Wednesday, July 18, 2012

Must Read: How this sickle cell anaemia patient had his blood changed from SS to AA

When he passed out of the University of Benin Teaching Hospital clutching MBBS (Bachelor of Surgery and Bachelor of Medicine) in 1993, Dr. Bazuaye Godwin Nosakhare  did not know he would be heading back to the school to help groom other doctors. He also had no inkling that 17 years down the line, he would lead a team to put the institution on the global medical map. Inside the aircraft on a long flight to Switzerland in 2009, four members of staff of the teaching hospital comprising two nurses, one staff in the haematology department, and Bazuaye began the
journey to history. At Basel, in Switzerland, they had an intensive one-year training in stem cell transplant, a relatively new branch of medicine that provides total cure for sickle cell patients, leukemia and other blood-related disorders. When their trainers certified them fit, Dr.  Bazuaye, Mrs. Imafidon Rose (pediatric  nurse) Mrs. Ogunlere Beatrice (adult nurse) and Mr. Eguae Osaretin of the haematology unit returned to Benin to begin a process that makes the hospital wave the flag as a pioneer in bone marrow transplant in West Africa, coming behind Egypt and South Africa.
Something new? Dr. Bazuaye would not be drawn into any controversy given claims by some people who say they ‘have been working on it since 2001’.  ‘‘I would rather not involve myself in any claims.  I can tell you  that we have successfully carried out bone narrow transplant here and the patient is alive and well. The World Health Organisation recognises it and verification teams from the Ministry of Science and Technology and Ministry of Health were here. Even the minister was here. We are not in any controversy. If anyone says he has done any such transplant, it will be nice to see the patient and see how well the patient is doing,” he says, preferring to discuss the job.

Ndik Mattew  was five when his distraught parents brought him to University of Benin Teaching Hospital. He was a  sickle cell patient who regularly fell ill. He was ‘problematic’ as described by the team that did the bone marrow transplant on him. He reportedly could not stand on account of stroke and paralysis.  He was the shadow of a healthy when he was brought the University of Benin Teaching Hospital.
Changing from SS to AA Shortly after the trainees returned from Switzerland Ndik became their first test. ‘It was a tough and rigorous process’ said Egua Osaretin of the hematology department who carried out countless blood tests on the patient and his elder brother whose blood came to his younger brother’s rescue. The donor was admitted for weeks so that his blood can be certified fit for his brother through radiotherapy. 

The process took the hematologist to lagos endlessly given that the equipment in UBTH had not been certified at that time. When this reporter visited recently the equipment  been certified. That  will further simplify the process should the hospital  undertake another transplant.   After series of verification and a close watch that saw Dr Godwin Bazuaye living in the hospital premises for weeks, the bone marrow transplant tool place on September 28, 2011.


Ndik free from sickle cell   Dr. Nosa and his team were lent a hand by one of their trainers in Switzerland. The highly technical process simply meant that ailing Ndik’s blood was drained and replaced with that of his brother whose blood had no trace of sickle cell anemia. It is a rigorous process. Contaminated air must not slip into the patient and there must be 24-hour electricity supply, which made UBTH provide stand by power and inverter. There was no power outage, a tall order in Nigeria. But for Ndik to escape from the strangle hold of sickle cell the near impossible was done. 
On completion of the transplant things began to take a turn for the better. Twelve days down the line dramatic changes occurred in Matthew’s system. The change process had commenced. His blood began to change. The SS blood group was disappearing and the AA was taking root. Expectations were that after one hundred days the injected blood would have been fully engrafted 

‘In a successful bone marrow transplant such as we did here, it is expected that in one hundred days the new blood must have been fully engrafted into the patient.  That is why the search for blood donor begins from a member of the immediate family. If non is found from the family then we look out. Ndik’s elder brother came to his rescue. I believe that must have helped matters because his rate of recovery was outstanding ‘ said the Hematologist. 
Six months after the hospital represented Ndik  to the public. He had virtually transformed.  There was no stroke or paralysis. He had begun to walk around. His elder brother had come to his rescue. As the saying goes blood proved thicker than water. Ndik’s cure had a family touch. The family is better for it. They have their son back. He has become a far cry from the sickly five- year, struck with paralysis.


Another method  Daily Sun findings showed that bone marrow or stem cell transplant is racing ahead with fresh discoveries. These days transplants can be done without a donor. An enquiry at the Moyo clinic in the United States of America with outposts in Florida, Arizona and Minnesota showed that the patient could be his donor. The hospital wrote thus:’ A bone marrow transplant or stem cell transplant, also known as a blood and marrow stem cell transplant, is a procedure that infuses healthy cells, called stem cells, into your body after you receive a course of chemotherapy with or without radiation therapy.
Your doctor may recommend a bone marrow transplant or stem cell transplant if you have a certain type of cancer, such as leukemia, or a type of blood (hematological) disease, such as sickle cell anemia. The transplant may be performed using cells from your own body (autologous transplant) or from donors (allogeneic transplant). ‘
The system to use is contingent on the disease and the diagnosis. The heart-wrenching situation is that University of Benin Teaching Hospital is stuck. It cannot proceed with more patients in spite of an avalanche of requests. There are no back up equipments. Dr Nosa Godwin confirms that the Chief Medical Director who was away on official assignment when the reporter called had tabled requests to relevant authorities in the health sector to help procure those equipments to enable more Nigerians to benefit from the institution. Nosa has extended his call to corporate bodies to bridge the yawning gap between Nigerians and bone marrow transplant. 

He says the country’s army of sickle cell patients [about three percent of the population] deserves more succor than they get. The stem cell centre at UBTH is secluded and quiet. As you walk away from the center, you simply shrug helplessly bewildered by a seemingly wasting asset. You are left wondering if and when the next patient will be saved from the debilitating strangle hold of sickle cell Anaemia. 

-The Sun

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