A LIFELINE THAT RURAL INDIA CANNOT DO WITHOUT -HINDU CBE 25.09.13

Twenty year old Putul living in a village 70 kms from a district headquarters town in Chattisgarh had been in labour for 2 days and a night. it was her first pregnancy. After a tedious 150 min journey she reached a non-profit hospital, deathly pale and in obvious shock from loss of blood due to a ruptured uterus. A match for her blood group was not available to her and her brother was sent 70 kms far away to fetch blood. At the blood bank they insisted on replacement donation. He could not donate his blood as he was anaemic. Then a tout directs him for his 2400. he rushes back with it to the hospital only to find his sister operated upon to remove her uterus and a dead baby. A single unit of blood is not enough to save her and she dies the next morning. There were enough donors at the hospital, which could have been of help to Putul in this life threatening situation. Their blood needed to be matched, tested for infection and then give to her immediately, without the need for banking, a procedure known as ' unbanked Directed Blood Transfusion (UDBT). This method of transfusion due to unscrupulous practices by some commercial blood banks UDBT became illegal and in a stroke, blood availability in emergencies in rural areas became almost impossible. Solutions: there is no other way other than legalizing UDBT for use in emergency situations after proper testing in certified institutions for physicians who have had some initial training. Secondly replacement of blood by a relative of the patient should not be made mandatory especially in emergencies.  there is need to ease infrastructure norms for establishing new banks in smaller towns and community health centers. Finally there is a great need to license several institutions in remote areas for UDBT after proper training of staff.