Eliminating blood shortage and eradication of corneal blindness

Author : J.C.Shukla and Vinod Dighe
Date added : 2003-09-19

Brief Project Background

Blood for All - Whenever required (Eliminating Blood Shortage)

India experiences shortage of blood almost in every state. Blood banking is still in the hands of private sector. Government authorities, being unaware of the intricacies involved in the blood banking business, have imposed strict regulations. As a result of this, almost all the states in India are facing a deficit of blood, ranging between 20% to 50%. Two of the states had to declare emergency on this account, and one of the state, had to make it mandatory for their police force, to donate blood. This has resulted into shady deals, profiteering, spurious blood supply, and barter system - blood in exchange of blood - (where family members of the patient, have to donate blood for replacement).

[ PROJECT DESCRIPTION ]

This is where our role comes, in alleviation of human sufferings. We started an experiment in the state of Gujarat, western India. We called 30 private blood bank owners, and made them agree, to cooperate for their own interest. We highlighted to them, the real crux of the problem - a huge gap between the supply and demand of blood. As a matter of fact, the demand of blood was generated from four metropolitan cities, where major hospitals and medical facilities are available. Blood was collected at various places in the state. And yet each blood bank had problem with the supply or demand of the blood. We worked the logistics and demand supply system. We proposed the following scheme, so as to have efficient and increased blood availability. This in turn has increased the business of the Blood Banks. This has been made possible, with the network of blood banks and ICT. All the blood banks were asked to cooperate, accommodate, and extend services to each donor, of the other blood bank.

For example if you are a donor of ’ x’ blood bank, and you need blood anywhere in the state of Gujarat, then any blood bank who is the part of our network, will extend the same facilities to you, as if you are their member / donor. This helped donors and patients tremendously, as they were treated as members / donors, and could get blood free of charge, and that too without replacement. The benefits of networking were elaborately explained to the members, in what manner it helps in saving precious human lives.

There were many issues of accounting between the blood banks, quality of blood supplied, and systems of quality assurance. All the problems were attended to the satisfaction of the participating members. Networking alone helped us meet the shortage by 25% to 30%. It also generated good results in donor’s participation, to the tune of increased blood supply. Moreover rare blood groups were easily available to every patient in the state.

We also studied the supply and demand patterns, and based on statistical model, designed an assurance scheme. If one member of a family donates blood once in a year, he is entitled to various benefits as under:
A) He gets two units of blood in exchange of one unit, which he has donated throughout the year. (Currently in India no such assurance is given, since it is in short supply.)
B) He does not have to pay for testing and replacement charges (currently depending on the shortage, various blood banks charge INR. 350/- to INR. 3,000/- per blood bag. Metro cities like Mumbai and Kolkata, have blood shortages on a higher side, as compared to the demand, so in those cities, the cost of the blood, is also on a much higher side. We made it available to the members of the network, absolutely free.
C) Moreover, the donor does not have to give blood in replacement, as it is in the case of present system, due to shortage of Blood.
D) The donor’s family of 4 members is entitled to this benefit. He can get blood from anywhere in the state of Gujarat, where networked blood banks are available (30 blood banks are networked, and between them, they have covered each zone of the state.)

Our primary objective is to see, that people get the right information, about the availability of blood, for the sake of transfusion, at their need of the hour, without running from pillar to post, and that there should be no harassment or inconvenience, in getting the required blood during emergency. Our dream is that no one should suffer, due to lack of blood during critical time, and that there should be no cancelled surgery or human deaths for want of blood.

Here ICT and networking places a major role, as we are linking the donors - blood banks. We are collecting and processing information, of regular demand and supply gap, and accordingly bridging it by use of ICT (like computers - telephone - fax - mobiles) and networking of blood banks. The information regarding the availability of blood stocks or any other blood related issues would be provided absolutely free of cost, to the people. Also, the donors are going to get immediate assistance, about the nearest availability of blood, in case of emergency, by internet or telephone. This will be a big assurance and relief, to the otherwise harassed relatives of the patient, for the life saving component - Blood. Moreover, this would avoid the likely chaos, and the public appeal for emergency Blood Donations.

We are sure that Internet Portal would be the right solution for this, since it would provide a platform, for bringing various Stakeholders under one umbrella and additional advantages of providing necessary services to the members, like e-mail id’s to all members, creating a data base for blood banks, voluntary organizations, hospitals, blood transfusion and related issues, easy access to stocks of blood, online requisition forms. All these activities will help in creating a Knowledge Bank, and Information warehouse on Blood, Blood Transfusion, and related issues management, so as to address global blood related problems in coming future.

