An alternative narrative
What the story of a Bangladeshi man who needed an urgent blood transfusion can teach us
KEM, a publicly funded institution, has a record of producing quality science
Sanjay Nagral
Jan 20, 2020, Mumbai Mirror
None of you reading this are likely to ever cross paths with Kamruzzaman from Dhaka. In 2016, this young worker was bleeding after an accident and urgently needed blood transfusion for lifesaving surgery.
Attempts by doctors to match the usual blood groups were mysteriously failing. Soon they realised that Kamruzzaman was one of those individuals who by the accident of his birth had one of the rarest types of blood groups in the world: The ‘Bombay’ blood group. This meant that he could not receive blood from any of the usual O, A, B and AB groups, but only from those exceptional individuals who also carry the Bombay group. This was going to be a stupendous challenge.
In 1952, a railway accident and a stab wound victim were treated within a span of a few weeks in Mumbai’s KEM Hospital. Both needed blood and seemed to have the common blood group O. Surprisingly, their blood reacted to all the common O blood group bottles with whom a match was tried. This had never happened before.
The perplexed but persistent doctors searched 160 further donors and finally found another individual whose blood matched. Their curiosity aroused, they then went on to study these patients and in an example of great science, zoomed in on the explanation of an absent antigen on the red blood cells that was responsible. Three Bombay doctors – Bhende, Deshpande and Bhatia – collaborated with four British doctors from the Medical Research Council on this work. They published their findings in the leading medical journal Lancet, and since the work was from Bombay, the blood group was named after the city. According to one estimate, one in every 17,600 people in India and one in every 25,000 people in the world has this blood group. It is perhaps more common in South Asia due to a higher incidence of consanguineous and endogamous marriages amongst family members and clans. Its incidence is falling in urban populations but is high amongst certain tribal communities.
Kamruzzman’s doctors were frantically looking for a Bangladeshi donor with the Bombay blood group, when through an online search they chanced upon and contacted a Mumbai-based NGO, Think Foundation, which runs a registry of individuals with this group. The foundation responded immediately and contacted its list of donors. The process needed clearances from multiple agencies, as transporting human blood across borders is an extremely onerous task. Kamruzzman was lucky. The blood of Swapna Sawant, Krishnanand Kori, Mehul Bhelekar and Pravin Shinde was flown to Dhaka after multiple permissions and Kamruzzaman’s life was saved.
There are several non-governmental organisations like the Think Foundation doing quiet, solid work in helping citizens in moments of crisis. Whether providing ambulances, blood, drugs, counselling or even training to deal with emergencies, the NGO sector’s contribution to healthcare is enormous. The recent initiative in Mumbai’s western suburbs by a group called ICARE to teach ordinary citizens to perform cardiac massage and use a defibrillator is one such example. In January last year, this newspaper reported how a Bandra businessman named Sameer Firasta saved the life of an architect, Prem Nath, who collapsed on Carter Road during a morning walk, by performing cardiac massage and using a defibrillator installed by ICARE.
The other area where the city pitches in is funds for medical care. I have personally experienced how many of my patients who run out of funds are helped by trusts and now, increasingly, by crowdfunding. What seems remarkable in this process is that there are no questions asked about the identity of the person needing help. Medical emergencies have the potential to evoke asense of urgent solidarity amongst ordinary people. In reality, these groups take the burden of activities that are actually the state’s basic responsibility.
In a sense, therefore, they bail out the state. The task of providing emergency care, whether for an accident victim or a heart attack, is in reality too complex and immense for only NGOs to handle. Utopian as it sounds to us, because we have never experienced it, organised public health takes care of such emergency needs in many countries. These NGOs remind the state about what it should be doing.
The Bombay blood group story is one that this city can be rightfully proud of for more than one reason. It’s an example of quality science from one of its publicly funded institutions. Of collaborative science across countries. It’s also acase of effective work beyond optics by acitizens’ NGO. And the willingness of common people to share with others.
But amid current talk of nationality, identity and citizenship, the story of the donors who saved the life of a Bangladeshi worker is a poignant reminder of an alternative narrative, expressed in lofty phrases like solidarity. Or more simply that every human being matters.