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And welcome to have check from the

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B, B, C and Claudia haven't that?

0:51

Every week on the show we bring

0:53

you the latest health stories from around

0:55

the world and today we have tails

0:57

of to patients. one who tried an

0:59

experimental treatment and gained extra time with

1:01

her family as a result and the

1:03

other might Powell who we've been following

1:05

in the run up to his kidney

1:07

transplant and Bbc Health Reporters. Meet him

1:09

under sad is joining me today. Would

1:11

you have first later? I've been looking

1:13

at research into Ancient Scout in some

1:15

four thousand five hundred years. Old and

1:17

what they tell if about how people

1:19

use to live and how they loved

1:21

and also add something cold blood Deserts

1:24

weapon. Look forward to that later on.

1:26

but I wanted a star in South

1:28

Korea were some hospitals have been turning

1:30

away patients due to a strike by

1:32

junior doctors which means that more than

1:34

two thirds of them and at work

1:36

Now the government said if they returned

1:38

to work by the end of February

1:41

no action will be taken against them,

1:43

but otherwise they could face arrest. So

1:45

meta does this mean that legally doctors.

1:47

Aren't allowed to go on strike in South

1:49

Korea and could be prosecuted. They are not

1:51

allowed to go on strike in. The Government

1:53

says that unless they to return to work

1:55

imminently by the end of the month then

1:58

they might face suspension of their life. practice

2:00

they might face a

2:02

$22,000 fine, they may even face

2:04

a prison sentence. And these are junior

2:06

doctors, why are they on strike? They're

2:09

striking because they are unhappy about

2:11

the government's plans to bring in

2:13

extra medical school places. There are

2:15

about 3,000 medical school places every

2:17

year in South Korea and they

2:19

want to bring in another 2,000.

2:22

Now why are the junior doctors

2:25

unhappy about that? Well it's quite

2:27

complicated and our colleagues in Seoul

2:30

themselves said it was quite a

2:32

difficult landscape to work out.

