When Yvonne Chacha, 25, walked into Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) in severe pain, it was another sickle cell crisis — the kind that has shaped much of her life.
This time, however, her visit marked a turning point. She became among the first patients to benefit from automated red cell exchange at the hospital’s Victoria Annex, where a newly installed apheresis machine is transforming care for people living with the genetic blood disorder in western Kenya.
The hospital has rolled out the Spectra Optia system, an advanced apheresis machine that removes damaged sickled red blood cells and replaces them with healthy donor cells.
Dr Thaddeus Masawa, a clinical and anatomical pathologist at JOOTRH, said the procedure significantly reduces the risk of life-threatening complications.
“Sickled red cells are sticky and can block blood vessels, leading to clots or stroke. We remove those damaged cells and give healthy red cells. Since the lifespan of a red cell is about 120 days, patients can undergo another exchange after about three months. The goal is to improve quality of life and reduce painful crises,” Dr. Masawa said.
He added that the hospital was strengthening its blood transfusion unit to ensure a steady supply of screened blood to support the service and noted that the facility had also acquired a new screening machine capable of testing donated blood and performing other important laboratory investigations.
Dr Brenda Misore, a paediatric haematologist and oncologist at JOOTRH’s Victoria Annex, said the service will be especially beneficial for children, since most serious sickle cell complications begin early in life.
“The aim of doing red cell exchange transfusion is to prevent complications so these children can grow and live into adulthood,” she said.
She pointed out that stroke was one of the most common and devastating complications among children with sickle cell disease and revealed that the hospital plans to introduce transcranial Doppler ultrasound screening to identify children at high risk and start preventive transfusion early.
Before the automated system, many children in the area, she said, depended on chronic manual transfusions, which carry risks such as iron overload and alloimmunisation.
Automated exchange, Dr Misore said, reduces those dangers describing it as a game-changer for sickle cell patients in the lake region.
She disclosed that before the introduction of exchange transfusion services, the paediatric sickle cell clinic saw about 30 children every Wednesday, but that number has now risen to around 60 due to growing awareness and demand for the procedure.
Last year, in collaboration with Nairobi West Hospital, JOOTRH conducted eight automated red cell exchange procedures.
With a permanent machine now in place, she said, the hospital can perform the procedure more than two or three times a week, including emergency cases such as stroke risk, severe acute chest syndrome and priapism.
Even with the new technology, Dr Misore emphasised that patients should continue taking hydroxyurea, a first-line disease-modifying drug, alongside infection prevention medicines and regular clinic visits.
“Apheresis is part of comprehensive care. Our patients must still be on hydroxyurea and attend follow-up clinics,” she emphasised.
Dr. Steve Nojuma, Director of Victoria Annex, said the hospital has the capacity to screen babies for sickle cell disease from birth.
“In our facility, about one in every five children born has sickle cell trait,” he said.
He added that previously, mortality among children with sickle cell disease could be as high as 50 to 80 per cent before age five.
“But among the 500 children we have screened and followed for the last four years, we have lost only 11. That brings mortality to about 2.2 per cent. Early screening and follow-up care make a huge difference,” said.
He added that the new apheresis machine would help manage complications arising from sickle cell disease and encouraged families in the Lake Region and neighbouring counties to seek screening and treatment early.
Kevin Otieno of Conrad Science, which partnered with Terumo Blood and Cell Technologies (BCT) to place the machine at JOOTRH, said the Spectra Optia system can perform up to 11 different procedures beyond red cell exchange.
These include therapeutic plasma exchange, platelet collection for oncology patients, stem cell and mononuclear cell collection for transplants, granulocyte collection, bone marrow processing and white blood cell or platelet depletion in selected cases.
He said the technology would support both haematology and oncology services as the hospital expands specialised care.
JOOTRH Chief Executive Officer (CEO) Dr. Joshua Okise said the initiative grew from the realisation that many families could not afford to seek the specialised procedure in private hospitals.
“For a long time, patients had to travel far or go to private facilities where the cost was too high,” he said. “Now this is a public service under our management. We have trained our staff, ensured supply of consumables and done a cost-benefit analysis to make it sustainable.”
He said hospital staff had undergone a week of specialised training and were already conducting successful procedures locally.
Looking ahead, Dr. Okise said JOOTRH had set aside Sh. 50 million in the 2025–2026 budget to establish a dedicated haematology centre at the Victoria Annex, with plans for a bone marrow transplant unit within a future comprehensive cancer centre.
He urged families not to keep sick children at home. “Do not fear. There is hope to live again and hope to see tomorrow,” Dr Okise said, asking residents to take advantage of screening and treatment services now available at the facility.
For Yvonne Chacha and many others living with sickle cell disease, the steady rhythm of the apheresis machine at Victoria Annex now signals more than a medical procedure.
It represents time gained, crises averted and a future that no longer feels so uncertain.
By Chris Mahandara
