Subhas Chandra Pattanayak
Hospitals are meant to cure illness and give new lease of life to the patients. But blood transfusion is an area where patients may be pushed into savage-death if the infused blood is contaminated with HIV I&II, HBV or HCV. This is happening in Orissa, as 80% of Government Blood Centres in the State have no NAT PCR screening facility, despite a mandatory order of the High Court of Orissa in W.P. (C) No. 13441 of 2009.
This was a case of a three year old boy of Baramba infested with AIDS due to infusion of blood contaminated with the dreaded HIV obtained from Blood Bank of Bhubaneswar Municipal Corporation (BMC). The shocked father of the Boy Sri Pratap Kumar Nayak had moved the High Court for direction to the Government for treatment of his only son. The State had claimed that the blood was ELISA tested and hence safe. After in-depth analysis of reality, in its judgment delivered on 28 July 2011, the High Court held the State Government responsible for the unsafe blood given to the unsuspecting patient and directed that NAT-PCR testing of blood in all the blood banks must be a must for the government. An excerpt of the verdict:
‘Needless to say that blood donated by one saves life of another. Donation of blood is a noble work. In order to achieve this avowed objective all necessary safeguards must be taken while collecting, testing, storing and supplying blood. Otherwise, instead of saving the life, the contaminated blood would take the life. It is not disputed that during window period, unless the special test known as Antizen test is conducted through Polymer Chain Reaction (PCR) method, the virus cannot be identified. Therefore, the Government must ensure that in all blood Banks the Polymer Chain Reaction (PCR) method is available to identify the virus of HIV during window period. We, further direct opposite party no.1-State to provide free medical treatment to the baby of the petitioner who is a HIV patient.”
The Government did not bother about implementing the Order. And on the other hand, mandarins of the health Department contemplated on moving the Supreme Court against the High Court verdict.
The victim belonging to my area, his father Pratap Kumar Nayak had attracted my attention to this problem. I had exposed the malady under the title “Shocking Reality: AIDS Being Aided by Government of Orissa”.
As the Government did not comply with the welfare order, we went on discussing the issue as often and as deeply as possible. This attracted attention of the then Opposition Chief Whip Prasad Harichandan, who raised a powerful debate in the Assembly over the matter. In reply to his motion, the Minister of Health assured the House on September 01, 2012 that the High Court Order would be fully honored and the Government will take all steps to install the NAT-PCR facility all over the State, to begin with the three Medical Colleges of the Government. ORISSA MATTERS recorded the development under an apt caption on September 02, 2012.
But the progress was impaired due to disposition of officials whose design to challenge the High Court order was defeated with the assurance of the Health Minister in the Assembly.
Young Odisha leader Amit Abhijit Samal moved the High Court in W.P.( C ) No.25727 of 2017 seeking implementation of the High Court order of 2011 in public interest. The mindset of Orissa officials is such that, in reply to the writ petition, they ventured to tell the Court in an affidavit on 25.07.2018 that, “A latest version of ELISA kits are going to be introduced throughout the State, which will substantially reduce the window period without much financial implication.”
Is the ELISA method as capable of detecting the above viruses in their window period as is NAT-PCR?
No. The Hon’ble High Court had observed in the 2009 case.
And the Directorate of Blood Safety, Odisha has also said so in a recent reply to a query under RTI.
Samples reported Negative in ELISA found Posive in NAT PCR
The Directorate has admitted that during the period from June 2016 to July 2022, as many as 2668 units of blood reported NEGATIVE in ELISA method were found POSITIVE in NAT-PCR test (Letter No. 676/SBTC, dt.22.8.2022).
This means, if the samples were not rechecked in NAT-PCR method, 2668 cases claimed to be safe due to clearance in ELISA could have severely affected the patients, exactly as had happened to the 3-year old victim of unsafe blood, a phenomenon which had formed the crux of W.P. (C) No. 13441 of 2009.
It is shocking that, despite office-records of the Directorate of Blood Safety, Odisha showing that as many as 2668 cases shown negative in ELISA test were detected positive in NAT-PCR screening, the officials of the health department have told the High Court in W.P.( C ) No.25727 of 2017 that “ELISA kits are going to be introduced throughout the State”. If anything it means, health department officials want unsafe blood to be infused to unsuspecting patients, as thereby “financial implication” would not be “much”.
According to the Directorate of Blood Safety, Odisha, the following Blood Centres have adopted NAT-PCR method: (1) SCB MHC, Cuttack, (2) VIMSAR, Burla, (3) MKCG MCH, Berhampur, (4) PRM MCH, Baripada, (5) FM MCH, Balasore, (6) SBB MCH, Bolangir, (7) SLN MCH, Koraput, (8) Capital Hospital, Bhubaneswar, (9) BMC Hospital, Bhubaneswar, (10) Central Red Cross Blood Centre, Cuttack and (11) OBC DHH, Jeypore. Orissa, according to this Directorate, has 55 numbers of Govt. Blood Centres. This shows that 80% of the Govt. Blood Centres are using ELISA method, which is, as shown above, incapable of detecting HIV I&II, HBV and HCV in window period their entirety. It otherwise means, 80% of Orissa Government Blood Centres are supplying possibly unsafe blood to unsuspecting patients. This further means, the Baramba case is being repeated in the areas of 80% Govt. Blood Centres in Orissa under the plea of “financial implication”. Sad, under such a fictitious plea, blood collected in 80% of the Govt. Blood Centers are given to critically ill patients, whose lives depend on Blood Transfusion, without them knowing that the blood given to them might be carrying the most dreaded HIV I&II or HBV or HCV.
If financial implication is not to be “much”, the Govt. should cover the ELISA dependent Blood Centres with the Centres where NAT-PCR facility is in operation exactly as it has done in cases of BMC Hospital Bhubaneswar, CRCBC Cuttack and OBC DHH, Jeypore. But the conduct of the Government is murkier than sincere in its approach to the terminally ill patients who live within geographical limits of 80% of the Govt. Blood Centres, mostly in rural areas and depend on blood transfusion for living.