2:34

They give a number of different reasons

2:36

that observers and doctors have

2:38

been talking about. One is

2:41

that they are dissatisfied with their

2:43

working conditions. Another, some

2:45

critics are saying well actually this is all

2:47

because they fear competition because to give you

2:49

the context at South Korea the majority of

2:52

the hospitals are private, the majority of healthcare

2:54

is privatised and so there

2:56

is a suggestion that these extra medical school

2:58

places would actually mean that there are

3:00

extra doctors to compete for this private

3:03

work. Some doctors are

3:05

suggesting that actually bringing these extra doctors

3:07

is unnecessary, that it would mean over

3:09

treatment of the population. And

3:11

other doctors are perhaps saying, our colleagues

3:13

are hearing, that actually maybe they feel

3:15

the government's just going about this the

3:18

wrong way, that the real problems are

3:20

not that they need extra doctors but

3:22

that there are doctors concentrated in urban

3:24

areas and actually there are some needed

3:26

more in rural areas and they're concentrated

3:28

in the more lucrative specialties

3:31

like dermatology and not

3:33

so much in the less lucrative specialties

3:35

like paediatrics and obstetrics and others are

3:37

saying well medical schools wouldn't be able

3:39

to cope with that influx. No, the

3:41

government is saying look, South

3:43

Korea has one of the lowest number

3:46

of doctors to patients in the developed

3:48

economies, it has about 2.3 per thousand

3:50

people, you can compare that to Austria,

3:52

one of the highest which is more

3:54

than 5 per thousand

3:56

people and they're worried because there's a

3:59

bit time bomb here,

4:01

South Korea has an aging population with

4:03

more and more complex medical needs and

4:05

they're saying they feel that the country

4:07

needs more doctors. This is all happening,

4:10

it is worth noting, in an election

4:12

year and the

4:14

polls are very much in favour of

4:17

the government's plans and that some doctors

4:19

would argue that this is fairly

4:21

convenient that the government has brought this in

4:24

at this point. And might more senior doctors

4:26

join the strike though? There are

4:28

suggestions that senior doctors are going to join the

4:30

ranks, we'll have to wait and see. Well

4:33

thanks for that Sumita. Next to the

4:35

story of a woman whose life was

4:37

extended by scientists who tested wastewater

4:39

from across the US until they

4:41

found the ideal virus to tackle her

4:43

infection. Her name was Lynne Cole and

4:45

for almost a decade she

4:47

had infections that made her seriously

4:50

ill. Doctors tried all sorts of

4:52

antibiotics but again and again the

4:54

infection returned. At the last

4:56

hope they turned to something called

4:58

a bacteriophage, a virus which targets

5:01

and infects bacteria, killing them as

5:03

they try to replicate. The

5:05

Lynne story has just been published

5:07

as a case study by the

5:09

doctors treating her even though she

5:11

died in 2022 there are lessons

5:13

for those treating other patients. My

5:16

Cole is Lynne's daughter and I asked her what

5:18

her mother was like. My mom

5:20

was a very kind-hearted and gentle

5:22

person although she was sick she was

5:24

still very optimistic that you know she

5:27

would have good days and that we

5:29

would make memories. She didn't want to

5:31

you know let her sickness hold her

5:33

back as an individual but also hold

5:36

our family back as a whole. She

5:38

was a very hard worker, very smart,

5:40

before she got diagnosed she was a

5:42

respiratory therapist and she did a lot

5:45

of side jobs helping other people, volunteering

5:47

in places and then even once

5:49

she was sick she did her best to

5:51

you know try to do what she could

5:54

to still make connections with

5:56

people and help people at any capacity

5:58

even though she was sick. And

6:01

it sounds as though she had years of

6:03

getting these blood infections again and again. Yeah,

6:05

my earliest memory of the first blood infection

6:07

was about like 2010. We got a call from

6:11

our family doctor saying that her blood

6:13

cultures are positive. This means you have

6:15

to go in the hospital to get

6:18

antibiotic treatment. So we

6:20

packed her things and had to do a

6:22

direct admission to the hospital. That was just

6:24

like a recurring thing over the years. Dr.

6:27

Daria Van Tyne is assistant professor

6:29

of medicine at the University of

6:31

Pittsburgh School of Medicine and she

6:34

hunted down the right kind of

6:36

phage to give to Lynn. Daria

6:38

told me what phages are. Phages

6:40

are viruses of bacteria. They are

6:42

the natural predators of bacteria. Just

6:44

like we humans can be infected

6:46

with viruses that infect and attack

6:48

our own cells. Bacterial

6:50

phages are viruses, but they

6:53

can only infect bacteria. Now

6:55

I love the idea that in your lab you actually have a

6:57

phage library. What does that mean

6:59

and what does that look like? To get

7:01

some phages, to do phage therapy, you have two

7:04

different options. You either have to find them or

7:06

you have to make them. In

7:08

our lab we find phages. We go out

7:10

hunting or looking for phages. And

7:13

in our work we found that

7:15

wastewater is a particularly fruitful source

7:17

of bacterial phages. So

7:19

we start with bacteria from patients

7:22

that are infected and then we

7:24

literally fish in wastewater

7:26

to try and find these phages

7:28

that are active and can kill

7:31

the bacteria from the patient. And

7:33

once we've isolated and purified the

7:36

active phages, we can characterize them

7:38

and assemble them into libraries, but

7:41

we can then use to screen additional

7:43

bacteria from other patients' infections.

7:47

So in Lynn's case, I know that

7:49

doctors were running out of options for

7:51

her treatment. Why did they think

7:53

that phages might work? This is the case of

7:55

many patients that receive phage therapy. At the moment

7:57

we call phage therapy a compassionate use through a

7:59

lab. last-ditch final effort when

8:01

all other potential treatments have

8:04

failed. So Lynn had repeated

8:06

episodes of infection. Her bacterial

8:08

infection kept coming back over

8:11

and over again and when

8:13

it was clear that antibiotics were not

8:16

sufficient to treat and control her infection,

8:18

her doctors reached out to our laboratory

8:20

to ask for some experimental

8:23

alternatives. And then do you have to

8:25

find something that's very specific, that's matching?

8:27

Can you get that from your library?

