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STREET VIBE: Being infected with HIV by your own Gov’t adds to T&T’s litany of woes 

“All blood must be tested to determine at least ‘type’ and, one would expect, for other possible infections, including hepatitis, sickle cell, etc.

“Clearly this is not the case with the blood bank in T&T. This explains how not one, but several persons, have become infected with transfusions. What is even more frightening is that it is quite possible that many others have been infected and are unaware.”

The following Letter to the Editor was submitted to Wired868 by Rudy Chato Paul Sr:

Photo: Presumably clean blood at a blood bank.
Photo: Presumably clean blood at a blood bank.

Reading the story of one of the persons who was infected with the HIV virus from a blood transfusion passing away, made me angry.

I am angry for a number of reasons. Primarily among them is that this person’s death, unlike the daily murders, was avoidable. Compounding the insult is when some fly-by-night, neophyte wannabe politician comes telling the population that the person did not die because of HIV.

It is evident that this political parasite lacks information about HIV and health issues in general. People who contract HIV don’t ‘die’ from AIDS; they die from related issues as a result of their immune system’s inability to resist simple things like pneumonia. So cause of death would not read AIDS/HIV, but simply “pneumonia.” Further complicating matters, in recent times, cause of death in many instances have been simply given as “unknown.”

This bothers me because several years ago I took issue with the blood bank when asked to donate blood for a friend. Upon entry to the blood-bank donors were provided with a questionnaire.

The questionnaire seeks to ascertain one’s life story: one’s sex life, including one’s sexual orientation, if one has a criminal record, number of tattoos, how many body piercings one had accumulated to date, etc.

The questionnaire was both intrusive and ridiculous. And I made it known to the staff. They indicated they were “only doing their job”—a common response by people who are too lazy to even think.

Photo: A girl receives a blood transfusion.
Photo: A girl receives a blood transfusion.

It also implied that if one manages to answer all the questions correctly, then there was no need for the blood to be tested. This basic assumption is seriously flawed. All blood must be tested to determine at least ‘type’ and, one would expect, for other possible infections, including hepatitis, sickle cell, etc.

(Wired868 cannot confirm that some blood is not tested by hospital staff based on a questionnaire).

Clearly this is not the case with the blood bank in T&T. This explains how not one, but several persons, have become infected with transfusions. What is even more frightening is that it is quite possible that many others have been infected and are unaware.

The issue of private and public health institutions are not immune from the fallout of this scandalous behaviour. Someone should be held accountable. But in a land where the “blame game” is the only game people become proficient at, expecting that someone, anyone, will ever be held accountable is simply an exercise in futility.

I made the point on several occasions, both in discussions and in writing, that one of the major problems facing this nation is our poor work ethic. This poor work ethic explains from why BPTT would refuse to have their platform built here to why we have challenges in every sphere, in particular state institutions.

It explains why BWIA/CAL, WASA, Petrotrin, T&TEC, NHA/HDC, government schools, and other state institutions are forever operating in the dark. Meanwhile, we have yet to see any bank in this nation record a loss, despite recurring claims of recession and depression.

Photo: Bank foreclosures are expected in the current recession. (Courtesy The Simpsons)
Photo: Bank foreclosures are expected in the current recession.
(Courtesy The Simpsons)

The almost non-existent detection rate on murders by the Trinidad and Tobago Police Service (TTPS) can also be explained by our sorry work ethic. And while I agree with the current PM that the government is not responsible for solving crime—it is the function of the police—the PM should know that when the government wishes to take credit for when “crime is down,” then they will be blamed for when it goes in the opposite direction.

I have also indicated on numerous occasions that cleaning up this nation is not a job for the faint-hearted. It is not a job for anyone who sees it as just “doing a job.”  Cleaning up this nation requires testicular fortitude of the highest magnitude, since we did not wake up this morning and became “lawless.”

We have been on that lawless path for quite some time and no one saw it fit or necessary to “bell the cat.” Now that the box is finally opened, it is disingenuous to act surprised as we watch our citizens die.

