Blood Drive, Burundi Style

by Rachel

I work with a lot of blood.  Obstetrics is probably one of the bloodiest fields in medicine...and I sort of sheepishly admit that I love the mess.  I mean, I prefer it when the patients lose LESS blood rather than MORE blood during their surgery, but the sight of a hemorrhaging patient certainly doesn't make me faint.  I do feel a weighty sense of responsibility when it comes to blood transfusions, though.  Our blood bank will occasionally run out of blood, and sometimes there are even national shortages, so I sometimes make the decision not give someone a unit of blood, even if their hemoglobin is low, because we're saving that last unit for something really critical.  I have been amazed time and time again how sometimes even just one or two units of blood will literally save my patients from dying.  One unit of whole blood can restore their bodies to living, functioning organisms instead of deteriorating, dying creatures.  Even just last year when I was practicing briefly in the US, I was shocked at the availability of blood.  The postpartum hemorrhage protocol at our US hospital was to type and cross SIX UNITS of blood with one quick phone call.  Sometimes we don't have 6 units total at Kibuye.

And, unfortunately, getting more blood here is hard.  The hospital is not authorized to collect our own blood.  Instead, there are national collection and distribution centers (which makes sense, I suppose, to maintain a level of quality screening for the blood).  This had been hard when we have dying patients and some known O negative blood donors on our team, but the hospital can't even stock blood collection kits in the lab for emergencies.

So, I was super happy to hear this week that the local collection center in Gitega was coming on Wednesday to organize a blood drive at Kibuye!  Ironically, my lecture to the medical students on Monday was on anemia (and transfusion reactions) and at the end, I exhorted all of them to come and give blood on Wednesday, to set a good example as providers.  They all laughed nervously (making me wonder, as usual, if there was some cultural faux pas that I had just made).  But come Wednesday, I came up to our morning devotions/staff room and found it full of close to 50 people on the benches, waiting to donate blood!  Many were hospital staff, and some were patients' families (perhaps lured by the promise of a free Fanta and bread after the donation!).

It was no Red Cross bloodmobile, but some elements were the same.  I got my blood pressure taken, then sat at a table with a man and his notebook to answer "the questions."  In the US, it's stuff like, have you ever had mad cow disease?  Or, have you ever had sex, even once, with a man who's had sex with a prostitute in Asia before the year of 1965, or things like that.  Here, I was asked, "Are you married?"  "Are you pregnant?"  "OK, here's your collection bag."  Super smooth. :)  And no one checked to see if I was anemic... but hey, I'm sure I was fine!  We sat on benches around the outside edges of the room and blood flowed into collection bags on the floor.

And then, after the bag had finished filling, we got our choice of refreshments!  Toby "helped" me drink my Sprite and eat my roll.  It was fun to feel like a part of the hospital community, rallying to provide life saving measures for our patients.  I hope they come back in another 2-3 months so we can keep the blood drives going.  We can't give blood in American any more (due to living in a malaria endemic area), so I'm glad that our blood can go to good use on a continent that has become such a part of our lives.