Sickle cell disease is an inherited condition characterised by sickle shaped red blood cells and chronic haemolytic anaemia. It can be explained as a genetic mutation with a single amino acid substitution in one of the chains of the haemoglobin molecule.

This condition claims a number of lives of children under 15 years confronted with a number of problems directly related to sickle cell among which are painful crises and in most cases anaemia,  and in saving lives, blood has been of great help.

Blood transfusion is a widely practiced procedure in health profession with the sole aim of saving lives. There is no factory for blood and every human being needs it in order to survive. Trials of blood transfusions have always brought families think they have a future. For these one may go abroad outside his or her homeland and will not be surprised to see that its being done even in America and the other outside world. So globally, blood is a very important event for every working person, making it a pre-requisite for life.

In Atutur hospital in Uganda, we have a very big clinic handling over 1,000 patients set weekly every Tuesday. And from experience, many patients, about 5 every clinic day come with anaemia resulting from either hyperparasitemia or infection leading to hemolysis with resultant anaemia. These have ended up in transfusions with lives having been saved.

Many clients especially those coming from far tend to delay with patients at home or in the clinics and later on come when they are severely anaemic, these have always been subjected directly to blood transfusions, enough to explain that blood is important in saving lives.

In a hospital setting, it’s not amazing saying that blood is very necessary in savings lives of sickle patients because there is no alternative other blood transfusion for child who is in pain and has sickle cell anaemia.

A big number of patients from over 15 sub counties come to visit Atutur sickle cell clinic and on the basis, anaemia is common with many patients ending up in the ward for blood transfusions.

There is always an accreditation to the laboratory personnel for making sure that blood is readily available most especially at rare hours in the evening on receiving desperate patients whose attendants cannot raise money to facilitate themselves to another unit where a transfusion service is offered. In these situations, some lives have been lost in the process of referral and at the destiny where blood is available.

Blood transfusion a very necessary event should be taken paramount, otherwise if altered many lives would be lost. It’s for free not at any cost and is available to anyone in need. The sicklers often cripple the economic status of the family due to frequent visits to the hospitals. Therefore if it were for sale many lives for sicklers would have been lost because repeated visits to the hospital demoralises the parents and they begin wishing for death which blood has always combated when given to sickle cell anaemic patients

Usually, in our unit, patients are referred to Mbale RRH for transfusion in times of crises where there are shortages. This is because blood is frequently picked from the blood bank of Mbale as we don’t have sophisticated storage equipment in the unit. For these, some patients who are severely anaemic for sickle cell disease have either reached successfully or ended dying on the way as for the prolonged period for them to get blood transfusion.

If availability of blood in the setting where sickle cell patients is guaranteed, then those who go with anaemia can be corrected immediately and life ia saved. on assessment, sickle cell patients have a reduced haemoglobin level which keeps on dropping in their life time and need frequent blood transfusion to maintain the level of haemoglobin for them to grow well.

It’s from the above that an appreciation for blood in the treatment and management of sickle cell can be based as a requirement otherwise, without it life would not be saved.

Blood donation which is a sole supplier should be encouraged to every human being in the communities nationally especially adolescents and adults so that a regular supply is ensured, otherwise a deficit will mean many people dying especially sickle cell patients who are prone to anaemia which cannot be treated by giving water or drugs to save lives in case of emergency.

The screening system should be improved with technical skills related to blood transfusions to avoid errors in the screening, grouping and cross matching of blood which can call for death.

Blood is a natural resource in that there is no factory manufacturing it. So in case of any need, it means it has to be obtained from  another normal person and given to the patient after it has been thoroughly screened for other chronic conditions which can be directly be transfused.

I work in Atutur hospital sickle cell clinic and I got touched one day, a Friday the 27^th Aug 2016 when I received the patient of sickle cell who had poorly been managed in a certain clinic from Kolir in Bukedea District. The patient was a 2 year 10 months old child who arrived at the hospital in the late evening with severe pallor of the mucus membranes; rest- lessnes and was almost going into heart failure. In saw the patient and ordered for the emergency haemoglobin estimation and transfused. But since it was late evening, the laboratory staff had already left and the one on call was quite far away thus immediate attention was not possible. However the lab person who was on call tried to hurry on receiving the call and emergency haemoglobin estimation with the results being so low as 2.0 g/dl indicative of severe anaemia. Grouping and cross matching was also done with result group B+.

The patient was rushed to the ward where the nurse quickly tried to put the intravenous line which was successful. A blood transfusion was started under hydrocortisone. To my surprise despite the fact that I had hopes in the child surviving and also basing on the fact that it had already gone into heart failure due to the severe anaemia, the child ended up dying after the initiation of blood transfusion. This left the managing team shaken and tension because they did not expect this to happen. However it was an inevitable event following the delay which had been made back in the village. This necessitates health professionals to always sensitize parents with such children that in case any deviation from normal, they should not delay with children in the clinics but hurry them very fast to a health setting or nearby facility.

If this child had been started on blood transfusion early enough probably would have survived because on experience a number of sickle cell anaemia patients have always been saved when subjected to blood transfusions especially for our case in Atutur Hospital .

This expounds the event of blood transfusion as very important in the treatment and management of sickle cell disease. Due to the above scenarios, it is important that health workers should avail themselves in their places of work at any time as sickness has no time to wait. The care takers of the patient should make sure that they visit the facility early enough to get timely treatment. For availability of blood, donation should be strengthened as there is no factory for manufacturing it. So let’s save lives in order to get a reward is in heaven.