About Rudy Chato Paul Sr

Rudy Chato Paul, Sr, is passionate about gardening, music and writing and boasts post-graduate certification in Anthropology, Criminology and Sociology. He also studied Theology, which is why he is actively seeking to make Trinidad a better place rather than waiting for divine intervention. 

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131 comments

  1. what you did was an autologous unit, thats usually an option if you know surgery is coming up and you prepare and donate a couple weeks in advance… however…. most of the time, that aint the case…. and i wouldnt say the mixup happened at the hospital, the entire system is a lil difficult… also you have to remember at the hospital with clearance, all units are cleared in pairs… 2 technicians clearing in tandem, then switching and double checking what was just done by the other…

  2. The hospitals keep all units, what is sent to NBTS is the donor samples (usually 2-3 vials per donor)… so the samples are sent daily, and the hospital keeps their original donated unit unit the clearance sheet is faxed the following day after testing overnight (yes, the majority of testing is done at the end of the work day as all samples must be sent to NBTS at the close of the blood banks) Also all units a together pre clearance… after clearance however, all cleared units are then finished off so to speak and groupings are attached etc… the units for discard are tossed and the units on hold go to the hold fridge for follow up documentation over the next 2 days or so

  3. This entire thing is based on partial information, misinformation, heresay… as a Medical Technologist I’m trying hard to figure out why noone contacts the technicians and actually gets the information from the source itself.
    I have worked in the immunohaematology field for a number of years and sitting here and reading this thing makes me so sad you wouldn’t believe . The field is clearly just misunderstood… shrug.
    If you have a question about anything in particular… feel free to ask. I can detail the entire process out but it would be a long long post… it might be more efficient to just answer a question I guess

    • lets speak hypothetically for legal reasons and all that…
      it could be based on 2 things:
      1) the afflicted unit came from mt hope (hypothetically) and was cleared at the central blood bank, so we can look at the preanalytical problems there.
      2) at the analytical stage, 1 unit of blood is typically split into 3 separate components which can be used for 3 different patients… it can be split into more, but under typical situations its only split in 3 with different shelf lives… Partially Packed Red Cell (PPC) (28-35 days), Platelets(5 days), Fresh Frozen Plasma (1 year)

      So if we are looking at it from the preanalytical, the questionnaire is used to basically weed out and reject high risk potential donors, however, if you get rejected in one blood bank because of high risk they sometimes go to another blood bank in another hospital and just lie the second time (risk)…. however even if you pass the questionnaire and the Hb test with the copper sulphate (blue liquid to check blood count), ALL units are tested ALL… not a pool, ALL. its done using on site ELISA by NBTS (all hospitals send units to NBTS for centralized testing to ensure quality)…
      Now lets move unto the actual testing part… the units are tested for hep, chagas, hiv, syphillis etc… but not really for herp (everybody generally is seropositive for herpes… everybody). Problems at NBTS range from reagent shortages, facility issues (old old building with equipment and bad power grid etc), and criminal understaffing ( its usually like 3 technicians to cover all 7 days for 24hrs shifts)… so these folks are chronically tired… and staff just isnt assigned to NBTS… and they are directly under ministry of health not the RHA’s so it is indeed a ministry problem.
      when a positive is noted, the technicians on duty holds the unit for a few days and retests… and send a list of the units that have passed or not passed back to the hospitals where the units are stored on hold awaiting “clearance”. When an individual unit is positive, and held, it’s retested a minimum of 3 times to make sure of the result basically, sometimes hypothetically an error could be noted at this stage of retesting, or hypothetically a unit mistakenly cleared when it still has to be retested… but this happens almost never… within the 99th percentile… lets say once every 5 years or something to be fair…
      and because the unit would have been split into 3 already it can be distributed as soon as that list hits the individual hospitals. We have a shortage in the hospitals as people rarely donate voluntarily (always for tanty, or uncle, or mom, or dad, or somebody) so as soon as a unit is cleared, its usually gone (all private hospitals get their blood free from the hospitals too, plus all the random patients on the ward already in need of blood or blood products, so you can see where the shortage becomes evident)
      the last and overlooked area where mistakes could have been made is the double checking of units at the individual hospitals after they got cleared… cus its usually like
      unit 1-2017: clear
      unit 2-2017: clear,
      unit 3-2017: clear,
      unit 4-2017: hold
      unit 5-2017: clear,
      unit 6-2017: clear
      unit 7-2017: discard,
      unit 8-2017: clear

