Blood and blood components are rare, scarce and precious in nature as they are only obtainable from individuals who donate it. Many countries require more number of people who are willing and eligible to donate blood in order to ensure a stable supply of safe blood and blood products that meet national requirements.
Many international organisations like WHO, the IFRC, the Council of Europe, the International Society of Blood Transfusion, the International Federation of Blood Donor Organizations have defined voluntary non-remunerated blood donation as a founding and guiding principle. They have stated that no coercion should be brought upon the donor to donate.
Blood donation should be a voluntary self-made decision that is taken without force. It should be taken basis free will with no payment, in cash or in kind which could be considered in exchange for money. Small tokens, refreshments and reimbursements of direct travel costs are compatible with voluntary donation.
Situation in India: India has a population of over 1 billion and is lagging behind in blood collection. From administrative point of view, India has four types of blood banks/centers. They are managed by the public (Government) sector, Indian Red Cross Society (IRCS), Non-Government Organizations (NGOs, on no profit basis), and commercial sectors. Therefore the blood bank services are fragmented in India.
Many blood banks in India still lack the needed facilities to make blood components and thus most of them issue whole blood; thus, contributing to the shortage of blood and unnecessarily overburdening the patient cause harm at times, as blood transfusion reactions are more common in with whole blood transfusions.
At present, India follows a procedure of mandatory licensing under the Drugs and Cosmetics Rules for blood banks.
Who can donate: Any healthy man and woman can donate. Donor should be between 18-65 years of age. Their weight should be 45 kg or above. Pulse rate, body temperature and blood pressure should be normal. Donor with history of HIV, psychotic disorders, abnormal bleeding tendencies, severe asthma, cardiac disorders, malignancy are permanently unfit for blood donation. Woman donors who are pregnant or lactating are not taken as their iron reserves are already on the lower side.
Our body has 3.5-5 litres of blood of which only 350-450 ml of blood is taken depending upon weight of donor. The withdrawn blood volume is restored within 24 hours and the hemoglobin and cell components are restored in six-eight weeks.
Challenges in blood donation: There are several problems with regard to blood donation in India. Such as, finding donors who are eligible to donate blood, ensuring that blood transfusion is done in a safe manner, enabling people to understand the benefits and merit of blood donation, ensuring that the donated blood is kept in a safe manner so that it remains usable.
Types of donors: (Family /replacement donors) These donors give blood to their own family members as in when the situation requires. (Paid or commercial donors) give blood in return for payment or other benefits that satisfy a basic need or can be sold, converted into cash or transferred to another person. They give blood regularly. (Voluntary blood donors), particularly regular donors, are the first line of defence in preventing the transmission of HIV, hepatitis viruses and other blood borne infections through the route of transfusion. A number of studies have reported significantly lower prevalence of transfusion transmissible infection markers among voluntary donors compared with other types of donors,with the lowest rates among regular donors.Voluntary donors are motivated by altruism and the desire to help others and by a sense of moral duty or social responsibility. They feel personal satisfaction and self-esteem which provides a sense of social engagement and belonging that's recognised by the community.
(The writer is Senior Consultant, Department of Transfusion Medicine, Fortis Memorial Research Institute Gurugram)