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Tribute: South Africa can celebrate the women in blood transfusion medicine

The Covid-19 pandemic has had a global effect on the supply of and demand for blood. Despite the pressures this has placed on the South African National Blood Service (SANBS), the organisation – recognised worldwide as an innovator in blood collection and blood transfusion medicine – has continued its work on several pioneering projects with women at the helm.

Women are playing a leading role at SANBS. This is partly because healthcare in South Africa is female led at present, but also because SANBS creates an enabling environment for women to thrive, with progressive policies that understand and support women and the various roles we play in and outside of work.

Driving innovation

Innovation is one of our key strategic objectives and the areas in which we are innovating are broad, with many projects being conceptualised and led by women.

My role, as the medical director, is to ensure that our blood products are of the highest quality. We need to be pedantic. It is not an environment where one expects to see agility, and yet innovation happens, because for us it is a strategic imperative, embedded in the culture of the organisation.

Many people don’t think of the blood bank as a hub of innovation but just look at Lebohang Lebogo, a technical support officer, who became the first black woman to develop a drone-based programme that delivers blood products to hospitals in rural areas and collects samples for testing. This reduces the cost and time it takes to deliver blood. The programme is currently being piloted and will be ready for take-off once the Civil Aviation Authority (CAA) grants us a licence to operate.

Under the direction of Dr Tanya Glatt, we manufacture plasma serum eyedrops (SEDs) for patients with eye surface diseases. SEDs closely resemble natural tears and improve symptoms associated with dry eye disease. SEDs are currently made to order, but we are in the process of developing a more cost-effective off-the-shelf product.

We encourage all blood donors to maintain healthy iron levels through our #IronStrong programme led by Dr Pheello Lethola. Donors’ haemoglobin, the protein that contains iron, is tested at donation centres and we provide iron supplements for all donors under the age of 46 to help replace the iron we take from them. We are one of the few blood services globally that have a comprehensive programme of testing and issuing iron supplements at the time of donation.

Vanitha Rambiritch, the head of learning and development (technical), has made a name for herself internationally in the area of transfusion medicine training. She is a key member of the AABB Global Health Education Working Group and has been invited to co-author a book on transfusion medicine training which will form part of an international curriculum. 

Dr Riana Cockeran, who works in our cell factory, developed a system to produce research-grade human platelet lysate, a product that is used to grow cells from expired platelet products. Currently, when researchers want to grow stem cells, for example, they use a bovine-based product which is not ideal. Now we can offer them the first commercial, research-grade human platelet lysate in South Africa. Cocheran is also heading up a project to collect mesenchymal stromal cells. The use of these cells is exploding in the treatment of chronic inflammatory conditions, such as ulcerative colitis and other autoimmune diseases. 

Patient Blood Management is an international WHO-supported programme that aims to preserve a patient’s own blood. This avoids transfusion-associated complications and has been shown to improve patient outcomes. The programme is led by Dr Petro-Lize Wessels and SANBS is one of the few blood services actively involved in patient blood management. Elsewhere in the world these programmes are mostly led by doctors and hospitals.

Innovation as they say, is also often borne from necessity. Another woman doing incredible things is Dr Thabiso Rapodile, our lead consultant for training, education and advisory services who in response to Covid-19 restrictions, initiated a programme to put routers in blood banks to provide virtual training to doctors and nurses during lockdown.

Covid-related research

We have several Covid-related research projects underway, including the use of Covid-19 convalescent plasma (CCP), also known as “survivors” plasma’, to treat high-risk oncology and haematology Covid-19 patients. CCP contains antibodies to the coronavirus. Marion Vermeulen, a researcher and the national manager of operations testing at SANBS, led the project for the collection, quantification and processing of the CCP. This CCP was used in various clinical studies, including a project led by Dr Tanya Glatt where it is used to treat select patients with Covid-19 who are immunosuppressed – like cancer, stem cell and organ transplant patients – with positive results. 

We are also conducting a Covid seroprevalence study, again led by Marion Vermeulen. We test samples from blood donors for SARS-CoV-2 antibodies, which enables us to track the spread of the disease throughout the country over time. The tests are able to show whether the antibodies are acquired naturally, or from the vaccine. This data is being used by the Covid Ministerial Advisory Committee and is helping to inform the response to public health needs. 

At present, less than 1% of South Africans donate blood, and most only consider the transfusion element to patients in need. While that is a critical and core function of what we do to save lives, there is so much more. The incredible women driving innovation at the SANBS are truly working every day to find innovative and cutting-edge ways to save lives. 

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Karin van den Berg
Dr Karin van den Berg is medical director of the South African National Blood Service

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