‘New blood disorder test shows the Army’s inclusive culture’
DOCTOR SAYS THE CONDITION, WHICH COMMONLY AFFECTS ETHNIC MINORITIES, IS NO BAR TO A SERVICE CAREER
IN A bid to improve the wellbeing of soldiers, the British Army has launched a test specifically for sickle cell disease, a group of blood conditions that most commonly affects people from black, Asian and minority ethnic communities.
People with the disorder endure severe pain during a ‘sickle cell crisis’ that can occur multiple times a year, often requiring hospital admission where they can be given morphine to control the pain and prevent organ failure, which can be fatal.
The Army has started to test for sickle cell trait (SCT) so it can better support an individual who may not know that they have the condition. And if a recruit is found to be a carrier, it will not stop them from having a fulfilling career in the Army.
“We want people to know that if you have the sickle cell trait (SCT) you can still join the Army – we will take care of you,” said Dr Darshan Seehra, who is part of the Army’s recruitment team at the Defence Medical Services, in Whittington, Staffordshire.
“We know through previous research that people of African, Mediterranean, Middle Eastern, Caribbean, and Indian heritage are at a higher risk of SCT.
“So, through looking at health assessments and questionnaires, we will recommend the SCT blood test for those who come from one of these backgrounds,” he said.
As they are carriers of the inherited gene, people with SCT do not have any of the symptoms of sickle cell disease. However, the condition can present health challenges when they are involved in situations related to extreme exertion, increased atmospheric pressure, high altitudes or significant dehydration. Symptoms include severe pain, fever, one-sided paralysis, difficulty walking, sudden vision changes and confusion.
The Army has launched a campaign – which includes leaflets, articles and videos – to make people aware of the symptoms and prevention of exertional collapse associated with SCT (ECAST) – which is very rare and usually only occurs during intense or unaccustomed exercise.
Rare complications include muscle breakdown (rhabdomyolysis), reduced blood supply to the spleen, or increased pressure in the eye (glaucoma) following eye injuries.
The test is to ensure Army personnel are looked after, and the associated campaign is aimed at raising awareness among colleagues who may be the first to spot any symptoms.
“The Army keeps an eye on exertion and fitness levels of all new recruits. Their training in the beginning is very much graduated, very much monitored,” said Dr Seehra.
“While SCT should not impact your future Army career, certain specialist career pathways and activities must be considered on an individual basis in the pre-course medical, such as high-altitude mountaineering, diving, aviation and special forces.”
New recruits are assigned to a Physical Training Instructor (PTI) for strength and conditioning, as retaining a good level of fitness reduces the risks of any problems. The Army also provides emotional support for recruits who might be concerned about SCT and the impact it can have on their family lives.
Dr Seehra said, “If they have a diagnosis of sickle cell trait, it can have implications on their future children.
“Unfortunately, there is a higher risk of having children with sickle cell disease, which definitely is a bar from Army entry.
“We have appropriate counselling and discussion on this in quite a few areas across the country.”
Dr Seehra added that the Army supporting soldiers who might have SCT is another example of the organisation being inclusive and diverse.
“I was a Reservist for around four years, and I worked with Army recruitment for around eight years. I have always been respected,” he said.
“I have never faced any kind of discrimination in any shape or form. I am a Sikh who wears a turban and I have always been encouraged to share my culture. I have delivered lectures and presentations on Sikh inclusion,” he added.
“We are encouraged to promote our culture and religion and as the lead doctor here, I always encourage that automatically, because it is good to know about each other’s cultures.
“The Army promotes equality to a big extent.”
Meanwhile last month, NHS England followed the Army’s lead by announcing a campaign titled ‘Can you tell it’s sickle cell?’ which was aimed at boosting public understanding of the condition.
It also launched an NHS training programme for staff.
Dr Bola Owolabi, NHS England’s director of health inequalities, said: “Sickle cell disease is a debilitating illness that thousands of people live with, but which has historically been poorly understood.
“This is why the NHS is launching this brand-new campaign and asking: ‘Can you tell it’s sickle cell?’
“It is vital that we continue to tackle healthcare inequalities head on.
“This means improving care and experience of NHS services; access to the latest, cutting-edge treatments; and proactively raising awareness of conditions such as sickle cell disorder that disproportionately affect some of our
communities.”