8:30

Correct, yeah. So as phase researchers we

8:32

often call ourselves match thinkers. So

8:34

we're taking bacteria from infected patients

8:36

and we're trying to match each

8:38

patient's bacteria to a phase or

8:41

multiple stages that match the particular

8:43

bacteria causing the infection in the

8:46

patient. I was

8:48

a little skeptical, not gonna lie,

8:50

just because like I never really

8:52

heard of bacteriophage therapy but we

8:54

were at the point where you

8:56

know we had exhausted all other

8:58

forms of treatment and ran

9:00

into options that you know I was

9:02

still ready to jump on it because

9:04

it was honestly our last hope. And

9:08

did the therapy make your mother more

9:10

comfortable? Yeah for about six

9:12

months. She had a little more color in

9:14

her face, a little more sparkle in her

9:16

eyes, and she had a little bit more

9:18

energy so it definitely made her feel better

9:20

for a period of time. Her

9:23

clinical response is quite dramatic. We were

9:25

all pleasantly surprised. Within 24 hours of

9:27

starting phase therapy the bacteria were gone

9:29

from her bloodstream. About a week later

9:32

she was able to leave the hospital

9:34

and return home and these were things

9:36

that were not possible when she had

9:38

been receiving antibiotic alone to treat her

9:41

infection. Every summer our

9:43

family made it a goal to

9:45

make it to the beach. We were a little

9:48

scared because we weren't sure

9:50

how we were gonna continue to

9:52

stage therapy while not at home

9:54

because the phages were made weekly

9:57

so we had to pick the phages up at the

9:59

hospital. every week for her to

10:02

use, but the medical team

10:04

was super great with working with

10:06

us. They actually sent that week's

10:08

pages to overnight shift it to

10:10

our hotel. And it

10:12

was really special that they, you know, made that

10:14

effort for us because that ended up being the

10:17

last family vacation that we had

10:19

together before my mom passed. Unfortunately,

10:22

at the end, she had a

10:24

recurrence of her infection. She

10:26

performed additional testing in the laboratory and

10:28

got some information that suggested to us

10:30

that the phages may not have been effective

10:32

anymore. And at that point, the

10:35

decision was made to withdraw phage therapy. But

10:37

in Lynn's case, the impact of phage was

10:40

really providing her a longer amount of time

10:42

and improving her quality of life and the

10:44

ability to spend time with her family outside

10:46

of the hospital. Are there things

10:48

you can learn from Lynn's case that will help you with

10:51

treating other people in the future? Certainly.

10:53

So we're so grateful to Lynn

10:56

and her family for giving us

10:58

the opportunity to learn from her

11:00

medical journey. She agreed to

11:02

provide us blood samples as well as

11:04

stool samples throughout the course of her

11:07

therapy. And in the

11:09

subsequent years since her case, we've been

11:11

performing research to try and learn things

11:13

from the specimens and the samples that

11:16

she provided. Since Lynn's case,

11:18

we've actually used the same two phages

11:20

used to treat her, to treat an

11:22

additional two other patients. So

11:24

the amount of phage that we give to those

11:26

patients, how we monitor those patients, what we

11:28

look for in treating those

11:31

patients, all of those decisions were informed

11:33

by what we learned from the experience

11:35

of treating Lynn. This is

11:37

just one story of one patient. When

11:39

do you think you might be able to move to bigger trials?

11:43

So there are clinical trials happening in

11:45

the United States and many other countries

11:47

at the moment to try and move

11:50

beyond single patient experiences. And also to

11:52

test in a more controlled manner to

11:54

see how effective phages could really be.

