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HEALTH INTERACTIVE WITH DR. AMINU MAGASHI Blood Donation and Emergency Maternal Problems
Not too long ago I was co- facilitating a training for Community Facilitators who at the end of the training would work in some LGAs in Kano for increasing women access to Emergency Maternal Care , when the issue of blood donation came to focus , I asked rhetorically why women in our societies are not donating blood under emergency conditions . The ladies in the hall were aghast and gave me a very astounding look. One of them mentioned that she never thought in her life women can donate blood , as she believed that such task is a men’s business , when asked why , she could not provide meaningful answers .
A lot of things that women are not participating in our country, Nigeria are not governed by laws, but rather tradition that one cannot trace its basis. It is in the same scenario that women’s desire are turn down for bailing out their relatives under police custody. I have asked many senior police officers that I happened to interact with, and all of them revealed to me that such law that prevents women from bailing does not exist. It is rather a tradition that every body including the police officers have getting used to and gradually that tradition assumes the status of law.
Now coming back to blood donation, not only women, but men also do not like donating blood even to their wives and close relatives. When ever a man is asked to donate just a bag, the next question one will heard from him is: whether there is one for sell.
Among the fears people generally experience were:
1. The fear of the unknown 2. that the health worker will take too much blood and the loss of blood will weaken them 3. Having their blood rejected (Some men have had their blood rejected in front of the other men from their community.) 4. If during the screening, the lab worker discover that I have HIV/AIDS that will be the end of my life, because every body will come to know that I am living with the virus. 5. They may end of dying during the process of taking the blood
These are some of the fears people exhibit and prevent them from donating blood and they prefer to buy. Now coming to Emergency Maternal Problems, these are problems that mean life and death within a very short time. A woman who is 9 month pregnant suffers heavy bleeding that led to shock due to Placenta Pravia (Low level position of Placenta that is below the fetus) or Abruptio Placentae (Premature separation of the Placenta before commencing labour). These two conditions are critical and emergencies that need prompt action and blood transfusion. Other conditions like retained placenta after delivery for more than 30 minutes or the failure of the Uterus to contract after delivery( Uterine Atony ) .All lead to heavy loss of blood and capable of threatening the life of the woman .
Another scenario to the problem is the fact that some of these problems occur in rural areas where Health Facilities are not readily available. Other factors worsening the situation and leading to high maternal death , which we are still grappling with, are within the community, Delay in deciding to seek for care which is related to Poverty, Ignorance ( People are not aware of Danger Signs during Pregnancy ) and Male dominance , which can be explain in the angle of delay in giving permission by husbands for women to go to hospital when in need and other Cultural Norms and Values ( In some places , loss of blood during labour signifies having a baby boy ) . Even when a decision is reached for the pregnant woman to be taken to hospital , another risks factor of Delay in Transportation will pose a stumbling block due to distance from the affected community to the secondary health center where such free services are being provided . When such woman arrives the center, at times the problem is already complicated to either lead to death before instituting management or leads to morbidity after intervention. Majority of the Local Governments and Districts owned health centers in many of our communities are devoid of skilled midwives, medical doctors and facilities to respond to emergencies. All these contribute to the high maternal mortality ratio (Delay in Management)
To women, physiologically, there are some conditions that many capitalize on to prevent them from donating blood, the conditions are:
These three conditions , are contraindication to donating blood , but a woman that is not breast feeding , not pregnant or in her menses and is healthy and fit , there is nothing wrong with her donating blood to her relatives or sisters that suffer blood loss .
Let me say that we need to educate our people about danger signs of Pregnancy, how to identify them and take the right decision at the right time to save our women from complications of pregnancy. One way out of that, is to mobilize women that I called ‘Community Emergency Assistants and to train them on how to give support to women during pregnancy. They can be women that are influential and respected in the society or trained Traditional Birth Attendants (TBAs), because failure to provide adequate training to TBAs in communities poses the risks of complicating deliveries leading to massive bleeding, and also transmission of infections such as Tetanus, HIV, and other Genital Infections and many of them will not be willing to make referral when there is complication. Another group that needs to be recruited for Emergency Maternal Care is the Commercial Drivers who should be empowered to assist women during emergency.
In conclusion , I will like to encourage our sisters that are not within any of the three categories of women that are contra indicated to donate blood to change their attitude towards donating blood when in need and also for our Health Ministries and Hospitals to change that archaic tradition and policy of denying women the right to donate blood .
Dr Magashi is the Executive Director of Community Health and Research Initiative, Kano , Nigeria and can be reached at healthinteractive@hotmail.com
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