This activity is non-commercial, and not for profit. We envisage a network of various stakeholders, for addressing this problem, at a macro level. The basic problem is, lack of information and the link, between victims and the service providers, as also between donors and beneficiaries. The model is to establish the bridge, between information transmission, and knowledge sharing capabilities of ICT, specially the internet, and conventional telecommunication means. Breakthrough is also required, in creating awareness and education amongst various stake holders, for which we are regularly creating awareness campaigns. Another major bottleneck, is the assurance to the donors, of availability of blood and quality - which we have addressed, by introducing Blood Assurance Scheme (as mentioned above) and Quality Certification.

Eyesight for All (No More Corneal Blindness)

India has an annual demand of approximately 4,00,000 corneas. Whereas the fact remains, that as against this requirement, only 14,000, corneas are collected in a year. This situation prevails, in spite of the known fact, that a corneal blind person, can get a normal eye sight, if the defective cornea is replaced, by a healthy human cornea. So, eradication of corneal blindness is possible, provided corrective measures are taken, in the right direction.

To begin with, we observed that there are many obstacles, which we need to take into consideration. First and foremost, lack of awareness and importance of eye donations. Religious superstitions, and family emotions prevailing, at the time of death, are some of the major obstacles, which come in the way. Added to this is the critical time factor, related to this activity. The retrieval of donor’s cornea, has to be carried out within 3 to 4 hours of death the donor, and that too by a medical practitioner only, as per the law. The consent has to be sought of the family members, before the removal of the cornea from the dead body. Retrieved corneas have to be preserved properly, to reach the Eye Bank, within the stipulated time frame of 6 hours, after the death of the donor.

[ PROJECT DESCRIPTION ]

All this poses a great challenge. And we are committed to help eradication of corneal blindness, with the effective use of ICT and Networking, with a proposed Internet Portal. We offer ICT services, to bring about increased awareness in eye donation, quality corneal transplants, and a better eye care facility, through a very wide network of multi stake holders like - eye banks, eye hospitals, donors, volunteers, beneficiaries, doctors, non government organizations (NGO), and private agencies.

To put this into practice, we started our activity in close coordination with one of the leading charitable institute, namely - Rotary Eye Institute (REI), located at Navsari, in the state of Gujarat, India. The institute carries out, on an average 1,700 corneal transplantation surgeries, during the year. We have offered our services, in the areas of ICT and Networking, for increased eye donations, and knowledge management for eyes. We have created a self - sustaining revenue model which is replicable.

The awareness for eye donations, is done by organizing regular eye donation camps and by spreading the message across in schools, colleges and institutions. Also by conducting free eye check-up camps, at the various industrial establishments. This activity has resulted in increased number of eye donations.

The knowledge management and bank for eyes, has helped in creating an information warehouse, for various issues related to eye care, like eradication of corneal blindness, corneal removal, storage and transplantation of corneas, regulations and standards, transplantation related problems, donor awareness, and cooperation amongst eye banks and other related Institutions. Another important role is to share knowledge, experience and problems with various world bodies working on the same subject.

Each eye bank maintains a list of needy recipients and donors, as well as an account of corneas received and given, which in turn is reported to the co-ordination center which is run by us. This activity helps us in balancing the right formula, between demand and supply. It also ensures the optimum supply of cornea so that it doesn’t get spoiled, and in the process, it helps in creating the much needed awareness, for eye donations. Moreover, there are other advantages for the eye banks from the information available thru the co-ordinating body that they can motivate the donors through awareness campaigns, can seek help in case of shortage / excess of supply, improve their services and credibility, in terms of enhanced services.

While going through the entire process, it was felt necessary, that in order to establish a greater awareness and keenness to pledge for eye donation from the prospective eye donors, there is a need to involve a religious sect or organization working at grass root level who can influence peoples’ thinking and mindset. There are many religions prevailing in our country. And when an appeal comes from the religious head of a particular sect or organizational head working with the masses, which has huge number of followers, it has got a ripple effect. So we approached a religious sect, known as Yogi Divine Society, and requested their Swami (Priest), soliciting their help, to spread the message across in villages.

Accordingly, we created a network of approximately 600 volunteers / motivators within their sect, who covered 600 villages, and started mass contacts and motivation process. The village community being very sensitive to religion, the appeal from the religious head worked, and it had the desired results. More and more people have come forward to register for eye donations.

