More Voluntary Blood Donors Are Needed

‘Give the gift of life: donate blood’, is the theme for this year’s World Blood Donor day celebrated last Friday.  A clarion call for voluntary blood donors, the importance of blood can never be over-emphasised as WINIFRED OGBEBO reports.

Adanma Eze was rushed to the labour ward of the Primary Health Care Centre, close by in Abakaliki Local Government Area of Ebonyi State, after her water broke. During childbirth, she suffered huge complication and lost so much blood.  Two of the community members came to her aid and voluntarily donated their blood and Eze successfully delivered a bouncing baby boy. However, few hours after delivery, she started bleeding once again; she bled helplessly to death because there was no blood in the blood bank.   Her husband wept profusely for many days but his endless cry could not bring back his lovely wife. He is today a father, but without a wife.

There is no alternative to blood. A woman who suffers from heavy bleeding after childbirth, what doctors call “postpartum haemorrhage” does not need drugs to get back the blood lost; she needs just blood. Likewise, a man who loses blood excessively during complex surgery and accident needs no drugs as antidote but blood and more blood.

In low- and middle-income countries, blood transfusion is usually given for the management of complications of pregnancy and childbirth and the treatment of severe childhood anaemia. In high-income countries, transfusion is most commonly used for supportive care in heart surgery, transplant surgery, trauma and cancer therapy.  On World Blood Donor Day, last week  Friday, June 14 June, the World Health Organisation  (WHO) called for all countries to obtain 100 per cent of their supplies of blood and blood products from voluntary unpaid blood donors by 2020.

The need for blood and blood products is increasing every year, and many patients like Eze requiring life-saving transfusion do not have timely access to safe blood and blood products. The WHO stated that in 2011, nearly 83 million blood donations were collected worldwide from voluntary unpaid blood donors, an increase of close to 8 million donations from 2004.

 The WHO Coordinator for Blood Transfusion Safety, Dr Neelam Dhingra, said, “Blood collection from voluntary non-remunerated blood donors is the cornerstone of a safe and sufficient blood supply in all countries. More voluntary blood donors are needed to meet the increasing needs and to improve access to this life-saving therapy,”  He stated that regular voluntary unpaid blood donors are the safest source of blood as there are fewer blood-borne infections among these donors than among people who give blood in exchange for money or who donate for family members in emergencies.

In Nigeria, however, it is estimated that 1.5 million units of blood is needed every year but experts have said that the number of blood units collated from the Natiional Blood Transfusion Service (NBTS) networks and outside its networks like teaching hospitals, secondary hospitals and medical centres across the nation is grossly inadequate for blood transfusion and most of them are not even voluntarily donated.

Many Nigerians earn a living through sales of blood. Among the blood sold, there could also be an HIV-infected blood, especially in rural areas where measures for proper safety of blood transfusion are not properly upheld.

Providing safe and adequate supplies of blood and blood products should be an integral part of every country’s national health care policy and infrastructure, said the WHO,which has consistently emphasised that the safety and quality of blood and blood products should never be compromised.

 In Nigeria, keeping the blood supply safe is the ultimate responsibility of NBTS. Hence, there has to be a universal access to safe blood transfusion to ensure 100 per cent quality assured testing of donated blood.

To ensure safe blood transfusion, medical experts have unanimously suggested the following measures among others; all donors are voluntary and unpaid.

Unpaid donors are the safest source of blood; proper screening of donors –  donors who have any risk factors are not allowed to donate; all donated blood is tested and free of Hepatitis B, and C; HIV 1 and 2; Syphilis and Human T Cell Leukaemia (HTCL) and United States of America Food and Drugs Administration (FDA) recommends testing for West Nile Virus and Trypanosoma Cruzi (Chagas disease).

Currently, 60 countries collect 100% of their blood supply from voluntary unpaid blood donors (35 are high-income countries, 18 middle-income countries and 7 low-income countries). Six of these countries have achieved this target from a percentage lower than 75% reported in 2004: Cook Islands (from 40%), Kenya (from 53%), Nicaragua (from 41%), Turkey (from 40%), United Arab Emirates (from 59%) and Zambia (from 72%).

However, more progress is needed, with 73 countries still collecting more than 50% of their blood supply from replacement or paid donors.

 Seventy five countries report that they are collecting fewer than 10 donations per 1 000 population. Of these, 38 countries are in WHO’s African Region, 6 in the Americas, 8 in the Eastern Mediterranean Region, 6 in Europe, 7 in South-Eastern Asian and 10 in the Western Pacific. All are low- or middle-income countries.

There is also a marked difference in the level of access to safe blood between low- and high-income countries.

Data about the gender profile of blood donors show that globally, 30% of blood donations are given by women, although this ranges widely. In 18 of the 104 reporting countries, less than 10% donations are given by female donors. The age profile of blood donors shows that overall 6% of donors come from the under-18 age group, 27% from people aged 18–24, 38% from the 25–44 group, 26% from 45–64 group and 3% from those over 65.

In low- and middle-income countries, proportionally more young people donate blood than in high-income countries.  Demographic information of blood donors is important for formulating and monitoring recruitment strategies.

Now, many are asking, what role can government play in making sure that 1.5 million units of blood are made available on annual basis?   Obviously, the NBTS, a body that is saddled with the responsibility of providing adequate and safe blood to Nigerians needs to be repositioned and adequately financed in order to meet up with the 21st century challenges.       

Efforts should be made to encourage first-time donors to become regular or repeat-donors through moral suasion and strategic behavioural and social communication campaign on social media, television, newspapers, magazines and other media platforms.

Records show that in 1998, paid donation or donation from family members constitutes 80 per cent of its blood supplies in China but in 2008, the country had achieved 98.5 per cent voluntary non-remunerated blood donation. Similarly, the United Arab Emirates progressed from zero per cent of voluntary donations in 1990 to 80 per cent in 2004 and 97.6 per cent in 2006.

Also, NBTS needs to be more empowered in order to expand its current operational blood transfusion centre so as to meet up with the 1.5 million units of Nigeria’s blood transfusion demands per annum. According to a public health anlalyst, Dr Obi Echemeta, “Blood is life and life is blood. Supplying adequate and safe blood is therefore efforts towards promoting a healthy society. Donate blood today to save life.”


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