On 23 December 2016, an incredible feat was achieved when units of extremely rare Bombay Negative blood group were transported from India to Sri Lanka for a patient fighting cancer.
Requests for extremely rare groups are fairly routine for Sankalp’s Emergency Team. However, the request for Bombay Negative Blood units from The National Hospital of Sri Lanka for a 69 year old Nun who is battling with Cancer was immediately concerning. Bombay negative is known to be present in about 1 in 85,000 individuals in India - 5 times rarer than Bombay positive. However, it was not Bombay negative which looked a challenge to organise. The idea of getting the logistics and permissions in place together to make the transfer happen was daunting. Nevertheless, we pulled all our resources and energy together and decided to do the best we can.
The nun was receiving chemotherapy and with each cycle her hemoglobin was falling. It had reached a stage that the chemotherapy was being postponed until hemoglobin recovered. We were initially approached by Sr Annie Thomas from Chennai who connected us to Sr Francine Muthugala who is the Province Leader of the Mission of Sisters of the Good Shepherd, the same organisation to which the patient belonged. There were two possibilities - either to bring the patient to India for further treatment - where logistically it would be simpler to organise the units or to find a way to send units to Sri Lanka. After consulting the patient and the concerned physicians the first option was ruled out.
Now , when it was clear that the only option was to send the units, we started working in parallel on multiple tasks. Firstly, together with the National Blood Centre, Sri Lanka we started working on the permissions from both the countries for the transfer to happen. With the experience of having managed Bombay blood group units for a patient in Istanbul a few years earlier, we knew that the only way forward was to secure permission from National Institute of Immunohematology, Mumbai. After a few email exchanges, we could connect to Dr Ajit C Gorakshakar, Scientist F (Senior Deputy Director) who gave a very patient hearing to the situation and promised to help. Our immense gratitude to Dr. Manisha Madkaikar, Scientist F (Director In-charge) and Dr Gorakshakar for considering the request from us and their counterparts in Sri Lanka and giving the permission to send the units from India. In the meantime, Sr Francine Muthugala secured the permissions at her end. With the authorities taking a humanitarian and considerate stand on both ends, the next challenge unfolded.
You could count the Bombay negative donors on your fingertips in India. With this, organising for units also was a tricky matter. We approached all the eligible donors and two of them agreed to donate, while the third was unreachable. Both the donors are from the finest pool of humans - donating their blood regularly. However, there were additional challenges. The first of the two donors needed to come back in a few days to donate because he was on a medication that could potentially cause complications for him post donation. The other one, very unfortunately, met with an accident on his way to the blood bank. As usual, the team accepted the changed scenario and reworked the plans. We reconnected with the third donor and this time we were able to reach him. He kindly agreed to travel from Chennai to Bangalore for the donation - something that was crucial to be able to get everything right for the transfer to happen on time.
We must admit that while we balance our time amidst extremely demanding schedules and requirements working on blood requests, however, the time spent with the donor as he/she is donating is very refreshing. Our donors, the faceless heroes who donate single-mindedly to save the life of that unknown person who is struggling to survive, are such a pleasure to be around with and talk to. Once the units were donated and tested, this part of the challenge looked complete. It’s a story for a different time about how the demand for more Bombay negative units was already keeping our team busy by this time.
With the permissions and the units available, safe packaging and transport were the next challenges. There was no second chance. A lot was at stake and we had to make sure that we build a full proof plan to ensure that the units reach safely from Bangalore to Colombo.We summoned the experience we have accumulated over the years attending to extremely rare blood group emergencies to plan for the transport, coordination, packaging etc. First, we approached the several international courier services. Unfortunately, none of them responded positively. Then we requested Sr Francine to send someone to pick the units and thankfully Sr Prisca agreed to come. She reached India on the night of 22nd December 2016.
In-spite of the preparation, there were some problems changes required to the documents. Together the doctors from Sri Lanka, Sr Francine’s team and our team worked closely to get everything right. On the night of 23rd December, a plane took off from Bangalore carrying in it the units to Colombo. We anxiously waited to receive confirmation that the units reached safely, which we got by midnight.
Looking back, this was a very unique challenge. Colleagues of the patient, doctors, authorities on both sides, blood donors and our team came together to overcome every hurdle in the way of making the critical units find their way from one vein to the other. Of-course it fills our hearts with optimism, faith in the inner goodness of people and commitment towards of our mission to give each life a better change. This said, for Team Sankalp, at least for the time being, one more request closes as more await to be attended to.