In this report, VINCENT KURAUN investigates the fraud allegation made against LASUTH blood bank officials and other hospitals while exploring the standard practice for blood donation in Nigeria.
Blood transfusion remains an essential practice that continues to save the lives of people in need across the world. Such need usually arises as a result of blood loss associated with traumatic accidents, complicated surgical procedures or those with specific medical conditions. But as crucial as blood is to humans, it has remained insufficient and much sought after globally.
Data available from the World Health Organisation (WHO) website suggests that about 120 million units of blood donated every year cannot meet humanity’s general demand for blood as “many patients requiring a transfusion do not have timely access to safe blood.”
While many hospitals across the globe are enjoined to maintain a standard practice in the donation, collection, storage and eventual transfusion of blood, such cannot be said of hospices in most developing countries. In Nigeria, for instance, how some hospitals carry out this life-saving exercise has left a sour taste in the mouths of many Nigerians.
Weeks ago, an X (formerly Twitter) user identified as Lola Okunrin (@lollypeezle) stirred up an important discussion on the unseemingly straightforward manner officials of the Lagos State University Teaching Hospital (LASUTH) conducted themselves when the wife of his friend, who was scheduled for surgery at the hospital, required blood transfusion.
Before the surgery, the hospital officials, he claimed, asked the patient and her husband to donate some pints of blood to the hospital’s blood bank ahead of the procedure as a safety net towards her surgery.
The husband, according to him, obliged and donated two pints of blood, but after the procedure, the officials were only able to give the patient one pint of blood as against the two her husband had donated. The rest of the blood she was transfused with was sourced and paid for. The cost: N25,000 per pint.
“When you come in for the surgery and need the blood you donated earlier, they will never be available,” Lola complained in the lengthy post on Twitter. “It’s always ‘no blood on ground.’”
Explaining further, he wrote: “Your wife is being wheeled into the theatre for surgery, you are running around for blood, therefore won’t care where the blood will come from. Now you have to approach a lab to buy blood.
“The attendants will tell you you must only go to the labs registered with them to buy the blood. ‘Only the ones registered with them’ for N25,000 per pint.
“I even heard some doctors are tired of these people. Why is blood always not available after people had donated them?
“After my friend’s wife spent several days there, my friend was only able to recover one of the donated pint of blood from their blood bank from the two he donated. He sourced for the rest. Isn’t this what fraud looks like?” he queried.
Other people, who said they had suffered similar experiences, then joined in to corroborate his claim.
One of them, JUBREEL (@BayoBreel), in his comments, said: “When my friend faced this same thing in LASUTH, I couldn’t wrap my head around it. I felt they were only taking advantage of her because she’s gentle and doesn’t ask too many questions.”
JUBREEL is yet to respond to Sunday Tribune’s message seeking more information about his experience.
However, O. M. Ayankojo (@holuwafemi_002), whose niece recently had surgery at LASUTH, said the officials never forced the patient or relative to donate blood ahead of the procedure, adding that it was only a piece of advice.
In his account, he said he paid N7,000 to later get blood at the hospital’s blood bank when required.
“No one will force you to donate any blood. My niece still had surgery on Wednesday at the same LASUTH. I stood in as the father and they just advised me to please try to donate blood and not force me.
“I collected the blood from the blood bank and took it to the theatre myself and it’s even N7,000,” he said.
When contacted on Tuesday, he promised to give Sunday Tribune more details later in the day. He is yet to do so as at press time.
Meanwhile, the management of LASUTH, in a statement posted on X in response to Lola’s tweet, said it has decided to conduct a thorough investigation into the fraud allegation made against some officials of the hospital’s blood bank.
“Needless to say that in the light of a very high demand for blood, a resource that is not available to be picked up on supermarket shelves all over the world, certain individuals attempt to fraudulently corrupt well laid down protocols.
“The allegations, which suggest that patients may have been defrauded in relation to blood transfusion services are of serious concern to the hospital management,” the statement read in part.
“To ensure transparency and accountability, LASUTH management will initiate a high-powered committee internally, to examine the allegations comprehensively. This investigation will involve a detailed review of procedures, documentation, and relevant details pertaining to the operation of the blood bank,” it added.
