NDF and Blood

The NDF. The Namibian Defence Force serves the people of Namibia, they would give their lives of any us on the battle field – they literally give their blood. “The people of the NDF were eager to donate blood and they checked ‘no’ ‘no’ ‘no’ in all the boxes”. These boxes are on the blood donation form and they ask the donor about previous contact with sex workers, partners with other concurrent sexual relationships and HIV positive partners. Interestingly, the NDF men and women did not hesitate to tick “no” in the boxes that asked “Are you donating blood in order to go for an HIV test?” or “Are you HIV positive?”

I donated blood today and happened to strike up a conversation with the nurse that was attending to my pouch which slowly filled with the life-giving crimson stuff. She remarked that going to the NDF is not cost effective, because “out of 100 donations, you can only accept 10.” She said this in passing – as if she was just giving an example of the senselessness of a blood drive at the NDF – rather than referencing a precise statistic. But she made me think as lay I there, reclining, squeezing that red ball in my hand to pump blood. The blood donation clinic stopped going to the NDF about “three years ago”, but they probably still have records of the times they did drives there. Is it possible to access these records in order to determine the HIV seroprevalence in the pool of donors on particular blood drives?”

HIV seropositive blood is but one of many cases when blood is rejected. The presence of other infectious microbes – such as Hepatitis virus – would also warrant a rejection. However, if the reasons for rejection are recorded by the Blood Transfusion Service of Namibia, one could tease out the HIV positive blood. The account of the nurse suggests that most of the NDF personnel who donated did not declare their seropositivity for a number of infectious diseases – including HIV. Without such a declaration, their blood was accepted unknowingly by the Blood Transfusion Service. In reflecting on reasons for which this declaration was omitted, denial of engaging in high risk activities for HIV coupled with ignorance of HIV status comes to mind. I based this hypothesis my other observations, where I discovered that soldiers in the NDF are prone to engage in sexually risky behavior (concurrent partnerships, involvement with sex workers). I wonder to what extent the people that go for blood donation in the NDF are a representative sample of the whole NDF. Is the sample a fairly equal mix of men and women and are the donors from all different divisions of the NDF or are they mainly soldiers?

When the NDF seroprevalence study is done, it would be illuminating to compare these findings with seroprevalence reported from blood drives in the past. Moreover, the seroprevalence reported by VCT sites accessed by the NDF could be compared to that of blood drives, especially since people who donate blood were probably ignorant or in denial of their status, while persons who visit VCT tend to take charge of their lives after testing. Here, I assume that firstly there would be no ethical problem in accessing the records of the blood drives at NDF, given that the identifying information of the donors is removed. Secondly, there would have to be a large enough a sample of people that donated for it to be considered a statistically meaningful sampling of the NDF. And the issue of representative sampling would have to be determined, by asking the blood transfusion service about the profile (sex, age, division ect.) of the NDF members that donated years ago. I know I am assuming quite a bit, but even if none this is possible, it is worth thinking about it.