11:56

We're also a site for a couple

11:59

of other patients. of clinical trials

12:01

that are already ongoing. How

12:03

does it feel when you hear the doctors and

12:05

the scientists now saying how grateful

12:08

they are feel, mum, in

12:10

helping with them with their research and that

12:12

they're really hoping that this experience will really

12:14

help others and that they're able to take

12:17

this research forward? Yeah, it

12:19

makes me really happy and really proud

12:22

of my mum and my family

12:24

because, you know, we were told before

12:26

we started the phage therapy that, you know,

12:28

this is no guarantee, you know, this

12:31

is very experimental, even

12:33

in knowing that my mum said openly

12:35

to lots of people, like, even if

12:37

this doesn't work for me, I want

12:39

it to continue on. So hearing

12:42

all of this, reading these articles,

12:44

participating in these interviews, it makes

12:46

me really proud of her and

12:48

us as a family because we

12:50

are doing what she asked. And I

12:52

understand you're studying to be a physician's

12:54

assistant yourself. So you're interested

12:57

in medicine, clearly. Yeah, most

13:00

of my life, my childhood and stuff was

13:02

centered around her care because I was, you

13:04

know, the little kid always like asking people

13:06

what are you doing? And like, you know,

13:08

of course, even more interested and curious because

13:11

that was my mum that they were treating

13:13

and, you know, it just continued throughout my

13:15

life. So I would say that our

13:17

experience has definitely had a hand in my

13:20

future aspirations. Well, best

13:22

of luck to Maya Cole with her

13:25

career. And before her, there was Dr.

13:27

Dariot van Tyne. You're listening to HealthCheck.

13:29

I'm Claudia Hammond. And today my guest

13:31

is BBC health reporter, Smita Amundasad. Now,

13:34

Smita, I wanted to ask you about

13:36

some new findings about some ancient genetic

13:38

material and researchers might have found the

13:41

first ever prehistoric case of

13:43

a child with something called Edwards syndrome.

13:45

So let's start with that. What is

13:47

Edwards syndrome? Babies with Edwards syndrome have

13:49

three copies of the chromosome 18

13:53

and that can have a wide

13:55

range of effects on how a

13:57

baby develops and grows. Sadly.

14:00

most of them do not survive

14:02

a long time because of serious

14:04

illnesses. And now researchers

14:06

have discovered that a prehistoric baby

14:08

had Edwards syndrome and they found

14:10

the remains of other children who

14:12

have another genetic condition, Down syndrome.

14:15

They found six remains of

14:17

babies and children with Down

14:19

syndrome and that's a condition

14:21

where people have three

14:23

copies of chromosome 21 and it can cause

14:25

a range of different effects on how the

14:28

body develops and how the mind develops too.

14:30

And I thought it was interesting that the

14:32

researchers sounded very surprised because would we not

14:35

assume that genetic conditions like these would have

14:37

been around for a long time? I

14:39

think what was really surprising to them was

14:41

that actually it's been really hard to find

14:44

definitive proof of people

14:46

who existed with these conditions in

14:49

skeletal remains because before archaeologists and

14:51

anthropologists would be looking at the

14:53

bones and it can be very

14:55

hard to tell whether someone has

14:57

something like Edwards syndrome or Down

14:59

syndrome from bones but they found

15:01

this new technique where they can

15:03

look at the DNA and

15:05

find out whether there are these extra chromosomes

15:07

and that's what they've done. And what is

15:09

nice is that in these few cases at

15:11

least the suggestion is that these babies were

15:14

treated well. It's really lovely when

15:16

you're reading this paper. I'm used to reading things

15:18

about the future and reading something about the past

15:20

is a really new experience actually for me. What

15:23

was incredible was that when they looked at the

15:25

graves of the skeletons

15:27

they found that there were

15:29

things like coloured beaded necklaces,

15:31

bronze rings and even seashells

15:33

from the Mediterranean and

15:35

they felt that that means that at

15:38

that time many of the dead would

15:40

have been cremated, not buried. So the

15:42

researchers would argue that this shows that

15:44

ancient societies really did care for these

15:46

babies and infants. Thanks for that, Smita.

15:48

Now we've been following the British journalist

15:51

Mike Powell as he prepares to receive

15:53

a kidney from a friend of his.

