, <strong>who</strong> donate 5,216 litres of blood which produce 12 kinds of bloodproducts each year. But that amount supplies only 60% of necessary blood products inhospitals. And only 0,5% of citizens are involved in donor movement, therefore we shouldput more effort to fulfil blood requirements. On <strong>World</strong> <strong>Health</strong> Day we opened a donoreducation cabinet at the <strong>Blood</strong> Centre in Ulaanbaatar.Further we hope to participate in <strong>int</strong>ernational events on donor movement and want toseek support from WHO.in the development of bloodtransfusion services in Mongolia.Our doctors and specialists ofblood transfusion services arecommitted to supporting anational programme that wouldprovide blood and blood products,and guarantee blood safety. ▲For further information on bloodsafety activities in Mongolia,contact:Dr D. UlaankhuuDirector of the <strong>Blood</strong> CentreMinistry of <strong>Health</strong> and SocialWelfareUlaanbaatarTel: +976 11 324871Fax: +976 11 372857E-mail: bloodcenter@mongol.net.112 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
SAFE BLOOD STARTS WITH ME – BLOOD SAVES LIVESViet Nam<strong>World</strong> <strong>Health</strong> Day 2000communications campaignThe Ministry of <strong>Health</strong>’s Centre for<strong>Health</strong> Education joined <strong>with</strong> theTherapy Department, the Haematologyand <strong>Blood</strong> TransfusionInstitute and the Hanoi <strong>Health</strong>Service to organize a communicationscampaign <strong>with</strong> themessage “<strong>Safe</strong> blood begins <strong>with</strong>each of us”. With support fromWHO, the ten-day campaignaround <strong>World</strong> <strong>Health</strong> Day focusedon the following major objectives:— raise public awareness of thesignificance of voluntary, nonremuneratedblood donation;— increase the number of safeblood donors.To achieve these objectives, thefollowing activities wereimplemented.National televisionbroadcastsA three-minute official messagefrom the Director of the WHORegional Office for the WesternPacific was broadcast on primetime on <strong>World</strong> News in Vietnameseand on VTV1 in English andFrench.Two reports were filmed on thesame television channels, one on“<strong>Blood</strong> donation to save lives”filmed at the Haematology and<strong>Blood</strong> Transfusion Institute, andanother showing an <strong>int</strong>erview <strong>with</strong>the WHO Representative during ameeting dedicated to <strong>World</strong> <strong>Health</strong>Day 2000.Only 20% ofViet Nam’s requirementsfor blood are metIn addition, a television spot wascommissioned to explain thesignificance of voluntary, nonremuneratedblood donation andself-screening for blood safety.A second television spot urgingpeople to give blood spanned sixdays at targeted viewing times(health, cultural and sportsprogrammes) on the Voice ofViet Nam.<strong>Blood</strong> drive in advance of<strong>World</strong> <strong>Health</strong> Day 2000More than 300 students and youngpeople from the capital citydonated blood in preparation forWHD 2000. The donations weremade at a meeting organized bythe Steering Board of theHumanitarian <strong>Blood</strong> DonationMovement of Hanoi. Launched in1994, the movement hadcollected, by 1999, 14,000 litresVice-Presidentof blood from 54,000 donors.According to the Haematology and<strong>Blood</strong> Transfusion Institute,voluntary donations account foronly 25% of the country’s bloodreserves.<strong>Me</strong>eting on voluntary,non-remunerated blooddonationA meeting was held at theMinistry of <strong>Health</strong> on 6 April2000, <strong>with</strong> a view to reviewing theimportance of voluntary, nonremuneratedblood donation, the113 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
achievements made by the healthsector in this direction and thestrategy for blood transfusionservices for the next twenty years.Key participants among the 150-strong audience included theDeputy President, the Minister of<strong>Health</strong>, the representative of WHOin Viet Nam, senior experts,correspondents from the mediaand students from variousuniversities.<strong>Me</strong>dia impactMany articles appeared in thenational and local press duringMarch and April 2000, coveringdifferent aspects of safe blood, e.g.blood safety as a global healthissue, the need for safe blood,strategies to increase voluntarydonation, perspectives fromstudents, the science behind safeblood transfusion and, of course,safe blood activities to celebrate<strong>World</strong> <strong>Health</strong> Day 2000. An articlethat appeared in the Viet NamNews on Saturday 8 April providesan overview of the blood donationsituation in the country, an extractof which is reproduced below:National blood programmeneeds more effectivemanagementThe chronic shortage of safe bloodsupplies and healthy blood donorsare matters sparking considerable<strong>int</strong>erest and challenge in VietNam’s health care industry,particularly in connection <strong>with</strong>rural, mountainous and islandareas.Addressing the topic at a meetingcommemorating <strong>World</strong> <strong>Health</strong> Dayin Hà Nôi, the Minister of <strong>Health</strong>Minister of <strong>Health</strong>Do Nguyên Phuong said that thenation’s health sector needed toplace more emphasis on effectivemanagement of the national bloodprogramme and improving bloodsafety screening.Viet Nam’s health care sectorrequires some 400,000 litres ofblood annually, but according tothe Director of the NationalInstitute for Haematology and<strong>Blood</strong> Transfusion, Do Trung Phân,only about 20% of the demand ismet.Participants at the meeting alsoheard that although the movetoward voluntary blood donationhas been operating for years, alarge number of localhospitals still have torely on paid donors andon family donations.Last year saw thenational health sectorcollect 55,000 litres ofblood <strong>with</strong> theproportion of blooddonated by paid donorsaccounting for morethan 70% (and up to 90% in someprovinces).Most paid donors come fromprovinces across the country,resulting in difficulties insupervising sources of blooddonations, as well as blood quality.Viet Nam’s target is to increasethe proportion of voluntary donorsto between 25% and 40% of totaldonors by the end of the year2000, while ensuring that allblood donations are screened forHIV, hepatitis B and otherepidemic diseases.The Minister of <strong>Health</strong> admittedthat not enough patients arereceiving necessary bloodtransfusions as a result of afailure to attract donors. Most ofthe country’s hospitals lack stocksof blood, meaning that patientsneeding transfusions in emergencysituations frequently have to waituntil supplies can be obtainedfrom city hospitals. This oftenresults in unnecessary deaths.Another major problem facinghealth experts is the inadequacy114 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
