Annual Report 2022-23 RBC D.I.

Khan

REGIONAL BLOOD CENTER,

D.I. KHAN
KACEHRI CHOWK DERA ISMAIL KHAN

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TABLE OF CONTENTS
INTRODUCTION______________________________________________________1

DATA ANALYSIS AND INTERPRETATION______________________________2

VISITS AND TRAININGS_______________________________________________9

EVENTS_____________________________________________________________20

AWARENESS SESSIONS______________________________________________22

CAMPS DETAIL _____________________________________________________26

TRAINING AND RESEARCH ACTIVITIES______________________________27

PHOTO GALLERY___________________________________________________28

DEFICIENCIES______________________________________________________33

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ABBREVIATIONS AND ACRONYMS

SBTP Safe Blood Transfusion Project
RBC Regional Blood Center
HBBB Hospital Based Blood Bank
BBMIS Blood Bank Management System
BTA Blood Transfusion Authority
BTS Blood Transfusion Service
FFP Fresh Frozen Plasma
HBV Hepatitis B virus
HCV Hepatitis C virus
HIV Human Immunodeficiency Virus
RCC Red Cells Concentrates
AIDS Acquired Immunodeficiency Syndrome
CUB Clinical Use of Blood
DHQTH District Headquarters Teaching Hospital
MMMTH Mufti Mehmood Memorial Teaching Hospital
ISBT International Society of Blood Transfusion
GIZ German International Technical Cooperation
KfW German development bank
DNA Deoxyribonucleic Acid
RNA Ribonucleic Acid
QA Quality Assurance
QC Quality Control
APH Antepartum Haemorrhage
PPH Postpartum Haemorrhage
RSA Road Side Accident
RTA Road Traffic Accident
FAI Fire Arm Injury
ITP Idiopathic Thrombocytopenia
VWD Von Willebrand Disease
DCC Day Care Center
PDU Pediatric Daycare Unit
LRW Labor Room Ward
C/S Caesarean Section
FSW Female Surgical Ward
MSW Male Surgical Ward
ICU Intensive Care Unit

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ACKNOWLEDGMENT
I want to take this opportunity and present the first annual progress report of Regional Blood Center
(RBC) D.I. Khan (Jan-Dec 2022). The report provides an annual review of the RBC activities,
which is carried out to approve the planning and evaluation of services. It enables us to improve
shortcomings by finding them scientifically. During the reporting period, RBC D.I. Khan has
managed 11,065 blood donors and approximately 27,591 units of blood components provided to
needy patients, which is acknowledged by:

 Mufti Mehmood Memorial Teaching Hospital D.I. Khan.

 District Headquarters Teaching Hospital D.I. Khan.
 Zanana Hospital D.I. Khan.
 District Headquarters Hospital Bannu.
 District Headquarters Hospital Lakki Marwat.
 District Headquarters Hospital Karak.
The figures mentioned above speak for the remarkable effort the RBC team has put into the
foundations of this center.

The RBC staff is grateful to the Government of Khyber Pakhtunkhwa and the German Government
for their continued support through the KFW (German development bank) and GIZ (German
International Technical Cooperation).

I want to take this moment and thank our blood donors who have enabled us to help poor and
needy patients, especially the thalassemia kids. I am grateful to all RBC staff, the management of
the affiliated hospital's blood banks and all the donors for their continuous support and cooperation.
I hope and look forward to continuing these efforts in the coming years.

Dr. Tahir Manan Khakwani

Manager, Regional Blood Center, D.I. Khan
Health Deptt: Govt of Khyber Pakhtunkhwa

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INTRODUCTION
Regional Blood Center is a project funded by the German Government under the "Safe Blood
Transfusion Program" (SBTP). Later, the status was shifted to regular by the KP Government to
ensure safe blood transfusion. RBC Dera Ismail Khan provides blood to Mufti Mehmood
Memorial Teaching Hospital D.I. Khan, District Headquarter Teaching Hospital D.I. Khan,
Zanana Hospital D.I. Khan, DHQ Tank, DHQ Lakki Marwat, DHQ Bannu, DHQ Karak. The
donated blood undergoes a series of testing; TTI-A transfusion transmissible infection (TTI) is any
infection transmissible from person to person through parenteral administration of blood or blood
products through high-tech equipment.

Lastly, we would like to pay our heartiest gratitude to the Government of Khyber Pakhtunkhwa
for the regularization of its employees.

