PHA-Exch> Sri Lanka to privatise blood banks?

[Garance UPHAM]

In the WHO's weekly posting of the Safe Injection network, we read the
worrisome information that Sri Lanka will privatise the blood bank.
While admitting ignorance of Sri Lanka's domestic politics, this news (see
article below from Daily Mirror, Colombo), invites a few comments:
In China 40 to 60% of former blood donors are infected with HIV, (UN
figures) simply because private blood collectors did not properly sterilize
equipment!
Blood collection that is not strictly controlled is a prime vehicule for Hep
C and HIV.
Unfortunately the non-informed public (because the UN agencies are very
quite internationally on the problem) and even people in charge of AIDS
program are only paying attention to ^blood transfusion' and do not include
'blood collection' as a factor transmitting bloodborne retroviruses (as all
improper and unsafe injection practices)
In 2006 and 2007, for example over 250 children were contaminated with HIV
in health care in Eastern European countries of Kazakstan and Kyrgystan, -
these countries gov't conducted thorough investigations of the
disease-problem was the re use of catheter, re-use of syringes, and
especialy, improper use of multidose vials : nurse takes a clean syringe to
draw medicine from vial for one patient, and change only needle to draw
additional drug for same patient, then the vial is used for another patient
with another sterile syringe... Most carers don't see a problem with that,
even in USA where in 1997 a study of injection practices in anesthesia found
50% of anesthesists did not understand that just changing the needle
contaminated the multi dose vial with whatever pathogen- HIV, Hep C etc.,
was in the first patient...People are not aware of the hydrodynamics of
'reflux'- the fact that after the injection, when withdrawing the syringe
from the patient, a minute quantity of blood - and pathogen- gets back into
the syringe and a new needle does not do the trick: when putting the old
syringe-new needle into the vial, the nurse injects blood from the patient
into  the vial.
Unknown to the public, many IVDU infect themselves with Hep C or HIV through
the same process: contaminated containers. Ignorance of that fact means that
clean needle exchange program have reduced but have never eliminated HIV
spread among IVDU.
Today, large parts of the poorest, are subject to mass epidemic ot HIV due
to dirty injection practices which continue under a wall of silence.
One of the problem in Kyrgystan and Kazakhstan was poorly paid health staff,
poor supplies, etc.. the result of shock therapy...
By the way, interested people should look at "Points to Consider" a new book
by David Gisselquist dealing with HIV spread in health care... As regards
HIV spread through blood not sex in Africa and elsewhere, his views are
shared with Steve Minkin, old time friend and collaborator of GK, and
participant in the first People's Health Assembly. I met David and Steve
again this summer in the USA.
Nance

Sri Lanka: Govt. plans to privatise Blood Bank says JVP
by Kelum Bandara & Yohan Perera, Daily Mirror - Colombo,Western,Sri Lanka
(13.09.08)

The JVP yesterday charged in Parliament that the government was planning
to privatise the Blood Bank.

JVP MP Vijitha Herath said this was to be done through the Blood
Transfusion Service Bill which was to be presented to the House shortly.

Mr. Herath made this point during an adjournment debate on the blood
transfusion equipment controversy of the National Blood Bank in the House
yesterday.

He said Section 4-1 of the Ordinance provides provisions to issue licence
for the private sector to open private blood banks and collect plasma.

Mr. Herath warned this would result in the decline of the standards in the
collection of blood and would lead to the spreading of AIDS which spread
through blood transfusion.

He said the collection of plasma without a proper standard led to the
spreading of AIDS in France some years ago.  The JVP MP pointed out that
recent findings of outdated blood transfusion equipment at the National
Blood Bank would also be used as an excuse to allow setting up of private
blood banks. "These moves should be stopped immediately," he said.He said
the security forces would also suffer because of this contaminated
transfusion equipment. "The blood donors in this country mostly donate
blood for the injured soldiers and using outdated and low standard
equipment to give blood to soldiers would lead to various health hazards
among them," he added.  Mr. Herath said the Health Ministry started
focusing on the issue only after it was revealed by the media.

He called on the Health Minister Nimal Siripala De Silva to tender a
public apology to the nation on the issue. "In other countries the
Ministers resign whenever there is any scandal or serious shortcomings in
their respective Ministries and Sri Lanka too should also follow such
practices," he said.
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