of effective blood screeningmeasures. The result is that somehealth units engaged in bloodtransfusions do not yet fullyconduct blood screening to avoidthe risks of infection from HIV/AIDS, hepatitis B and C, syphilisand malaria.Extract of a Presentationby the WHORepresentativeOn 7 April 2000, 52 years exactlyafter the foundation of the <strong>World</strong><strong>Health</strong> <strong>Organization</strong>, everywherein the world from Buenos Aires toMoscow and from Hanoi toMontreal, it will be <strong>World</strong> <strong>Health</strong>Day.This Day is the annual occasion tohighlight an important healthproblem, and in 2000, WHO hasselected blood safety. Why is bloodsafety an important issue forWHO?— Because each year tens ofthousands of people die in theworld for lack of a bloodtransfusion; andThere are simply notenough blood donors— Because these deaths areavoidable if hospitals have afew bottles of blood which havebeen collected, tested andstored according to<strong>int</strong>ernationally agreedprocedures.In Viet Nam every year, hundredsof people die from heavy loss ofblood, <strong>with</strong> women often the firstvictims of this situation. Postpartum haemorrhage, retainedplacentas and ectopic pregnancyare among the main causes ofmaternal mortality and claim thelives of around 2,700 youngwomen annually in this country.Between 400 to 600 of them mayhave been saved had blood beenavailable.Traffic accidents, killing 7,000people and seriously injuring24,000 others last year, are on theincrease. The availability of safeblood in emergency wards wouldsave many of these lives too.Finally, to cite but one otherexample among many, countlesslives are lost during surgery inmany hospitals due to a lack ofsafe blood.Today, Viet Nam is confronted <strong>int</strong>his area <strong>with</strong> two main problems:1. the lack of blood—there aresimply not enough donors; and2. the quality of the availableblood.Global experience clearly showsthat, in order to have sufficientquanitites of safe blood, we mustincrease the number of voluntary,non-remunerated donors fromlow-risk populations.A media campaign should belaunched in Viet Nam to sensitizethe public around the simple idea“Giving your blood will save lives.Even your own if you need bloodone day.”There are of course obstacles thatprevent more widespreadvoluntary donations, such as theperception that giving blood makesyou weak. These beliefs can in factserve as the basis for effectivestrategies. Several Asiancountries have shown howvoluntary blood donations canbecome part of the local culture,<strong>int</strong>egrated as a practice ofsolidarity. In China, for example,donating blood is seen as acitizen’s moral obligation.But it is not enough to collectblood. To address po<strong>int</strong> two above,this blood must meet <strong>int</strong>ernationalstandards for quality, and be usedappropriately. Laboratories shouldbe in place to test all donatedblood systematically and eliminateblood containing viruses such asHIV/AIDS or hepatitis B which canbe transmitted throughtransfusion. It was estimated thatin 1997, 100 people contractedHIV infection in Viet Nam throughtransfusion.<strong>Blood</strong> transfusion in manycases may not be the mostappropriate, cost-effective orsafe <strong>int</strong>ervention115 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
lood is a precious product …a cause worth fighting forAnother key element is to useblood only when needed. <strong>Blood</strong>transfusion in many cases may notbe the most appropriate, costeffectiveor safe <strong>int</strong>ervention.Viet Nam has certainly madeprogress to ensure safe blood forits population. Yet there is still along road before reaching bloodsafety. National authorities fromthe highest level should committhemselves to developing acomprehensive blood programmeand well-organized bloodtransfusion services. WHO willcontinue to support theGovernment of Viet Nam in itsefforts to ensure blood safety foras long as this governmentcommitment is there.<strong>Blood</strong> is a precious product, it isour common source of life. Itshould be available to all womenand men when needed and itshould be safe. This is a causeworth fighting for. It is why WHOdecided to devote <strong>World</strong> <strong>Health</strong>Day 2000 to blood safety. ▲For further information on bloodsafety activities in Viet Nam,contact:Prof Do Trung PhanDirector, National Institute ofHaematology and <strong>Blood</strong> TransfusionBach Mai Hospital10 Giai Phong StretHa NoiTel: (84 4) 868 7007/868 5582Fax: (84 4) 869 6250/869 1607116 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
ANNEX 1Pledge 25—A blood donor club <strong>with</strong> a differenceZimbabwe’s youth realized thattheir future was in their ownhands. This is why, some yearsago, a project was launched byyouth themselves which hassignificantly contributed to thesuccess of the nation’s safeblood supply. The project,already being emulated inneighbouring countries, iscalled “Pledge 25”.HIV caused <strong>Blood</strong> TransfusionServices across the world to rethinkseriously their blood donor“… and we have about1,000 Pledge 25 Club members<strong>who</strong> have already reachedtheir certificate, so that’show successful theprogramme has been”.Dr T.J. StampsMinister of <strong>Health</strong> and Child Welfare,Zimbabwe during an <strong>int</strong>erview for<strong>World</strong> <strong>Health</strong> Day 2000 on<strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With <strong>Me</strong>recruitment strategies and, in 1989,Zimbabwe started targeting an as yetuntapped pool of low-risk donors:school-children aged 16-19. However,history proved that—successful asthe programme was—most schoolblood donors ceased to donateregularly upon leaving school. ThePledge 25 Club was therefore createdby and for school leavers, <strong>who</strong> pledgeto make at least 25 donations ofblood. <strong>Me</strong>mbers also actively shareinformation and knowledge <strong>with</strong> othercurrent and prospective donors and,in this way, help to promote healthylifestyles, and reduce the level of HIVprevalence in peer groups and theamount of infected blood collected.Club members were honoured on<strong>World</strong> <strong>Health</strong> Day in April 2000, andthe first group of Club members hadtheir graduation ceremony—to marktheir 25th donation—at the AnnualGeneral <strong>Me</strong>eting of the National <strong>Blood</strong>Transfusion Service (NBTS) on6 September 2000. Many of thepioneers are considering theformation of a “Pledge 50” division.to ensure the running of their affairs.Selected Peer Donor Promoters nowassist the NBTS <strong>with</strong> the recruitmentof voluntary, non-remunerated,regular donors from low-risk groupsand in turn, the NBTS supervises andcounsels the Club.It is critical to reiterate the selfmotivatedcommitment of the pupilsthemselves that has led to a windowof hope for the national blood bank. Itis thanks to the students, <strong>who</strong>instituted a National Youth <strong>Blood</strong>Donors Day, that the availability ofsafe blood at peak times of the yearsuch as Christmas, has gone from50% to 80% and is still rising. Other% HIV +ve unitsHIV rates in donated blood (1989–1999)54321The Club elects national and0provincial administrative committees 1989 90 91 92 93 94 95 96 97 98 99statistics speak for themselves: HIVsero positivity among blood donorshas fallen from an average of 4.45%in 1989 to 0.7% in 1999 (comparedto sero prevalence in the sexuallyactive population in general: 25.8%);99.3% of all blood collected in 1999was HIV-negative; and nearly 70% ofthe 82,365 units collected in thissame year were donated by pupils. ▲For more information, contact:The National <strong>Blood</strong> TransfusionServiceHarare, ZimbabweE-mail: zimnbts@africaonline.co.zw117 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
