The importance of developing world haematology

Abstract

The field of haematology has always had a considerable interest in the developing world where anaemia prevalence often exceeds 50%. Awareness of the potential benefits and lessons that can be learnt from this arena of haematology is emerging as a result of the considerable input over many years from general and specialist haematologists many from the more developed economies. They have facilitated not only improvements in basic care, but have also contributed to an increasing understanding of the science behind haematological disorders. This supplement for the British Journal of Haematology develops some of the understanding and ideas from a successful meeting at the British Society of Haematology in April of this year, but can be applied internationally by the more developed nations. The reviews and paper in this themed issue demonstrate the work which is being achieved and opens up the potential to facilitate future partnerships. Haematologists from Uganda being trained in India and a flying pathology service from East Africa are just some of the interesting developments described. Understandably many of the reviews focus around anaemias. The reviews move from how malaria infection modifies the red cell, to greater understanding of what causes anaemia in children in developing world. Treatment dilemmas are also identified where understanding the best strategies for treating children with anaemia need to take into account, for example, why blood transfusion can be so precarious. What happens if the underlying disorder is not treated, particularly when the most likely outcome of transfusion is a recurrence of the anaemia? Reviews also cover the provision of adequate management of haematological conditions in resource poor countries, from the management of haemoglobinopathies and haemophila to malignant haematology, including myeloma and lymphoma. There are also areas where we would not have thought there were problems, such as care of the dying. The use of opiates for these people you would have though was simple effective and available, being of low cost. However, many barriers occur including legal and cultural issues that result in totally inadequate humanitarian care and highlighting these issues may permit us to make significant changes that are not cost but culturally driven. We hope the readers will enjoy this special supplement, which spans both the globe and the wide range of haematology conditions. Our aim is to inspire haematologists to become involved and contribute in to this challenging area of development. The greater awareness of global health can not only improve humanitarian conditions but also make it a safer world. Please see the BSH website for further information on how you too can contribute.