Maldivian Blood Services (MBS) was formed on 1st November 2012. “National Thalassaemia Centre (NTC)” and “National Blood Transfusion Services (NBTS)” were merged to form Maldivian Blood Services with the hope and aim to provide better service to patients suffering from hematological disorders like Thalassaemia and other hemoglobinopathies and also to provide safe blood to those who are in need.
MBS has two main units: Thalassaemia and Other Haemoglobinopathies Centre (TOHC) and Central Blood Bank (CBB) TOHC is the only centre throughout Maldives serving exclusively to patients of Thalassaemia and other haemoglobinopathies.Thalassaemia and other haemoglobinopathies patients can get registered at MBS to get free service. TOHC will give free consultation by 4 experiences medical doctors. Patients who need blood transfusion will be taken care of by these doctors and well experienced and caring nurses at a welcoming and pleasant environment. As Thalassaemia is the most prevalent haematological disorder in the country TOHC has free facility to screen for Thalassaemia and also running programmes to increase awareness of Thalassaemia and other haemoglobinopathies among general public.
TOHC is also providing free medications to Thalassaemia patients. These include Desferoxamine (Desferal), L1 and Asunra.
Both voluntary and direct donors are received by CBB and work hard to create a cheerful and comforting environment to blood donors so that donors could have a good and memorable blood donation experience. CBB expects every donor to come back and donate after every 3 months. CBB is providing free blood to patients seeking treatment at TOHC.
MBS also has a common laboratory which caters for the needs of TOHC and CBB. Laboratory has facility to screen blood for Transfusion Transmissible Infections, cross-match blood for transfusion and Thalassaemia Screening.
Thalassaemia is a major socio – medical problem in Maldives.
Beta Thalassaemia is the type most common in Maldives. But with the improvement of laboratory techniques, homozygous and heterozygous states of alpha thalassaemia and abnormal haemoglobin disorders such as HbE, HbS, HbC and HbD cases are frequently seen.
It is not known when the first thalassaemia case was diagnosed in Maldives. The first few cases were diagnosed in the nearby country Sri Lanka approximately 20 years back. Awareness regarding thalassaemia was nil at the time. Many children die at the age of 5 to 7 years due to intercurrent infections, severe anemia and ultimately heart failure without being diagnosed or treated. A minority of severely anemic children who seek medical help were transfused without knowing proper diagnosis.
Diagnostic facilities were introduced around 1984. The government hospital in Maldives, the only one at the time, started diagnosing beta thalassaemia majors with HbA2 and HbF estimation by elution technique and macro column chromatography along with Hb estimation and peripheral smear cytology.
Two leading physicians in the work of thalassaemia presented two country reports based on the existing situation of thalassaemia in Maldives.
Dr.Bernadette Modell (UK), in 1988 estimated that 40 nre patients would be born every year in Maldives.
Professor Calogero Vullo (Italy), in 1992 estimated that 1 out of every 5 to 6 persons in Maldives is a carrier for Beta Thalassaemia.
Society For Health Education a local Non Governmental Organisation, conducted a survey in 1992 on 496 students (age group 14-20 yrs.) Based on this survey the beta thalassaemia carrier rate was estimated as 18.1%. One 120 births is expected to be a case of beta thalassaemia major. 1 in 30 marriages is expected to be between two beta thalassaemia carriers.
Based on the prevalence data of carriers, and if the birth rate does not change, approximately 60 to 70 new cases are expected each year.
The spread of thalassaemia may be due to the considerable in – breeding within the island communities although there is no convention of consanguineous marriages in Maldives. This may be due to confinement of the people to one’s island due to the difficult geographical situation.
Registration of thalassaemia cases at the beginning of 1992. Number of cases registered (as of September 15th 1998) are 326 and total number of deaths are 57. It is estimated that this number of registered cases is only a quarter of all the thalassaemia cases in Maldives.
Till the end of 1994, the diagnoses cases were managed in the OPD and later in a separate clinic in the government hospital ( Central Hospital) in Male’.
Due to the constant increase in the number of thalassaemia cases, the need arose to open a separate centre for their management.
Thus on 29th December 1994, the paediatric wing of the Central Hospital was converted to National Thalassaemia Centre (since a new hospital was opened the same year).
All the expences for blood transfusion and desferal therapy are covered by the government.
Cost of treatment per child per annum is $6000 (need to revise the figure)
In 1997, a Thalassaemia Advisory Committee was formed to give advice on different issues related to thalassaemia and its control.
National Thalassaemia Centre is a day care centre open for 12 hrs during 5 week days and 7 hrs on Saturdays.
When the centre started, it was manned by 19 staff members including 1 doctor, 2 staff nurse and 3 laboratory technologists. Today there are 46 staff members including 4 doctors
Maldivian Blood services commits to excellence by providing quality and equitable services for thalassaemia and other hemoglobinopathies in the country.
1. Provide quality and equitable care for thalassaemia and other hemoglobinopathies patients
2. Timely access to safe blood and blood products throughout the country
3. Prevent and control thalassaemia and other hemoglobinopathies in the country.