ANNEX 2Questions and answers about donating blood“To give blood is a privilegeTo receive blood is a right”Thank you for thinkingabout blood donationDonation of blood is a gesture ofgoodwill and care for the fellowhuman beings. There is no gift morevaluable than a Gift of <strong>Blood</strong>, as it isactually a Gift of Life for the person<strong>who</strong> receives it.<strong>Safe</strong> blood is blood that does notharm the donor, is free from infectionor other harmful agents, that neitherharms the recipient, and is used forthe benefit of the patient’s health andwell being.The slogan <strong>Safe</strong> <strong>Blood</strong> <strong>Starts</strong> With<strong>Me</strong> denotes that it is me <strong>who</strong> is thedonor of safe blood. This unit of yourblood will save the life of more thanone patient. As a member of society,it is your responsibility to donateblood. You can go to the nearestgovernment approved blood centre,which is based on voluntary, nonremuneratedblood donation, andmake your significant contribution tosaving the life of a patient. Yourcontribution is extremely valuable.The following is a list of frequentlyasked questions <strong>with</strong> comprehensiveanswers about donating blood.Why should peopledonate blood?<strong>Safe</strong> blood saves lives. Every day,thousands of people would die ifothers did not donate their blood.Many people know someone <strong>who</strong>might have died unless anotherperson had given them the gift oflife—safe blood. Most transfusionsare given to:— women to treat haemorrhage as acomplication of pregnancy— children <strong>with</strong> severe anaemia— accident victims— surgical and cancer patients.<strong>World</strong>wide, about 600,000 women dieof pregnancy-related causes everyyear. Approximately 25% of thesematernal deaths are associated <strong>with</strong>the loss of blood. Many of these livescould be saved if enough safe bloodwas available.What is blood andwhat is it used for?The red liquid called blood iscomposed of several differentelements, each of which fulfils aparticular function. <strong>Blood</strong> can be used<strong>who</strong>le or can be separated <strong>int</strong>o itsindividual components. These can beused for specific purposes so thateach unit of donated blood can beused for more than one patient.Whole blood is commonly used insome countries to treat the majorityof life-saving transfusionrequirements.<strong>Blood</strong> componentsRed cells are widely used to replaceblood loss caused by haemorrhage inchildbirth, during surgery and inaccidents. Red cell transfusion canalso be life-saving in certain types ofsevere anaemia.Platelets are very small cells thatare essential to blood clotting. If aperson’s platelet count is low, thismay lead to easy bruising and majorbleeding. Patients <strong>who</strong> haveleukaemia or bone marrow failureusually have very low platelet countsand need platelets to preserve theirblood clotting function.Plasma, the yellowish liquid in whichblood cells are suspended, is usuallyprocessed to produce vital bloodproducts:— Clotting factors, such as FactorVIII which enables haemo-philiacsto lead virtually normal lives— Immunoglobulins:• non-specific immunoglobulin,which is used to treat abnormalfunctions of the immune systemand to prevent hepatitis A• specific immunoglobulins, suchas anti-D immunoglobulin whichis used to prevent Rhesusdisease of the newborn118 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
— Albumin, which is an importantprotein of the blood and issometimes used for critically illpatients <strong>who</strong> have lost largevolumes of body fluids.Is there any alternativeto blood?The need for transfusion can often beavoided by the prevention, earlydiagnosis and treatment of conditions,such as anaemia and malaria, thatmight otherwise lead to the need fortransfusion. It can also often beavoided by the use of <strong>int</strong>ravenousreplacement fluids to replace bloodvolume or pharmaceuticals ormedical devices to minimize bloodloss.But there will always be manypatients <strong>who</strong>se lives depend on theavailability of safe blood. Manyothers, such as haemophiliacs, relyon blood products that are made fromdonated blood.Scientists are working to developartificial blood, but it will not beavailable in the foreseeable future.Which blood groupsare needed?There are four main blood groups: O,A, B and AB.<strong>Blood</strong> from donors of all blood groupsis always needed, but group O bloodis usually in greatest demand becauseit is the most common group and canalso be given to patients of otherblood groups.What is safe blood?<strong>Safe</strong> blood is blood that does no harmto the person <strong>who</strong> receives it. <strong>Safe</strong>blood can be life-saving, but unsafeblood can cause serious illness oreven death to the recipient.<strong>Blood</strong> is unsafe if, at the time ofdonation, any infection is present <strong>int</strong>he donor’s blood that can betransmitted by transfusion or throughany blood products that have beenmanufactured from the blood.Infections that can be transmitted byblood include:• HIV, which leads to AIDS• Hepatitis B• Hepatitis C• Syphilis• Chagas disease• Malaria.Who can give blood?