Should a donor be promised blood for free in case of need?
Time and again a debate about this promise of free blood to the patient and his/her primary relatives pops up in the blood donor community. The issue arises from the incentive that few blood banks in the country give in the form of a time bound assurance to provide blood free of cost to the person who donates blood and his/her primary relatives.
I strongly oppose this and it is not without reason. I will share a few with you here.
Consider a scenario when a regular blood donor working in a good IT company is in need of blood. The person calls up bla-bla-bla blood bank and reminds them that he/she had donated blood and was promised free blood in case of requirement. There may be 2 possibilities. Either the blood bank does not have stock, (in which case they will simply refuse to provide blood anyways) or the blood bank has blood. In the second case, the blood bank should not hesitate in issuing blood to you whether you are a donor or not (Did they not tell you that they provide the blood they collect from you to the needy without bias?). So effectively, it boils down to an issue of Rs.500/- or something close to it. Any of us who donate in corporate blood donation drives are medically insured and thereby we can anyways refund all the money we spend on treatment. So, is there any logical value addition by promising a unit of blood unless the blood bank is involved in partial and un-just distribution of blood? If a blood bank promises to issue blood on need basis to everyone who approach it and if you are medically insured then the promise of free blood will only put the poor and the suffering that should have benefited from that free unit at loss.
Secondly, this process of promising blood free of cost is actually a twisted form of a genuine practice that existed some years back. It was the time when there were very few voluntary blood donors and so the blood banks took replacement for each unit of blood a person requested for. At that time, the promise was not to ask for the exchange unit of blood in case the relatives or the person him/herself required blood. Makes Sense? Yes! Today, things have changed. When a blood bank approaches you for blood, it also boasts of extraordinarily high (even up to 100%) number of voluntary blood donors. So, the concept of necessary replacements is already dead. What remains is the money part of things. Should the blood donation process be completely voluntary or should it be transformed into some sort of a blood insurance scheme?
Here is how the International Red Cross and WHO define Voluntary donors: "Voluntary unpaid donation shall mean the donation of blood or blood components by a person of his/her free will and without receiving payment in cash or in kind in return which could be considered a substitute for money. This also includes time off work reasonably required for donation and travel. Small tokens, gratuities, refreshments and the reimbursement of direct costs and direct travel expenses are compatible with the voluntary and unpaid donation of blood." The question is -"With incentives like a promise of free blood, does the donation qualify as voluntary?"
In Sankalp when someone asks us for this guarantee I have just one thing to tell - "Since 23rd May, 2003 we have never refused anyone who was in genuine need of blood. Whether you are a donor or not makes no difference to me. When you need blood, call us. Either we will guide you to a source where you can find blood or arrange for it. This has nothing to do with the blood donation." Please donate blood if you wish to. We are working day and night to stand by the patients in need. For us, all of them are the same and the only criterion is medical urgency.
One last point! This is about the high tech modern and well financed NGO blood banks versus the poor Government Hospitals. Accept it or not, but the truly helpless and suffering come only to the government hospitals. Their only hope is the highly subsidized blood units from the blood bank there. It is close to impossible for such blood banks to have special reservations like free blood for donors. If some blood banks in the city make use of the donor incentives like free blood, it becomes extremely difficult for these government hospitals to convince donors to donate for them.
You need to make a choice. You need to ask yourself where the free units of blood that the blood banks afford should go. You need to ask whether the motive is free and fair distribution of blood to all or whether some special shelves be made for the donors. Yes, the supply is low and we need more donors. But, should we build people's convictions of people in this field of service or should we take some shortcuts? I leave it to you to decide.
(Rajat is a senior Sankalp Volunteer who has been working to arrange blood for the needy. In the short span of five years of his service, he has been exposed to the blood donation and transfusion in a very comprehensive way)