Posted on May 11, 2015 by Travis Jones
Anyone who has ever received a blood transfusion is grateful that they had access to the blood when they needed it. Thanks to the efforts of organizations like the Red Cross and the generosity of individuals worldwide, most developed areas have regularly replenished supplies of blood for those in need. Singapore is no exception. At the time of this writing, the city has ‘healthy’ supply levels of all 4 types of blood (A, B, AB and O) according to Donorweb, a website which tracks blood supply levels in Singapore. However, as we will discuss in this article, one size does not fit all when it comes to blood, and if some demographics are not taken into special consideration when it comes to blood transfusions, it can have very serious impact on patient health.
Singapore blood supply
In 2013 the HSA reported that 116,200 units of blood was needed for the year. (That’s 16 units per hour.) While only slightly less than 2% of Singapore’s residential population donated blood in 2013, this number still accounted for almost 71,000 individual donors, 39% of whom were regular donors; all of who allowed the city to reach its blood supply needs. Of the blood donated, the majority was needed for general surgery and medicine. Accidents and emergencies only accounted for 6% of blood transfusions in Singapore during the year.
One type of blood that is often overlooked in Asia is Rhesus negative (Rh negative) blood. Beyond the 4 basic types of blood, every person’s blood is also either Rh positive or Rh negative. If you have Rh positive blood, it simply means that you have a protein on the surface of your red blood cells that is not found in Rh negative blood. This factor does not have an impact on a person’s health normally.
Of all the blood donated in the most recent year on record, only 1.48% of it was Rh negative. For some populations, such as Asian and African peoples, those with Rhesus negative blood make up less than 1% of the population, so Singapore’s blood supplies are likely adequate to address their needs. However, people of European heritage are far more likely to have Rh negative blood, as it flows through the veins of 16% of their population. This means that Caucasian people in Singapore could run into an issue with blood supplies, if they were to make up most of the population. However, when we consider the actual number of the city’s Caucasian population, we get a clearer picture. Since Singapore’s population is composed of only about 1.3% Caucasian people, the Rh negative blood taken in by local donations should be adequate.
Is there enough?
This is in stark contrast to a city like Hong Kong, where Rh negative blood should be a big concern for people that may need it since the amount of Rh negative blood collected through local donations in Hong Kong each year is unknown. While the amount and types of blood collected each year by the Red Cross in Singapore is public knowledge (at least for the time being), what is not known is the amount of blood that is on hand at each hospital in the city. When reached for comment, a representative of the Health Sciences Authority stated that they were unable to provide these numbers because it is “restricted information.” This is another difference from Hong Kong, where it has been known for some time that hospitals normally keep 2 pints of O-negative blood on hand (type O blood being a universal donor), and can request more from a central store maintained by the Red Cross. It should be noted that Matilda International Hospital in Hong Kong, which is a premier medical facility for expatriates, actually keeps a larger supply of 4 pints on hand to cater to the demographics of their patients. Additionally, Hong Kong currently has a system in place with a provider in the UK to transport Rh negative blood into the city should their stores be depleted.
The American Red Cross states on their website that a single car accident victim can require as many as 100 units of blood. Does Singapore have this much Rh-negative blood to transfuse? Only the HSA knows for certain, but if we look at the total number of units of Rh negative blood donated annually and spread it out over the year, there should be more than 100 units available each month, although this will not all be type O blood. Consequently, depending on your blood type, it is hard to know for sure if a person with an Rh negative blood type in Singapore is truly safe in the event of a serious accident.
The dangers of shortages
It has been reported that as much as 43% of blood transfusions worldwide use inappropriate blood products for the recipients. So what are the dangers of receiving Rh positive blood to Rh negative people? Well, if an immune system that is accustomed to Rh negative blood detects the protein found on Rh positive blood, it is likely to attempt to remove the protein from the person’s body. The exact reaction can vary greatly depending on the individual, but the result could range from a burning sensation, chills, fever, general pain and a “feeling of impending doom” to shock and clotting that can lead to death. Thankfully, most reactions can usually be detected and corrected early, and mortalities due to improper blood transfusions are rare.
In addition to these problems, pregnant women are especially susceptible to issues that can be caused by receiving blood with the wrong Rhesus factor. A reason that pregnant women are at risk more than most is that profuse bleeding is not uncommon during delivery, and transfusions are needed relatively regularly in maternity wards. The real problem here is that if an Rh negative woman is given Rh positive blood, she is likely to become sterile and unable to have children in the future. For this reason, many hospitals will immediately require an Rh factor test upon admitting a maternity patient so that the wrong blood will not be given if it can be avoided.
All this may lead affected people to ask, “How can I make sure that I’m protected in the event that I am in an accident or have a surgery that would lead to heavy blood loss?” The first and most obvious actions to take are to make sure that they donate blood regularly and encourage others to do the same. If communities of Rh negative people do this, they will not only ensure that there is blood available for them if needed, they will be helping others in need as well. People can even ‘bank’ their own blood weeks before a surgery when possible to make sure that there is a supply available. The next point is to talk to officials at your local hospital to ensure that they have a supply of blood on-hand for you (preferably O-negative). After all, you may not be able to wait for blood to be transported when you need it most.
Pacific Prime Singapore has a large number of expatriate clients in the city, and supports efforts to ensure that their medical needs are well taken care of. In light of this, we believe that full transparency is essential to make sure the Rh negative stores of blood in local hospitals are always at appropriate levels. Since Pacific Prime cannot directly supply blood to our clients, we encourage people to contact their local care facilities and Red Cross branches regarding this issue. However, for any international health insurance needs, our agents are always available to provide you with free quotations and information on plans from the world’s best insurers. Contact us today to find out more.