      and if done on a long list of units an error is possible, and thats why its usually double checked in technician pairs… but again, human error.

      i really really tried to give an overview and give the reasons… but i hope this helps Lasana

    • Yes. That helps with the bigger picture, which is identifying the flaws in the system so we have a shot at addressing them.
      To be fair to the letter writer, he doesn’t pretend to be a medical expert. He is just a frustrated citizen horrified by an error with grave repercussions.
      I didn’t agree with everything he said. But I do understand his angst too.

    • i read it and got a headache… it can be tiresome getting blamed for things and nobody knows just what you are putting up with in a failing and faltering system….
      Next week from 23rd ti 29th April is Medical Laboratory Professionals Week… so thats Technicians, Technologists, Lab Assistants, Phlebotomists… i wish there was a way to improve awareness of the field as its just in the background, noone asks questions once lab results keep coming out, but everyone is quick to condemn when a mistake happens and doesnt bother to check the conditions these folks are operating in to begin with… sigh

    • Thank you Owen Winnifred Anderson.

    • Owen Winnifred Anderson thanks for sharing. Email at lasana@wired868.com if you really are interested in getting more information on this field out. We can help.

    • Owen, this is good to hear. I think I was most horrified at the idea of pooling which I got from an earlier comment in the thread. I empathize with the fact that you are usually on the receiving end of blame. All scientists at one level or the other are held accountable for errors. While I don’t agree with the questionnaire to some extent, I can appreciate the fact that it categorically reduces “risk”. I especially feel disheartened to keep hearing about failing systems and resources in the public sector generally, health being a critical sector. Do you think an automation and records system for monitoring units at the different stages of batching, testing and retesting would help to reduce the chance of error? Do you know if NBTS has any kind of international accreditation or certification e.g. either complies with or ISO certified?

    • Alana its takes money for automation etc… and if they not even willing to hire more staff to do the testing, its even more unlikely they gonna pelt money for automation… also there are NO labs in trinidad and tobago that are accredited NONE, neither public nor private… inclusive of the private lab by emerald plaza side that has as a letter head that they accredited… they not… the lab isnt, they however have 1 test that has been accredited and they used that as creative licence to say the whole lab is accredited… buh dais another story and a marketing strategy…
      the standard for clinical/medical laboratories is ISO 15189, and all public and some private labs are trying to head there to be fully accredited but to be honest, the entire caribbean is unaccredited, and i cant remember the island that recently got accredited, but they are the only lab on that island up the caribbean to be accredited
      what NBTS uses are a set of standards and guides published by the American Association of Blood Banks and other accredited sources. the AABB are guides are generally the Gold Standards for immunohaematology labs internationally. but using the best guidelines and not having personnel etc isnt helpful.
      as for retesting, if more people were voluntary donors so blood could afford to be held for a few more days and retested and restested in case of lag period transmission (lag period is the time where somebody is infected but they have very low antibodies or antigens that can be detected and after the unit is tested and reads as neg, sometimes the unit can become positive as the immunogens rise after donation… up to 2 weeks)
      but in our system right now, if you donate a unit of blood today… by tmrw morning it has to get used by somebody cus it eh have blood in the hospitals

    • Lasana i’ll send you an email, i’m on a council for medical laboratory professionals, i’ll run it up the chain and shoot you an email in a bit

