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Save a life

Why is there always a better time to donate blood than now? Why is there a general feeling of apathy towards blood donation? Dr. SARANYA clears misconceptions and myths.


There is a latent, and unwarranted, fear of the process of blood donation.

RECENTLY, we received a call at the blood bank asking us to send donors of a rare blood group to a corporate hospital in Chennai. We offered to provide components as we had them screened and available, but were told that the hospital did not want to use this. The call was from a person who has organised several blood donation camps and it was ironic that at a time of need, donors were not available. We spoke to some regular donors and they were gracious enough to respond. The crisis was resolved, but what hit home was that in the last seven years, the situation has not changed very much.

Let's take a look at the situation today. "In India, about three million units (1997) are collected annually against the requirement of seven million for a population of 900 million. The blood donation system is still dependent predominantly on replacement family donors. According to the blood collection figures in 1997: 40 per cent donors were voluntary, 30 per cent replacement and 30 per cent were paid blood donors." Overview of Quality Assurance in Blood Transfusion Services (BTS) in the region presented by Dr.Sudarshan Kumari, Regional Advisor, HLS, WHO/SEARO on the status of blood transfusion services in nine countries of the South East Asian region based on the response to a questionnaire sent by the World Health Organisation.

Unpublished data from Chennai shows that 25 per cent are truly voluntary donors.

In Chennai with its population of a little over 4.2 million, about half are eligible to donate blood. Our annual requirement of blood is about 120, 000 units. Here too, there is a wide gap of almost 40 per cent between the demand for and availability of blood/components. These are unpublished figures, but give a rough estimate of the situation.

Why is there always a better time to donate than now? Why is there a general feeling of apathy towards blood donation? Misconceptions and myths, while they do exist, are luckily waning. Most often, people say that nobody asked them and, to some extent, there is a fear of the whole process of donation. While just around six or seven per cent of donors at Jeevan Blood Bank and Research Centre are women, an interesting fact showed that women appeared to be far safer donors.

What is donation all about? Can I donate blood today if I want to?

There are certain criteria that one needs to fulfil before donating blood. Most banks provide information on donation and a questionnaire to be filled in as accurately as possible. This will ensure that there are fewer chances of rejection in the screening process.

  • A few basic stipulations: the age of the donor has to be between 18-60 years, a minimum weight of 45 kg is required, the donor should be afebrile, a minimum haemoglobin count of 12.5 gm/dl and the blood pressure needs to be within acceptable range of 110/70 mmHg to 180/100 mmHg and should not be under medication. The donor should also not be on treatment for diabetes, cardiac problems or any other medical ailment. If he feels they need some clarification, a trained counsellor or the medical officer can be approached.

    When anyone donates blood, a fixed volume of 350ml (450 ml is collected when components are prepared and correspondingly the minimum donor weight has to be 50 kg) is collected into a sterile single use disposable plastic bag with anticoagulant in it and with constant mixing during the process of collection. This process takes about five or seven minutes. Blood is, then, collected into labelled glass tubes , and screened for transfusion transmissible infections (TTI).

    Single-use throwaway lancets are used for haemoglobin check and single-use disposable transfusion sets that are attached to blood bags (these are closed units and cannot be tampered with) are used during the process of donation. If these safe practices are followed , there is no possibility of acquiring an infection. The bank cannot stop with just collecting blood. The blood now needs to be processed and separated into components and screened. Separation into components takes a couple of hours and needs to be done within six hours of being collected which is why most banks that prepare components prefer to stop collecting blood by 5 p.m.. Screening for infectious diseases, if done by internationally acceptable methods, requires four or six hours. This cannot be done on a sample before the actual donation as some infections have a short incubation period hence they may be missed if the sample is drawn earlier. In India, screening for these diseases is mandatory — HbsAg; HIV antibody, HCV antibody, Malaria, Syphillis.

  • A prospective donor needs to ensure that the blood bank follows all the safety requirements to ensure safety of both the donor and the recipient. Any recipient has the right to know if the blood he/she receives has been screened. Also, proper storage and finally compatibility testing before issue of a unit are an absolute must.

    If these need to be done properly every time, blood needs to be available all the time. People need to donate blood without waiting for a call from the bank or a friend. This saves precious time that is otherwise spent hunting for donors and then a further period of waiting till this blood is properly tested and certified fit for use.

    On national holidays, or on birthdays of film stars/politicians, "mega" camps are held and organisers feel justifiably proud that large numbers of people have donated blood. Mega camps should be discouraged as, in most instances, donor safety is not given top priority. In addition screening large volumes of blood in a short span of time increases the likelihood of mistakes.

    If at this level of population, we are unable to satisfy our blood requirements, what's in store for us? Already there are times when the blood bank has, say five units of a particular component and we have eight requests. How do we decide whom to give the blood to? People must understand the importance of blood donation and come forward voluntarily through the year. In a bid to ensure that safe blood/components are available on demand and to make us self-sufficient in meeting our blood requirement, a "Jeevan" initiative Donor Recognition Empowerment Awareness and Management (DREAM) was launched on April 6, 2001. With this, it is hoped to mobilise 100,000 truly altruistic blood donors by April 7, 2003 who can donate blood once/twice a year. You can show your commitment to this cause by registering as a blood donor at www.safeblood.org

    The writer is Director, Jeevan Blood Bank and Research Centre, Chennai.

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