Around 4:00 p.m., the ringing of the telephone made Nersa look at her watch. A request for blood had come in from Dr. Ernesto Guevara General Teaching Hospital. An elderly woman in her 32nd week of pregnancy, with a high-risk pregnancy, had undergone emergency surgery due to bleeding. She didn't think twice. A mother was defending the possibility of having her child with her life, and she needed help.
In seconds, the usual process was set in motion at the 28 de Septiembre provincial blood bank. Two bags of B+ were provided, but they only had three units of platelets (the others had been used that day), and the mother needed seven. Ipso facto, they began to call for emergency donors.
The protocol set the pace of work until dawn. Special donors from group B were located, gave their consent, and were picked up by the center's transport service. After the usual series of checks, the delivery finally took place, and after 1:00 a.m., the machines were turned off to resume again the next morning.
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This was not at all an unusual day for Dr. Nersa Vega Rivas in her role as director of the bank, nor for the group of nearly 100 workers who, beyond working hours and weekends, provide support to hospitals to ensure the lives of patients.
There, at the slightest sound of ambulance sirens (which are sometimes confused with those of the PNR) or social media posts announcing mass accidents, “everyone” springs into action and tracks down blood as if it were gold. Many specialists at the center emerge as donors; even Nersa herself has rolled up her sleeves on several occasions.
“Our social objective is to collect safe blood to support medical care. It's a program that people love because we work with an organ that is donated voluntarily, and there is always high demand. Therefore, we are constantly on the move in search of it, day after day; sometimes we make a trip just for four donations,” emphasizes the doctor.
“We are responsible for administering the resource to both the Mártires de Las Tunas pediatric hospital and the Guevara hospital, and we assist some municipalities that report difficulties. We support all emergencies and the Maternal and Child Care Program (PAMI), for which we maintain a reserve, given its importance. We also have a great responsibility to on hematological and hemodialysis patients.”
WHO IS RESPONSIBLE?
Amid growing demand in this area, the blood bank has a strict schedule for collecting donations, for which fuel is provided no matter how empty the tanks are. It is understood that the search is for life.
"We go to the municipalities and their health areas, we depend on their ability to mobilize people, and the importance that the family doctor and nurse clinics give to the program. I insist it is not a matter of complying with a plan, it is painful to have a loved one who needs blood and there is none available; we have to act with that sensitivity."
"In the province, there are banks in Puerto Padre, ‘Amancio,’ and Jobabo. In addition, we have a special extraction center in ‘Jesús Menéndez.’ The responsibility of ‘28 de Septiembre’ is for the territories of Las Tunas, Manatí, Majibacoa, and 'Colombia'."
"We have a plan for a thousand donations per month, which are distributed among the different districts. Currently, we are unable to meet that target. It is very painful because sometimes we make a trip and come back with no more than four bags. That deficit has consequences."
"When I talk about this, I always emphasize that we lack the power to mobilize people, that we need greater mobilization and awareness on this issue. We give even our blood, and we know that many people in Las Tunas do not do so because they are not called upon, since empathy is something that the population has in abundance."
“There are requirements for donating, such as being under 65 years of age. Think about it, this province has a considerable aging population, which is on the rise. How can we guarantee the future of this program, which is voluntary, moreover?”
It is also no secret that we live in complex times in which it is difficult to have a protein-rich diet and, therefore, not everyone has normal hemoglobin levels. We must be very objective and, in this context, defend the supply we do have at all costs.
THE INVIOLABLE PROCESS
Once certain tests have been carried out, including one to determine hemoglobin levels, blood donation proceeds with the written consent of the volunteers. Each person's identification is always required because their organ will then be subject to further testing and, if necessary, they must be notified.
“The blood follows a critical path until it reaches the last link, where it is determined whether or not it is suitable for providing that final product with quality medical care,” adds Vega Rivas.
“In the Production Department, the resource is received, classified, centrifuged at high speeds, and tested. They count the erythrocytes, which are red blood cells; they make platelets, cryoprecipitate, fresh frozen plasma, and pediatric fresh frozen plasma.”
All plasma that is not used to make any of these derivatives is sent to the industry to promote valuable tests within the public health system.
To the pride of Las Tunas and amid complex contexts, the provincial bank boasts a first-rate program that is responsible for machine plasmapheresis, for which it has a hundred donors with special immune systems.
Similarly, it is the only institution of its kind in the country that complies with the Anti-D program, a vital component for the production of vaccines required by pregnant women to prevent what is known in medicine as Rh conflict. To ensure this mission of notable recognition, a single donor in the territory fulfills the state mandate.
ESSENTIAL SUPPORT
Julio (let's call him that) covers his face when I bring the microphone closer to him, and after assuring him of his anonymity, he pours his heart out.
"My elderly mother died at the Guevara Hospital. They gave her blood and always treated her well. Since then, I have donated whenever I can. It's a debt of honor I've taken on myself. The last few times, I haven't been satisfied."
“You don't go there for a snack, but you need it to get back home or to work. Last time they gave me a small roll with raw ham; the girl offered it to me apologetically because she knew it wasn't what I needed. I spent the morning feeling dizzy. I think the cold cuts even made me sick.”
Julio also tells me that his brother had worse luck. The day he went, there wasn't even any bread. Both have decided to postpone their activity, but only for the moment. When they feel better, they will return to fulfilling their commitments and convictions.
Dr. Jorge Luis Gutiérrez González, head of quality control at the 28 de Septiembre blood bank, whose face flushed with love for this remnant of life, assures us that the program, in general, is suffering and that it is urgent to give it importance and achieve intersectionality to keep afloat an activity that is synonymous with survival.
"I am ashamed to admit that our donors are not being well cared for and, as a result, we are losing them. I compare processing blood to processing sugar. To get good donations, we need to provide better conditions for the human beings behind the bottle, starting with food."
"There are regular, anonymous donors whose altruism is unknown in Las Tunas. They respond to emergencies when called upon, donate plasma repeatedly, and if we do not provide them with sustenance to revitalize them, they suffer because their protein and hemoglobin levels drop. Sometimes we have to tell them that they are not in good condition, and it is painful."
“It is essential to provide more support in this area because our community is large. Here, bread has often been purchased to ensure snacks for workers through collections among the workers.”
In the course of this investigation, other anonymous sources warned that the supplement that plasma donors should receive after each extraction, consisting of some fish, chicken, a bag of milk, and a liter of oil, is delayed, and sometimes they make up to three donations without receiving this diet, which is essential for their revitalization.
The provincial bank has identified around 100 plasma donors who can donate every seven days, but without the necessary support, their contribution is not feasible, nor is it accepted by the collective.
“I NEED O-, I WILL PAY ANY PRICE”
It is not uncommon to find someone on digital platforms calling for or buying blood donations. This gives an idea of the current need for blood and, even more so, the imperative to encourage this voluntary activity.
“We are aware that people ask for help on social media and that the majority of the population always responds positively, even offering their arm. We must take advantage of that power. We do not feel that this detracts from our work; we understand the pain and desperation of others. Of course, money is unacceptable here,” says Dr. Nersa.
