17 April 2020
While many blood stem cell transplants are still going ahead during the Covid-19 pandemic, the logistics around arranging the transport of the stem cells across the globe for people with blood cancer have become much more challenging and complex. Here, we speak to Maria Schmiing, 34 from Cologne who works for DKMS Germany but also volunteers as a stem cell courier. Recently, she travelled from Germany to America with a very special cargo – life saving blood stem cells for a patient with blood cancer.
Where it all started
Maria said: "It was through an acquaintance of mine that I became aware of the need for volunteers to travel the world and deliver blood stem cells to hospitals. She is a teacher and carries out stem cell transports during the school holidays - I was immediately drawn to this work and signed up for it,". She applied to Ontime Onboard Courier GmbH, one of the transport companies that DKMS works with to bring life-saving blood stem cells to the recipients.
Maria's first assignment took her to Leiden in the Netherlands - an important place in the fight against blood cancer as its headquarters of World Marrow Donor Association (WMDA). "I was really excited before I even started the journey," she recalls.
After many travelling assignments as a courier, Maria applied for a job at DKMS in Germany. "For me, the circle is complete; I'm doing something meaningful with my life. I am very aware of why I am doing this: for patients who desperately need our help. This job makes me feel great and I also feel really supported by my team and my managers, especially in the current situation."
In desperate need
Blood stem cell couriers like Maria are currently in great demand to ensure that blood stem cell donations reach their recipients all over the world safely, even during the Corona crisis. A few weeks ago, her latest assignment was to travel to the US. "The process for a courier mission is actually always the same," she explains, "we have a briefing the day before and go through all documents together and the entire itinerary is discussed. Everything important detail is marked and addressed."
But something is different at the moment: the couriers must carry a special permit that allows them to enter the US. Currently, entry to the US is only possible because DKMS, with the support of the US Stem Cell Donor Register: National Marrow Donor Program (NMDP/Be the Match), has obtained a special permit for stem cell couriers to enter the country - so that patients can receive urgently needed transplants.
Packing up and getting ready to go
The next day, Maria went to the collection centre and picked up the life-saving blood stem cells from specially trained staff. The stem cells had already been collected from a DKMS donor and prepared for transport. All documents and data were double checked based on the 4 eye principle before the transplant was handed over. "We pay particular attention to the donor number and compare it, we have to be categorically sure that the patient receives the right transplant".
Maria can then start her journey. Stem cell couriers are allowed one additional piece of hand luggage. "Most important are the blood stem cells or the bone marrow. We must not lose sight of the transplant during the entire journey. I look after this suitcase like my own personal treasure, like a mother who looks after her children. I am acutely aware of the responsibility and it stays with me until I have delivered the blood stem cells safely to the patient's clinic."
Before the departure to the US, she made sure that at the Frankfurt Airport the suitcase with the stem cells was not X-rayed. "I always have to explain that this is harmful to the transplant – something most people know. Only after an officer has brought the suitcase through the security area, do I then follow. This is the only time we hand the suitcase over to somebody else. Fortunately, there were no problems either at the security check or at customs.”
Once on the plane she informed the crew - an important and regular task for her - and did not let the suitcase out of her sight during the flight. "Sleep, of course, is out of the question. We are not allowed to drink alcohol 24 hours before and during the flight and, of course have to take the suitcase everywhere with us."
Arriving in the US
Upon arrival in the US, Maria noticed two differences "After landing, several security officers entered the plane and talked to the crew - only then were we allowed to disembark. In addition to this, they took the temperature of all passengers”.
She then continued her journey by taxi to the transplant clinic. "Everything went really well, and I was met at the clinic by a member of staff. Again there, we double checked everything and went through the documents according to the four eye principle. Once we get back to Germany, there is also a debriefing and I then return the suitcase."
A sigh of relief
After handing a transplant over, there is always a moment of great relief for Maria: "The tension disappears.” Afterwards she has a ritual that is very important for her. "I go to the hotel, have a shower and then go out and raise a glass of beer to the patient. I think about how they are doing and what is still ahead of them. I then tell myself that I've done everything I can to help them and I wish them all the best."
Going out and having a beer was not possible this time; none of shops or bars were open in the American city - even the hotel restaurant was closed. "I changed my ritual and toasted the unknown patient with a glass of tap water in my room!"
Going back home
The next day she went back to Germany and soon the next flight will be scheduled for her - couriers are rare in this Corona crisis-ridden time. "My learning from this journey: I will take an emergency ration of trail mix with me, you never know," she says with a wink. She reflects on her commitment to patients. "I am still available when my help is needed. I am aware of the risk and take the best possible care and comply with all safety precautions. It is also clear that patients cannot wait - and despite everything with the current situation, they should still be given a second chance at life.”