The entire process, of the schematic network operation, can be described as follows:- Village motivator is appointed or created - - - this volunteer motivates the prospective eye donors to pledge for eye donation on their death - - - and collects pledge forms from them - - - informs us, who manage logistics, database and co-ordination between them and eye banks. In the event of death, motivator contacts local doctor - - - doctor removes eyes from the dead person and gives it to eye bank - - - eye bank informs patients from our collected database, calls them and performs eye transplantation - - - thus blindness is removed from one blind person.

With the effective use of ICT and Networking, it is possible to manage the above activities, which was impossible to manage earlier, due to restricted time factor. Here as above mentioned in blood bank, there is a great importance of Internet portal as a great extent of work is needed to be done for co-ordination, managing the smooth flow of activity and creating knowledge database and management is required, so that effective results are generated and work can be replicated in other geographic domains and other countries also. An Internet portal has the same application and work as mentioned in blood bank project.

Results

In case of blood project, the scheme turned out to be a grand success and we could generate excess blood in the state of Gujarat. We would like to mention here that for the first time in the history of Blood Banking in India, one state - the state of Gujarat, generated excess Blood, and offered it to the neighbouring state - Maharashtra. And all this could happen, without the assistance of the Government.

This scheme does not require major financial involvement, as excess blood could be sold to other blood banks, or states at a particular cost. This is a self-sustaining and replicable model. Our experiment generated good results, and we could almost eliminate blood shortage in Gujarat. Encouraged with the results, we have taken the first step towards bridging the shortage of blood in India, through our Internet portal and networking model. For this, we are putting lot of systems in place, to cater to the national demand and supply problems and mindset of people in India. We would also be glad, to share and help implement this novel scheme, to other societies and countries

In case of eye project, the awareness is created in a specific geographic domain and people have started pledging their eyes for donation. The eye banks and hospitals are geared up to undertake the job of corneal operations to the receipients. We have started making the database of donors and receipients of the corneas. Also training to volunteers and doctors are being offered to cater to larger areas and population

Lessons

We have learnt the the present day nagging problems cannot be addressed by conventional solutions. It has to be addressed by out-of-the-box thinking and devicing socio-economic models which have self sustaining revenue models.

Also, there needs to be the right judgement of the gravity of the problem and how to address it.

ICT and networks plays a pivotal role in making the models work and reach to the masses. It also creates administrative conveniences and user-friendliness of the projects.

It is also important to work with different bodies and make them the stakeholders in the project and work on the strengths of all parties involved.

Social apprehensions and ethoes have to be addressed and society have to be assured that these projects are working in their benefits and the benefits have to be shown and given.

Knowledge management and database has to be created to address to various aspects of the subjects. Experiences, knowledge generated and different technical issues have to be shared and logged for future references and solution generation.

Development Impacts

We have experienced and also foresee that these projects will not only in the long term address the issues of blood shortage and removal of corneal blindness but will also alleviate society for these sufferings.

To make it reach deep and far, many people - volunteers - motivators etc will be involved, which in turn is the employment generation done.

Also, many future problems will be easily solved and addressed by networking and ICT as all the problems, solutions and experiences will be shared thru the Internet portal, which everyone i.e. stakeholders and beneficiaries will have access to.

Knowledge warehouse and management will lead to higher platform of problem solving and sharing issues and solutions at global platform because it is very vital that knowledge networking is done at a global level, where everyone working in the similar subject co-operates and shares the problems, agonies and provides knowledge and solutions to others.

All these important characteristics are critical and useful in solving in many global problems by knowledge networking, innovative and self-sustaining working models, networking between various stake-holders and wide reach possibilities and applications of ICT

Project Information

Organisation : Nahak Overseas Ltd
URL : http://www.nahak.com
Total budget in US$ : Between 1 to 1.5 million is estimated, and later on it will be self sustaining.
Country of activity: India [IN]

Are there any partners involved : Nahak Overseas Ltd
Rotary Eye Institute
Yogi Divine Society
Blood banks and hospitals
Eye banks
Friends and well-wishers which constitutes the trust members also
What is partners role?: All the partners are multi-stake holders in the project and everyone has a specific role to contribute to the success of the project. Volunteers create awareness and inform the eye & blood banks in case of need. Eye & Blood banks' role is to collect and process. They in turn, reinstate the eye or blood in the needy patients. Yogi divine society's role is to create awareness and motivate people to come forward and pledge / donate eyes and blood. Nahak does the overall co-ordination of the project.

Contact Information

J.C.Shukla and Vinod Dighe
jcshukla@nahak.com and info@nahak.com
104,Synergy House,Gorwa Subhanpura road, 390023 Baroda, Gujarat State, +91 - 265 -2285350

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