<strong>Blood</strong> can be donated by most people<strong>who</strong> are healthy and do not have aninfection that can be transmittedthrough their blood.The age at which people are eligibleto give blood varies betweencountries, but is commonly betweenthe ages of 17 and 65.Provided that the criteria for safedonors are met, many centres willaccept donations from people fromthe age of 16 and will also extend theupper age limit beyond 65 years.Who should not give blood?You should not give blood if yourown health might suffer as aresult. The first concern of the bloodtransfusion service is to ensure thatblood donation does no harm to thedonor. You should not give blood if:— you are feeling unwell— you are pregnant or have beenpregnant <strong>with</strong>in the last year— you have certain medicalconditions, such as heart disease,high or low blood pressure,diabetes, epilepsy— you are taking certainmedications.You may be able to donate blood at alater time. In some cases, however,you will be permanently excludedfrom donating blood in order toprotect your own health.You should not give blood if itmight cause harm to therecipient. <strong>Blood</strong> can transmit lifethreateninginfections to the patients<strong>who</strong> receive it. You should not giveblood if:— you have or may have recentlycontracted a sexually-transmitteddisease, such as HIV or syphilis,that can be passed on to a patientthrough your blood— your lifestyle puts you at risk ofcontracting an infection that canbe transmitted through yourblood: for example, if you havemore than one sexual partner orhave sexual contact <strong>with</strong>prostitutes— you have ever injected drugs— if you have recently had a tattoo,skin scarification or ear or bodypiercing— you have had sexual contact <strong>with</strong>anyone in the above categories.119 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Who are the safest blooddonors?Voluntary non-remunerated (unpaid)donors <strong>who</strong> give blood regularly arethe safest blood donors. Researchfrom many countries shows thatpeople <strong>who</strong> give blood freely and<strong>with</strong>out any financial reward havelittle reason to conceal informationabout their health and lifestyle thatmay make them unsuitable to giveblood, either temporarily or permanently.Their primary motivation is tohelp other people and not to obtainany personal benefit, except thesatisfaction of knowing they havehelped to save someone’s life.‘Family’ or ‘replacement’ donors giveblood only when blood is required bya member of their own family orcommunity. Their blood has beenproven to be less safe than that ofvoluntary non-remunerated donorsbecause they may be under pressureto donate when they are unsuitable todo so because of the risk oftransmitting infection to the patient.Where it is not possible to find amember of the family to donate blood,relatives may pay another person togive blood. This constitutes a ‘hidden’paid system as, very often, there areinsufficient relatives present whenthe demand to provide blood is made.People <strong>who</strong> give blood for paymentare usually motivated by what theywill receive for their blood ratherthan by the wish to help other people.They may harm their own health bydonating blood more frequently thanis recommended. They are also morelikely to endanger the lives of therecipients of their blood by concealinginformation about why they shouldnot give blood.The life of every patient <strong>who</strong> receivesblood depends on the openness andhonesty of the individual donors <strong>who</strong>have given their blood.What will happenwhen I give blood?Whether it is the first time you giveblood or you are a regular blooddonor, the blood transfusion servicemust make sure that you will come tono harm by giving blood. It must alsocheck that your blood will be safe forthe person <strong>who</strong> receives it.So before you give blood, you will beasked some questions about yourmedical history, current health andlifestyle. You may also be askedquestions about recent travel; forexample, if you live in a region wherethere is no malaria, you will be askedwhether you have recently visited atropical country.These questions will be asked only tosafeguard your own health and thehealth of the person receiving yourblood. Any personal information thatyou are asked to give will be keptconfidential and will not be used forany other purpose.You will be told whether you areeligible to give blood and, if not,whether you may be able to donateblood in the future. If required, youmay be referred to a health facility ora counselling service for furtheradvice and care.You will also be given a brief medicalexamination to check your pulse,blood pressure and weight. A drop ofblood will then be taken from yourfingertip to check that giving bloodwill not make you anaemic. Yourhealth is very important to the bloodtransfusion service and blood will notbe taken unless you can safely make adonation that day.Donating blood is simple. You will bemade as comfortable as possible,usually in a special chair or on a bed.The area inside one of your elbowswill be cleaned <strong>with</strong> an antisepticsolution before a trained healthworker inserts a sterile needle,connected to a special blood bag, <strong>int</strong>oyour vein. It usually takes about 10minutes to give a unit of blood.After resting for 10 or 15 minutes andtaking some refreshment, you will beable to return to your normalactivities although you should avoidstrenuous activity for the rest of theday. You should drink plenty of fluidsfor the next 24 hours.Very occasionally, some people mayfa<strong>int</strong> after donating blood. If thishappens, you should rest for asufficient time before returning toyour normal daily routine. If you arein an occupation where this couldendanger yourself or others, youshould consider not returning to workthat day.How much blood willbe taken?In most countries, the volume takenis 450 millilitres, less than 10% ofyour total blood volume (the averageadult has 4.5 to 5.5 litres of blood). Insome countries, 250 millilitres istaken.Your body will replace the lost fluid inabout 36 hours and your red cellcount will return to normal <strong>with</strong>in21 days.120 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Are there any risksin giving blood?There is no risk of acquiring anydisease, such as HIV, hepatitis B or C,through donating blood if new, sterileand disposable equipment is used foreach donation.Remember that you will only beaccepted as a blood donor if you arefit and well. Your health and wellbeingare important to the bloodtransfusion service. <strong>Blood</strong> donation isvery safe and few donors suffer anydiscomfort or problems during orafter donating.How often can Igive blood?<strong>Health</strong>y adults can give bloodregularly. In most countries, men cangive blood every 3 months and womencan donate every 4 months.Why should I give bloodregularly?A regular supply of blood is vital—red cells normally last 35 days andplatelets 5 days after blood donationbefore they can no longer be used.When people donate blood regularly,the blood transfusion service can planthe collection of blood so that thereare normally enough units of eachblood group available to meet thecountry’s needs. Without regularblood donors, many people would diebecause there would be insufficientblood available.Regular voluntary blood donors aresafer than other blood donors,including first-time voluntary donors,because they understand theimportance of safe blood. Regulardonors are also more likely torespond to appeals for blood donorsin emergencies, when large volumesof blood may be needed, or whenstocks are low, such as during holidayperiods.What tests are performedon donated blood beforetransfusion?WHO recommends that all donatedblood should be tested for thefollowing infections that can betransmitted by transfusion:• HIV• Hepatitis B• SyphilisWHO also recommends that, whereappropriate and possible, donatedblood should be tested for otherinfections, including:• Hepatitis C• Chagas disease• MalariaIn some countries, blood is still notyet tested for all infections that canbe transmitted by transfusion,particularly outside the main urbancentres. This is why it is so importantto be truthful about any reasons whyyour blood might not be safe.Although blood is donated voluntarily,it costs at least $50 to test andprocess it before it can be releasedfor transfusion. If blood has to bediscarded because tests show thepresence of infectious agents, it is ahuge waste of financial and humanresources.