Sickle cell anaemia occurs due to inherited abnormal haemoglobin gene, which changes the red blood cells from its normal biconcave shape to a 'sickle shape'. Sickle-shaped RBCs also reduce the cell's ability to propel blood through the capillaries, obstructing the flow of blood into vital organs resulting in retarded growth. Studies have shown that as the bone marrow is not capable of producing enough blood cells to keep pace with the rate of destruction, often leading to heamolytic anaemia, which in turn, causes haemolytic jaundice, changing the colour of face and palm to yellow. In other words, the anaemia in sickle cell patients is not linked with iron deficiency but rather to deformed RBC, say doctors.

Concerned over the high incidence of this genetically linked disease, the state health department has now, in collaboration with the Valsad Raktdan Kendra (VRK), set up 78 screening and counselling centres in Surat, Tapi, Valsad, Dangs and Navsari, places where this disease is more prevalent. The 78 centres in South Gujarat to screen the sickle cell traits and disease include one in Surat Medical College, three general hospitals, 44 primary health centres, 29 community health centres and one at Valsad Raktadan Kendra.

An additional 11 field laboratories are being planned to be set up in Narmada, Bharuch and Chottaudepur in South Gujarat in the near future.

Doctors say out of a total of 76,653 tribals tested for sickle cells so far at these centres, 10,351 were found carrying traits of the disease, with 677 of them suffering from the disease.

As part of the drive, authorities distributed three types of laminated colour coded cards depending on the shape of the haemoglobin cells. An all white card indicated normal haemoglobin, half white-half yellow, sickle cell trait and all yellow, sickle cell disease.

To ensure that children with sickle cell trait or disease were not born, unmarried boys and girls, yellow cardholders have been advised against marrying among themselves. Councillors have advised that a half-white half yellow cardholder or an all yellow cardholder should marry only to an all white cardholder.

According to Dr. Yezdi Italia of VRK, which has been chosen as implementing agency for state government's sickle cell anaemia control programme, the state government has in principle agreed to spend a sum of Rs. 24.76 crore in the next five years over diagnosis, control and treatment of the disease.

Chief minister Narendra Modi has also announced to allocate a sum of Rs. 2.88 crore for the project in the financial year 2008-09.

Dr. Italia said efforts are now being made to carry pre-natal tests as well as screen all newborn babies of tribal mothers for sickle cell disease.

“Within a short time we shall be able to carry out prenatal diagnosis for sickle cell trait and sickle disease. If the sickle cell trait is found in pregnancy, the couple can terminate the pregnancy if it's a confirmed case of sickle cell disease.