On a Blood Shortage Mission: Marine Conservationists to the Rescue

Words and Pictures by Elizabeth Fitt 

“Guys an emergency has occurred to one of TRACC’s loyal friends, his name is Zainal, his Mum has lost a lot of blood. The hospital is unwilling to use their low reserve on a local Bajau old lady with no nationality, but they are willing to do a blood exchange”

It’s 00:40 on a tiny Island in the Coral Triangle when the WhatsApp message comes through, sent to all at The Tropical Research And Conservation Centre (TRACC). It’s from Kit Wui Sien, 24, Science Officer on the board of directors at TRACC. and he’s mobilising a group of Marine Conservationists to volunteer in a way they were certainly not expecting when they decided to come to TRACC to study Marine Science, carry out research, and rebuild coral reefs. “I’m going to donate as much blood as I can at Semporna Hospital. Is there anybody that would like to join me in some blood donating activities tomorrow?” he asks.

Norabil Jinti Jaiman had been enjoying a visit from her son, Zainal, at her home on Kalapuan Island on Monday, when she lost consciousness. “I was supposed to bring back my new boat to Semporna, but ended up bringing my Mom” said Zainal, who has IC and lives in the small coastal town of Semporna. “I couldn’t bring her straight to the hospital because she doesn’t have the proper documents. So I brought her to a private clinic. The Doctor told me she needs serious care and helped me to write a letter to the government hospital so that I could take her there” he explained. The hospital went on to tell Zainal that his mother needed a minimum of four pints of blood and that, because of a blood shortage, this would not be possible unless he could find people to donate this for her.

By morning the TRACC WhatsApp group was inundated by a flood of willing volunteers and breakfast conversation was dominated by the subject. Those deemed most likely to pass the hospital’s screening questionnaire were loaded into the organisation’s boat to begin the 30km voyage to the mainland. Five of Malaysian nationality, one British person who’s lived in Malaysia all his life, an American type O- included in case the hospital was willing to take blood from non nationals as a last resort and a second British person who just really really wanted to try to help.

Semporna Hospital is small and though slightly run down, the grounds look nicely kept and the staff are very helpful. After a short wait for the lunch break to finish the Marine Conservationists are ushered into the Phlebotomy Unit. Nurul Adira, 25 is the Medical Laboratory Technician in charge today. She takes obvious pride in her work, efficiently supervising the Marine Conservationists through blood type tests and screening questionnaires. “We always have a shortage of blood” she says ruefully. “We need family members to replace blood if their family member needs a transfusion. It’s because this is a small hospital in a district where a lot of people have no IC documentation and we can’t take blood from them so there are not enough donors. For Bajau Laut people no blood replacement is possible without it being from their family.”

Jaiman is Bajau Laut and is stateless – with no legal access to state medical care. Without blood donors coming to the hospital to give blood for her, she would not be able to have the blood transfusion she desperately needed when she lost consciousness because her blood haemoglobin levels dropped to 3.8 (they should be around 10 or 11 in a healthy human). For hospital staff this is very difficult, Adira says she feels terribly guilty when patients sometimes can’t have a blood transfusion when they need it. “Sometimes we have to ask Tawau to give us some blood la. And sometimes with people with symptomatic anaemia we have to withhold blood from them when we don’t have enough and they have to wait” she says, obviously troubled. The hospital is not legally allowed to take blood from the Bajau Laut to replace the stock that is sometimes needed to treat them because they have no identification papers and the blood is therefore not traceable. Compounding this issue, there are not enough local donors to keep the blood bank at the hospital topped up enough to treat everyone as required. The Marine Conservationists are therefore a welcome bonus, more than replacing the quantity of blood required by Jaiman. Individually they are very positive and eager to help out, “I’m here because I want to help Zainal’s Mother. I know Zainal is very close to TRACC, I met him personally and I would want this if something happened to my Mum” explains Science Assistant Farhana Azmi, 22 – effectively summing up an attitude the district could clearly benefit from. It is likely we would all want a team of people to rush to our aid if we ever found ourselves in Jaiman’s position. The more Malaysians willing to adopt Azmi’s attitude the faster this problem will be solved in Semporna and other areas where blood supplies are low.    

Making tough decisions as a medic is normal, but Adira has an idea that might help to alleviate this particular situation. After five of the Marine Conservationists are able to donate blood (one has had a tattoo within the last twelve months, two have blood pressure that is below the threshold and one has had chicken pox too recently to qualify) they chat with Adira about the blood shortage. There is excitement as they discuss the fact that there is a whole conservation camp full of prospective donors who could really make a difference. “You must contact our Supervisor and then we can arrange for TRACC to come here regularly, or we can come to Pom Pom Island and collect blood” Adira explains. This suggestion is met with great enthusiasm – these people are very eager to help the hospital meet the needs of the patients, especially Bajau Laut who are very short of options when it comes to medical care. They understand that it is hard for the hospital to meet both legal obligations, patient needs and the emotional impact of not having enough blood donors and explain how grateful they are for some of the medical treatment the hospital has provided to people at TRACC from time to time.