Blood donor base is the foundation of any blood transfusion system. In India any able-bodied individual between the age of 18 and 60 yearscan donate blood upto 168 times.After the historic directives of the Supreme Court officially, there is theoretically no paid blood seller in India from January 1, 1998. So, at the moment, blood donors are of two types:
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 or 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. Such recognition of donor is universal.
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 bank or transfusion centre provides the right group of blood for the patient and replacement donor belonging to any other blood group replaces the supply in quantity. But whenever blood is donated by a relative donor 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. 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 and accepted all over the world that non-profit blood is statistically less contaminated by diseases, than blood obtained from commercial or 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 redominantly 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. More than half the population of the country is medically fit to donate blood. But 4 out of 1000 of the population in India are blood donors. 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.
- Motivators should also know the reasons for blood donation by thepresent microscopic minority.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:
- Regular, voluntary non-remunerated donors are safer than family or family replacement donors and commercial donors.
- 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.
- Potential donors may be unsuitable to give blood because of their own poor health they are not giving blood voluntarily risk behaviour.
- It is not possible to detect HIV antibodies during the ‘window period’.
- HIV seroprevalence is generally higher in blood sellers and even in the so called replacement or relative donors than amongst regular voluntary donors.
- 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.
- 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 behaviour .Blood bank staff should always provide opportunities for donors to ask for confidential unit exclusion. In such cases, strict confidentiality must always be maintained.
- Donors should be asked questions in a private area. Result seeking donors who approach blood banks should be deferred.
- Considering history-taking as a barrier in collecting large number of units of blood is a great mistake.