<strong>Blood</strong> is also tested to identify thedonor’s blood group and anyantibodies in the blood beforetransfusion. This is to make sure it iscompatible <strong>with</strong> the blood of thepatient <strong>who</strong> will receive it in order toavoid serious immune transfusionreactions.Why does safe blood start<strong>with</strong> me?<strong>Blood</strong> is the most precious gift thatanyone can give to another person -the gift of life. A decision to donateyour blood can save the life of one oreven several people.But patients <strong>who</strong> need blood have theright to receive blood that is as safeas possible and that will cause themno harm.If you think that your blood may beunsafe, another person’s life maydepend on your decision not to donateblood.Remember, you or a member of yourfamily may need the gift of blood oneday. You would expect to receive safeblood others have an equal right toknow that the blood they are given issafe. ▲121 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
ANNEX 3. BLOOD TRANSFUSION SAFETYInformation for National <strong>Blood</strong> ProgrammesWHO strategy forblood safetyThe HIV/AIDS pandemic hasfocused particular attention onthe importance of preventingtransfusion-transmitted infection.WHO estimates that between 5% and10% of HIV infections worldwide aretransmitted through the transfusionof infected blood and blood products,while many thousands morerecipients of blood products areinfected <strong>with</strong> hepatitis B and Cviruses, syphilis and other infectiousagents, such as Chagas disease andmalaria.In the past, strategies to promoteblood safety tended to focus primarilyon screening donated blood fortransfusion-transmissible infections(TTIs). However, while systematicscreening is essential, it isinsufficient in itself to ensure thesafety of the blood supply.Evidence from all regions of the worldindicates that the absence of anationally-coordinated bloodprogramme, lack of safe blood donorsand the unnecessary clinical use oftransfusion are equally importantcontributory factors to thetransmission of infection bytransfusion.The WHO strategy for blood safetyemphasizes an <strong>int</strong>egrated four-foldapproach. Effective quality assuranceshould form an essential part of thisapproach.1. The establishment of acoordinated blood transfusionservice that can provide adequateand timely supplies of safe bloodfor all patients in need.2. The collection of blood only fromvoluntary non-remunerated blooddonors from low-risk populationsand the use of stringent donorselection procedures.3. The screening of all donated bloodfor transfusion-transmissibleinfections, including HIV, hepatitisviruses, syphilis and otherinfectious agents, and bloodgrouping, compatibility testingand processing of blood.4. A reduction in unnecessarytransfusions through theappropriate clinical use of blood,including the use of <strong>int</strong>ravenousreplacement fluids and othersimple alternatives to transfusion,wherever possible.<strong>Blood</strong> transfusion serviceA coordinated blood transfusionservice (BTS) is a prerequisite for anadequate supply of safe blood. Thenational health authority maydelegate responsibility for the bloodsupply to a non-profit nongovernmentalorganization, but theBTS should be developed <strong>with</strong>in theframework of the country’s healthcare infrastructure.The BTS should be established inaccordance <strong>with</strong> an agreed nationalblood policy and plan and <strong>with</strong>in alegislative framework. It should beresponsible for establishing andma<strong>int</strong>aining a national quality system,including the development ofguidelines and standard operatingprocedures, staff training, aninformation management system anda system for monitoring andevaluation.The BTS requires formal governmentcommitment, support and recognitionas a separate, identifiable programme<strong>with</strong> a budgeting and finance systemthat can ensure a sustainable bloodprogramme through cost recoveryand/or annual budget allocation. TheBTS should be managed by anExecutive Committee and assisted,where necessary, by specialistadvisory groups. BTS personnelshould include a medical director, aquality manager and staff <strong>who</strong> havebeen adequately trained in all aspectsof management, quality systems,blood donor recruitment, bloodcollection, screening, processing andthe storage and distribution of bloodand blood products.Low-risk blood donorsThe safer the source of donated blood,the safer the final product is likely tobe.122 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Voluntary non-remunerated blooddonors from low-risk populations <strong>who</strong>give blood regularly are thefoundation of a safe and adequatesupply of blood.In all regions of the world, a higherincidence and prevalence oftransfusion-transmissible infectionsare reported among family/replacement donors and, inparticular, paid donors. Furthermore,the use of family/replacement donorsmay constitute a hidden system ofpaid donation. These donors may notreliably respond to questionsregarding risk behaviour and theirsuitability as blood donors.A system of voluntary, regular nonremunerateddonation is thereforenot only safer than the use of family/replacement donors or paid donors. Italso enables more cost-effective useto be made of limited resources byreducing the volume of donated bloodthat has to be discarded because ofevidence of infectious diseasemarkers.<strong>World</strong>wide, more than 75 millionunits of blood are collected annually.In developed countries, the bloodsupply comes from voluntary nonremuneratedblood donors. Globally,developing countries contribute only16% of the voluntary nonremuneratedblood donors whichshows that the blood supply dependson a very high proportion of family/replacement/paid donors in thesecountries. High priority shouldtherefore be given to eliminating theuse of paid blood donors, convertingreplacement donors to voluntary nonremunerateddonors and motivatingthem to donate regularly.Many countries have <strong>int</strong>roducedlegislation requiring blood donationonly by voluntary non-remunerateddonors. In practice, this can only beachieved through the establishment ofan effective programme of blooddonor recruitment and retention,staffed by trained personnel, <strong>with</strong> anefficient donor information, educationand motivation programme.It also requires strict criteria fordonor selection and screening toidentify donors for deferral orexclusion, and efficient