Blood donor base is the foundation blood transfusion system in any country. In India any able-bodied individual between the age of 18 and 60 years can donate blood upto 168 times during this period i.e. if they donate every three months. After the historic directives of the Supreme Court only voluntary blood donors can donate blood. Paid blood donors have been banned in India from January 1, 1998. They all have to be necessarily healthy men and women who donate blood out of their free will as a social responsibily, without expecting any renumeration either in cash or kind. Blood donations can be done in designated blood banks or blood donation camps. At times donors or donor organisation expect something in return such as gifts, sponsorship of events, advertisement in lieu of camps, etc. This is a wrong practice which should not be entertained and which also leads to a bad name to the movement of voluntary blood donation.
Types of voluntary blood donors.
Voluntary Blood Donor: A voluntary blood donor donates blood out of his/her free will without expecting anything of monetary value from the blood bank, patients, relatives or any other source at the time of donation or in future. Acceptance of voluntary blood donor’s certificates, badges or cards is permissible according to the law of the land.
Replacement Blood Donor: Replacement blood donor is a member of the family or a friend of the patient who donates blood in replacement of blood needed for the particular patient without involvement of any monetary or other benefits from any source. Normally, blood banks provides the right group of blood for the patient and replacement donor belonging to any other blood grouphelp replaces the blood issued, so as to help keep adequate stock of blood in the blood banks. There should be no compulsion for replacement. Blood banks have to take care that donors should not have been paid in cash or kind.
Directed Blood Donor: Whenever blood is donated by a relative or a friend for a particular patient, it is called Directed Donation. Directed donation from relatives is not always safe. Husband’s blood given to wife can lead to antibody formation causing problems to the foetus in future. Blood from any blood relative such as father, mother, son, daughter, brother, sister can lead to serious medical complications which we call GVHD. Even for transfusion transmitted infection, the close relation who had been socially pressurized to donate, are at times not able to disclose their risky sexual behaviour. Such donation should be avoided as far as possible to maintain ethical code of anonymity between the donor and the recipient and to avoid many future complications — social, legal, emotional.
It has been proved universally accepted that non-profit blood is statistically less contaminated by diseases, than blood obtained from other sources.So, in the days of blood communicable infections, which are often fatal any ideal transfusion service should depend on real voluntary blood donors recruited through education. In view of the city based health care service in a predominantly agricultural country with a very low national income, rural people coming to city based hospitals are unable to organize replacement/relative donor to meet their blood need. At the moment we have just about 0.5% people who donate blood in the country. The requirement is just 1%. So the reasons for not donating blood should be studied by blood donor motivators to convert the non-donor to donor.
The reasons for not donating blood are:
· Fear of the needle
· Fear of pain
· Fear of sight of blood
· Fear of future weakness
· Fear of possible ill effects
· Objection from the elders
· Social taboo
· Medical excuses
· Story of wastage of collected blood
· Ignorance and illiteracy
· Blood is sold at a high premium
· Inconvenience due to location and timing of blood collection
· Apprehension of post donation reaction
· Has never been asked personally.
Reasons for donating blood are:
· Service to the community
· Sense of social duty
· Gaining experience
· Personal obligation
· Personal appeal
· Social pressure
· Group pressure
· For helping friends or relatives
· For blood donor credit card
· For recognition and awards
· Checking up health
· Reciprocity to pay back the social debt
· For- knowing blood group
· Seeing others donating blood
· Celebrities appealing to donate blood.
· Motivators should appreciate that in the materialistic world of today
· the donor has some expectations.
· Expectations are:
· Cordial reception
· Painless bleeding
· Clean and hygienic environment
· Blood group and credit card
· Proper utilisation of blood
· Availability of blood in later time of donor’s need
· Transparency of blood transfusion service.
It is well known that in the corner of every human heart there is a desire to do good to others without causing any harm to oneself and be remembered for the service, therefore, donors and non-donors should be handled keeping in mind the eternal human psychology. The donors have a right to know many things. Donor motivators should equip themselves to satisfy the quest of the donor for knowledge about blood and blood transfusion service, which includes basic blood science, blood group, its inheritance, principles of selection of donors, blood need of the state or region and present supply, procedure for procuring blood from blood banks in time of need.It should be borne in mind by the donor motivators that blood donors are not mere numbers in statistics but are human beings in flesh and blood and should be handled with tender loving care. Blood donors are the ambassadors of blood transfusion service. They can become donor-recruiters too, in course of time. The word of mouth from blood donors may bring credit or discredit to any transfusion service.
Identifying Low-risk Donors
The donor recruiter must appreciate that to ensure safe blood transfusion, identifying and recruiting low-risk donors is absolutely essential.
Selection of low risk donors may be based on the following considerations:
1. Regular, voluntary non-remunerated donors are safer than family or family replacement donors and commercial donors.
2. People who give blood under pressure or for payment are less likely to reveal their unsuitability as donors. They are therefore a risk to blood transfusion.
3. Potential donors may be unsuitable to give blood because of their own poor health they are not giving blood voluntarily risk behaviour.
4. It is not possible to detect HIV antibodies during the ‘window period’.
5. HIV seroprevalence is generally higher in blood sellers and even in the so called replacement or relative donors than amongst regular voluntary donors.
6. Every blood transfusion service and hospital blood bank should be aware of national criteria for identifying low risk donor groups and, therefore, potentially safe donors. They should concentrate on finding donors from amongst low risk groups by: Avoiding unsuitable donors Recruiting regular voluntary non-remunerated donors.
7. Potential donors who have engaged in high risk behaviour or who are in poor health should be encouraged to self-exclude or self-defer. This is only possible if potential donors are made aware of risk behavior. Blood bank staff should always provide opportunities for donors to ask for confidential unit exclusion. In such cases, strict confidentiality must always be maintained.