15:55

Now if the transplant isn't a success

15:57

then he knows the alternative is kidney

15:59

diastole. and he wanted to know more about

16:01

it, so we put him in touch with Justin

16:03

Pham in Los Angeles, who also has

16:06

kidney failure and has been on dialysis

16:08

since last year. And Justin is determined

16:10

to spread the word on TikTok and

16:12

Instagram. All right, things that I

16:15

ignored before having kidney

16:17

failure. If you skin,

16:19

leg cramps. What a great voice

16:21

you've got Justin. Love it. Thank

16:23

you. Justin's sick, stomach

16:26

aches. Maybe we could start with you

16:28

just telling us how your

16:30

kidney failure started because for me it was

16:33

a gradual thing over several years. Actually

16:36

it was a long kind

16:38

of play with my health. When

16:40

I was nine, I actually

16:43

had a surgery on my kidneys

16:45

where the tube from

16:47

the bladder to the kidney was too

16:49

long, so they cut it and because

16:51

of that it stopped my kidneys from

16:53

growing. So I had two half kidneys

16:55

my entire life. So basically one kidney,

16:58

my entire kid to adulthood,

17:00

I would have swelling feet, I was

17:02

running out of breath. Even just walking to my car

17:04

or parking my car and going to the grocery store,

17:06

I would just run out of breath. And

17:09

eventually that's kind of when I went in

17:11

and that's when they told me about my

17:14

kidneys completely failed and they

17:16

put me through an emergency dialysis

17:18

through my neck. The artery, the

17:20

hemodialysis. To me it was like

17:22

shocking. Everything was just shocking. I wasn't even like

17:25

scared or like sad. It was just

17:27

everything was out of shock. How old were you at

17:29

that stage? I was 31. They

17:31

said that your kidneys had failed. Have they

17:33

gone into end stage kidney failure? They told

17:36

me and sometimes I always just like kind

17:38

of don't believe them but they told me

17:40

is that zero percent. Zero? Yeah like my

17:42

kidney function was zero and I'm always thinking

17:44

that's interesting because I was always still able

17:46

to urinate. And I still urinate a little

17:48

bit, not as much anymore just because like

17:50

I'm doing PD dialysis every day so it

17:52

kind of takes the fluid. When you think

17:54

of a kidney function of zero, I mean

17:56

I'm At eight percent at

17:58

the moment. Am I

18:01

I get exhausted and you know after

18:03

after swimming and things like that since

18:05

and get headaches and all the other

18:07

sentenced to we're getting those symptoms at

18:09

the time he i got a lot

18:11

of symptoms and the a genius at

18:13

nights not been able to sleep little

18:15

tingling see at night when i wake

18:18

up a had all that but i

18:20

think because i was so scared and

18:22

so. And aware of

18:24

my health I was just trying

18:26

to disguise it would just. With.

