Rampant demand for replacement undermining voluntary blood donation movement

Replacement for blood is just refusing to go away.. and now it has started affecting voluntary blood donation as well!

A person got his father admitted in a reputed hospital for a cardiac surgery. He was told that 5 blood donors were required to be brought in before the surgery. When he went back to his office he realised that most of his friends had donated blood a week back since the company had organised a large blood donation drive where 400 units were collected across all offices. The organisation which collected the blood unit said that he can take as many units as required without any replacement - but his hospital refuses to take blood from anywhere outside. He frantically calls all the people he knows and after struggling for a day and a half manages to find the units.

A couple of days later he sends a mail sharing his experience to the senior management of his company asking - "If voluntary blood donation in camps cannot help the patients when they need blood then why at all should their company organise a blood donation drive?" The act of demanding replacement puts into peril regular blood donation drives which are being organised in his company. It took a lot of effort to pacify the situation and prevent the taking of a decision which would have deprived the city of more than 1500 units of blood a year coming from the 3 camps that the company organises! - Replacement is destroying VBD

25th March 2013: Today there is plenty of blood in Bangalore

There are more than a 1000 units of B+ve blood units in Bangalore today. An estimated 1500 units of O+ve also find place on the shelves across the city. Even for the groups considered hard to find, today tens of units are there in blood banks. A majority of these units have been donated by voluntary blood donors in blood donation drives. I have just come home after spending a day at one of the voluntary blood donation drives. Looking from an overall perspective, it seems like an ideal day for people associated with voluntary blood donation.

However, people are being made to suffer

However, the fact is that even today people in Bangalore struggled and suffered to organise blood units for their relatives. Even today people reluctantly left their work and travelled large distances to go to blood banks to donate blood. In spite of the fact that the city had very good stock - there is no shortage of those people who were told that the treatment of their loved ones would proceed if they organised for walk in donation at some particular blood banks. Some people who would have suffered today would be wondering why at all one should organise and participate in voluntary blood drives when all such efforts fail to comfort the person in need of blood? Even on a wonderful day like today some hospitals in Bangalore coerced helpless relatives to organise for 'replacement blood units'. They not only made the patients suffer they also undermined the work done by everyone who is struggling to ensure blood is available off the shelf by means of voluntary blood donation

Replacement Blood Donation is Rampant Here are 4 events from the week gone by:

  1. Thalassemiacs being asked to replace blood units

    Mother of a 13 year old girl who receives blood transfusions to combat thalassemia called us up last week. She had called to ask what we were going to do about thalassemia day cares in future. She told me that each time her child needed transfusion, she was being asked to take along donors to replace the units! With trembling voice she hopes that soon something would enable her child too would get blood without having to find replacement donors.

  2. However many units available, leave work and come to replace!

    Sankalp helpline got a call from a person requesting for help with blood. He needed B+ve units. Without second thought the volunteer on the helpline started giving the numbers of the places where the blood units were available to be provided without replacement. The man on the other end interrupted. He insisted that he needed donors alone. The hospital had asked him to get 4 people several kilometres away from the city between 9:30 AM and 5:00 PM on a weekday. This was a person taking treatment at an extremely famous and well known hospital. On hearing the name, the volunteer knew that there was no other way. The hospital would agree for nothing short of seeing 5 people lose a day of work, come down and donate.

  3. Artificial emergencies

    Sankalp was congratulated by someone in blood banking for helping during emergencies. Sankalp volunteer in question was very uncomfortable. The person knew that what was being referred to as an emergency was in fact routine blood requests. The fact was that by insisting upon in-house donations, this policy had converted simple normal blood requests - tens of which are handled by Sankalp each day into full blown emergencies. Donors were rushed out of their workplaces and into the blood bank at short notice. The family members prayed that the donations happen - or else they stood a chance to get their scheduled surgery cancelled!

