March 6, 2005

Contrary to what many may believe, donating blood is not only a very healthy activity, it is also benefitial to the national health sector

BLOOD is the fluid of life. It is a special gift of nature, which is never exhausted even if donated regularly as it is replenished in just few days. This is unique to blood because other organs of our body, like the kidneys, heart, liver and cornea can be donated only once. This is the most convincing evidence in favour of regular blood donation.

Every healthy man has five to six litres of blood and every woman, 4.5 to five litres. Blood is composed of four components i.e. red cells, white cells, platelets and plasma. Each component has a specific job; the red cells provide oxygen and exude carbon dioxide from the body. White cells guard against infections while the platelets help the blood coagulate in case of bleeding. And in the end, plasma, which carries coagulation factors, keeps our blood in the fluid state. Plasma also contains numerous proteins and many other elements that all play a vital role in normal homeostasis.

SAFE BLOOD: By ‘safe blood’ we mean blood which is free from viruses, bacteria, drug influences, alcohol and from possible transmissible diseases. It is therefore necessary that if a blood donor suffers from any disease, he/she must not hide his ailment from the blood bank doctor and should refuse to donate blood.

A healthy person has healthy blood and receiving blood from non-remunerated voluntary blood donors is a first step towards the safety of the recipient.

Screening donated blood for diseases like Hepatitis B, C, HIV, malaria and syphilis is the second step towards the safety of the recipient. It must be remembered that the methods employed to screen blood are not hundred per cent sensitive. Furthermore, there are uncommon viruses (Hepatitis G, E, HTLV, TTV) and diseases (Leishmaniasis) for which no standard screening methods have been devised as yet.

Screening is one aspect in blood safety and a safe blood system demands that the collection, grouping, storage, cross matching, issuing, transportation and transfusion, all must be done in a standardized way to ensure maximum safety of the recipient.

WHY DONATE BLOOD: Blood is a life-saving medicine of which no alternative exists. The lives of millions of people depend on an uninterrupted supply of safe blood; but only 30 per cent of those who need blood get an adequate supply of it. The trend of blood donation is highly unsatisfactory in developing countries like Pakistan where the need is higher due to a higher level of malnutrition, infectious diseases (malaria, diarrhoea, TB, hepatitis etc.), blood disorders (thalassaemia, haemophilia, aplastic anaemia, leukemia etc.), poverty and poor health systems. Also, in any society the need for blood may arise any time. All such needs can be met easily if the community has a culture of voluntary blood donation. It therefore is of utmost importance that we promote the culture of voluntary blood donation in our society, particularly among the youth.

WHO CAN DONATE BLOOD: If you are aged between 18 and 65 years, weigh 50kg or more and have no fatal disease or habit, you are fit to donate blood. It is recommended that the donor should eat something, two to four hours prior to blood donation. You can donate blood every three to four months. Women can also donate, six to eight weeks after childbirth. Religion, cast or sex is not a barrier in blood donation. People who have documented evidence of Hepatitis B and C infection are permanent deferrals. But if you have suffered Hepatitis A or E type and you carry a proof of it, you can donate blood 12 months after this. If you have no evidence of the type of hepatitis you had, then it is better that you should not donate blood.

AIDS patients or those who are HIV positive or those likely to acquire it should never donate blood. Those suffering from ailments of the liver, kidney, heart, lungs, TB, cancer or some acute psychiatric ailment are not permitted to donate. If you have a cold or other acute infections, you may not donate for the time being. Those who have received the Hepatitis B vaccine can donate blood. Other high risk groups like addicts, prisoners and long route truck drivers should not donate blood because of their high risk behaviour.

Remember that the blood donor should not expect any kind of reward or gifts. Also, the donor should not be aware of the recipient and the recipient should not be told whose blood he is being transfused with.

STEPS IN BLOOD DONATION: Blood donation is carried out in a hospital, blood bank or special camps. The doctor on duty will ask you certain questions about your physical and social well being. You should answer these questions correctly, otherwise it could be disastrous for the recipient.