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 Annual Report 2022-23 RBC D.I. Khan

DATA ANALYSIS AND INTERPRETATION

Total Number of Blood donations
The total number of donors who visited 11065
RBC
Deferred donors 674 (6.09%)

Donors Accepted 10307 (93.15%)

Donors left during history and 84 (0.76%)

examination
Total Number of Blood units Collected 10239 (99.34%)

Donors refused after selection to donate 68 (0.6%)

blood

Reasons for Pre-Donation Deferral

About 674 (6.09%) blood donors were deferred during the whole calendar year. Blood
donors are deferred following guidelines of AABB during history taking and physical
examinations. Some deferrals are made either for the benefit of the donor or the recipient's
benefit. A list of reasons for donor deferral is given below in Table

Causes Number Percentage

Deferrals during Medical History 388 57.57 %
Not Feeling Well 50 12.89 %
Malaria 70 18.04 %
Epilepsy/ Seizure disorder 23 5.93 %
Last Donation within 3 months 40 10.31 %
Multiple Sexual Relationships 5 1.29 %
History of Surgery within 6 months 42 10.82 %
Heart disease 10 2.57 %
Tuberculosis 9 2.32 %
sharing of blades 22 5.67 %
Viral Hepatitis 28 7.22 %
Medicine Intake 10 2.58 %
Vaccine Intake 6 1.55 %
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Drug Addict 36 9.28 %

Diabetes Mellitus 10 2.58 %
History of Blood Transfusion 3 0.77 %
Under Age 13 3.35 %
Above Age 1 0.26 %
Pregnancy 1 0.26%
Periods 8 2.06%
Deferrals during Physical Examination 286 42.43 %
Raised Body Temperature 4 1.40 %
Pale Eye Color 6 2.10 %
Underweight 30 10.49 %
Hemoglobin not in the normal range 197 68.88 %
Pulse not in the normal range 10 3.51 %
Diastolic BP not in the normal range 18 6.29 %
Systolic BP not in the normal range 15 5.24 %

Monthly Progress in the number of Blood Donations

As Regional Blood Centre Dera Ismail Khan was operationalized at the start of 2022, it was a great
struggle for staff to increase the number of donations, both voluntary and exchange. In the southern
region of KP, there is no trend to donate blood voluntarily due to many misconceptions regarding
blood donations. Our team suffered many disappointments to overcome these situations but didn't
lose hope. Furthermore, after April, the weather in our region is not friendly as the temperature
goes beyond 400c.

But on the other hand, it was also difficult for our team to attract exchange donors because the
concept of component therapy was new in this area. Physicians were reluctant to transfuse blood
components. To replace whole blood with blood components and to introduce the concept and
usage of blood components, we did interactive sessions, awareness seminars, CPCs and regular
visits to linked hospitals. Our monthly progress graph of the Number of Blood donations per month
shows the fruit of our efforts.

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Monthly Progress
1200

1000

800

600

400

200

Months 2022

In April 2022, due to the holy month of Ramzan, our graph was a little spiked down. In July 2022,
there was extremely hot weather, and it was impossible to arrange camps; the number of blood
donations was comparatively less. Although this struggle is never-ending, we still struggle to
improve our voluntary donations.

Number of Donations Depending upon the site of collection

0.94%

7.35%

91.75%

In-House Camps Collection Point

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During 2022, a total of 11065 blood donors attended, out of which 10152, i.e., 91.75% of blood
donors attended In-house (Regional Blood Centre), while 809 blood donors attended in different
Blood Donation Camps arranged by Regional Blood Centre Dera Ismail Khan and 104 blood
donors (0.94%) dealt in Collection Point (Mufti Mehmood Memorial Teaching Hospital HBBB).

Type of Blood Donations

9.54%

Type of donation

90.44%

Exchange Voluntary

Out of 10986 blood donors selected to donate blood, 9936 (90.44%) blood donors were exchange/
Replacement blood donors, and 1048 (9.54%) were voluntary donors.

Gender-Wise Blood Donations

Gender wise blood donors distribution

1.21%

98.79%

Male Female

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Component Preparation
10,986 units of blood collected during the year 2022, 9953 (97.2%) units were processed into
components. 9953 Red Cells Concentrates were prepared, 9622 Fresh Frozen Plasma, 7122
Platelets Concentrate, and 446 units of Cryoprecipitate were prepared, and 1205 pediatric bags of
different components were prepared.

12,000

10,000
No. of units prepared

8,000

6,000

4,000

2,000

0
RCC FFP Platelets Conc. Cryoppt Pediatric Bags
Blood Components

Screening for Transfusion Transmitted Infections

10,986 units of blood collected were first screened for 5 TTI markers before transfusion, i.e., Hep
B, Hep C, HIV, Syphilis, and Malaria. The first 4 TTIs were screened by Attelica IM 360 Solution
using the Chemiluminescence technique (CLIA), while Malaria was screened by
immunochromatographic technique (ICT Method). 460 blood donors (4.18%) came out to be
reactive for TTIs.