    • Thanks so much Owen Winnifred Anderson. Automation isn’t always expensive. Automation is sometimes more about process. I am not familiar with medical laboratories in the Caribbean so I can’t say what standards they operate at. You should be ISO compliant before applying for certification. That’s not actually difficult as most operational standards and recommendations are easily found. It does take a lot of time though and requires heavy management input and the willingness to systematically change. I only asked about accreditation as I was unaware of if there was benchmarks and applications for private medical institutions to say, the government, or if there is an international body. Again, I am not familiar with how the health sector is managed. Blood tests and the range of diagnostic tests that should be offered will always be limited by standards and systems. Until we understand what we are entitled to and demand it we will be forced to accept far less. I have an interest in technology in the life sciences and medicine and I am always interested in what’s going on. So I’ll look forward to information you post. 🙂

    • yeah, almost everyone is in the process of doing the accreditation, we have bureau of standards from the ministry and we also have the caribbean medical laboratory foundation (CMLF) they both liaise with labs to check in on their accreditation journey and how far they reach

    • Oh ok. Well I suppose local accreditation is a start. Cool.

    • the local bodies act as guides for the international ISO 15189, and CMLF performs the function of guide and reference for the entire region… so almost everyone in trinidad is working towards it… almost

    • That’s good to hear. That should mean they’re aiming for compliance. I suppose when you post about your field, the bodies and people involved and the limits it may be good to point out that these efforts are being made.

    • Owen, I’ve written about this process for my column in the past but officials have been cagey about discussing these issues. I’d love to have a publication focused discussion about this with someone empowered to talk about it. Feel free to DM me to follow up.

  4. This is certainly a fatal mistake. However the screening is not 99% perfect. I am not trying to absolve anyone from blame. Remember the case of Arthur Asche, not sure of the correct spelling of the surname, some years ago?

  5. Someone asked about the questionnaire. I’m alarmed at the level of ambiguity in this matter. I believe that some people don’t understand fully and that’s alright. However, if asked to complete a very ‘intrusive’ questionnaire, then you are free to object and abandon the blood giving mission. Simple Pimple.

  6. Ok so I finally read what was posted. The minister said the tainted blood came from one donor and it was divided into 3 part hence the 3 persons becoming infected. They are right that persons don’t have on their death certificate death via HIV but HIV related illnesses, but what if you die via heart attach not related to HIV what should one say? In the 30+ years of HIV being diagnosed in this country this is the first incidence of this nature that I know about. We were 1 of the first countries to test for HIV after it became a health concern. It is 1 too many. Especially if it was caused by human error.

    The first line of defense in testing is the questionnaire and it is that way for a reason to weed out high riskers, testing blood is expensive. All blood is supposed to be tested after taken from donors.

    There are several assumptions in the article on which they have no facts.

    I think the writer wanted to complain about the state of affairs in the country and used a topical issues as their entry point!

  7. Lasana any update on the investigation?

  8. Infected with HIV by your govt?
    What a dotish statement!

    • Ahmm Melina. Who do you think the victim will sue for that botched surgery if they are employed by the Ministry of Health? Think carefully.

    • That is not an answer to my question.
      Is the Minister supposed to be there and everywhere ensuring that health workers do their job??
      Answer that!

    • So apparently the Minister of health and the PM deliberately went to the hospital and willfully infected these people. Talk about jackass mentality.

    • Yes, there is.
      The headline “infected with HIV by your govt” is absolutely false!
      And that is the point I’ve been making all along.
      The govt didn’t give anybody HIV!
      That is a ridicilous assertion that you answered by saying that the govt can be sued.
      The govt giving people HIV is not the same as the RHA being responsible for the acts of their employees!
      I hope you finally got it.

    • Melina, headlines can sometimes be clumsy because of the space you have to try to give a gist of what is being said. This one might very well have been clumsy.
      It isn’t like I necessarily agree with everything the letter writer is saying at all.
      Now he did tie the infection of the children with HIV to a general level of incompetence by the Govt. Is that fair? The answer to that would probably depend on who you speak to.
      If you’re talking about the headline then I can’t begrudge you taking exception to it really. But it is just an opinion piece.
      There are parts of the letter that I agreed with and parts I didn’t.

