Photo Courtesy: Image by Mohamed Hassan from Pixabay
Arhomo C Ngullie (Master of Social Work)
Blood is a vital resource that cannot be manufactured or artificially created. As such, blood donation is a crucial necessity in modern healthcare. Blood transfusions are used for the management of a variety of medical conditionsin adults as well as in Children e.g Surgery, Anaemia, Cancer, Chronic Kidney Disease, accident cases,various Haematological blood disorders etc. Without an adequate supply of blood, it would be impossible to provide the lifesaving care that patients need. Although there have been significant advances in medical technology, to date there is no substitute for human blood. Blood is composed of a variety of different components, including Red blood cells, Plasma, and Platelets, each of which performs a different function in the body. These components cannot be synthesized, meaning that the only way to obtain them is through blood donation.
According to the research paper which was conducted and published on the topic; “Assessment of Performance of Blood Banks in India: A National Level Cross-Sectional Study” by Edwin Sam Asirvatham, Joy John Mammen et.al it has found that the estimated annual population need was 26.2 million units of whole blood to address the need for red cells and other components after the separation process. The need for medical conditions was 11.0 million units), followed by surgery 6.6 million, Children 5.0 million, and obstetrics and gynaecology 3.6 million units. The gap between need and demand which depends upon the access and efficiency of healthcare service provision was estimated at 13 million units.
They conducted the first national assessment of blood bank systems, services, practices, and performance in India. The study was conducted based on a cross-sectional survey of all 2626 blood banks and assessed the administrative, technical, and quality aspects in 2016. Of the 2493 blood banks that participated in the study, most were public (38%) or not-for-profit (38%), and 51% had component separation facilities. Of the 11.65 million units of blood collected annually, 72% was through voluntary blood donation. In 2015, India had approximately 2760 blood centres with an annual collection ranging from 200 to 50,000 units of blood. However, timely access to safe blood is still a challenge in many areas of the country, and there is vast inequity in the availability of blood across geographic regions. It is not clear whether the annual blood collection in India is adequate, equitably distributed, and available to people who need blood transfusions. The World Health Organization (WHO) recommends obtaining 100% of blood units through voluntary donation, quality-assured testing of donated blood, and strengthening blood transfusion services with evidence-based, innovative, and result-oriented strategies to ensure universal access to blood. Additionally, it is essential to optimize blood usage, develop quality systems in the transfusion chain, strengthen the workforce, and build effective partnerships. The study brings evidence to highlight the gap between need and demand and the importance of addressing it. It cannot be just the responsibility of blood transfusion or health systems; it requires a multi-sectoral approach to address the barriers affecting the conversion of need to clinical demand for blood.
Coming back to our state Nagaland, particularly under Dimapur (Civil Hospital) and Chumukidema, CIHSR (Christian Institute of Health Sciences and Research) each District, has one blood centres typically open 24/7 to ensure a timely and reliable blood supply for patients in need. Many medical procedures, such as Surgeries, Blood disorders, Accidents Cancer treatmentsetc, require Blood transfusions, and a delay in receiving blood could have serious consequences for patients. By staying open around the clock, Blood Centresensure that patients receive the blood they need when they need it.
From the data available on the Donor’s forms at CIHSR, Blood Centre, there are three categories of Blood donors (Voluntary, Replacement and Professional Blood Donors) of whichthere has been a trend of an increasing number of Replacement donors and a decreasing number of Voluntary donors. Replacement donors are those who donate blood specifically for a particular patient, often a family member or friend, who is in need of a Blood transfusion. Voluntary donors, on the other hand, donate blood on a voluntary basis without any specific recipient in mind.The reliance on Replacement donors can lead to issues with the safety and availability of the blood supply. Professional Blood donors donate blood for money or other incentives on a regular basis. This practice is illegal and not recommended as it can put both the donor’s and the recipient's health at risk. Professional donors are more likely to hide medical conditions or falsify their medical history to meet eligibility criteria, leading to the transmission of infectious diseases. It is essential to raise awareness about the risks of professional blood donation and encourage more voluntary donations.
