AN unusually high death rate among sickle cell patients this year could be due to sufferers failing to attend regular medical checkups, according to a senior doctor. Amina Hassan Hammaqi, 45, on Saturday became the 31st sickle cell patient to die since January.
It was the 22nd fatality connected to the disease in the past three months, sparking claims that not enough was being done to care for people living with the condition.
But Salmaniya Medical Complex (SMC) genetic department chairwoman Dr Shaikha Salim Al Arayyed, who heads a Health Ministry committee overseeing the treatment of sickle cell cases, defended Bahrain's efforts to treat sufferers.
"Though there is a problem in Bahrain we are not sitting with our hands tied and looking the other way," she told the GDN yesterday.
"Bahrain has a much better record as far as fatalities arising out of sickle cell disaese (SCD) are concerned.
"In Bahrain, such patients can in many cases live to be more than 70 years old, while the international average is just 60."
She also said Bahrain has not had a fatality in patients aged under five, while in the US 20 per cent of deaths were in that age group.
"The situation in Africa is worse and 50pc of SCD babies die even before they are two years old and in India 50pc of SCD patients under 15 die," added Dr Al Arayyed.
"This compares very well with the situation in Bahrain, where the majority of the fatalities are between 20 and 30 years old."
She claimed Bahrain operated an effective screening system and insisted on examining sickle cell patients regularly.
However, she said patients often became complacent as they got older and stopped visiting clinics for follow-up.
"The problem is that until the age of 14 or 15 such patients visit the special clinics regularly," explained Dr Al Arayyed.
"After that, they fail to come. This leads to many complications not being detected."
The expert revealed most SCD patients only visited SMC when they started to experience pain because they wanted to be prescribed painkillers.
"If they attend clinics regularly, their conditions can be detected early and remedial measures taken," she added.
"Complications that we see regularly may not even then occur."
Sickle cell disease is a genetic disorder that can only be managed, since there is no known cure.
Patients can experience severe pain, but Dr Al Arrayed said that was only one of the issues.
"They have a lot going on inside their bodies - something that needs to be detected and treated," she added.
One side effect of the disease is low immunity among patients, making them more susceptible to other ailments.
"They can rapidly suffer pneumonia, a stroke, chest infections as well as infections of the spleen and bone marrow," explained Dr Al Arrayed.
"Renal and liver failure is also common.
"This is not unique to Bahrain, this is the norm among SCD patients all over the world."
She revealed the Health Ministry saw between 400 and 500 sickle cell patients daily at its facilities.
"Two hundred of these are examined in the (SMC) Accident and Emergency Department, 90 to 100 are in SMC wards at any time, the Kanoo Community centre has 44 patients at one time and there are several others who visit laboratories, X-ray clinics and health centres," said Dr Al Arrayed.
However, she acknowledged the lack of an autopsy when sickle cell sufferers died meant the exact cause of death could not be determined - fuelling speculation that authorities were to blame.
"In many other countries there is an autopsy that determines the exact cause of the death," she said.
"This is absent in Bahrain so it is easy to blame negligence."
She also dismissed allegations that SMC's Intensive Care Unit (ICU) was lacking beds, saying a critical care bed had never been denied to any patient.
Campaigners claim negligence and inadequate facilities have contributed to deaths of sickle cell sufferers, along with a lack of ICU beds and critical care.