The necessity of safe blood transfusion

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Yasmin Rimi
Eleven-year-old Ipsita has been afflicted with Thalassamea when she was three and a half. Thalassamea is an incurable disease with no permanent cure. A patient inflicted with this disease needs frequent blood replacement. Since Ipsita has been diagnosed with Thalassamea, she has been having blood replacement after every 30 to 45 days. At present, she needs blood replacement after three weeks.
Says her mother Lucky Rahman, "Since my girl needs blood every month, significant amount of blood is required for her. Initially, I used to take blood from professional donors, but after screening it was found that blood received from them is not safe. For the sake of my daughter's life and according to doctors' advice till now I have been collecting blood from my friends and relatives."
The blood that is bought to save dying patients contains germs of various incurable diseases. Due to an unholy alliance among a section of professional blood sellers, middlemen and blood bank employees, blood is collected untested ignoring all rules and regulations, which is why the supply of safe blood has become uncertain.
According to concerned sources, the country requires 300,000 bags of safe blood every year for treatment. About 60 per cent of the demand is met by professional blood donors.
But, according to the 2002 statistics of Bangabandhu Medical University blood transfusion department, 51 per cent of the total demand comes from the professionals while 19 per cent and 30 per cent are met by relatives and voluntary donors respectively.
In our country not everyone is as fortunate as Ispita is. In case of emergency, many of us have to take blood without making sure whether it is safe or not. Sometimes critical patients need instant blood transfusions, so they are given whatever blood is available at that time. As a result, people are afflicted with deadly diseases like hepatitis B and C, malaria, anemia, syphilis and AIDS.
Dr M Ashadul Islam, an assistant professor of Blood Transfusion and Distribution department at the Bangabandhu Medical University College, says, "A patient can even die after receiving contaminated blood. Patients will inevitably suffer from liver cirrhosis if they are given blood containing germs of deadly diseases like hepatitis, malaria, anemia, syphilis and AIDS. The deaths of liver cirrhosis patients are unavoidable. Apart from sexual activities, one can be afflicted with AIDS by blood transfusion. This deadly disease also spreads if anyone use the syringe previously used by an AIDS affected person."
He also says, "From 2000 till now 45 blood donors have been found HIV positive. There are many centres where there is no screening facility. So many healthy people are being afflicted with deadly diseases like AIDS while taking blood in those places."
Dr Murad Sultan, Bangladesh National Programme Coordinator of World Health Organisation (WHO), says there are 98 government-run pure blood transfusion centres in Bangladesh. The government has a plan to set up another 100 centres while 19 important blood transfusion centres will be modernised at a cost of 3 million US dollars from the World Bank. WHO will provide the technical assistance.
President of Bangladesh Blood Transfusion Society Dr Musharraf Hussain says, "It's very important to give emphasis on the health of a blood donor, such as, a donor has to be between 18 and 57 years of age, there has to be 75 per cent hemoglobin, pulse has to be between 60 and 100, weight has to be minimum 50 kilograms and temperature should not be more than 99 degree fahrenheit. A healthy person can donate blood after every 56 days."
He also says, "The blood collected from the professional donors can be harmful as the amount of hemoglobin in their blood is very low and they suffer from various diseases."
In order to regulate the activities of government and private blood banks 'Safe Blood Transfusion Act 2002' was passed in Parliament on April 10, 2002 that came into effect on August 1, 2004.
Although under the new law it has been made mandatory for all private blood banks to obtain licenses, so far no one has taken any license. For setting up of an unauthorised blood bank, there is a provision of a two-year rigorous imprisonment and a fine of Tk one lakh. Furthermore, if anybody is afflicted with infectious disease due to blood transfusion the guilty person can be imprisoned for up to five years.
There is a council, 'National Safe Blood Transfusion Council', under the Ministry of Health. The council has formed a committee to run the private blood transfusion centres. But, nothing seems to be able to stop the 'blood business'. People are forced to buy contaminated blood due to scarcity of blood.
To make the matter even worse, blood is also sold at much higher rate than the government fixed one. As per the government rate, a bag of blood should be sold at Tk 100. But, blood is sold at different prices at different places.
Abdur Rahim, who was undergoing treatment at Ward 32 of Dhaka Medical College Hospital (DMCH) following a road accident, says he has lost a significant amount of blood in the accident. The attending doctors asked him to collect five bags of blood urgently. His blood group is 'B' negative. After trying hard two bags were collected from his relatives and the remaining three bags were bought at a cost of Tk 5,000.
A professional blood seller, who does not wish to be named, says, "I'm a drug addict and to buy drugs I have been selling blood for last three years. I sell blood once in a month, sometimes after every 20 to 25 days."
The blood bank of DMCH is in the grip of corrupt employees and middlemen. When contacted a blood bank high official declined to comment on this.
To save people from the curse of impure blood, different social and cultural organisations are working across the country. Bangladesh Red Crescent and 'Sandhani' have been playing a leading role in the voluntary blood donation movement since 1973 and 1978 respectively.
Organisations like 'Orka', 'Badhon' and 'Quantum' also conduct voluntary blood donation activities. From November 1, 2003 to October 31, 2004 'Sandhani' collected a total of 33,785 bags of blood while from April 1, 2004 to March 31, 2005 'Quantum' collected a total of 15,063 bags through voluntary blood donation activities.
Jolly Biswas, head of Transfusion Medicine department at the Bangabandhu Medical University, says many countries in the world have voluntary blood donors' organisations. In those countries, voluntary blood donation has been included almost in all programmes. For instance, one has to donate a bag of blood to get driving license or while joining a job. Even blood is collected on the day of a festival. If these sorts of steps are taken in our country buying blood from professional sellers will be stopped.
Dr Md Ashadul Islam says, "Upcoming June 14 is Blood Donors Day. Ahead of this day we are also motivating people in many ways apart from organising meetings and seminars. We have made a list of doctors, nurses and employees of our university, who will donate blood after every two months. We have taken steps to introduce and monitor this activity in every hospital and clinic."
Dr Musharraf Hussain says, "about 2.5 crore people of the country are capable of donating blood. If only 2 per cent of them donate blood voluntarily, the demand for blood will be met satisfactorily. In this situation, the government has to take initiatives to motivate the people and provide direct and indirect assistance to the voluntary organisations.
— NewsNetwork