Crisis Management Experience of Egyptian Blood Services by: Dr F Moftah

Background, 1 World wide Promotion of Safe and Sustainable Blood System Global: Man Made and Natural Unrest & Disasters Risk is the Probability of Adverse Event will happen Crisis is the happening of an adverse event

Background,2 People in all societies have the right to expect that any blood and blood products supplied to them, be provided in a way that is safe, sustainable and supports their communities and their health systems Health security is a fundamental and indispensable prerequisite to global, national and individual development Ref; IFRCRCS

Egypt Experience,1 Presence of Contingency Plan Stereotype Scenarios - Major Accident - Political Trigger Always practiced [N.B. Natural Incidents are not anticipated]

Egypt Experience,2 Crisis planning is an essential part of Egyptian MOH. It includes all measures to respond to sudden increase in demand under all circumstances. Egyptian National Blood Transfusion Services (ENBTS) after being reconstructed, established a contingency plan to deal with any crisis. However; plan's scope focuses on specific incidents/accidents but not nationwide disaster.

Introduction (1) ENBTS faced a unique situation during January 2011, [Egyptian Revolution]. It was nationwide crisis including all governorates. ENBTS management team dealt with it on an ad hoc basis. 800 deaths were reported, and over 6,000 have been injured in different governorates during the first week of the revolution.

Introduction (2) Situation of instability lasted more than a month [ and still !!! ]. Instability passed through different stages. The Organization's vulnerability and capacity; supported proper handling of the situation. MOH Officials disappeared

Introduction (3) Examples of difficult situations Staff stranded in homes and in work place. Violent demonstrations in front of NBT center. Staff strikes, and strange demands. Banks closed, no salaries for staff. Interrupted supplies delivery. No gas for vehicles. Many others

Aim Improving the response to unexpected disaster situations. Reducing vulnerability, is achievable by incorporation of blood services in the health /national crisis plans.

Material & Method (1) Stage1; Jan 26 till Feb 1, 93 units collected at NBTC (in Cairo) No telecommunication, cellular phones, internet. Curfew was declared and national security was deteriorated. Crisis management began from top of organizational hierarchy and immediate action plans for possible consequences were prepared by management team. Possible measures to maintain adequate blood. Curfew hindered blood collection through mobile drives, & stock distribution.

Material & Method (2) Stage2; Feb 2 till 17, 2798 units collected at NBTC Adequate blood supply was achieved by calling for donation through media (TV), organizing secured blood drives, encouraging in-house donation, utilizing stocks of blood, consumables, testing kits and reagents within NBTS network. Overwhelming reaction of donors and organizations for donation was managed by mobilizing staff to handle sudden donors' influx requiring accelerated drawing to meet emergent need. Contingency team in all departments handled work over load.

Material & Method (3) Stage3; Feb 18 till March 2, 388 units collected at NBTC Preventing blood wastage through this stage was achievable by slowing down collection rate, rescheduling blood drives. Conducting workshops for donation staff to come up with better performance plan of action.

Results ENBTS was capable to overcome hazards of triggering events. Neither shortage nor wastage of blood was experienced. Collection during 3 stages of crisis reached 3270 donations from organized blood drives, 544 donations in-house at NBTC. It was sufficient and met demands units were collected during the same time in the previous year. Regional Blood Centers all over Egypt followed the same pattern.

Conclusion Most of BTS crisis plans are designed to deal with localized incidents assuring high certainty of information and communication. Situation in Egypt highlighted the importance of having alternative telecommunication solution for the network (Intranet work) Stocks should be available in hot spots that receive emergency cases outside NBTS. Integration of NBTS plan within National Health plan is mandatory. Proportion between blood collection and demand should be optimized to prevent shortage/wastage during different stages of crisis.

Recommendations Risk management is important for modern BTS. Scenarios should include untraditional stories. Contingency plan should be integrated with National Health one. Learn lessons from other situations.

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