  4. Companies questioning VBD

    When we visited a particular organisation to propose a blood donation drive, a team of volunteers was there to meet us. One of them strongly argued that there should be no camps. His argument was that when someone from his office gets admitted in hospital, eventually they are asked to replace blood units. The associates leave work and go ahead to donate. Then what is the point of organising blood drives. He was correct in the sense that the volunteers know that there are so many hospitals in the city - specially the better known ones - who force people into organising for blood - only from their own blood banks by means of replacement!

There is lesser need for Emergency Blood Donation

Over last few years, though the number of blood requests which Sankalp is handling has steadily increased, there has been almost no increase in the situations that need a blood donor to be rushed to the hospital. With better networking and better blood availability most of the times, the unit of blood that is needed is available on one or the other shelf in the city. There was a time - 10 years back when sometimes A+ve and AB+ve was hard to find very often in blood banks. Very rarely it still does happen for selective components of blood. However, the fact of the matter is that most of the times, blood can be organised off the shelf. Still there is need for blood donors to be rushed into blood banks. This is for the aphaeresis requests, the Bombay blood group requests and on occasions when the entire city is short of blood (happens in some months). However, the fact remains that because of certain blood banks who deny any units of blood the family organises outside their premises, the situation of having to run to the blood bank to donate is one of routine.

The Regulators are Confusing Silent

Ask a blood banker in the corporate hospitals on why they do not switch from replacement to voluntary blood donation and they point towards a major flaw in the blood banking regulation and policy of the nation. On one hand the National Blood Policy 2002 aims to achieve 100% voluntary blood donation and on the other, it imposes restriction on blood donation drives. Several blood banks are not allowed to conduct camps. If so, then where does the Government expect them to get voluntarily donated blood from? It is a well known and recognized fact that the expectation of people walking into the blood banks after traveling distances just to donate blood is not realistic to take care of the entire requirement. So while the nation aims at 100% voluntary blood donation, it leaves the door shut for several blood banks to move from replacement to voluntary blood donation.

In such scenario, the hospitals insisting on donations in their own blood banks are undermining and defeating the goals and objectives laid out for the nation by the National Blood Policy and the regulators have turned a blind eye towards this problems. Is it so difficult to understand that no matter how many units of voluntarily donated blood are available - 100 % voluntary blood donation can never be achieved because some blood banks continue to ensure that each unit they issue is replaced? Road into 100% VBD is missing.

Hospitals indulging in replacement are causing long term damage

What hospitals promoting replacement must understand is that even before the patient walked into the hospital numerous people have already donated enough blood for him/her. By not accepting voluntarily donated unit they are making the patients suffer unduly. By insisting upon replacements they are inflicting mental, financial and physical agony on the families.

What hospitals promoting replacement donations must admit to and understand is that by forcing people to donate in exchange for the blood they issue, they are undoing the efforts of everyone who is working for voluntary blood donation. They are strengthening the notion that donating blood when required by a near and dear in better than donating blood voluntarily. For the sake of safeguarding their individual interests, they are compromising the interest of the society as a whole! Let it be understood in no uncertain terms that blood on shelf saves lives not blood in veins. In cases of emergency, road traffic accidents, major haemorrhages and several other conditions there is no time for anyone to get donations. By forcing people to replace blood - the institutions are discouraging voluntary blood donations - and hence denting the stocks on blood available off the shelf for one and all.

There is hope

While there is restriction on some blood banks to organise blood donation drives just by themselves, there is no restriction on them participating with an authorised blood bank to collect blood units in camps. While doing the research for this article we spoke to some blood bankers who promised to looks seriously into participating in camps instead of demanding replacements. Such proactive steps are the need of the hour.

An appeal to everyone seeking replacements

Please understand that each unit of replacement that you seek, not only denies access to voluntarily donated blood to the person in need, it also affects the future prospects of voluntary blood donation. Please understand that at least in cities like Mumbai, Delhi, Hyderabad, Chennai, Kolkata and our own Bangalore - if a person still has to replace blood units in a routine kind of a manner - then this is nothing short of combined failure of blood banking services in these cities. Please do make amendments to your policies and embrace voluntary blood donation. Let's bring an end to harassment of individuals for the sake of blood. Let us give voluntary blood donation a chance!