Blood transfusions gone bad – the new healthcare concern in Sierra Leone?

Mohamed Cozie Kosia

Sierra Leone Telegraph: 29 May 2017

Recent spike in deaths at Choithram Memorial Hospital due to negative blood transfusion reactions is a major concern. During discussions with friends about the passing of relatives, I kept hearing stories about other people who had negative reactions to blood transfusion they received at the hospital.

In one instance, the father of a close friend of mine ultimately lost his battle in a London hospital with Hepatitis B – an infection which he was exposed to through blood he received during a transfusion at Choithram Hospital. Yet another tragic occurrence was that of a lady whose negative reaction to blood she received at Choithram Memorial Hospital. Luckily, her family was able to fly her to London in time for remedial treatment.

Yes, no doubt, there are great success stories at Choithram Hospital, and others can point to in-caring for patients. However, stories of people who have lost loved ones due to other conditions unrelated to blood transfusion and the issue of wrong diagnosis, pale in comparison to their success stories.

This makes one wonder, if Choithram Hospital is a Hospital for healthcare or Hospice care?

From my perspective, these catastrophic reactions to blood transfusion administered at Choithram Hospital are far from normal. My background in health management has taught me the importance of treatments that include blood transfusions.

In particular, for a country such as Sierra Leone where automobile accidents, birthing women, sickle cell anaemia, the stabilization of surgical patients, etc., safe blood transfusions should not be a ‘hit or miss’ treatment option.

Furthermore, the examples shared above of affected reference occurrences known to me personally, I believe there are more such cases or stories.

In deciding to investigate this issue, I went to Choithram Hospital and asked to meet with someone in their Public Relations Department. I was directed to the Medical Superintendent’s office where I met with Matron Tucker. I explained to her my concerns about the frequent occurrence of severe adverse reactions (up to and including loss of life) of patients who have received blood transfusions at Choithram Hospital (Photo).

I gave Matron Tucker specific names, including Dr. Christian J. Smith. I told Matron Tucker that I wanted to give the Hospital an opportunity to address these grave allegations concerning the catastrophic results of blood transfusions at Choithram Hospital.

Matron Tucker stated that Choithram Hospital does not have a blood bank and they procure blood from several places including Connaught, Princess Christian Maternity (PCMH) and the 34 Military Hospital.

However, because of its close proximity, most or all of Choithram’s blood supply is obtained from the 34 Military Hospital. Matron Tucker stated that the high number of patients suffering from adverse reactions to blood transfusions has been a concern for the Hospital as well.

She showed me a list of patients who have had adverse reactions.  They have been compiling this log of patients since March 2017. According to her, the Hospital has scheduled a meeting with the 34 Military Hospital to discuss and address this issue.

Matron Tucker later took me to the Medical Superintendent, Dr. Modi, to whom I reiterated my concerns. He also said that the problem is not with Choithram because they do not have a blood bank; they get most of their blood supplies from the 34 Military Hospital (Photo).

I asked Matron Tucker if she could put me in touch with their contact at the 34 Military Hospital and she gave me the name and contact information of someone by the name of Mr. Morseray, a lab technician.

I called Mr. Morseray and met with him at the 34 Military Hospital Laboratory. I told him the reason for my meeting with him, following meetings with Matron Tucker and Dr. Modi at the Choithram Hospital. Mr. Morseray said it is a concern for them also at the Military Hospital. He stated that they have had several discussions with Choithram about the frequent occurrence of adverse blood transfusion reactions.

According to Mr. Morseray, one of the major problems with Choithram is that they do not have a blood bank. When blood is collected from them, it is stored in a refrigerator at the hospital, until needed. And, blood should be kept within a specific temperature range.

Unfortunately, most refrigerators do not have the capability to keep blood consistently and constantly within the required temperature range. Because Choithram Hospital does not have a blood bank, the occurrence of adverse blood transfusion procedures is increased.

I later on was invited to Dr Phlip E. Gevao’s office.  Dr. Gevao heads lab operations at the Military Hospital. He reiterated the issue of proper storage facility at Choithram Hospital. He stated that he is confident of, and stands behind their process and procedures of collecting and storing blood.

Dr. Gevao further stated that his colleagues and staff are well trained and have been doing blood work for a long time, with no such prior complaints. (Photo: Choithram).

During our meeting, another officer by the name of Mr. Alex interjected that (at Choithram Hospital) a patient whose wife stated that her husband was receiving blood and his temperature increased tremendously, causing early stages of rigor. The nurse continued with the blood transfusion, which is very dangerous.

This led me to wonder about the level of training nurses and other medical care providers receive, particularly with recognizing and reacting to critical symptoms associated with adverse blood transfusions.

Lastly, Dr. Gevao stated that in his opinion, given the severity of the allegations, Choithram Hospital personnel should have “raised an alarm” so this issue could be more closely investigated, addressed, and possibly remedied.

I find it interesting that no one I spoke with at the Military Hospital mentioned the fact that blood infected with Hepatitis B (as was in the case of Dr. Christian Smith) has nothing to do with proper blood storage (as is inferred in the dealings with Choithram Hospital).

Pre-screening methods are the responsibility of the originator – in this case the 34 Military Hospital.

One of the few good things the Ebola outbreak did for the people of Sierra Leone was to expose the deplorable conditions of the healthcare system to the world. Unfortunately, healthcare affordability and delivery are still of major concern in Sierra Leone.

This is clearly evident by the devastating manner in which the Ebola outbreak brought the nation’s health and social care, economy, and infrastructure to a standstill. It affected and slowed the positive trajectory of the economy. There are many personal stories of friends and relatives who will support this sad truth.

