SUB-SAHARAN AFRICA — Emergency procedures are needed everywhere. Especially in traumatic situations like ectopic pregnancies and traffic accidents, potentially lifesaving techniques like blood transfusions are going to happen — even if it means scooping up the victim’s own blood with a ladle, and filtering it through gauze pads.
The “ladle and gauze-pad” technique is a very real method of blood transfusion in many nations in Sub-Saharan Africa. This mode of self-transfusion is a rudimentary approach to a revolutionary idea given the history of blood shortages in the region: use the own patient’s refiltered blood to save his or her life.
However, just because the technology exists in developed nations, does not mean that those same solutions are effective in developing countries. When things like electricity are hard to come by, something as powerful as a life-saving transfusion device is less useful than a kitchen ladle.
In 2013, a Michigan biotech startup called SiSu took it upon itself to create a product that overcame the infrastructural problems in the developing world. Started by University of Michigan graduates Carolyn Yarina and Gillian Henker and Albion College graduate Katie Kirsch, SiSu has created Hemafuse, the first auto-transfusion device that is portable, safe and easy to use.
Hemafuse acts as a giant syringe that can draw the desired amount of blood out of the body and transfer it to a blood bag where it can then be filtered and recycled through the patient. This type of emergency method eliminates a great deal of the dangers of contamination that were prevalent in the “ladle method.” It is also a great deal faster, and can transfer four to five pints of blood in a third of the time with one-ninth of the staff.
“This device […] can intervene during a pivotal moment in an individual’s care,” wrote SiSu founders Yarina, Henker and Kirsch on their blog. “Compared to most moments when autologous blood transfusion occurs, the Hemafuse, as an intervention, will be both more urgent and more evident in terms of results. Its handheld, sleek design reduces both blood flow issues and failure modes from a slippery, gloved hand mid-surgery.”
One Tanzanian doctor even claimed that it would replace the existing “messy and sometimes futile process.”
Blood transfusions have proved to be one of the most pressing issues in Africa to date. In the first month of 2011, drastic blood shortages at hospitals in the Côte d’Ivoire resulted in the death of 86 at a main city hospital, many of them children. Of the 923 people who needed transfusions in 2011, 19 percent did not get the blood they needed.
Half of those 19 percent died from conditions that could have been cured had they received the necessary transfusion, local and international health officials estimated.
Before the development of Hemafuse, the only option for auto-transfusion required a cell saver machine, which prevents cell degradation during blood filtration. These machines are bulky, wheeled apparatuses that have an excellent track record in hospitals but are not fit for emergency use on an unpaved backroad.
Additionally, these machines cost about $3,000 on average, with an additional $400 fee per use. The substantial costs of the Hemafuse originate from the filters, which need to be replaced once every 50 uses and cost roughly as much as a pint of blood. A typical pint of “red blood cell product” ranges from $130-150, even during blood shortages.
This gives Hemafuse over a $3,000 cost advantage on the cell saver machine, not to mention the portability advantages that arise from its design.
According to the U.S. Department of Commerce, “80% of the medical equipment in the world is only designed for 10% of the world’s population.” Given this, Hemafuse may be one of many products to come that are designed with the limitations of developing countries in mind.