Buddhist Compassion Relief Tzu Chi Foundation

In April 2020, a charter flight from Singapore landed in Hualien, east Taiwan, and left an hour later on the return journey carrying the bone marrow that saved the life of a 40-year-old woman. It was the first time that the Tzu Chi Stems Cell Center has handed over the precious material via an international transit charter flight. This was made possible by the full support of the Hualien airport, the Hualien County and Health Bureau and the Aviation Police.

The quarantine restrictions required by the Covid-19 pandemic have disrupted the delicate arrangements used to transport bone marrow. Normally, it is hand-carried for the entire journey. But this became impossible because of entry restrictions imposed by Taiwan on March 19 and Singapore on March 23. So the person carrying the bone marrow would be quarantined for 14 days at either end, making such a delivery impossible. Dr. Lin Shinn-Zong, Superintendent of Hualien Tzu Chi Hospital, said that, after finding a suitable bone marrow match, a leukemia patient undergoes a series of chemotherapies. If the transplant surgery does not take place within the set amount of time, this patient may have serious infection or even die. So how to solve this apparently insurmountable problem?

This leukemia patient seeking the bone marrow is a Singapore woman about 40 years old. She failed to find a match in the Singapore Bone Marrow Registry. Then, at the end of last year, she sought a cure from the Tzu Chi Stem Cells Center. She was very fortunate and found a match. Center Director Yang Kuo-Liang said that matching of at least 8 of 10 HLA (Human Leukocyte Antigen) markers is required for the transplant. In this case, all ten markers matched. This is truly a very rare affinity.

The patient was originally scheduled to have her HSC (Hematopoietic stem cells) transplant at the end of March. At the same time, the bone marrow donor had taken time off work to go to Hualien Tzu Chi Hospital for the donation procedure. However, the pandemic caused many countries and regions to implement border entry restrictions. These interrupted the preparation for bone marrow delivery. The family of the leukemia patient in Singapore proposed to send a charter plane to pick up the bone marrow. The Tzu Chi Stem Cells Center and volunteers took the proposed plan to the Hualien Airport and Aviation Police Bureau and received great help in finalizing the steps to satisfy border entry requirements, security checks, and health checks during this pandemic period.

The direct flight took off from Singapore and arrived in Hualien after a flight of four and a half hours. To meet the regulations governing Covid-19, those handing over the bone marrow had to keep social distance. Dr. Lin Shinn-Zong and Mr. Yang Kuo-Liang wore hospital gowns and from a distance transferred the life-saving HSC to representatives from Singapore. Dr. Lin expressed his welcome and gratitude. He said: “I am grateful that you have traveled more than a thousand miles to come to Hualien, Taiwan to rescue a life of a leukemia patient. With the threat of Covid-19, this is the first time that we have worked with a charter flight to deliver bone marrow, while observing social distancing. With this transfer from a distance away, we send our good wishes to the patient for her speedy recovery.” In a legal sense, the plane did not enter Taiwan.

On the ground for less than an hour, this plane took off again on the return flight. It carried the bone marrow with love from Taiwan to Singapore to save a leukemia patient badly in need of the HSC transplant. Dr. Lin Shinn-Zong expressed special thanks to Hualien Airport and Aviation Police Bureau for their assistance. Together, this mission to save life was completed safely, while following the pandemic prevention measures. A very good quality of bone marrow was delivered in good time to Singapore.

Hualien Airport and Aviation Police Bureau had no prior experience of doing this. Tzu Chi is grateful for the full support of Hualien County Government, Health Bureau, and all the agencies involved to complete this difficult and timely task to rescue life.

Mr. Wu Fu-he, director of Hualien Airport, said: “This is the first such case. For pandemic prevention, this method of transit flight without border entry is the first case in Hualien. I also want to thank the Immigration Agency, Custom Administration, security units, and other agencies for their coordination and assistance to make this bone marrow transfer successful.” Mr. Gao Guo-sheng, Director of Aviation Police Bureau in Hualien, also said that this Singaporean charter flight is a humanitarian relief mission. After fulfilling the safety and security requirements, they gave their full cooperation.

Mr. Chu Chia-Hsiang, Director-General of Hualien County Health Bureau, said that international bone marrow donation was a very rare and precious issue during the peak of the coronavirus. He said: “I see the Singaporean nurse and Tzu Chi medical team dress up in full personal protective equipment, including medical gown, eye protection, and gloves. Infection control professionals are on site to guide all participants, including medical teams, members from Aviation Police Bureau and airport. Each infection control procedure is followed and every prevention step is well carried out. The entire event is truly very touching. I believe this is a first of its kind in the world.” Mr. Chu participated for the entire transfer with full personal protective equipment. He witnessed the bone marrow transfer and its love beyond national boundaries during the pandemic period.

The bone marrow link between Singapore and Tzu Chi began in 1994, the second year after Tzu Chi Stem Cells Center was founded. The center’s first international bone marrow donation was sent to Singapore. With the close similarity in ethnicity, matching between Taiwan and Singapore is higher than between other countries. As of April 2020, Tzu Chi Stem Cells Center had provided 144 HSCs to Singapore.

Report by Peng Wei-yun
Translated by Chou Yu-ru