A few weeks ago, Aamir Mahmood, the founder of Pakblood, a not-for-profit initiative that aims to connect blood donors with blood seekers through an online platform, was contacted by a poor man who worked as a driver in the same housing colony. The man, visibly distressed, requested him to donate blood for his son, a thalassemia patient. He said it had been over 10 days since and he hadn’t found a donor.

Mahmood was quite surprised to learn that there were no donors despite the fact that the patient’s blood group was B+, one of the most common blood types. That is how the coronavirus outbreak has impacted the blood banks in the city, causing huge problems for patients who require regular blood transfusions, especially the children who are suffering from thalassemia.

“We require 1,200 to 1,500 blood bags per month at our centre, in order to meet the needs of the patients,” says Dr Adnan Gilani, medical director at Sundus Foundation, a non-profit organisation that provides blood transfusion services to patients suffering from thalassemia, hemophilia and other chronic diseases.

Organisations like Sundus Foundation are highly dependent on blood drives and camps at universities, colleges and factories to meet their demands for donated blood, all of which were cancelled as soon as Covid-19 hit Pakistan. “Our [blood] donations dropped to zero,” Dr Gilani reveals. “We had no idea how to carry on with our services.”

This month they were saved by Dawat-e-Islami’s ameer, Maulana Ilyas Qadri, who sent his followers to Sundus for blood donations. Sundus also approached Shoaib Dastagir, the inspector general of Punjab Police, who helped it set up camps at police stations and urged policemen to donate blood. “Thank God, we now have sufficient blood to last us the first two weeks of Ramazan,” Dr Gilani says.

Fatimid Foundation, another NGO, is now using its donor directory and contacting previous donors individually and requesting them for donations. “We have also requested patients to bring donors with them. This has helped keep us afloat,” says Col Iftikhari Naqvi, the Operations general manager at Fatimid. “The biggest issue we are facing are the patients coming to us from far off places like Pattoki and Okara, who are unable to make their blood transfusion appointments due to the lockdown.”

According to Dr Faiza Bilal, Head of Hematology and Pathology at Services Institute of Medical Sciences, Lahore, it is not only the private blood banks that are facing difficulties. The public ones too have seen a big decrease in donations. At public hospitals, the main source of blood donations are reference blood donors who are usually friends or family of the patient. However, amid the pandemic, “there’s a general fear of visiting the hospitals and healthy people do not want to get near the premises of a healthcare building. All this is creating a shortage of blood supply.”

Dr Bilal, who is also the chairperson of Services’ Blood Bank Committee, says that while hospitals are trying to keep blood transfusions and other elective procedures on the low side, in order to avoid reactions and problems of viral load from donors to recipients, there are patients who are dependent on blood transfusions for their survival.

“The most vulnerable people in this situation are patients of thalassemia, red cell aplasia, people with hematological disorders and pregnant women,” Dr Bilal adds. “None of them can delay their blood transfusions or wait for things to get better before coming to hospitals.”

While hospitals are trying to keep blood transfusions and all other elective procedures on the low side, in order to avoid reactions and problems of viral load from donors to recipients, there are patients who are dependent on blood transfusions for their survival.

The Thalassemia Federation of Pakistan (TFP), an umbrella organisation of all the societies working for the disease across the country, states that Beta Thalassemia is one of the most commonly inherited disorders, with a prevalence rate of six percent in Pakistani population. Thalassemia is an inherited blood disease where the body makes an abnormal or inadequate amount of hemoglobin — the protein in red blood cells that carries oxygen.

Mahmood, who has also been involved in the Safe Blood Transfusion Programme, says that while those managing blood transfusion facilities are fearful of inadequate resources and blood banks are drying up, the other side of the crisis is the transport issue during the lockdown that is keeping patients from reaching hospitals and clinics in the first place.

“Most thalassemia patients come to Lahore from rural areas, for their monthly blood transfusions,” he adds. “In the absence of all local transport, it is impossible for them to get to the clinics. Also, it is financially unviable for them to book a private car, and a group of people from a village can’t even get together and car-pool.”

According to Dr Muhammad Ashraf Chaudhry, professor and head of Community Medicine at CMH Lahore Medical College, if the situation of the pandemic doesn’t settle by the end of May, the issue for blood banks and patients dependent on them will become bigger.

He says that hospitals and blood donation organisations keep the numbers of previous donors and it is them they should contact during this time and even collect blood donations at the donors’ doorsteps. Furthermore, he says, the government should organise a special taskforce dedicated to patients requiring regular blood transfusions, including in- and outstation patients. “The government should work together with organisations like The Red Crescent and Thalassemia Foundation to facilitate these patients.”

The government of Punjab seems to have taken notice of the issue. Silwat Saeed, special secretary for Specialised Healthcare, Punjab, insists that she spoke to the president of Sundus Foundation regarding the issues faced by the NGO and was assured that they have enough blood bags for the next two weeks.

“I’ve also invited organisations like Sundus and Fatimid as well as Thalassemia Prevention Programme and The Institute of Blood Transfusion to better understand the situation,” she says. “If we can help them through administrative action, we will do so. We are also going to involve commissioners and deputy commissioners and set up blood banks at the district level so that patients don’t have to travel for blood transfusions during this time.”

Like Pakistan, blood banks globally have experienced a massive drop in supplies due to Covid-19, and are trying to deal with the situation in different ways. India, for example, has introduced an E-pass for blood donors so that they are not stopped at barriers during the lockdown. Some countries are running media campaigns asking for healthy donors to come forward to avert shortages. Indus Hospital in Karachi is collecting blood donation at the doorstep of donors. The situation is currently developing in Pakistan and we are yet to see how the country deals with this huge task and assists patients who are unable to reach their blood transfusions centres or can’t find donors during this time; and also how blood banks continue to meet their blood bag requirements amidst the crisis.

“By now, everyone has come to terms with the fact that corona is not a short-term problem,” says Dr Shabnam Markaz, member of Social Sector at the Planning Commission, Government of Pakistan. “So we are trying our best to come up with policies to ensure continuity of services in every sector and cause the least possible disruption for people.”