TTI Technique No. of Reactive Donors Percentage

Hep. B CLIA 171 1.55
Hep. C CLIA 82 0.74
HIV CLIA 27 0.24
Syphilis CLIA 173 1.57
Malaria ICT 07 0.06
Total 460 4.18

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Prevalence of Blood Groups

Blood grouping is performed by the Tube method (forward and reverse grouping) and is
Reconfirmed by the slide method. Rh factor was positive in most blood donors, i.e., 8508
(91.08%) and negative in 762 (8.22%) blood donors. Blood group B with positive Rh factor
remained the most prevalent blood group while blood group AB with negative Rh factor
remained least prevalent with the number of donors 78 and %age of 0.76%.

Blood Group Number of Blood Donors Percentage

A +ve 2273 22.29
B +ve 3341 32.76
O +ve 2855 28.00
AB +ve 884 8.67
A -ve 228 2.24
B -ve 276 2.71
O -ve 262 2.57
AB -ve 78 0.76

Distribution of Blood Components

Blood components processed and prepared were distributed to linked Hospital-based Blood
Banks (HBBBs). HBBBs linked with RBC Dera Ismail Khan are DHQ D.I.Khan, MMMTH
D.I.Khan, DHQ Bannu, DHQ tank, DHQ Lakki Marwat, DHQ Karak

DHQ D.I.Khan
Whole Blood 192
RCC 7311
FFP 1811
Platelets conc. 1919
Cryoppt 83
Pediatric Bags 1208
MMMTH D.I.Khan
Whole Blood 48
RCC 976
FFP 1706
Platelets conc. 1069
Cryoppt 144
Cryosupernatant and Pediatric Bags 136

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ZHQ D.I.Khan
Whole Blood 135
RCC 2590
FFP 373
Platelets conc. 99
Cryoppt 04
Pediatric Bags 128

DHQ Bannu
RCC 48
FFP 1403
Platelets conc. 104
Cryoppt 128

DHQ Karak
RCC 10
Platelets conc. 20

DHQ Lakki Marwat

RCC 47
Pediatric Bags 12

DHQ Tank
RCC 05

DHQ Bhakkar
FFP 27
Platelets Conc. 49

CMH D.I.Khan
RCC 06
FFP 20
Platelets conc. 34
Cryoppt 02
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VISITS AND TRAININGS

1. Basic IT Training:

True-Tech Solutions team providing training about Basic IT to RBC Staff.

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2. RESCUE 1122

Rescue 1122 D.I.Khan team providing training about Fire Extinguishers and other disaster training.

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3. PSYCHOLOGICAL FIRST AID TRAINING

Mental Health Psychological Support Program KP Health Department providing Psychological

First Aid Training Sessions.

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4. WASTE MANAGEMENT TRAINING

Brig. (Retd.) Prof. Dr. Javaid Usman (MBBS, MCPS, MPhil, FCPS), Consultant Microbiologist, Providing
training sessions on Waste Management.

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5. VISIT OF HEALTH MINISTER KP

A Visit of Mr. Taimoor Jhagra, Health Minister KP, to Regional Blood Center D.I. Khan.

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6. VISIT OF BOG, MTI D.I. KHAN

A Visit of Mr. Ali Raza Khan, Chairman Board of Governor, MTI D.I. Khan, to Regional Blood
Center D.I. Khan.

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7. VISIT OF MINISTER FOR BLOOD DONATION

Mr. Faisal Amin Khan Gandapur, Minister for Local Government, Elections and Rural
Development, visited RBC D.I.Khan and donated blood.

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8. WORKSHOP

Workshop conducted in RBC Peshawar on Immunohematology and Quality control in Blood

Banking.

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9. VISIT TO LINKED HBBS

a. DHQ BANNU

The Officials of RBC D.I.Khan visited DHQ Bannu to streamline the blood banks and to
mobilize the staff regarding the importance of blood donation.

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b. DHQ LAKKI MARWAT

The Officials of RBC D.I.Khan visited DHQ Lakki Marwat to streamline the blood banks and to
mobilize the staff regarding the importance of blood donation.

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c. DHQ KARAK

The Officials of RBC D.I.Khan visited DHQ Karak to streamline the blood banks and to
mobilize the staff regarding the importance of blood donation.

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EVENTS
1. NURSES DAY

International Nurses Day was observed on 12th May 2022 by the staff of RBC D.I.Khan with full
enthusiasm.

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2. REGULARIZATION

Celebrating the regularization of the services of the employees of RBC D.I.Khan.