It also noted that it is committed to “addressing any issues identified during the investigation promptly and taking appropriate corrective measures.”
A Common Practice in Nigerian Hospitals
However, some Nigerians who shared their experience said what the X user posted is a common practice in most hospitals in the country.
One of the tweeps alleged that the same scenario played out at an Abuja-based hospital last October where he and the neighbour of a friend donated four pints of blood days prior only to be told the donated blood was no longer available on the day of the surgery. When contacted by Sunday Tribune to give more information on the incident, he claimed not to have the patient’s express permission to share the details to the media.
One Ogbeni Ceejay (@debola_femii) said: “My brother was scheduled for surgery at Igbobi Orthopaedic Hospital. I donated my blood and it was a couple of weeks after the surgery that I mentioned it during a conversation and my brother said they never gave him any blood.”
Another tweep, Denike @hebukun22, said: “This happened to me last year. My husband donated two pints of blood at General Hospital, Ifako. On the day of delivery, I was booked for emergency CS. My husband was told to go and get another blood which he did and in the long run, they didn’t use it for me.”
Imo State resident, BaalPerazim Nwabueze (@BaalPerazimN), said: “There’s this hospital in my city. We provided the required amount of blood needed for my mum’s treatment before she passed on. One week later, when we came back, they had sold the blood without refund nor remorse.”
Efforts made to get these X respondents/complainants to provide more clarifications were rebuffed as none of them was willing to offer more information or proof of their involvement and the veracity of their claims.
Paying Blood Donors
But some hospitals, the investigation revealed, actually give certain rewards/stipends to blood donors whenever there is a dire shortage of the vital substance. In such a situation, the health institution having paid to “buy” would want to recoup its money, a health worker volunteered.
A blood donor and former worker in a hospital where buying and selling of blood was commonplace, Funmilayo Adeyanju, told Sunday Tribune that the unethical practice forced her to stop general blood donation in hospitals, an exercise she has been doing for some years.
Speaking extensively to Sunday Tribune, Adeyanju clarified that the issue of selling blood is a nationwide issue and not just in Lagos State, adding that “ordinarily, people shouldn’t be paid to donate blood as voluntary donations are encouraged as a healthy act.”
She, however, blamed the phenomenon on the country’s harsh economic conditions that have made it hard for some people to survive and have forced them to “turn donations to a stream of income.”
She explained further: “When the hospital/laboratory personnel pays a donor, they try to recover the money from the patient, but they charge almost four times the amount paid sometimes, including and excluding screening charges.
“When there are voluntary donors, it’s still unfair to charge exorbitantly for the blood. And like in Lola’s case, it’s completely unfair they brought their donors ahead of the surgery and still couldn’t access the blood when needed because the hospital thought they could make do with the available blood before the patient needed it, forgetting that some people only want their relatives and friends to be their donors.”
Speaking on her experience in her former place of work, Adeyanju said: “I worked in a medical facility where buying and selling of blood was a common practice. Some staff even get outsiders to donate their blood for a token which they sell to patients and pocket the rest of the money.
“Sometimes, families in need get donors numbering up to four, but the patient makes use of one or two pints and sometimes none at all in a few cases, but the patient doesn’t get refunded.
“I have donated to women in labour on several occasions in the same facility till I discovered their scheme and stopped donating. I later found a sickle cell carrier to whom I donated four times a year.
Whenever I move to a new location, I try to look for sickle cell carriers in need to donate strictly to them.”
When asked if the management was aware of the activities of the officials, she said: “The management, in most cases, is not aware. The nurses are quick to act like they want to help and a patient that is already vulnerable will just follow accordingly.”
Nigeria’s Blood Deficit
Data from the National Blood Service Commission (NBSC) and cited by the WHO Regional Office for Africa in June 2023, showed that Nigeria gets only 27 percent (500,000 pints) of its annual blood need from voluntary blood donors, leaving a shortfall of about 73.3 percent of blood need every year. With this in mind, it is not surprising that many hospitals encourage patients and their relatives to engage commercial donors when in need as Lola explained.