18:29

My mindset as i also kill off the

18:31

but also next in the next as next

18:33

ale fargo way maybe I'm just sick. Which

18:36

I regret now. and a thing as I

18:39

get educated and get more serious about health

18:41

and lives and respect a little bit more

18:43

a know I can cel people and my

18:45

friends and family the same thing. like I'll

18:47

go get a check else to say guys

18:49

know guys are we can I just without

18:51

it works out about that computer woman and

18:53

a woman gets hacked up morphing for li

18:55

li generally. but ah silica. lot of guy

18:57

friends never get check so I think that's

18:59

the thing just in his name ready. I

19:02

mean just trying to raise awareness and for

19:04

people to to get themselves checked. fight for

19:06

somebody doesn't. They will die as this means

19:08

it always sounds us a pretty scary word

19:10

what was involved in it when they were

19:12

telling ya to be on hemodialysis the emergency

19:14

room where a put a Mari I was

19:16

confused or it's a really you I thought

19:19

it was something there were going to do

19:21

just once not the my original thought I

19:23

was like okay cigarette with is too dumb

19:25

artery in your second of the without a

19:27

perfect as in later on they told me

19:29

his gonna be in there for a while

19:31

Mcfate what I was Alex six in the

19:33

morning. Partner. Doctors chinese my

19:36

brain and their tell me these big

19:38

news about a mile beyond this the

19:40

rest my life in if I don't

19:42

do that and and a transplant need

19:44

and it's and here in all those

19:46

things just right amount of nowhere you

19:48

just. Just. In shock. You know

19:50

I wasn't scared I wouldn't. Silos is

19:52

in shock the whole time and ah,

19:55

Yeah. on and and then that's when they put me

19:57

in then they told me how to be on pd which

20:00

is peritoneal dialysis, which

20:02

is they take the toxins out of

20:05

your stomach and it flushes

20:07

out and you put solution in and you

20:09

repeat the sessions. How

20:12

many times a week do you have to

20:14

do that? It's actually every day, nine

20:17

hours a day and I do it

20:19

when I go to sleep. How does this affect

20:21

your sleep though? Are you able to get a

20:23

decent night's sleep? Honestly I have

20:25

not got real sleep since then so it's been over a

20:27

year since I've got like a real sleep. So

20:30

now I value the naps to

20:32

be honest. Awful. I can

20:34

really feel for you not getting that decent

20:36

sleep to think that it's got to be

20:38

nine hours every single day. Is it

20:41

noisy? Yeah it was and

20:43

you just get used to it now and

20:46

I think I'm pretty good with that with my mindset. Yes.

20:49

And while you've been on

20:51

dialysis, do you feel better because of

20:54

it? Well the funny thing is when

20:57

I'm on dialysis, I kind of just now I

20:59

don't have those random sick days and those little

21:01

small symptoms. So in that sense

21:03

I feel a little better. Good.

21:06

And with regard to kidney

21:09

transplant, what kind of possibility is there

21:11

for you to have that and to

21:13

finish the dialysis for good? Yeah

21:16

I'm looking into trying to get donors.

21:18

A lot of my family members weren't

21:20

able to which is fine and I know

21:22

that's a little touchy subject for a lot

21:25

of people because a lot of people don't

21:27

want to go through something like that and I

21:30

don't like pushing people. Are you on a waiting

21:32

list? I am on a waiting list, yeah, but

21:34

out here since I'm in California and Los Angeles

21:36

there's a lot of people looking for kidneys

21:38

apparently and so it's about 10 year wait list.

