Blood, babies and the realities of expat healthcare in Bali

IMG_1256A newborn Kiran, already angry – he screamed non-stop for an hour after being born.

Bear with me on the gory title, I’m going somewhere with this.

I was inspired to write this by a campaign that was going around on my Facebook news feed yesterday about a Russian woman living in Bali who had lost her unborn baby during her last month of pregnancy due to complications and was now in Sanglah hospital in a coma, fighting for her life. The campaign was to try and find as many people as possible to give B+ blood to increase her chances of survival. I just checked in on the story now to find that she has sadly died, leaving her husband and 4-year-old daughter. So utterly tragic.

Would she have lived if she was in a different country, perhaps with a readily available blood bank? Impossible to say but this problem comes up time and time again. Bali does simply not have enough blood and if, god forbid, you ever get into a serious accident or have a life-threatening illness that requires a blood transfusion, there is a good chance you will need people to donate “on demand”.

And people do get into accidents – motorbike accidents usually. Then childbirth is another big risk. I hemorrhaged after having Kiran, luckily not badly enough to need donated blood but it’s definitely something to consider in advance if you’re planning to have a baby here. I’m in the lucky position of having AB+ blood which means I can receive donations from any other blood type, but others are not so fortunate.

Pregnant women with a rhesus negative blood type are particularly at risk as it is in critically short supply in Bali. While around 15% of Caucasians have rhesus negative blood, only 1% of Asians do. The problem is a real one and I’ve heard of women shipping in blood from Singapore in preparation for labour, in case of complications.

The Red Cross maintains a register of rhesus negative donors in Bali and if you plan to live here for any significant length of time, I would urge you to make sure you know your blood type and add yourself to the register so you can be contacted when a supply is needed. My ‘lucky’ AB blood is almost useless as it can only be donated to other AB types.

From time to time incidents like the poor Russian girl come up and I do think about those of us who have chosen to live in countries less developed than the ones we come from and the risks we are taking. Bali’s medical care is improving but is still way behind the likes of Malaysia and Singapore and expats with serious conditions are usually flown out of the country.

It never really occurred to me to go back to the UK or go anywhere else to give birth – there are some good hospitals here, with well-trained doctors (although maybe a little on the laid back side – read Erica’s account of the differences between Jakarta and Singapore). They just don’t always have the resources that other countries do when things go wrong. As expats we’re often spoiled with hospitals that look like 5-star hotels with service to match. It’s easy to forget that most of the rest of the country don’t have access to these facilities – the maternal mortality rate in Indonesia is one of the highest in Southeast Asia.

If you’re interested in donating Rh-negative blood while you’re travelling in Bali, you can contact the Red Cross or Kim Patra. If you’d like to donate to a cause to improve healthcare access to pregnant women in Indonesia, Bumi Sehat is a wonderful organisation.

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