    • A general level of incompetence by the govt?
      How?
      Aren’t people entrusted to run the RHAs and the Blood Bank?
      It’s impossible for the govt to run everything!

    • Ray Maneesh Dhanoo slackness under their governance

    • So the govt is supposed to be at the Blood Bank watching over the persons who are supposed to be doing their job?
      If a nurse gives a wrong injection to a patient or a doctor performs botched surgery, it’s the govt’s fault too??

    • Melina is correct on all points here, the headline and opening statement is misleading.

    • I’m trying to make it simple for you. The CEO of United Airlines didn’t drag anyone off a plane himself did he? Nor did the pilots… But somehow people are focusing on the airline as opposed to the two security guards who dragged off the passenger.
      Go share your brilliant logic with them and explain why the company has nothing to do with the action of its employees. Because in this case, the employer is the government and the employees are the nurses.

    • You still haven’t answered my question.
      You think that you are the only smart person here who knows that the Regional Health Authority is sued for the negligence of its doctors??
      Let me make it simple for you.
      In LAW and that’s the keyword LAW, the employer is held liable for the acts of its servants provided that those acts are done in the course of its duty.
      That doesn’t mean that in FACT, and the keyword here is FACT, the govt or the Minister was negligent in the performance of their duties.
      I thought you were smart enough not to mix up the LAW with THE FACTS.

    • Some people just like to be difficult yes

    • The only person who suggested that maybe the Health Minister should be there and everywhere is you.
      So you made a ridiculous assertion and then answered it yourself.
      But I’m glad that you know the Govt would be liable. There really isn’t anything else I’d like to add on that particular topic then unless there is another aspect of it you want to discuss.

  9. and the blame goes to the position of Dept Head ‘s vacancy-we good yes

  10. Does anyone know the reasons for the questioniare and the basis for the questions in it?

    • The questions are standard and I posted the US equivalent earlier in this thread.

    • I realized that part. That they are standard questions. However, I wanted the reasons for those particular questions. I can’t figure out the relevance of the questions to blood collection and testing. If the staff’s explanation of the reason to the donor is “they’re just doing their jobs” then I’m left to wonder if they understand. Blood donors are providing a voluntary service. At the least an explanation should be afforded or references as to the reasons for the questions.

    • It is meant to identify high risk donors. Such persons are generally not allowed to give blood.

    • When you talk about risk reduction for a voluntary service like this the end product that has to be used is blood. Therefore the questions make no sense from the standpoint of reducing risk to the receiver. The questions only reduce risk if there was no lab or standard scientific testing involved. The questions only make sense if no testing was being done. Since testing procedures exist and proper scientific procedures would demand independent testing of each batch I still don’t understand the need for a questionnaire at all. “Risk reduction” using such subjective questionnaires seems to only serve as a first line cost cutting measure. Based on an earlier comment pooling blood from different donors and doing larger batch testing (that’s how I interpreted the comments) is also cost cutting. Highly wasteful of human voluntary input and sad.

    • Thanks Kendall. Perhaps I misunderstood

    • It is a risk reduction strategy. Testing blood is expensive.

    • I am not explaining this again as the point was made repeatedly in the thread.

  11. I am always amazed that these armchair critics are have 20-20 vision after the fact and then seek to apportion blame to others. Did we have problems with blood donations in the recent past? I can’t say with any certainty we had or did not because no such information was in the public domain. If in fact there was a problem where were all of these medical critics. They are merely band wagon riders.

  12. Who tested the samples , they are the ones to face the music .

  13. It is situations like this that cause me to regretfully state that if there was a Fourth World status, Trinidad would be certified as belonging to it.

