A few days ago, I was at a Valley hospital to see my colleague’s mother who had been admitted in the emergency ward after an accident. She was bleeding profusely. The doctor immediately recommended five units of blood. As is the practice, the blood bank, in return, asked for donors to replenish its stock. It was then that I discovered how difficult it is to organise donors. My colleague, the only son, was reluctant to give his own blood as parting with one’s blood is though inauspicious. But it is a misconception, nothing else. What more, the annual collection of blood is far below the requirement. If only three per cent of Nepal’s eligible population donate blood, there will be no shortage.

The shortage of blood affects particularly children suffering from blood diseases like thalassemia and haemophilia; others affected include trauma victims, cancer patients and those undergoing major surgeries, especially the poor and the disadvantaged. Globally, more than half a million women die each year during pregnancy, childbirth or in the postpartum, 99 per cent of them in developing countries. An estimated 25 per cent of those deaths are caused by severe bleeding. It is the most common cause of maternal mortality and contributes to around 34 per cent of maternal deaths in Africa, 31 per cent in Asia and 21 per cent in Latin America and the Caribbean. Blood transfusion has been identified as one of the eight key life-saving facilities that should be available in healthcare centres providing comprehensive emergency obstetric care.

Blood is a complex fluid consisting of different blood cells suspended in yellowish liquid called plasma. The blood cells comprise a mixture of red cells (erythrocytes), white cells (leukocytes) and platelets (thrombocytes). Blood serves as a transport medium to carry its components to and from different organs of the body. Blood collected in an anticoagulant can be stored and transfused to a patient in an unmodified condition. This is called ‘whole blood’. Blood may be used more effectively if component therapy is practiced. One unit of donated blood may be separated into components including red cells concentrates (which can be stored up to 42 days), plasma (can be stored up to 1 year) and platelet (can be stored up to 5-6 days) to meet the needs of more than one patient.

It is not only the common people who are ignorant about many facts of blood, some doctors are too. For instance, it is unscientific to prescribe one unit blood for transfusion or write “Arrange Fresh Blood”. It is medically proven that a single unit of blood transfused does not benefit the patient because 0.8gm to 1gm haemoglobin is too little for therapeutic effect in the body. In developed nations, blood is transfused in cases where minimum requirement is of two units. According to WHO norms, blood should be tested for four hours, but fresh blood is usually not tested, which can be fatal to blood recipients. Blood preserved in cold temperature kills certain germs.

Technical issues apart, the most important thing which people should understand is that blood donation at three months’ gap is not injurious to health for a healthy person, but rather a very safe and healthy practice. Interestingly, blood donation reduces the chances of a heart attack because it thins out the blood. Physiologically, 70-80 ml of red blood cells die on their own every 120 days and the bone marrow churns out new ones. So, donating blood in no way interferes with body system, but can save the life of a dying patient.

Without blood there can be no blood transfusion service and without donors there can be no blood to transfuse. Also, without voluntary blood donors no transfusion service can ensure the steady supply of safe blood in right quantity at the right time. So the blood transfusion programme should be based on voluntary blood donation motivated purely by humanitarian considerations because this is the safest and most effective way of providing the needed volume of blood. In order to reach this goal, awareness has to be created for voluntary blood donation by NGOs, government and corporate organisations. Misconceptions and prejudices have to be dispelled by rationally showing that blood donation is harmless and beneficial to society.

Shortage of safe blood and blood-derived products results in premature deaths of countless Nepalis, though no one has yet come up with an accurate figure. There is no substitute for blood. In the window of half-an-hour, 350 ml of blood may be the difference between life and death. Even so, we are allowing patients to die for want of blood. What a shame! Our lives near the end the day we chose to be inactive on things that matter. Who can change the dismal state of blood donation programme in the country? If you want the change, be the change you want to see. Donate blood at least once a year, for example on your birthday, and encourage others to do the same.

Ghosh is CEO, National Insurance Company Ltd.