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AWARENESS SESSIONS
1- APEX Medical Institute D.I. Khan

RBC Staff conducted an awareness session at APEX Medical Institute D.I.Khan.

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2- Awareness Session at QURTUBA University D.I. Khan

RBC Staff giving awareness to students about blood donation at Qurtuba University of Science
and Technology.

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3- Awareness Session At Gomal Medical College D.I. Khan

RBC Staff giving awareness to medical students regarding blood donation at Gomal Medical
College D.I.Khan.

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4- AWARENESS SESSION TO BLOOD SOCIETIES.

Health Education Officer Sajjad Ahmad and Social Mobilizer Waheed Ullah are giving
awareness to the blood society "Blood Heroes" at Regional Blood Center D.I. Khan.

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CAMPS DETAIL

S.NO CAMP SITE

01 Pharmacy Deptt: Gomal University D.I.Khan
02 APEX Institute D.I.Khan
03 Al Qasar Institute of Health Science
04 Agriculture Deptt: Gomal University D.I.Khan
05 Govt. Degree College No.1 D.I.Khan
06 Quaid e Azam Campus Gomal University D.I.Khan
07 Chashma Sugar Mill D.I.Khan
08 Govt. Degree College No.1 D.I.Khan
09 Qurtuba University D.I.Khan
10 CPEC road Dera Jaat Jeep Rally
11 Quaid e Azam Campus Gomal University D.I.Khan
12 Govt. College of Commerce and Management D.I.Khan
13 Govt. Degree College No.2 D.I.Khan
14 IBA Gomal University D.I.Khan
15 Biological Science Dept. Gomal University D.I.Khan
16 Chemistry Dept. Gomal University D.I.Khan
17 Gomal Medical College D.I.Khan
18 Allied Health Science, Gomal University D.I.Khan
19 ICIT Dept. Gomal University D.I.Khan
20 English Dept. Gomal University D.I.Khan
21 Govt. Degree College No. 1 D.I.Khan
22 Jamia Rooh-ul-Madaris D.I.Khan
23 Jamia Mariful Sharia Shorkot D.I.Khan
24 DHQ & Police Line Lakki Marwat
25 MMTH D.I.Khan
26 Qurtuba University D.I.Khan
27 Mathematics Dept. Gomal University D.I.Khan

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28 Physics Dept. Gomal University D.I.Khan

29 Govt. College of Commerce and Management D.I.Khan
30 APEX Institute of Medical Sciences D.I.Khan
31 Govt. Degree College No. 1 D.I.Khan
32 Gomal Welfare and Medical Institute of Science
33 Pharmacy Dept. Gomal University D.I.Khan
34 Pakhtoon Student Federation Camp Gomal University

Training activities
 Awareness session and presentation in ZHQ, DIKhan on "Usage of Blood components in
Obstetrics department" and "Comparison of Whole blood vs. Blood components
transfusion."
 CPC in DHQ DIKhan, presentation on "Introduction of blood component therapy."
 Awareness session in Gomal medical college and presentation on "What is safe blood"
and "Effects of blood donation on blood donors' health."
 CPC in MMMTH DIKhan, Presentation on "Indications of blood components."
 CPC at DHQ Karak, and Women and Children Hospital.
 CPC in DHQ DIKhan, presentation on "Rational use of blood."
 More than 50 internees have been properly trained and provided with hands on
experience at RBC as a part of our mission statement.

Research activities
 Counseling of Reactive blood donors of the southern region of Khyber Pakhtunkhwa.
(Submitted)
 Syphilis: A transfusion Transmissible Infection (Accepted for International conference
2023, "New Horizons in Medical Sciences," Feb 2023 Gomal medical college)
 Prevalence of Transfusion Transmissible infections in Blood doors of Southern region of
KP, Pakistan (submitted)
 Impacts of malarial infections on hematological parameters (Accepted)

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PHOTO GALLERY

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Deficiencies

The report will be incomplete without citing any deficiencies and issues. The year 2022 was a
year of unprecedented Progress. It was the inception of a new era in blood components
transfusion in the southern region of KPK. However, in the past year, RBC D.I.Khan
encountered a few deficiencies, which the RBC team is working enthusiastically to rectify. Yet,
few need dire attention from other stakeholders as well. Those deficiencies are elucidated below

 Budget/ Operational cost

A budget is an expenditures plan and proposals for how to meet them with resources. The budget
is the backbone of the organization. It is required to execute the department's vision and mission
statement and exploit new avenues to support future plans.

