Contending with dearth of blood donors

June 15, 2014

Blood donor

The World Health Organisation marked this year’s World Blood Donor Day on Saturday, June 14. ARUKAINO UMUKORO writes about attitudes of Nigerians toward voluntary blood donation

There was a flurry of activities at the Laboratory Services Unit of the Lagos State University Teaching Hospital, Ikeja, as people trooped in and waited to donate blood.

However none was a voluntary donor.

“I came to donate blood for my father who had a surgery recently. The doctors said he needed two pints of blood,” said Abubakar Oluwabaji, an undergraduate of the University of Lagos.

Oluwabaji, who came to LASUTH with his younger brother, said they had been waiting for a long time to get the results of their blood tests to know if theirs was compatible with their father’s. He complained of being tired of waiting.

Five hours later, a beaming Oluwabaji rushed back with a form which showed that his blood was compatible with his father’s. And the doctor ushered him and his brother into the waiting room.

A man, who simply gave his name as Michael, was also a donor. He had just donated a pint of blood for his five-year-old son and was waiting for his father to donate another pint also needed for the small boy.

Everyone spoken to by our correspondent came to the hospital to donate blood for their family members or friends who were on admission at the hospital.

Some people who spoke with SUNDAY PUNCH admitted that they had never donated blood voluntarily.

This attitude should change, if more lives are to be saved, especially in cases of emergency, noted the Head, Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Prof. Sulaimon Akanmu.

He said, “We are losing a lot of lives unnecessarily in the hospitals because we are usually not prepared to meet with the challenges of emergency cases that come every now and then. People die in road accidents daily because they bleed to death. Some who are moved from the accident spot to nearby hospitals die in between that period or in the hospital.

“This is simply because the hospitals do not have enough blood stored in their blood banks. If there were enough units of blood stored in the hospitals, at least some lives would have been saved. This is the most important reason why Nigerians should be their brother’s keeper and volunteer more to donate blood.”

Akanmu, who is also a consultant haematologist at the Lagos University Teaching Hospital, Idi Araba, noted that Nigerians were very reluctant to donate blood due to traditional beliefs and myths surrounding the issue of blood donation.

“Some people actually believe that if they donate their blood, someone may use it against them through diabolical means that could affect their lives. This kind of belief is widespread among Nigerians, particularly in the southern part of the country,” he said.

There are also religious reasons for the apathy towards blood donation.

A member of the hospital liaison committee of Jehovah’s Witnesses, Mr. Nicholas Abayomi, said that Jehovah’s Witnesses were against blood transfusion, and blood donation, because it was against their scriptural beliefs.

He said, “Blood donation is for transfusion. We don’t do that because the Bible said we should abstain from blood. So, it is strictly for that reason. And we don’t just obey the Bible when it is convenient. We as Jehovah’s Witnesses follow strictly what the Bible says and when it was written, there was nothing like blood transfusion. Transfusion for saving lives is a modern medical phenomenon.

“Don’t get us wrong, we go to hospitals and we are not faith healers; we don’t believe in it. We have doctors, nurses and medical professors among Jehovah’s Witnesses. But we are saying that we accept alternatives to blood transfusion. There are many medical alternatives, depending on what is being treated.”

Another reason is ignorance. “Some people really believe that once blood is taken from them it is not replaced and it may not be sufficient for their own use. These are major reasons why there is so much apathy to voluntary blood donation. It is easier to talk people out of their ignorance but more difficult to talk them out of their belief surrounding blood,” Akanmu told SUNDAY PUNCH.

For those with such belief system and ignorance, Akanmu said blood is naturally replaced in the body daily and there was no cause for alarm for voluntary donors.

He said, “The most important component of blood is the red cell haemoglobin that helps us to extract oxygen from our lungs to our tissues. When blood is destroyed by one per cent on a daily basis, it is also re-formed by another one per cent. An adult has about five litres of blood in a day and what is removed from a donor is less than half a litre, which is about 400-450ml.