As per our data records at CIHSR, blood centre, Replacement donorshave more infectious diseases (Sexually Transmitted Diseases) than voluntary blood donors, which could put the health of the patient in need oftransfusion at risk (Transfusion Transmissible Infections). Additionally, because replacement donors are often solicited by family and friends of the patient, they may feel pressured to donate, which could result in a less-than-optimal donation experience and may not be sustainable over time. In contrast, voluntary donors are generally more committed to the donation process, which can result in a more reliable and safe blood supply. However, recruiting voluntary donors are more challenging, as it requires educating the public on the importance of Blood donation and addressing any fears or misconceptions they may have.Blood centres rely on a steady stream of donations from Voluntary Blood donors to maintain an adequate supply of blood. And also by increasingthe number of voluntary donors, Blood Centre ensure that patients receive the blood they need, while also maintaining a safe and sustainable Blood supply for the future.
Meanwhile, at CIHSR,the hospital itself number Blood utilization sometimes goes up toaround 400 plus units in a month besides the regular blood demands from the patients of other hospitals in an around Dimapur and as well as from other districts in Nagaland.Currently, CIHSR, a Blood Centre is providing the facilities like blood and blood components which includes Whole Blood, Packed Red Blood Cells, Fresh Frozen Plasma, Platelets and Cryoprecipitate. Having fewer voluntary blood donors in our state, the Blood Centres are facing lots of difficulties and challenges to meet the demands of blood for patients needing transfusionon a daily basis.
It is important to understand that the availability of blood in a Blood Centre can vary depending on the time, day,location and the demand for blood group type and its components in that area. While it is true that Blood Centres are established to provide a constant supply of blood for medical emergencies, it is not always the case that blood is readily available in large quantities. Blood Centres rely on Voluntary blood donations from individuals, and the availability of blood can depend on the number of donors and the frequency of donations. In some areas, there may be a shortage of donors, which can result in a shortage of blood in the Blood Centre. It is also important to note that not all blood types are compatible with each other, When a patient needs a blood transfusion, it is not simply a matter of donating or taking blood from the Blood Centre and giving it to the patient.
Some of theflowsinvolveblood donation from donors until the blood bag dispatch generally follows the following process which involves registration and physical examination by a trained Blood Centre Staff, where the Donors are required to go through a screening process to ensure that they meet the eligibility criteria for blood donation. This involves checking their medical history, weight, vital signs, and haemoglobin level. After which if the donor is eligible, they proceed to the blood donation area where a trained Staff collect their blood. The entire process from registration and physical examination to donation to refreshment room usually takes around 30 minutes. Donated blood is tested for infectious diseases such as HIV, Hepatitis B and C, Malaria Parasites and Syphilisto ensure that the blood is safe for transfusion, and to clear all these infectious diseases the screening process time it normallytakes around 2-4 hourswhereby during in the case of emergencies for blood transfusion, the patients might end up losing their precious lives, if there is no sufficient stock in the Blood Centre to be availed by the patients,which are already screened and cleared the process infectious diseasestesting and are kept ready to be used for transfusion. The blood is also separated into different components such as red blood cells, plasma, and platelets. Blood centres have strict guidelines for the screening of donated blood to ensure the safety of the blood supply. When a donor’s blood is found to be infected with certain diseases or viruses, the blood bag is discarded and not used for transfusion. These infections can be transmitted through the blood and can be serious or even life-threatening for the person receiving the transfusion. As a result blood centres have strict protocols to prevent contaminated blood from entering the blood supply. Any blood that is contaminated with these or other infectious agents is discarded to protect the safety of the blood supply. Blood Centre strictly discouragespeople who are at high risk of behaviour notto donate blood because it can save time and resources of the Blood Centre that would otherwise be spent on testing and screening blood products that may not be safe for use. This helps to ensure that the blood supply is safe and reliable for those who need it. Henceforth,Only after clearing all the screening processes, the blood components are stored in specialized refrigerators or freezers to maintain their quality until they are needed.