blood donorrecord systems. The identification ofdonor populations at low risk fortransfusion-transmissible infectionsand the monitoring of transfusiontransmissibleinfections in both thegeneral population and the donorpopulation are also key elements of astrategy for blood safety.The screening andprocessing of bloodWHO recommends that, beforetransfusion, all donated blood shouldbe tested for:• HIV• Hepatitis B• SyphilisWHO also recommends that, wherepossible and appropriate, donatedblood should be tested for otherinfectious agents, including hepatitisC, Chagas disease and malaria.Nevertheless, each year, more than13 million units of donated blood arenot tested for all transfusiontransmissibleinfections. Testing isalso sometimes unreliable,particularly when performed byinadequately trained staff or whenthere are shortages of suitableequipment or erratic supplies of testkits.Each country should thereforedevelop a national policy and strategyto ensure the systematic and effectivescreening of blood for transfusiontransmissibleinfections. Thisrequires:— the development of protocols forthe testing, selection andevaluation of the most appropriateand effective screening assays tobe used at each site— the development of qualitysystems for screening, bloodgrouping, compatibility testingand component preparation— the training, updating andcontinuing education of laboratorytechnical staff in BTSs andhospital blood banks— the central procurement, storageand distribution of reagents andmaterials to ensure continuity inscreening at all sites— an adequate budget.All donated blood units should also beroutinely tested for ABO and Rh (D)blood grouping and red cell antibodyscreening.Good laboratory practice usingstandard operating procedures andthe ma<strong>int</strong>enance of an effective bloodcold chain for the storage andtransportation of blood and bloodproducts is equally important.Reducing unnecessarytransfusionsThe primary responsibility forensuring the appropriate clinical useof blood lies <strong>with</strong> clinicians. However,the BTS has a key role in promoting123 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
effective transfusion practice bycontributing to the development of anational policy and guidelines on theclinical use of blood.It can also play an important part <strong>int</strong>he implementation of the policy andguidelines by participating in aNational Committee on the ClinicalUse of <strong>Blood</strong> and promoting theestablishment of hospital transfusioncommittees.The BTS should also assist in thedevelopment of a standard bloodrequest form and standard operatingprocedures for each stage of theclinical transfusion process, foradaptation by hospitals at all levels ofthe health care system. These shouldinclude procedures for monitoring thetransfused patient and theinvestigation and management oftransfusion reactions. ▲Give safe bloodand save a lifeAnyone may need blood at any time. A serious illness or accident can happenanywhere in the world, in the course of daily routine or while travelling, <strong>with</strong>the loss of blood in life-threatening quantities. It is therefore in everyone’s <strong>int</strong>erestto have safe blood supplies available worldwide.Thanks to the people <strong>who</strong> give safe blood anonymously, lives are saved. All blooddonors must know that they can save lives only if the blood given is safe (that is,free of infection). Likewise, each person should understand that when givingunsafe blood (disease-carrying) he or she will be responsible for transmittingpotentially life-threatening infection to, and even killing, another person.Experience has shown that the safest donor is one <strong>who</strong> gives blood at leasttwice a year <strong>with</strong>out receiving money or goods in exchange, understands theprinciple of altruism, answers questions for donor selection honestly, and willdefer or exclude him/herself from donation if there is any risk to the recipient.Governments and health authorites must put <strong>int</strong>o place systems for the properselection and deferral/exclusion of potentrail donors so that only safe blood iscollected, and for the testing of all donated blood. These systems will includeeffective infrastructures to collect, process and store the blood; training for healthcare workers to deliver blood in sterile conditions; and promotion andimplementation of appropriate clinical use of blood.An individual in need of blood should receive blood that is as safe as possible; itis the privilege of an individual to give safe blood. ▲124 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
ANNEX 4. THE APPROPRIATE CLINICAL USE OF BLOOD AND BLOOD PRODUCTSInformation for CliniciansThe appropriate use ofblood and blood products<strong>Blood</strong> transfusion is anessential part of modernhealth care and has alsodemonstrated its efficacyin secondary health carein developing countries.Used appropriately, transfusion cansave life and improve health.However, it always carries potentialrisks for the recipient and should beprescribed only for conditions <strong>with</strong>significant potential for morbidity ormortality that cannot be prevented ormanaged effectively by other means.Transfusion is often unnecessary forthe following reasons.1. The need for transfusion can oftenbe avoided or minimized by theprevention or early diagnosis andtreatment of anaemia andconditions that cause anaemia.The patient’s haemoglobin levelcan often be raised by iron andvitamin supplementation <strong>with</strong>outthe need for transfusion. Red celltransfusion is needed only if theeffects of chronic anaemia aresevere enough to require rapidraising of the haemoglobin level.2. <strong>Blood</strong> is often unnecessarily givento raise a patient’s haemoglobinlevel before surgery or to allowearlier discharge from hospital.Where possible, anaemia shouldbe corrected and depleted ironstores replaced before plannedsurgery.3. Transfusions of <strong>who</strong>le blood, redcells or plasma are often givenwhen other treatments, such asthe infusion of normal saline orother <strong>int</strong>ravenous replacementfluids would be safer, lessexpensive and equally effective forthe treatment of acute blood loss.4. Patients’ transfusionrequirements can often beminimized by good anaestheticand surgical management,including:• using the best anaesthetic andsurgical techniques to minimizeblood loss during surgery• stopping anticoagulants andanti-platelet drugs beforeplanned surgery, where it issafe to do so• minimizing the blood taken forlaboratory use, particularly inchildren• salvaging and reinfusingsurgical blood losses• using alternative approachessuch as desmopressin,aprotinin or erythropoetin.<strong>Safe</strong> blood transfusionBefore prescribing blood or bloodproducts for a patient, it is alwaysessential to weigh up the risks oftransfusion against the risks of nottransfusing.The transfusion of red cell productscarries a risk of serious transfusionreactions and the transmission ofinfections, such as HIV, hepatitis B,hepatitis C, syphilis, malaria andChagas disease.Plasma can transmit most of theinfections present in <strong>who</strong>le blood andcan also cause transfusion reactions;there are very few indications for itstransfusion and the risks very oftenoutweigh any possible benefit to thepatient.Any blood product can becomecontaminated <strong>with</strong> bacteria and isvery dangerous if it is manufacturedor stored incorrectly.The risks associated <strong>with</strong> bloodtransfusion depend on:— the incidence and prevalence oftransfusion-transmissibleinfections (TTIs) in the blooddonor population— the effectiveness of procedures forblood donor recruitment,selection, screening, deferral andexclusion: blood donated byregular voluntary nonremunerateddonors carries alower risk of transfusiontransmissibleinfection than blooddonated by family/replacementdonors while paid blood donors125 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