Because of the meager budget, the department is still deprived of proper signboards. The
camping activities are severely hampered. Proper awareness sessions are on hiatus. The
department is fully operated through exchange-based blood. The volunteer-based blood donation
pool contrived throughout the year is stumbling rapidly.

However, RBC D.I.Khan is still scrambling for its operational cost, which is imperative for the
department's existence. The department is in crisis, turning every stone to get POL and
laboratory supplies so that the operations keep running and needy patients never return desperate
and empty-handed.

On the plus side, the Government of KPK took a bold step by regularizing the services of the
employees. This landmark development has reinvigorated the spirit of employees. But the
bifurcation in the financing of operations has led to an anxious situation. Because the KPK
government will finance the employee salaries, financing lab supplies and other operations are
still on the Table for further discussions. In verdict, the operational budget is the heart of day-to-
day activities, and further delay regarding its future will severely affect RBC's image and
performance.

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 HBB's Performance
The number of connected hospital blood banks (HBB) with RBC D.I.Khan is working
tremendously. Proper communication is done with every hospital. RBC D.I.Khan is also
supplying blood components to other districts upon their demands. The RBC DIK caters blood
bank of hospitals in DHQ D.I.Khan, ZANANA, MUFTI Mahmood, Karak, Lakki, Bannu and
Tank.

These Blood banks were properly upgraded with state-of-the-art appliances provided by KFW.
However, the Tank HBB is still not operationalized due plethora of handicaps in which
uninterrupted power supply is one of the major issues. This particular HBB is not operationalized
to date, and Our team is constantly working to solve the issue by reporting to higher authorities.
And because of this particular issue, our team has requested the vendors and GOPA to extend the
appliance warranty period.

 Human Resource Demands

For the proper performance of the department, a sufficient workforce is imperative. As of now,
RBC DIK is operating with 42 employees. According to the devised plan, the department was
created to serve 2 shifts, i.e., morning and evening, with this workforce. However, Due to the
demands of connected HBBs and hospitals, our department is buckling up for the night shift. A
pilot project is already embarked on. However, sustaining 3 shifts without additional induction or
recruitment is not feasible. As the southern region is more prone to emergencies, catastrophes
and violent activities, further employee induction is demanded for seamless and hassle-free
delivery of safe and free blood components to the people of the southern region.

 Nucleic Acid Testing (NAT) Machine

Nucleic acid testing (NAT) is a molecular technique for screening blood donations to reduce the
risk of transfusion-transmitted infections (TTIs) in the recipients, thus providing an additional
layer of blood safety. NAT technique is highly sensitive and specific for viral nucleic acids. It is
based on amplifying targeted regions of viral ribonucleic acid or deoxyribonucleic acid (DNA).
It detects them earlier than the other screening methods, thus, narrowing the window period of
HIV, HBV and hepatitis C virus (HCV) infections.

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RBC DIK lacks a NAT machine that will provide extra protection and safety to patients in the
southern region. As HIV/aids patients are increasing each day, the induction of such a
phenomenal machine must be on the checklist while providing appliances to already existing
Blood Centers. National AIDS Control Program Pakistan has already shared a report citing more
than 0.21 million infected patients in Pakistan. Also, a seminar conducted in Karachi showed
another startling fact that among these 0.21 million cases, 65pc of HIV/AIDS patients did not
return for treatment due to the problematic behavior of their healthcare providers.

In addition, Pakistan already has one of the highest cases of hepatitis C, while hepatitis B
infections are also rising at an alarming rate. It is a well-documented fact that more than 70pc of
hepatitis B and C infections in Pakistan are transmitted at healthcare set-ups. So, the aim and
slogan of the safest blood transfusion are incomplete without the provision of this state-of-the-art
machine. Secondly, this machine is already provided to RBC Abbottabad and Peshawar but not
to RBC DIK.

 Backup for TTI's

Another area where extra strides are required is providing a substitute machine in case one runs
out of order. Right now, we are using one machine for TTI's scanning, which gives random
errors on different occasions, due to which the supply chain of blood components chokes a lot.
Therefore, providing a backup machine for TTI's scanning is a dire need of RBC DIK. The team
is already in contact with different stakeholders but still no silver lining.

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 Expanding through MOU

Among other noted deficiencies, our team is working hard to infiltrate and permeate into other
avenues to increase our blood collection through a Memorandum of Association (MOU). A few
are Combined Military Hospital (CMH) Dera Ismail Khan and Police Line Dera Ismail Khan.
RBC DIK is already catering to their patients through civil and Direct channels, but both are
hesitant to clinch MOU.

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DONATE BLOOD, SAVE LIVES

THANKYOU!

REGIONAL BLOOD CENTER, DERA

ISMAIL KHAN

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