When life-saving blood kills

There are several unlicensed blood banks in the country as well further bolstering this black market. Around 34 per cent of the blood banks in India are unlicensed. Photograph:( WION )

WION New Delhi, India Aug 01, 2016, 07.58 AM (IST)
I have seen people pleading for blood at hospitals, looking for it here and there, calling their friends at the last minute. This, at a time, when they are dealing with the trauma of a loved one being sick.

I can’t think of a civilisation that would increase your suffering when you are already weak and trying to cope with that. Then you have the added responsibility of finding blood units. It is one of the most ridiculous experiences of being in a hospital. How could a society, that is so advanced, be so poorly prepared for such eventualities!

Paid donors

Blood donation is an altruistic activity. It should be on a voluntary basis. We don’t need anyone to certify this aspect of blood donation, but just to drive home the point even the highest judicial institution of the country says the same.

The reality is quite different. According to a research paper in Asian Journal of Transfusion Science, 50 per cent of blood collection is estimated to be from paid blood sellers and merely 5 per cent of the voluntary donors are repeated donors.

With the severe shortage of blood in Indian hospitals, there is a burgeoning market for buying and selling of blood. Usually people from poor backgrounds such as daily wage earners or construction workers find this as a lucrative way of earning money.

At the same time, people from impoverished sections are at a higher risk of contracting HIV, hepatitis and other diseases. In some of the case studies, it has been observed that first these people start voluntarily as paid donors, risking their health but after a while they are forced by the touts to give their blood. They are unable to get out of this quagmire.

There is a lot missing

Also, in India, the culture of blood donation is lacking immensely. Most of the times, a person would donate blood only when his/her family member is in hospital and he/she is required to replenish the hospital blood bank with the same quantity of blood as used in the treatment.

There are several unlicensed blood banks in the country as well further bolstering this black market. Around 34 per cent of the blood banks in India are unlicensed. Private blood banks are legal as long as they obtain a government licence which comes at Rupees 8,000.

These issues put a big question mark on the quality of blood collected, whether there has been proper check for the infections or not and also, whether the blood collected is from a paid donor or a voluntary donor.

Contaminated blood

All blood banks in India have to mandatorily test all collected blood units for five transmission infections, including HIV, Hepatitis–B Virus, Hepatitis-C Virus, Syphilis and Malaria.

Ideally, the banks should be checking for infections, but how many actually do is a different story. The numbers in this regards are not comforting.

In a recent Right to Information (RTI)  reply, the National AIDS Control Organisation in India said that in the past 17 months, at least 2,234 people have been infected with HIV while getting blood transfusion.

The number is the highest for Uttar Pradesh where 361 such cases were reported while Gujarat came second with 292 cases, Maharashtra third with 276 and New Delhi stood fourth with 264 such cases.

The National Thalassemia Welfare Society estimates that 6-8 per cent of its own patients contract diseases, including HIV, through transfusions.

In 2013, two thalassemic children died and 21 others were diagnosed with HIV after a single, unlicensed blood bank was found to be transfusing patients without testing in Junagadh, Gujarat, reported the Indian Journal of Medical Ethics.

How other countries handle such situations?

People have been infected in all parts of the world with contaminated blood. The All Party Parliamentary Group for Haemophilia and Contaminated Blood last week published a critical report about the help provided to the thousands infected with Hepatitis C and HIV by contaminated blood during the 1970s and 1980s.

Between 1978 and 1985, more than 1,500 haemophiliacs were infected with the HIV virus in a similar way, most of whom were co-infected with hepatitis C as well.

Many haemophiliacs were infected at the Royal Free hospital’s unit and many have since died. Currently, all those infected by Hepatitis C or HIV receive a £20,000 lump sum when they join the payment scheme and if someone progresses to the more serious stage of Hepatitis C they get another £50,000.

In the 1980s, Canada also went through a blood contamination crisis and paid billions of dollars out. Since then the Canadians have taken steps to contain the problem.

No lesson learnt

According to the World Health Organisation, India with a population of 1.2 billion needs 12 million units of blood annually but it collects only 9 million.

There is a deficit of 25 per cent. India has no law under which the police can take penal action against somebody selling blood.

Even though, the Supreme Court in a judgment in 1996 has banned paid donations, the lawmakers have not formulated any blood-related law till now. Beyond that, tens of thousands have been infected and not a dime has been paid in compensation.

Lessons have not been learnt and blood testing continues to stay archaic. Blood testing and stopping contamination may still be a far cry as basic healthcare is still missing. It is shameful for politicians and the medical community to have a failure like this stare them in their face.