generally have the highestincidence and prevalence of TTIs— the quality of screening of alldonated blood for TTIs— the quality of blood grouping,compatibility testing andcomponent preparation— the efficiency of the blood coldchain for the storage andtransportation of blood products— the reliability of the system forensuring that patients receiveblood that is compatible <strong>with</strong> theirblood group, red cell antibodiesand other special requirements— the clinical use of blood and bloodproducts only when noalternatives to transfusion areavailable.Every prescriber of blood should befamiliar <strong>with</strong> the local system for thecollection, screening and processingof blood and understand anylimitations that it may impose on itssafety or availability. In particular,knowledge of the occurrence,distribution and spread oftransfusion-transmissible infectionsis essential to informed judgementsabout the risks and benefits oftransfusion.Prescribing blood:a checklist for cliniciansAlways ask yourself the following questions before prescribing blood or blood products for apatient1 What improvement in the patient’s clinical condition am I aiming to achieve?2 Can I minimize blood loss to reduce this patient’s need for transfusion?3 Are there any other treatments I should give before making the decision to transfuse, such as<strong>int</strong>ravenous replacement fluids or oxygen?4 What are the specific clinical or laboratory indications for transfusion for this patient?5 What are the risks of transmitting HIV, hepatitis, syphilis or other infectious agents through theblood products that are available for this patient?6 Do the benefits of transfusion outweigh the risks for this particular patient?7 What other options are there if no blood is available in time?8 Will a trained person monitor this patient and respond immediately if any acute transfusion reactionsoccur?9 Have I recorded my decision and reasons for transfusion on the patient’s chart and the blood requestform?Finally, if in doubt, ask yourself the following question.10 If this blood was for myself or my child, would I accept the transfusion in these circumstances? ▲126 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Other than in the most exceptionallife-threatening situations, bloodshould not be transfused unless it hasbeen obtained from appropriatelyselected donors, has been screenedfor TTIs and has been tested forcompatibility between the donor’s redcells and antibodies in the patient’splasma.All patients should be monitoredbefore, during and after transfusion.Prescribing blood andblood productsPrescribing decisions should be basedon national guidelines on the clinicaluse of blood, taking individual patientneeds <strong>int</strong>o account. However,responsibility for the decision totransfuse must ultimately rest <strong>with</strong>individual clinicians.The key principle of clinicaltransfusion practice is thattransfusion is only one part of thepatient’s management. The decisionto transfuse blood or blood productsshould always be based on a carefulassessment of clinical and laboratoryindications that transfusion isnecessary to save life or preventsignificant morbidity. It should also bebased on knowledge of the resourcesavailable for managing patients andthe safety of the blood and bloodproducts available.The extent to which blood is usedappropriately depends on a range offactors, such as the effectiveness ofprogrammes to reduce nutritionalanaemia and the availability of<strong>int</strong>ravenous replacement fluids. Manyof these factors are beyond theimmediate control of prescribers ofblood. However, it is theresponsibility of individual cliniciansto ensure that their own clinicaldecisions on transfusion areappropriate for their patient.Remember that, when used correctly,blood can be life-saving.Inappropriate use can endanger lifeand may cause a shortage of blood forother patients <strong>who</strong> require it. ▲127 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
ANNEX 5. BLOOD TRANSFUSION SAFETYInformation for National <strong>Health</strong> Authorities<strong>Blood</strong> safety<strong>Blood</strong> transfusion is avital component ofevery country’s healthcare delivery system.It can be a life-saving <strong>int</strong>ervention,but it may also result in acute ordelayed complications and carries therisk of the transmission of infections.Between 5% and 10% of HIVinfections worldwide are transmittedthrough the transfusion of infectedblood and blood products. Many morerecipients of blood products areinfected by hepatitis B and C viruses,syphilis and Chagas disease.More than 75 million units of bloodare donated each year throughout theworld. A significant proportion ofthese expose recipients of blood andblood products to unnecessary risk.In developed countries, the bloodsupply comes from voluntary nonremuneratedblood donors. Globally,developing countries contribute only16% of the voluntary nonremuneratedblood donors whichshows that the blood supply dependson a very high proportion of family/replacement/paid donors in thesecountries. Voluntary non-remuneratedblood donors are at significantlylower risk for transfusiontransmissibleinfections than family/replacement donors and paid donors.More than 13 million units of bloodare not screened for transfusiontransmissibleinfections.In addition, many transfusions areclinically unnecessary, providing littleor no benefit to the patients <strong>who</strong>receive them and wasting a scarceresource that may result in ashortage of blood products forpatients in real need.The costs of unsafe blood<strong>Blood</strong> is a national resource. It is theresponsibility of governments toensure that the blood supply is safe,adequate to meet the needs of patientpopulations and available to all <strong>who</strong>require it.It is also the responsibility ofgovernments to ensure that allclinicians are trained to prescribeblood and blood products only whenclinically necessary.This cannot be achieved <strong>with</strong>out cost.However, an unsafe or inadequateblood supply