How much blood does India need?

The following article appeared in the economic times on 10th Feb, 2008

Last week, I was at a city (New Delhi) hospital to visit a relative who had been admitted in the intensive care unit (ICU) in the terminal stage of liver  psorosis. His body had swollen up with accumulated fluids and the chances of survival were thin. His haemoglobin count was falling rapidly and as part of treatment in such cases, doctors recommended infusion of blood plasma, which contains all coagulation factors and proteins present in the original unit of blood.

It wasn’t too difficult to organise blood plasma units. But as is the practice, the blood bank, in return, asked for donors to replenish its stock. And then I discovered how difficult it is to organise donors, if there aren’t enough family members to contribute. In fact, stemming mostly from ignorance, such misconceptions prevail that it’s difficult to convince even educated people about the virtues of blood donation. Which explains why for the country as a whole, the annual collection of blood is only 5.5-6 million units against the requirement of about 8.5 million units. What’s more, it’s said that if only 3% of India’s eligible population donates their blood, there will be no shortage of blood and its components in blood banks. This would mean that a significant number of deaths could be avoided if people donate blood regularly and voluntarily, so that safe blood is always available. The shortage of safe blood particularly impacts children suffering from thalassemia, road traffic accidents and trauma victims, women with complicated pregnancy, cancer patients and those undergoing major surgeries. Then why this misconception and reluctance to donate blood, you may ask. Doctors say that a common misconception is that fresh whole blood is required for transfusion. But the fact is that with the availability of blood components such as packed red blood cells, fresh frozen plasma and platelets concentrates, the concept of fresh whole blood has vanished. In fact, there is no difference between one-day old and 30-day old blood, provided it has been preserved properly. For the uninitiated, blood is treated like a raw material at blood banks and once the sample is collected, it is separated into red blood cells (which can be stored up to 42 days), platelets (can be stored up to 5-6 days) and plasma (which can be stored up to one year). The key issue here is how well the products have been stored. Technical issues apart, the most important thing which people should understand, say doctors, is that blood donation is a very safe and healthy practice. Donating blood involves preliminary health check-up, screening for infection markers and blood group and knowledge about the health history of an individual.

Interestingly, blood donation reduces the chances of a heart attack because it thins out the blood. Actually, 70-80 ml of red blood cells get destroyed on their own every 120 days, and the bone marrow manufactures new ones. So, donating blood in no way interferes with your body system.Of course, safe and sufficient blood supply is the key for an effective healthcare system. But blood should be used after careful consideration as there are risks associated despite all types of testing, warn doctors. Says Dr R N Makroo, director, department of transfusion medicine, Indraprastha Apollo Hospital, New Delhi: “Blood is a priceless gift. But still it carries a price tag because of the services attached to it. Nowdays, blood collection banks have introduced integral filters to bring down the possibility of transfusion recations such as fever and viruses. Also, with better testing and narrowing down the window period for screening different diseases such as hepatitis and HIV, the blood safety has improved significantly. Still, it’s not possible to detect all infections and care should be taken.” That’s the only precaution to be kept in mind.

Note by Sankalp: People are joining in for the revolution. Companies are coming forward for drives. But a lot more is needed. Bangalore needs plenty of voluntary blood donors in the coming months. 800 units a day and counting, Bangalore will struggle to achieve this. You can help. Plan now organise a blood donation drive. Let's give life a better chance.