  14. One of my concerns are so many untoward things happen in this land. We hear about it in passing, but there is so much secrecy. hiring, firing, corruption wrong doing and the list goes on. Why is that so? We the citizens don’t unite and demand accountability and transparency, How long we going to take this nonsense,More than that., all governments are aware Trinis are 2 days wonder and just talk. Some people think voting them out every 5 years is the answer. No it isn’t, since nothing gets done.

  15. I gave my 25th pint of blood yesterday. Yes the questionnaire is a little embarrassing and intrusive, but honest answers offer a first filter on the process. I’ve been denied three times over the last 16 years because an answer raised red flags. Four vials of blood are taken along with every pint for testing. I am not in a position to say what happens after that.

  16. The incidence of HIV in T & T is higher than most people realise, particularly in Tobago.

  17. I was a blood donor for years until recently. I disagree about the questionnaire being intrusive and and you implying people are lazy. So you think people should walk off the street and just give blood? How did you come to the conclusion that after the questionnaire they don”t need to test the blood. Is that factual. T&T is not the first place this occurred. It’s’s human error and that person(s) should be held accountable. Social media has provided and forum for people to just talk without facts,. Everyone knows what governments should do and the blame game . BUT WHAT ARE WE DOING ? talk, talk, talk. when real issues arise do we as A people support the initiatives , no we take side in party politics , so here we are 50 years later playing the same games, accusing and blaming each other with NO SOLUTIONS, while WILD WILD WEST goes on unabated. An acting Police Commissioner for over 6 years , stopped by the Opposition in the Courts, I wonder why.? CRIME working for some people. The economy is stagnant and union leaders and unproductive workers want money. i see a person who knows the operations of the health sector is adressing statements above. Thanks for the information..The more things change they more they remain the same. I continue to pray for my land and for my PEOPLE to wake up

  18. Look all of this nonsense can be avoided if we had proper health records of everyone in the country

  19. Mind you some ppl find that questionnaire to be bias

    They think homosexuals should be able to donate no questions asked

  20. So all blood isn’t tested Karla? Or it was a massive filing error?

  21. “The questionnaire seeks to ascertain one’s life story: one’s sex life, including one’s sexual orientation, if one has a criminal record, number of tattoos, how many body piercings one had accumulated to date, etc.”

    There are good reasons why these questions are asked and they are standard questions.

  22. Dale Hassranah – care to comment?

  23. The new process will see the entire 25 donations dumped if the pool tests positive.

  24. From what I understand is that if 100 batches are taken , 25 are then pooled together and tested from there if one of the 4 samples test positive. Each donation of the batch is individually tested. There was an error a terrible horrifying error in this case.

  25. “It also implied that if one manages to answer all the questions correctly, then there was no need for the blood to be tested.”

    Rubbish. They ask the questions so that if you are at high risk, they do not take your blood. I am disturbed by this article because it presents zero proof and makes extremely serious allegations.

    • What allegations Kendall? This one: “It also implied that if one manages to answer all the questions correctly, then there was no need for the blood to be tested. This basic assumption is seriously flawed. All blood must be tested to determine at least ‘type’ and, one would expect, for other possible infections, including hepatitis, sickle cell, etc.”

    • That simply isn’t the reason they ask the questions Lasana. To even make the statement is ludicrous.

    • I will put an editor’s note for the suggestion that some blood is not tested based on the questionnaire. Otherwise, I found the other stuff to be the author’s opinion as opposed to serious allegations.
      But I’d agree that this line ought to be clarified.

  26. Someone supposed to be fired for this.

  27. Just to be clear, this also happens here in the US as well, not just Trinidad.

  28. I agree with everything he says about the work ethic. Before I agree with what he says about the blood bank, I would want some information on these people who became HIV+ from blood transfusions. When did they get the transfusions, etc. As far as I was aware, the purpose of the questionnaire was to weed out persons who may have blood issues (e.g. persons with tattoos may have hepatitis because of the use of needles similar to an intravenous drug user) and all the blood is tested. I don’t know if his comments are as a result of a story that I haven’t seen but I am sure that someone from the Blood Bank will respond.