is ultimately even morecostly—in both human and economicterms.The human costs of unsafe blood areincalculable—morbidity and mortalityresulting from the transfusion ofinfected blood have far-reachingconsequences, not only for therecipients themselves, but also theirfamilies, their communities and thewider society. Since a person cantransmit the infection during theasymptomatic phase, it cancontribute to an ever-widening pool ofinfection in the wider population.The economic costs of a failure tocontrol the transmission of infectionhave already been graphicallydemonstrated in countries <strong>with</strong> a highincidence and prevalence of HIV andAIDS—increased requirements formedical care, higher levels ofdependency and the loss ofproductive labour place heavyburdens on overstretched health andsocial services and on the nationaleconomy.While not the main route oftransmission, blood transfusion isalmost 100% effective in transmittingHIV and other infectious agents. Theincidence of transfusion-transmittedinfection—and its associated costs—will almost certainly increase incountries that do not take stringentmeasures to ensure the safety of theirblood supplies.An investment in safe and adequatesupplies of blood is a cost-effectiveinvestment in the health andeconomic wealth of every nation.National blood policyand planA national blood policy and plan areessential components of an efficient,cost-effective and sustainablenational blood programme. They128 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
should define the measures that willbe taken to meet the transfusionrequirements of the patientpopulation, equitably and whenrequired, at minimum cost, <strong>with</strong>minimum wastage and <strong>with</strong> optimumsafety and efficacy.The policy should include anappropriate regulatory and legislativeframework, including thedevelopment of new legislation orregulations, where necessary. Itshould also define national principlesin relation to:— quality systems and initial andongoing training— the selection of blood donors— screening for transfusiontransmissibleinfections— red cell serology testing— the preparation of bloodcomponents and plasmaderivatives— the clinical use of blood— records and information systems.The national blood plan should definethe functions, organization andmanagement of a national bloodtransfusion service (BTS) and thedelegation of responsibilities, whereappropriate, to institutions, hospitalsand non-profit, non-governmentalorganizations, such as the nationalRed Cross or Red Crescent Society orblood donor organizations.The policy should define the role andmembership of a National <strong>Blood</strong>Transfusion Service ExecutiveCommittee, including taking executivedecisions <strong>with</strong>in the mandate of thenational blood policy and takingoverall responsibility for themanagement of the BTS inaccordance <strong>with</strong> the national bloodplan.Nationally-coordinatedblood transfusion serviceIn 1975, Resolution WHA 28.72 of theTwenty-eighth <strong>World</strong> <strong>Health</strong> Assemblyurged <strong>Me</strong>mber States to promote thedevelopment of national bloodservices based on voluntary nonremuneratedblood donation. Becauseof a lack of national coordination andthe fragmentation of services, only35% of the 192 <strong>Me</strong>mber States havea national blood policy, relevantlegislation and one specificorganization responsible for thenational blood programme.The national coordination of the bloodprogramme remains an essentialcomponent of the WHO strategy forblood safety because it is aprerequisite for the preparation ofblood and blood products to optimalstandards of quality and safety,including:— the implementation of a nationalquality system for all aspects ofthe transfusion process— the collection of blood only fromvoluntary non-remunerated blooddonors from low-risk populations— the screening of all donated bloodfor transfusion-transmissibleinfections, including HIV, hepatitisviruses, syphilis and otherinfectious agents, such as Chagasdisease and malaria— good laboratory practice in bloodgrouping, compatibility testing,component preparation and thestorage and transportation ofblood products.A nationally-organized or coordinatedblood transfusion service requiresformal government commitment,support and recognition as aseparate, identifiable programme. Italso requires a budgeting and financesystem that can ensure a sustainableblood programme through costrecovery and/or annual budgetallocation.A well-organized blood transfusionservice is safer and more costeffectivethan a hospital-basedsystem. The coordination of servicespromotes adherence to qualitystandards, minimizes duplication andachieves economies of scale throughnational systems for blood donorrecruitment, blood screening andprocessing, and the central bulkpurchasing of essential consumablesand other supplies.A national programme for theeducation, motivation, recruitmentand retention of low-risk blooddonors, for instance, can achievesubstantial cost savings in thecollection and screening of bloodcompared <strong>with</strong> systems of family/replacement or paid donation. This isbecause a significantly lowerproportion of donated blood fromregular voluntary non-remunerateddonors needs to be discarded becauseof evidence of transfusiontransmissibleinfection.The appropriate clinicaluse of bloodResponsibility for the decision totransfuse ultimately rests <strong>with</strong>individual clinicians, but prescribersof blood do not work in isolation.A reduction in unnecessarytransfusions is dependent on theavailability of simple alternatives totransfusion, including <strong>int</strong>ravenous129 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
eplacement fluids for the correctionof hypovolaemia, and pharmaceuticalsand medical devices tominimize the need for transfusion.It also requires effective public healthand primary health care programmesthat enable the prevention, earlydiagnosis and treatment of conditions,such as anaemia and malaria, thatmight otherwise lead to the need fortransfusion.Each national health authority shoulddevelop a national policy andguidelines on the clinical use of blood,<strong>with</strong> appropriate supportiveregulations, and ensure that allclinical staff and BTS staff involved <strong>int</strong>he transfusion process receiveappropriate training, based on thenational guidelines.A National Committee on the ClinicalUse of <strong>Blood</strong> and, at local level,hospital transfusion committeesshould also be established to monitorand audit the implementation of thepolicy and guidelines. ▲130 ▲ WORLD HEALTH DAY ▼ SAFE BLOOD STARTS WITH ME
Department of <strong>Blood</strong> <strong>Safe</strong>ty and Clinical Technology<strong>World</strong> <strong>Health</strong> <strong>Organization</strong>1211 Geneva 27, SwitzerlandFax: +41-22 791 4836E-mail: blood safety@<strong>who</strong>.<strong>int</strong>www.<strong>who</strong>.<strong>int</strong>/bct
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