It happens much too often these days. A bomb explodes. Our fellow Pakistanis are killed and wounded. The survivors rally together to get the wounded to the nearest hospital. Relatives and friends show up at the hospital dazed and confused, and often the first thing they are asked to do is ‘arrange blood.’
It doesn’t have to be an act of terrorism. Quite routinely in medical situations and surgical emergencies, sometimes even at childbirth, the patient’s family is asked to ‘arrange blood.’ Often in the middle of the night, with a life hanging in the balance, the patient’s family starts calling everyone they know looking for someone, anyone, who is ‘A Positive’ or ‘O Negative.’ And even when they do find someone with the right blood group, there are questions that remain: is that person available to give blood, willing to give blood, and most importantly, is that person’s blood safe.
The problem with such donations isn’t just the last minute lack of availability. It is also the fact that a blood donor who happens to be relative or a friend of the patient is highly unlikely to disclose his complete medical history in such a high peer pressure situation. And since the blood is from a ‘known’ source, the mandatory testing is often ignored. Most blood donations in our country are such last minute directed donations.
The question is this: if everyone has blood, and if the need for blood is constant, why do we wait until the very last moment to go looking for it.
There are a few excellent blood transfusion services in Pakistan. These blood banks collect blood from volunteer donors even when there isn’t an emergency situation. The volunteers give blood knowing their blood will be given to someone who needs it, but not knowing which specific patient will receive their blood, The blood is tested for infections such as HIV and Hepatitis, and then stored safely for up to six weeks. Whenever there is a patient in need of blood, stored blood is issued, and the stock is replenished from more volunteer donors.
Research shows that volunteer blood donations are the safest of all. Such blood is given by the donor’s own choice, it has been tested for infectious agents, and it is stored properly. Unfortunately, such donations make up just a very small percentage of the total blood donated in our country.
We are a giving society. The problem is one of awareness and trust. People don’t know how long blood can be stored safely. People don’t know that one blood bag can easily help three different patients. And people don’t know of people who will honor their trust and not misuse the blood that has been donated. These are the challenges that will have to be faced as we gradually transform the blood supply in our country from event-based directed donations to volunteer donations.