“My husband and I started crying inside the doctor’s office. Our baby has spent the last three years in and out of hospital. His deteriorating health puzzled doctors until it emerged in April this year that he contracted the HIV virus from a contaminated blood transfusion in 2007.”
MmaGaone’s voice drops low as she tells the story. She dabs the corners of her teary eyes with the back of her thumb and takes a deep breath. She has relived that moment from four months ago a dozen times, but it still shakes her to talk about it.
I met MmaGaone at the BBS Mall parking centre. Tracing her was easy enough: she had given me directions to her “stall”. It turned out to be the back of a five ton truck displaying an assortment of oranges, apples and bananas in a teeming bustle of vendors. I walked past battered cardboard boxes displaying sweets and loose cigarettes and swerved past other vendors selling fruits and vegetables from the back of grimy pick-ups.
Her young boy is turning five next week Thursday and she is wondering if this will be his last birthday. The infant is already suffering the ravages of the virus. His once healthy body has withered away to skin and bones.
“Emotionally the toll the virus takes can be enormous,” she said. The social aspect started even before we knew he had the virus.”
MmaGaone, who is in her late sixties, has had to drive the truck to the market while her husband baby sits the sickly boy. Each time she hears of a new product that can boost the boy’s immune system she has had to take the day’s takings from the market to buy it. “There is this special milk sold in pharmacies which is very expensive, then there is the special juice and I also have to make sure that he has a regular supply of fruits and vegetables. The money I make from selling apples and oranges cannot go around feeding my husband, six other children and taking care of the sickly infant.”
I am lucky to find her tending the stall today. On most days she has to leave her truck unattended while either queuing at the hospital to have the boy’s viral load checked or running after Ministry of Health officers who are always in meetings. “I have had to wait outside their office from seven in the morning to two in the afternoon only to be told to come back the next day when they are not in a meeting. Since April, I have not had an explanation from the Ministry of Health. I want an explanation. I want to be able to tell my son how this happened and why it happened and who was responsible,” she says.
It is insulting to have ‘to beg’ for elementary justice, she says.
“My son is living under a death sentence for the mistake of having trusted in the cleanliness of blood from the Deborah Retief Hospital in Mochudi. We have suffered in the worst way possible, not only financially but by losing our livelihood and our ability to lead a meaningful life. And government officials will not even spare a few minutes to meet us and explain themselves.”
In desperation, MmaGaone has engaged BONELA to sue the Ministry of Health for P5 million. BONELA Legal Officer, Dikeledi Dingake, two weeks ago gave the Ministry of Health 30 days statutory notice of their intention to sue them.
According to the notice, the infant “fell ill sometime in 2007 and was taken” by his parents to Deborah Retief Hospital in Mochudi where after several tests he was diagnosed as being anemic. “Prior to the diagnosis, client was informed by the attending doctor that they have checked for all diseases from the urinal and blood samples and they were unable to pick any other diseases save “for the toddler being anemic”.
“ A blood transfusion was subsequently administered after assurance by the attending doctor to client that the procedure was not only in the best interest of the toddler as it was necessary to save his life but that the blood was very safe as it had been thoroughly screened in medical laboratories hence it was free from diseases.
“Relying on the assurance of the doctor, client verily believed same to be true and henceforth consented to the procedure. Thereafter, the toddler never recovered and instead started developing symptoms of HIV, eg enlarged lymph nodes. As the toddler’s condition deteriorated, client started frequenting both local clinic and Deborah Hospital with the toddler for medical attention.
“On the 15th April 2010, client was advised to check the toddler for HIV as he was exhibiting symptoms of HIV/AIDS and the worst was confirmed; the results were HIV positive. The situation brought untold fear for the loss of life of the infant, depression, shock and confusion upon client and her husband.
“Puzzled client approached the hospital manager, Dr Onyach for answers and he promised to investigate the blood transfusion as client suspected the virus was transmitted to her son then. In the meanwhile client and her husband went to test for HIV and their results were negative.
“Indeed Dr Onyach subsequently called client and her husband with a report: that indeed the blood sample from the sickly infant’s blood transfusion, which is normally kept for 5 years, was found and it tested HIV positive.
“At Dr Onyach’s insistence, client and her husband was once again called for a meeting sometime in May 2010. Present were Dr Ndwapi, Ms Makhwade, Ms Lopang and two others unknown to client and her husband.
“During the said meeting, Dr Ndwapi confirmed Dr Onyach’s report regarding the blood specimen and said there had been a mistake of some kind, nonetheless they will act on the matter and revert back to client. Since the said meeting, neither Ms Makhwade nor Dr Ndwapi is willing to meet client and have the matter resolved once and for all.
“The infant has and stands to suffer future trauma, domestic, social, psychological damages as a result of the negligence by your hospital personnel. The handling of such critical procedure can’t merely be said to be a mistake, especially where it is tantamount to an infringement of the right to life of such a young child.
According to the Botswana government website, the advent of HIV and AIDS has put the importance of safe blood transfusions into sharp focus. “It has been recorded that the risk of transmission of HIV from an infected donation transfused to a recipient is well over 90 percent. According to the World Health Organization (WHO) 10 percent of all HIV infections in developing countries is a result of transfusion with infected blood products. Botswana has adopted WHO protocols and procedures for screening blood for transfusion transmissible infections. Bar coding of samples, automation and/centralization of testing supported by appropriate blood bank software reduces the risk of Transfusion Transmissible Infections (TTI) due to human errors. In the year 2000 Ministry of Health formulated a National Policy for Blood Transfusion whose aim is to monitor and coordinate the recruitment and collection of blood from voluntary non-remunerated donors. In the quest to reduce the risk of TTIs, a year afterwards, the ministry published the national Guidelines for Clinical Use of Blood Products. Implementation of the policy was however fraught with constraints and sero-prevalence in the donor population was recorded at 9 percent.
Prevention of blood-borne HIV transmission has seen significant successes after the development of a 5-year Blood Safety and Youth HIV Prevention Programme in partnership with ACHAP, in 2003. In 2006 the blood discard rate due to transfusion-transmitted infections declined from 9 percent to 2.7 percent. This decrease has been due mainly to intensive HIV prevention interventions and the selection of low risk groups for blood donation. Blood is obtained through the Pledge 25 program that recruits young people to donate safe blood to Botswana’s hospitals and educate them on how to stay free of the HIV virus. Pledge 25 encourages young people to donate blood 25 times in their life. In addition to blood donation, Pledge 25 is intended to enhance HIV prevention among youth. Uncertainty about the legal age of consent for testing, however, has led to a number of cases where young people were deliberately misinformed about their sero-status.”
The case is expected to shed light on how the deadly tainted blood was able to get past the safety screening and how many more people may have been infected during transfusion. The overall risk of AIDS infection by transfusion remains quite small when compared to other commonly accepted risks. The Sunday Standard, however, has not been able to establish the amount of HIV-positive blood units entered the nation’s blood supply undetected.