To ensure the safety and effectiveness of the transfusion, a series of tests and procedures are performed to ensure that the donated blood is compatible with the recipient's blood. The first step in the process is to perform a blood grouping test on both the donor and the recipient to determine their blood group. This is important because not all blood types are compatible with each other. Once the blood group is determined, the Blood Centreperforms a crossmatch test to see the compatibility between the Patient & the Donor blood. If the blood is compatible, it can be used for transfusion. These measures are in place to minimize the risk of adverse reactions and ensure the best possible outcome for the patient receiving the transfusion.
With the highly increasing demand for blood by patients from Chumukidema, Dimapur and other Districts, CIHSR, the hospital has a Medical Social Worker (MSW)also known as a Public Relations Officer (PRO) who plays a vital role in Blood Centre, providing support to Donors, Patients, and Healthcare Professionals. The MSW is responsible for educating and supporting blood donors before and after donation, identifying and recruiting potential donors, and advocating for patients' rights and access to blood transfusions. MSW also work collaboratively with other healthcare professionals to ensure that patients receive appropriate and timely blood transfusion therapy, helping to improve patient outcomes and quality of life. Overall, Medical Social Workers in blood Centres play a crucial role in promoting the health and well-being of donors and patients alike.MSWin a blood centre is also responsible for managing the hospital’s relationship with the public, including donors, patients, and other stakeholders. MSW develop and implement strategies to promote awareness about the importance of blood donation and enhance the hospital's reputation.
Besides, all these networking, MSW in blood banks also provide counselling to reactive donors who test positive for infectious diseases or other medical conditions. Reactive donors are donors whose blood tests show that they may have a medical condition that could affect the safety of the blood supply, such as HIV, hepatitis B or C, or other infectious diseases. When a donor receives a reactive result, it can be a stressful and emotional experience. Thus, Medical Social Workers provide supportive counselling to reactive donors, helping them to understand their test results, providing information about their medical condition, and addressing any concerns or questions they may have. After counselling sessions, MSW provides referrals to other healthcare professionals, such as infectious disease specialists or mental health providers, as needed.
That being said the reason why we are appealing to the general public is thatBlood donation is a great way to Volunteer and give back to the Community. It is an opportunity to make a difference in someone's life and help those in need. The act of donating blood can be a rewarding experience, as it provides a sense of fulfilment and purpose in knowing that one has helped save lives and make a positive impact in the community. Blood donation is an easy and safe process which does not require a lot of time. A single blood donation can help save up to three lives, making it a very efficient way to help others. Moreover, blood donation is an important public health initiative that helps ensure the availability of blood supply. By donating blood, individuals can help their community and support public health efforts. It is also a powerful way for individuals to make a positive impact on their communities and help those in need.Voluntary Blood Donors can help ensure that hospitals and medical facilities have a steady supply of this life-sustaining resource, which can save countless lives and improve the health and well-being of others. Blood donation is important for many reasons, the most fundamental of which is that it saves lives. Blood is a vital component of medical care and is used in a wide range of procedures. Without a sufficient blood supply, Medical Professionals would not be able to provide the critical care that patients need to survive. Blood transfusions are often necessary and without blood donors, many patients would not have access to the blood they need to stay healthy and manage their condition.
In conclusion, by staying open 24/7 and implementing emergency response plans, Blood Centre ensures that patients have access to the blood they need, even in the most challenging circumstances. Therefore, blood donation is an essential component of healthcare and public health. It saves lives, helps people manage medical conditions, is a safe and easy process, and provides an opportunity for individuals to give back to their community. By donating blood, individuals can make a significant impact on the lives of others and support critical healthcare and public health efforts.
The writer is Medical Social Worker at the Department of Transfusion Medicine Blood Centre, CIHSR.
