The absence of an adequate, effective, safe and affordable National Blood Transfusion Service is an important health system problem that Pakistan faces today. The requirement for blood transfusion for potentially preventable maternal morbidity and mortality is quite high in Pakistan. Over 50% of under privilege mothers have hemoglobin level less then 10 g/dl (normal range 11.5 – 13 g/dl). The same is true of children below 5 years of age, 85 percent of whom have hemoglobin level below 10 g/dl (normal range 13 – 15 g/dl). Creation of blood –intensive specialty centers for Cancer Surgery, Chemotherapy, Radiotherapy, Renal Dialysis, Renal Transplantation, Cardiovascular by-pass Surgery, Thalassaemia, Leukemia, Hemophilia etc., have all led to an even greater need for blood and blood products.
It is estimated that, on an average, Pakistan requires around 3000-4000 units of blood every day. However, while the transfusion needs outstrip the currant availability of blood, Hepatitis virus prevalence rates in the potential Blood donors population is fairly high. Although systematic surveys have not been carried out in all areas of the country, between 10 –12 % of blood donors are estimated to carry hepatitis. While one cannot be complacent about the dangers of spreading HIV infections even in a low incidence country like Pakistan, its important to recognize the that hepatitis related diseases kills more people in two weeks than AIDS does in one year.
Transmission of HIV and hepatitis infections through blood and blood products has therefore further complicated the matter and has moved the issue of blood Transfusion to that of an adequate supply of un-infected and safe blood and blood products for transfusion. Now it is overwhelmingly important that the blood supply is safe. It is equally important that the clinicians are aware of the potential danger of unsafe blood transfusion so as to limit spread of transfusion-transmitted infections.
Since most of the blood transfused in Pakistan, except in few places, is derived from donors who are not selected to exclude high- risk groups and not in most cases screened for hepatitis and HIV. It is understood that a large majority of blood transfusion are potentially dangerous. At the same time, apart from individual efforts made by some members of the health profession, there is little evidence that a clinicians and public at large are benign sufficiently aware of the dangers of inherent blood transfusions. The public sector facilities are inadequate to meet the huge demands whereas private sector facilities, generally available only in large cities, charge exorbitantly. Another facet of the problem is the rampant commercialism of unregulated private blood banks. The questions regarding quality of blood and blood products are serious ones, and apply equally to the public, private and the NGO sector facilities.
There is an emerging consensus that the public and private sector cannot meet the need of the population on their own, and that the NGO sector has a vital role to play. It is worth recognizing that in many instances Non Governmental Organizations (NGOs) are the only organizations that have been able to effectively displace professional blood donors from the blood transfusion scene. It is a well-known fact that the professional blood donors, the main providers of blood in Pakistan, are mostly drug-addicts, who operate as groups of mafia and constitute a very high-risk group of blood donors.
Because of the fragmentation of blood transfusion services in Pakistan; the largely unsatisfied needs for blood and blood products; the dangers of unsafe blood transfusion; and the consideration of availability and accessibility of blood for transfusion, NGOs seem to be in better position to provide, at affordable cost, blood transfusion services with outreach the most parts of the country.
As a non-profit organization Sundas Foundation has been tackling at a fairly large scale the issues related to the blood transfusion services. The Sundas Foundation is the pioneer of the voluntary blood transfusion service and first of its kind in the whole of Gujranwala Division. Sundas Foundation is Registered NGO and also member of Thalassaemia International Federation.
Sundas Foundation was established in 1998 in Gujranwala as a Blood Transfusion Center. Before this institution many people started unequipped and unauthorized blood banks on commercial basis. Such blood banks provided unscreened and contaminated blood unfit for the very purpose of transfusion. After the establishment of Sundas Foundation all such quacks have vanished: that is major service, which we have rendered to community.
During the period of four years Sundas Foundation supplied more than 26171 units of healthy and screened blood and blood products. Now a day Sundas Foundation supplies more than 35 units of blood and blood products every day. This constitutes around 40% to 50% of the total requirement of blood and blood products at the Gujranwala.
Provision of specialized service for patients with blood disorders at a blood transfusion service center is a rare phenomenon in Pakistan. Sundas Foundation these days supplies hundreds of pints of healthy and screened blood and blood products along with free comprehensive treatment to hundreds of registered patients, mostly children, suffering from chronic blood diseases such as Thalassaemia, Heamophilia and Leukemia.
Besides this we provide Emergency Medical Services round the clock, the center is equipped with ample stocks of life saving medicines and other medical facilities.
The Sundas Foundation is staffed by a team of highly dedicated professional and volunteers, providing a ray of hope to all those who come to us in their hour of despair and need. If there would have no such foundation Gujranwala, these children shall not know where to go. The Government Hospitals provide no such facilities and Private Hospitals are out of the reach of these patients who need constant treatment and blood transfusion and for which charges are forbiddingly high in these organizations.