A mini check up will follow: pulse, blood pressure and weight. Your pulse rate should be 60-100 per minute and your blood pressure should be somewhere below 140/90 and your body temperature not exceeding 99.60F.

The next step is to check your haemoglobin (Hb). In females it should be above 11.5 and in male above 12.5. You will be taken to a blood donation area where you will lie down comfortably. The needle of the empty blood bag will be inserted painlessly into your hand’s vein. In about 10 minutes, approximately half a litre of blood will be collected in the blood bag. The needle is then removed, but you should remain lying down for eight to 10 minutes after which you can sit and are offered a glass of juice or a soft drink. After this you can leave the area and engage yourself in routine work.

BENEFITS OF REGULAR BLOOD DONATION: It has been found that regular voluntary blood donors have a lesser risk of cardiac attacks. A regular donor cares more for his/her health. Regular donations also provide a regular physical and laboratory checkup, which might reveal any hidden or unsuspected ailment, we may have been suffering from.

HAZARDS (IF ANY) OF DONATION: Donation is an entirely safe process. It gives no pain and one does not need to be anaesthetized during the process. It does not lead to anaemia or physical debility. However, certain people might experience low blood pressure and dizziness after donating blood, but this condition soon vanishes. It is for this reason that a donor should continue lying down for some time after blood donation. In some cases a stain mark, due to extravasation of blood, may appear at the site where the needle has been inserted, but this is not painful and would disappear in days to come. You can carry out your routine work safely after blood donation. There is a word of caution: those who suffer from prolonged dizziness or a drop attack after leaving the premises should not donate blood in the future.

BLOOD DONATION AND RELIGION: It is inconceivable that any religion would put a bar to humanity service. The very basic philosophy of our religion, Islam, is the unflinching service of mankind. It is permitted to donate blood to save a life, even if you are fasting.

OUR NATIONAL NEEDS: Our national need is about three to 3.5 million units of blood annually while only 1.2-1.5 million units is available. There is no alternative to human blood. It is neither manufactured in factories nor is it cultivated. It cannot be obtained from animals or through smuggling. The situation is dismal except in three to four major cities. We have no disaster management plans to meet the need in dire situations. It is our national and moral responsibility to voluntarily donate blood every three to four months.

BLOOD DONATION AND OUR RESPONSIBILITY: In Pakistan there is no culture of blood donation. Less than 0.5 per cent people donate blood; most of these are not voluntary donations but directed, exchange and paid donations. Voluntary blood donors constitute less than 0.1 per cent of the population. It is important that five per cent of the young and middle-aged people donate blood regularly. The situation appears relatively satisfactory in Karachi, Lahore and Islamabad. It is important to devise strategies to raise a future generation of regular blood donors.

BLOOD FOR WHOM: Directed blood donations and transfusion should best be avoided because it has been found that blood from close relatives and friends is less safe. The reason is that a relative or a friend may have a disease which the potential donor does not want to disclose to his near or dear ones. Thus, blood from such a donor is likely to transfer his disease to the recipient. Then, a lethal condition called ‘Graft versus Host Disease’ (TA-GvHD), and is more likely to be seen in recipients who receive blood from parents, siblings or close relatives.

Also, patients who intend to have blood and marrow transplantion (BMT) must avoid transfusion from close family members to avoid post-transplant complications like aGvHD. It is also recommended that husbands do not donate blood to their wives of reproductive age because of the fear of having hemolytic disease of new born (HDN) in the offspring. However, donation of a wife’s blood to her husband is quite permissible. Likewise, an old man’s blood to a young man and a young man’s blood to an old person can be transfused with impunity.

WHERE TO DONATE: You can donate blood in any large hospital/blood bank of your tehsil, town or city. But please make sure that you donate your blood at a government hospital or at a facility engaged in providing blood free of cost or at nominal charge. You can donate any time of the day.

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