What is it?
A young pregnant woman in a government hospital at a rural centre in south Tamil Nadu’s Madurai district made an explosive revelation mid-December. Expecting her second child, she heard from doctors, after she was admitted following a bout of sickness, that she had tested positive for HIV.
Later, as the story unravelled, in full media glare, it turns out she had acquired the virus after a blood transfusion in a district hospital following a diagnosis of anaemia. This opened up a Pandora’s box, and fear and distrust pervaded the community. Besides flagging the issue of the availability of safe blood in the State, it set in motion a sequence of events, mostly tragic, introspection, and some corrective action.
How did it come about?
The story did not end, or even begin, there. The blood donor, who had donated as a replacement donor when a pregnant relative required a transfusion, only discovered his HIV positive status after a test for a job interview. He rushed back to the hospital, laden with guilt, to inform authorities. By then, his blood had been transfused to the pregnant woman, and she had tested positive. His blood donation history retrospectively exposed chinks in the blood donation and transfusion cycle in at least two instances. He had already donated blood in 2016, but his blood was discarded after he tested positive for HIV. However, though the HIV law mandates that the patient be informed with counselling about his/her status, in this case the donor remained in the dark. In the second instance, when he donated his blood in November last year, two years after the first, the lab failed to test and/or detect his infection, which was clearly not in the ‘window period’ where the virus may avoid detection. The donor was distraught, and attempted suicide, and died in hospital later.
A few days later, another pregnant woman claimed she had been transfused with HIV-infected blood at Kilpauk Medical College and Hospital in Chennai. While her claim has been contested stoutly, the two incidents have, nevertheless, rocked the State that once won plaudits for its prevention of transmission programmes.
What is the process of donation?
There is a chain of approved processes to be followed in blood donation, aimed at quality control and negating the possibility of transmitting infections. Every qualified donor is put through a basic clinical evaluation (blood pressure and pulse). If normal, a sample of the blood donated is tested for HIV, Hepatitis B and C, sexually transmitted diseases and malaria. Meanwhile, the donated blood is stored separately in an ‘unscreened refrigerator.’ If the sample clears these tests, or if the tests turn negative, the blood will then be moved to the ‘screened refrigerator.’ If it tests positive for any of the infections, another sample from the same blood bag is tested again. If positive, the bag is discarded. The HIV Act mandates that the blood bank inform the positive donor, besides referring to the appropriate department for further treatment. When a requirement crops up, the blood bank does a grouping to confirm that the group is the same, does a cross-match with the recipient and releases it to the ward.
What next?
The Madras High Court has sought a report from the Health Department. The National and State Human Rights Commissions have taken suo motu cognisance of the issue and asked for the State’s response. The need, however, is to build confidence in the community that the most exacting standards are followed in collecting, testing and storing blood, and then in transfusing it. Even if this calls for a re-look at the entire process, it must be done. It is as crucial as making sure no one dies because they could not get blood in time.
( Assistance for overcoming suicidal thoughts is available on Sneha’s toll-free suicide helpline: 0442464 0050 )