“So, what is left is more than sufficient to collect oxygen from the lungs and deliver to the tissue. There is no way that donation of blood would adversely affect one’s tissue, except the rate of blood removal is so overwhelming that it overpowers the capacity of the bone marrow to form blood, then the individual becomes anaemic.”

The Executive Secretary, Lagos State Blood Transfusion Services, Dr. Modupe Olaiya, said that only people who have been certified fit and healthy should donate blood.

“Any male or female between the ages of 18 and 65 years, and whose weight is above 50kg or 110 pounds, can donate blood. But the person who is 65 years old must have donated blood before. Generally, the person should be healthy. Anybody diagnosed as having hepatitis, HIV or any transmittable disease cannot donate blood. Also, pregnant and lactating women and those in their menstruating period cannot donate. Aside from these, they can donate blood,” she told SUNDAY PUNCH.

Akanmu added that these were important criteria for voluntary blood donation, noting that the screening procedures are expectedly rigorous to avoid transmission of infections or diseases from donor to recipient.

Due to the shortage of blood in hospitals, many people in Nigeria still patronise commercial donors. However, Olaiya warned Nigerians to avoid patronising commercial blood donors because of the risks involved.

“Some people believe that donating blood is not for them, so they hire commercial blood donors to go and do it for them. Such commercial blood donors have been found to have a higher rate of transmittable infections. Voluntary blood donors are the foundation of safe blood and that is why we are encouraging it. People should adopt it as a way of life to come in to donate freely to save people’s lives instead of allowing the commercial donors to take over,” she explained,

She added that with more voluntary donors, Nigerians won’t have any excuse for patronising commercial blood donors and hospitals won’t have to mandate people to replace blood units used by patients who are their relatives. “The only thing we would ask them to do is pay for the processing of the blood that the patient is using,” she said.

Even this policy is controversial, as some persons our correspondent spoke to complained about it. One said he had paid N1,500 for blood test and another N4,500 for screening of the blood.

Olaiya said the policy has been misunderstood by many.

She said, “Some people believe that because they have donated their blood voluntarily, it then should be given free and we don’t need to collect fees for the screening and processing of blood. But, we cannot just give the donated blood to the other person like that without screening and processing it to ensure that it doesn’t contain any other transmittable infection such as HIV and hepatitis.

“Then the donated blood must be compatible with that of whoever is going to use it. So, we must group and cross match it. That’s why we put that cost on the recipient, which is the patient. We don’t collect money from the donor; the patient only pays for the processing. This is one of the challenges we face.”

Olaiya said about 25 public hospitals in the state have blood donation centres, and urged Nigerians to go to any one of them to donate blood voluntarily.

Fees aside, the biggest challenge, however, is poor electricity supply, said Akanmu, which makes the preservation of blood in hospitals’ blood banks difficult.

He said, “If blood is stored between two and six degrees centigrade, with the use of the proper anti-coagulant, the collected red cell can live for between 28 and 35 days in the blood bank. But we don’t have continuous power supply to ensure that the red cells are optimally or appropriately stored to be useful to the recipients.

“The Federal Government should take the issue more seriously. Hospital blood transfusion services should be properly equipped; staff should be exposed to training and re-training to give the best services to Nigerians. Equipment that can help for blood safekeeping and processing should be donated to these hospitals.”

The focus of this year’s World Blood Donor Day campaign is “Safe blood for saving mothers.”

“The goal of the campaign is to increase awareness about why timely access to safe blood and blood products is essential for all countries as part of a comprehensive approach to prevent maternal deaths,” read WHO’s statement.

“You never know, a pint of blood can save a life. Maybe it is something I should start practising from now,”’ said a lady who came to donate blood for a family member.

That should be the attitude of everyone, Akanmu agreed, adding that, apart from saving lives, which is the most important, voluntary blood donation has many benefits.

“There are medical advantages that accrue to such people who donate blood. They tend not to have anaemia of the elderly or aged and also live longer than their counterparts who have never been volunteer blood donors; their life span is increased up to 10 years. It also burns calories and reduces the risk of cancer and heart disease,” he said.