Author’s Note:

Mistakes or negligence in healthcare delivery can be catastrophic and fatal. Losing a loved one because of careless mistakes or negligence, makes that loss more difficult to accept.

This article is dedicated to Dr. Christian J Smith (the first Managing Director of Sierra Leone Commercial Bank and former President of East End Lions Football Club); and others who lost their lives due to severe negative blood transfusion reactions at the Choithram Memorial Hospital (Photo).

I hope the reader appreciates the fact that this article was not written as a means of finger-pointing.  It was written as a medium to find clear solutions to the dangers of poor blood transmission (from pre-screening to the administering of blood to patients), not only at Choithram Memorial Hospital, but also at all healthcare institutions in Sierra Leone…remedies that include proper blood screenings, recruitment, training, and monitoring of staff.

This article is also an appeal to our health authorities to create and enforce a structure of compliance, inspections, and auditing processes to ensure the end of needless loss of lives due to gross negligence and carelessness.

Author: Mohamed Cozie Kosia

9 Comments

  1. “Lastly, as if the writer did not have confidence in his writing or as if he knew there maybe retribution for having written the article, tried to apologize for writing it. In the world of the free press, journalists should not be afraid of printing facts.”

    Not when you are writing against the military, a unit that sees themselves as above the law.

    On a more serious note, 34 hospital is more interested in the money that comes from the blood that they sell even though they get the blood from volunteers for next to nothing. As long as money is at the centre of things in Sierra Leone, expect greed to take the better of any decency.

    In 2010, I went with my family to Sierra Leone on Holidays. My daughter got sick on 29 December. We took her to Choithram hospital. She was assigned an India or Pakistani doctor. I was very skeptical of the doctor.

    We had planned to get out of the country on the next available SN Brussels flight immediately. SN Brussels was the only plane that travelled from Sierra Leone to the west in 2010/2011. The other alternative was Air Morroc.

    On the 1st January, the doctor told us that our daughter will be discharged in the afternoon as she was okay. I went to the hospital at about 09.30 in the morning and I saw that my daughter was not breathing properly, and the doctor did not detect that during his morning rounds before he informed my wife that our daughter was fine.

    I drew the doctor’s attention to my daughter’s breathing. It was only then that the doctor noticed that my daughter was in severe danger. Two hours later she was gone. I have not set foot in that country since I left with the rest of my family on the 3rd of January.

    Most of the foreign doctors at Choithram I later learned, are sent to do their housemanship. They are not vetted by our government before they are allowed to practice in the country.

    Seven years since that ugly incident, I am still blaming myself for taking my kids to my country of birth.

  2. George, it is nice of you to be a Registered nurse, however I really don’t understand why you are being combative. I think we should focus on the intent of the writer and the content of his article.

    It is about the negligent actions of professionals, the horrible healthcare system in the country and the lack of proper government accountable. Healthcare is not about politics that we have to disagree just because… This is about people’s lives.

    It is about the image of your profession and our country. So I think it should be in your interest to support and encourage the writer to do more instead of being combative.

  3. Choithram is a very big hopistal. 34 should stop supplying them with blood until their blood bank is built.

  4. Well to my opinion 34 Military Hospital is responsible for most of the incidents, though according to them Choithram Hospital doesn’t have blood bank which is too bad for them to keep blood in their refrigerator. But 34 Hospital should have invited the head of medical at Choithram and tell them – ‘look you try and get a blood bank or we will stop selling blood to your hospital’.

    And according to the officer who heard a story of a nurse administering blood and the patient temperature rising, should have also alerted the Choithram Hospital doctor that – ‘see what we are hearing about your nurses, so please try and do something about it before it gets out of hand’. But everyone in that country just care about money.

    No one cares if another person’s loved one dies or not. So please, thanks for your article and I hope the two hospitals will do something about it to stop the killing of people. I have never ever even trusted that Choithram Hospital in my life. It was one of the reasons I had problems with my wife, because I told her to be taking my son to the government hospital and avoid that fancy hospital. Please, all medical centers in Sierra Leone should improve their medical resources and training of their medical staff, please

    • This should not be a question of who should carry the blame. We are dealing with people’s lives resulting to fatalities. The culture of quality care and responsibility must be adopted that every citizen would benefit irrespective of their status.

  5. These things should not be happening in Sierra Leone. Nurses who have undergone training must be aware of their brothers and sisters health. The hospital concerned must be investigated, including all those working there.

    This situation is a real concern to the families and all those who have had problems with the hospital. If you transfuse a different type of blood, there must be a rejection and possible death. Let nurses make sure they are transfusing the correct type of blood. Blood given must first undergo screening to be sure of the type of blood.There is no need to judge the nurses involved.

    • Abu, these things should not be happening in Sierra Leone? Like we have state of the art medical facilities? The statement should be why aren’t there more articles exposing the dangers of medical malfeasance in Sierra Leone. The topic of the article should be ‘Get Blood Transfusion In Sierra Leone At Your Own Peril’.

      As much as the writer of this article tried to expose the many fatal mistakes made by doctors and nurses in many cases in understaffed and underserved hospitals, he failed to educate his readers about the basic type of complications and interventions related to blood transfusion.

      If you are going to write article about healthcare, be sure to do your home work, like consulting medical experts on the topic, using quotes and references. If I wasn’t a registered nurse, I wouldn’t have understood the gravity of the problem you are bringing to light.

      Lastly, as if the writer did not have confidence in his writing or as if he knew there maybe retribution for having written the article, tried to apologize for writing it. In the world of the free press, journalists should not be afraid of printing facts.

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