Sickle Cell: A major contributor to maternal and infant mortality in Sierra Leone

Amilia Eva Gabba, Programme Coordinator of the Sickle Society Sierra Leone

The Sickle Cell Disease (SCD) is causing devastation in Sierra Leone amidst little attention to the genetic condition from the public health system, patients and a campaign group say.

SCD, also known as Sickle Cell Anaemia, is a condition caused by the abnormal growth of the red blood cell, leading to suffering among patients. The condition is hereditary, meaning it can transfer from parents to their offspring.

In Sierra Leone many sufferers dye in silent agony due to lack of proper care, say the Sickle Cell Society of Sierra Leone (SCS-SL), noting that it is also a leading driver of maternal and infant deaths in the country.

A normal red blood cell is round. An abnormal one is shaped like a crescent or sickle [the shape of the agricultural implement]. Unlike the normal red blood cells, sickle shaped red blood cells do not live for long. And since these red blood cells are responsible for the transportation of oxygen through the body, sickle cell patients often lack enough blood due to the short-live span of their red blood cells. This condition is called anaemia.

In addition, because of their shape, sickle cells tend to get stuck in blood vessels, blocking blood flow. This can cause pain and organ damage, as does constant deprivation of oxygen-rich blood. This organ damage is what makes sickle cell a fatal condition.

A chat with the National Blood Bank at Connaught

On the occasion of World Blood Donor Day commemorated on June 14, KMN talked to Saio Y. Koroma, Medical Laboratory Officer at the National Blood Bank at Connaught Hospital in Freetown.

We started by asking Mr Koroma to give us an overview of the state of the blood bank.

Koroma: The government and its partners have tried hard to set the stage for people to donate blood from time to time, but it’s unfortunate that the public is not responding positively.

One thing we need to know is that up until now we have not been able to get a substitute for blood, despite the intervention of scientists… In medical delivery, they have been able to make a lot of commodities with which lives of patients are saved. For example, we have tablets, capsules and injections at our disposal to alleviate pain.

But when someone is short of blood, they have not been able to produce something to sell. And we are not able to get people to come and donate.

KMN: When you say the public is not responding, how do you mean?

Koroma: It is not that people are not coming at all. We have three types of blood donations.

Firstly, there are the family or friend replacement donors. This category donates when family members or friends are sick and in need of blood.

Secondly, there are the commercial donors. They only donate in exchange for money.

Thirdly, there is the voluntary blood donor group. They come from time to time and voluntarily donate for safe keeping. These are the people who WHO [World Health Organisation] says to encourage. Their blood is not only available for family and friend, but for anyone in emergency. We use such to save lives.

What’s the current quantity of blood in the bank?

Blood Donation: Living the experience and Saving lives

KMN's Rachael Williams

As journalists we do not only report events, we also live the experience sometimes, while on the job.

This is what KMN’s Rachael Williams demonstrated last Wednesday when she accompanied a joint team of the Safe Blood Services of Connaught and Cottage hospitals at the Benguema Military Barracks to cover a blood donation ceremony.

Benguema, located in the heart of the small town of Waterloo, about 30km from Freetown, was one of over a dozen centers designated as donation site for a nationwide coordinated voluntary blood donation exercise. It was part of this year's World Blood Donor Day, commemorated every June 14.

Sierra Leone delayed the commemoration to organize the nationwide donation ceremony on June 21.

According to the Ministry of Health, the country faces a severe shortage of blood with potentially severe implication for a country battling an epidemic of maternal and infant mortality and high rates of deaths due to road accidents, among other life threatening health issues.

"Access to blood is critical to save the lives of, among others, women who experience haemorrhage (bleeding) during or after childbirth; sick children and babies; victims of road traffic accidents and disasters; and patients with cancer, thalassaemia, sickle cell disease and many other conditions," the ministry of Health and the World Health Organisation (WHO) said in a joint statement marking the day.

117 transformed into a public health hotline

One of the operators in action at the 117 Call Center within the EOC

KMN – Freetown (June 22) The Sierra Leone government has transformed the Ebola-era free toll alert system into a public health hotline with an eye on the twin epidemics of maternal and infant mortality.

The Ministry of Health and Sanitation and its partners on Thursday inaugurated a facility housing the 117 Call Center located within the Public Health National Emergency Operation Center (PHNEOC).

The 117 alert system was first created as a public health surveillance tool in 2012 as part of the government’s Free Health Care initiative which targets the three most vulnerable segment of the population: Pregnant women, lactating mothers, and children under five. But it was not until 2014, at the height of the West African Ebola epidemic, that it became popular. This is because it was used to report deaths and illness after the government outlawed burial without official permission.

With Ebola over, there had been discussions about the fate of the system which was located within a privately run telecommunication outfit. The UK government, through its international development arm DFID, purchased equipment and provided technical support through the technology firm e-Health Africa to relocate the call center to the EOC which is located within the Cockerill Military Barrack along Wilkinson Road in the west end of Freetown.