He noted that patients, whose available relatives cannot donate blood ahead of their surgical procedures, engage commercial donors through the help of agents stationed inside the hospital.
“There are agents around who will help you get people to donate those two pints on your behalf for N15,000 each or one person to donate the two pints for N30,000,” he said.
But the use of commercial donors and donations in itself isn’t a safe procedure as some experts in the recent past warned that blood from commercial donors is sometimes prone to infections.
In a recent interview with The Punch, a Professor of Haematology and Transfusion Medicine at the College of Medicine, University of Lagos and Consultant Haematologist at the Lagos University Teaching Hospital, Idi-Araba, Sulaimon Akanmu, said: “Nigerians must know that paying for people’s blood is not the way to go. The way to go is voluntary blood donation. All we want in the blood transfusion service is safety.”
He added that: “When you collect blood from commercial donors and you screen the blood and it tests negative, you still don’t trust it. Commercial donors usually test positive for infectious diseases.
“You don’t have to trust it because these touts get themselves involved in risky behaviours that may make them positive for infectious diseases. And the time of screening for blood donation may be the incubation (latency) period.”
The WHO also warned that despite the need for blood, “maintaining safe and effective procedures around the collection, storage and use of donated blood is essential.”
In another post on its website, the WHO listed three types of blood donors as voluntary unpaid, family/replacement and paid donors.
It pointed out that of the three, only voluntary unpaid donors are the safest group of donors that can provide an adequate and reliable supply of safe blood.
“An adequate and reliable supply of safe blood can be assured by a stable base of regular, voluntary, unpaid blood donors. These donors are also the safest group of donors as the prevalence of bloodborne infections is lowest among this group.
“World Health Assembly resolution WHA63.12 urges all Member States to develop national blood systems based on voluntary unpaid donations and to work towards the goal of self-sufficiency,” the WHO said.
Sunday Tribune also visited LASUTH, where the LASUTH Chief Medical Director (CMD), Professor Adetokunbo Fabamwo, explained that the kind of events that led to the unavailability of blood already donated by patients and relatives ahead of their surgical procedures was not commonplace in the hospital.
Speaking extensively on the issue, Fabamwo said: “The first thing is that there is a general scarcity of blood. That blood you donated for your patient could have been used for an emergency case, but that does not mean that the day your patient needs it, they would not give him blood that he requires.
“What has been happening is that some of our junior doctors don’t make the request for their surgical cases in time. For instance, if there is a surgery that is supposed to be done on Monday, a good junior doctor should have gone to the blood bank three days before that Monday to say that I have a surgery on Monday, and my patient has donated blood, please get blood available on Monday.
“If the people at the blood bank now check and see that they don’t have such blood, there are ways of scouting throughout blood banks in the state to get that blood.
“In the cases in which they will come and say there’s no blood on the day of surgery most of the time, it is because the request was not made in time.
“I am blaming the young doctors who are supposed to prepare patients ready for surgery. What we have decided to do now is that, for such cases that may come suddenly like that, instead of telling the parents that there is no blood and that they should go and source for blood themselves, we will never do that again.
“What we will now do is to have an understanding with some nearby private blood banks where we will go and get a requisite blood for the patient and later when we now have blood, we will replace it.
“Going forward, that is what we have decided to do now and also, we have taken measures in-house to correct the practice whereby young doctors, who don’t go on time to the blood bank to ensure that cases for elective surgery, will have blood on the day of operation,” thee CMD explained, stating categorically that the hospital does not charge patients and their relatives to pay for blood.
“The only money they pay is just money for testing the blood to make sure that it is compatible with their own body, but they don’t pay for blood per se. What we demand is that, after giving you blood at an emergency point, you must replace it before you go home.
“If at the emergency point, you are given six pints, you are required to bring in six people to come and replace it before you go home. That is the practice and that is what we do. There is no issue with payment for blood.
“Blood is not what we buy on the shelves. Some people must have donated it. So, paying for blood is a practice that is highly discouraged and we don’t do it,” he said.
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