By Dr. Dharmakanta Kumbhakar
Blood and blood products transfusion is an important component of modern health care system. In many major surgeries, emergency care of trauma patients, women with complications during pregncy, severely anemic women and children, cancer patients; persons suffering from sickle-cell anemia, thalassemia, hemophilia and many life threatening diseases require blood and blood components transfusions. It improves life expectancy and quality of life of patients suffering from life-threating conditions. In mass casualties, blood transfusions play a vital role in the life saving process and save millions of lives. In spite of rapid and remarkable conquests of medical science today, there is no factory that can manufactures blood. It is only in human beings that human blood is made and circulated. For those who require blood for saving their lives, sharing from other fellows is the only means.
The quantity and quality of blood pool available for transfusions is still a major concern across the globe, especially in the developing countries. In India, safe blood is constantly on high demand and blood services face the challenge of making sufficient safe blood available. Patients who require transfusion as part of their clinical magement have the right to expect that sufficient blood will be available to meet their needs and to receive the safest blood possible. Safe blood transfusion comes under the legal protection as it is life saving and also fatal. Article 21 under part III of Indian Constitution spells out that no person shall be deprived of his life. The Consumer Protection Act of 1986 also covers blood as a commodity. Presently our blood centers operate as, if a patient needs blood transfusion, a replacement donor from his or her family or friends should dote. In some conditions where blood transfusion is required off and on, sometimes more than 100 units to a particular patient; then how can the family or friends can bring all the required number of replacement donors and this gives rise to involvement of professiol or paid donors disguised as replacement donors. It is well established that paid donors constitute a group with high risk behavior leading to greater chances of transfusion transmissible infections in the recipients. Indian Panel code chapter XIV, sections 269 and 270 provide protection against spread of infectious diseases due to negligent and malignt acts. The supreme court of India has banned professiol blood dotion since 1st January 1998.
Over 92 millions units of blood are doted around the world each year, helping to save the lives of people. But alarmingly, only 32% of these units are collected in developing countries in which 82% of the global population lives. According to the WHO, Southeast Asia’s estimated blood requirement is about 16 million units per year, but it collects just about 9.4 million units annually, leaving a gap of 6 million units. India has 2,433 blood banks that can collect 9 million units of blood annually, but collects only 7 million.
To transfuse the safest blood to the needy patients, it is globally accepted that the best source of blood is from voluntary dotions and preferably from repeated voluntary donors. The WHO advocates and recommends to its member states to develop tiol blood transfusion services based on voluntary non remunerated regular blood dotion in accordance with World Health Assembly resolution 28.72, adopted in 1975. The WHO’s goal is for all countries to obtain all their blood supplies from voluntary donor by 2020. So far today, in just 62 countries, tiol blood supplies are based on 100% voluntary blood dotions (VBD), with 40 countries like India still dependent on family donors and even paid donors. The Indian tiol level of VBD is about 75%. States like Tripura, West Bengal, Tamil du, and Maharashtra having more than 90% of VBD, while Assam is about 40% only. After 39 years of World Health Assembly resolution 28.72; the issue of blood safety, equitable access to safe blood and blood products and their safe and ratiol use are still remaining as major challenges in this State.
But to achieve 100% VBD is not a magic figure for our state. People from every section of the society should come together and join hands to formulate strategies to achieve 100% VBD, so that any patient who needs blood transfusion can get the required blood units from the blood centers without replacement. In our state, there are so many mass casualties like bomb blast; gun shot injuries, road traffic accidents etc. If our blood centers do not have enough blood stocks, what will be the fate of these victims? To maintain a safe and sustaible supply of blood and blood products to all those in need, healthy Voluntary Non Remunerated Blood Donors (VNRBD) should come forward for VBD. Without a regular flow of real voluntary blood donors to keep blood bank self full, delivery of good quality blood in the right quantity at the right time can never be ensured. If one percent of the eligible populations of our state dote blood once a year, the blood needed for the state can be collected.
The most precious gift that human can give each other is the dotion of blood, a gift that can save lives and give a new lease of life to many persons in need. There are many ways to be a better human and to serve the mankind. Blood dotion is said to be one amongst those best services that a person can do. Doting blood is a noble work. If someone really loves oneself and other fellow beings, the only way to express it, is to dote blood voluntarily. This is the greatest gift one can do for the mankind. Doting blood means giving life to some one and it is believed that voluntary blood donors command the highest respect for their sacrifice. VNRBD gives blood or its components of his or her own free will and receives no payment, either in the form of cash or in kind which could be considered a substitute for money. The only reward they receive is persol satisfaction, self-esteem and pride. They are saviors of mankind.
Appeal to all the eligible donors of the state to come forward and join in this heroic act of giving the precious gift of life with a pledge to promote 100% VBD for the achievement of self-sufficiency, do away with family/replacement dotion, to protect the health of blood donors and recipients and the non commercialization of substance of human origin by voluntary and non-remunerated dotion.