21:41

10 years? Yeah that's why

21:43

I'm really trying to I guess

21:46

push with my voice out

21:48

there and making videos. I think you do so

21:51

much with TikTok and

21:53

Instagram. One of the videos

21:55

that I saw of you was talking

21:57

about the symptoms of when

21:59

you urine. urinate it being very

22:02

foamy. Yeah, I guess. And

22:04

I have the same thing and I wondered what

22:07

on earth that was about, you know, whether it

22:09

was probably because

22:11

I'd had a beer or something the night

22:14

before. It's not that, is it? No, it's,

22:16

you know, when I, when I, I think

22:18

I said in the video, originally for my

22:20

whole entire life, I just thought that bubble

22:23

came naturally from the distance because when

22:25

you, you know, you just made bubbles

22:27

from the water, but apparently that's the

22:30

protein that is coming out

22:32

of your urination because your kidneys aren't

22:34

filtering correctly. Well, you know, I

22:36

really hope it goes well for you Justin and

22:39

I think that it's fantastic that the

22:41

videos that you're doing, the awareness on

22:43

social media, you are really making a

22:45

difference to people's lives and

22:47

I really don't hope that you don't

22:49

have anywhere near a 10-year

22:52

wait and I hope it comes sooner

22:54

rather than later so that you can get a

22:56

decent night's kit. I know, thank you so much

22:58

Michael, really appreciate that. And if you want to

23:00

see Justin Pham on TikTok, he's at Platinum Kidney

23:02

and we'll hear more from Mike Powell

23:05

next week. Now before we go, Smeeta, there is

23:07

just time to talk to you about something known

23:09

as a blood desert. Now I have to say

23:11

that doesn't sound very nice. What is a blood

23:13

desert? A blood desert is

23:15

a place where it's really hard for

23:18

most people, 75% of people, to get

23:20

blood if they need it so maybe

23:22

somewhere really rural where they don't have

23:24

blood banks or maybe where most people

23:26

can't afford the blood if they need

23:29

it. And presumably the consequences of not

23:31

having access to blood for transfusion can

23:33

be very, very serious. It can be very

23:36

serious indeed because if you lose lots

23:38

of blood, which can happen for example

23:40

during childbirth, you need that replaced

23:42

quickly and if you're not near a hospital

23:44

or a blood bank then things get very

23:46

difficult. So to sort this out, 17 global

23:49

experts got together for two days to come

23:51

up with some solutions and there's three big

23:53

things they suggest. So I want to start

23:55

with the high-tech one, delivering blood by drone

23:57

and I know this was trialled during the

24:00

the Harge in Saudi Arabia last year. So

24:02

this means literally dropping off the blood, does

24:04

it, by flying drones? It does. It means

24:06

an unmanned aerial vehicle getting up into the

24:08

sky, taking the blood to exactly where it's

24:11

needed. Say you've got a huge mountain range

24:13

that you need to get past or the

24:15

roads are blocked for some reason, a drone

24:18

might be able to get blood into

24:20

an inaccessible place. So this does sound

24:22

really promising and it has already been

24:24

used, as you say, in lots of

24:27

different countries, in the US, in

24:29

Switzerland, in Rwanda, Haiti, the Dominican

24:31

Republic. So there are suggestions that

24:33

it could be a good way

24:35

to deal with these blood deserts. But of

24:37

course, you would need the public to be

24:40

on board with the drones, you'd need someone

24:42

at the end where the patient is

24:44

to be able to give the blood, which is not

24:46

an easy procedure and there's lots of things you've got

24:48

to look out for like reactions and that kind of

24:50

thing. And of course you'd need the

24:52

blood in the first place to be able to take it to

24:54

the patient. Now the second

24:56

solution is to actually collect

24:58

the patient's own blood while they're

25:00

bleeding and give it back

25:03

to them. How does that work? This

25:05

is something called intraoperative autotransfusion. And so

25:07

what happens, say you're having a cesarean

25:09

section and you're losing some blood that

25:12

can be collected by a gadget, for

25:14

example, and then it can

25:16

be filtered and then given back to

25:18

the patient. And that already happens in

25:20

South Africa, for example. The

25:23

researchers say, yeah, this sounds like a good

25:25

idea. It has been used in lots of

25:27

places, but there isn't enough research about how

25:30

good that blood is compared to blood from a

25:32

blood bank. There are lots of benefits because if

25:34

it's your own blood, you're not going to react

25:37

against it. For example, you don't have to screen

25:39

for all the diseases, for example, but there are

25:41

still some questions. And then the final solution is

25:44

known as civilian walking blood banks. Now I have

25:46

to admit I was picturing, I don't know, sort

25:48

of people walking along with needles in their arms,

25:50

giving their blood as they walked, but it's not

25:52

quite that, is it? That's what I thought of

25:54

too. But as I read on, I realized it's

25:56

a practice that I'm actually really familiar with in

25:58

India and in South Africa, for example. I've

26:00

been to places where actually if you're having an

26:02

operation or if you're about to give birth you

26:05

may ask a relative a friend Look if something

26:07

happens, please could you donate for me or in

26:09

some cases? Please could I buy some blood from

26:11

you and this does happen in lots of places

26:14

now You do need to be able to check

26:16

the blood check that it's free of viruses and

26:18

check that it's the right type Because if it's

26:20

not the right type to the person that you're

26:23

donating and receiving then that can be catastrophic and

26:25

fatal in fact So you still need some

26:28

sort of technologies in place And

26:30

what would be the impact if all of these things which

26:32

have been tried before and are used in some places What

26:35

would be the impact if they were all done more widely?

26:37

The researchers say look these are three

26:39

feasible options that make may work in

26:42

different places at different times But

26:44

actually the most important thing is to make

26:46

sure every country has a functioning working Blood

26:49

bank with all the technology that that requires

26:51

so yeah, these might be temporary solutions But

26:53

in the long term they want to make

26:55

sure every country has the blood any

26:58

and you can find more on that in

27:00

the Journal the Lancet. Thank you so much

27:02

Smita Mundisav for joining us today And thanks

27:04

to the producer of health check Claire Salisbury

27:07

and our studio engineers today plus McGee and

27:09

Jackie Marlgrom I'm Claudia Hammond do join me

27:11

if you can for the next episode of health

27:13

check in the BBC Do

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