Towards 100% voluntary blood donation in Nigeria

Ahead of the World Blood Donor Day (WBDD), which is marked every June 14, medical experts, International Federation of Red Cross and Red Crescent Societies (IFRC), and the World Health Organisation (WHO) have expressed worries that fewer people are voluntarily donating blood, while in Nigeria, there has been an increase in commercial blood donors, popularly known as “blood touts”.

There is indeed a cause for concern because according to the WHO, transfusion of blood and blood products helps save millions of lives every year. It can help patients suffering from life-threatening conditions such as accident victims, cancer patients, and children with sickle cell anaemia live longer and with a higher quality of life, and supports complex medical and surgical procedures. It also has an essential, life-saving role in maternal and childcare and during the emergency response to man-made and natural disasters.

Medical experts say a blood service that gives patients access to safe blood and blood products in sufficient quantity is a key component of an effective health system and that an adequate supply can only be ensured through regular donations by voluntary, unpaid blood donors. However, in many countries, blood services face the challenge of making sufficient blood available, while also ensuring its quality and safety.

Consultant/Senior Lecturer, Department of Haematology and Blood Transfusion, College of Medicine, Lagos University Hospital (LUTH), Idi-Araba, Dr. Adeyemo Titilope, told The Guardian that despite the fact that the practice prevents depression and heart diseases, less than one per cent of the Nigerian population is voluntarily donating blood.

Titilope said: “If five per cent of the population commits to regular blood donation then we will get to 100 per cent voluntary blood donation. As it is now, less that one per cent of the population is donating blood. The blood banks have to rely on commercial blood donors and unsafe blood donors to meet up with demand. So we need five percent of Nigerians to commit to regular blood donation, and then the hospital blood banks will always be ready for response to emergencies and complications.”

For the Red Cross, it is always short of blood and looking for new ways to get people to donate, noting that only about 38 per cent of the population are eligible to give blood, and only about 10 per cent of those people — that is three per cent of the population — give blood yearly. “But a lot of blood is needed. Without A, B and O, we cannot save anybody. Each year, fewer and fewer people are donating blood.”

The theme for this year’s celebration is “Be there for someone else. Give blood. Share life.” Every year, on June 14, countries around the world celebrate WBDD. The event serves to thank voluntary, unpaid blood donors for their life-saving gifts of blood and to raise awareness of the need for regular blood donations to ensure the quality, safety and availability of blood and blood products for patients in need.

To ensure more people donate blood voluntarily, the WHO in collaboration with IFRC has developed a global framework to achieve 100 per cent voluntary blood donation. The framework is designed to provide guidance and support to countries seeking to establish effective voluntary blood donor programmes to phase out family or replacement blood donation and eliminate paid donation.

In Nigeria, the National Blood policy recommends obtaining blood from regular, voluntary, non-remunerated donors, screening for Human Immuno-deficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS), Hepatitis B, Hepatitis C and syphilis. It also requires that records be kept in a uniform and specified manner while maintaining confidentiality.

There are three types of blood donors: voluntary unpaid; family/replacement; and paid. However, report from the Federal Ministry of Health (FMoH) indicates that in most cases, the demand for blood far outweighs the supply. In Nigeria, about 500,000 units of blood are collected yearly out of the required 1.5 million units of blood.

The Guardian investigation revealed that blood is usually obtained on an emergency basis. The typical scenario is that patients with an urgent need of a blood transfusion task his or her relatives to provide blood. The relatives donate blood or procure blood from private laboratories and blood banks. They may also enlist the services of commercial blood donors.

A poor blood donation culture exists in sub-Saharan Africa and several studies have shown that this is fuelled by religious, spiritual and superstitious beliefs. On the benefits of voluntary blood donation, Titilope, an haematologist explained: “Apart from lifting the mood and bringing people out of depression, it rejuvenates the body because when you donate blood, the body manufactures new blood cells to replace the ones you donated, so that means the body will be with younger and fresher blood cells because you donated the slightly old one.

“If you do this regularly, it means the body will always be in continuous state of rejuvenation, cleansing and replacing the older red blood cell. It helps the body to fight infections. It helps to regulate the ion content in the body because excessive ion is not good for the heart and blood vessels. So, regularly blood donation helps in preventing cardiovascular diseases. Donating blood to save someone’s live is indirectly saving your own live.”

Reacting to who can donate blood, the expert said: “In Nigeria, the age range allowed to donate blood is from the age of 18 to 65. So any healthy individual male or female between those ages is eligible for donation. If you get to a blood donation centre, the prospective blood donor will go for a fitness test. If you are not fit, it means you have enough blood for yourself but you are not fit to give blood, you do not have extra. So, the process of donating blood has ensured that the blood donation is safe for the donor and safe for the recipient. If the process will not be safe for donor, the experienced and trained staff will not collect the blood.”

Titilope advised Nigerians on the need for blood donation saying, “When we all donate blood regularly to the hospital blood bank. It means we are stocking the hospital blood bank and getting the hospital ready for any emergency. The emergency could be anybody and we are preparing to get the hospital ready to respond to emergency. Every day we see pregnant women being rushed to the hospital due to excessive bleeding, if the hospital is not stocked, there is a reduced chance of saving that woman in labour. Every day we hear about road traffic accident, when we all donate blood, we make the hospital ready to deal with the emergency.”

Meanwhile, the WHO has charged youths to support the growth and development of the health system and save lives by donating blood regularly. The organisation, in a statement on Wednesday to commemorate the 2018 “World Blood Donor Day”, said individuals who voluntarily donate blood regularly play an essential life-saving role in maternal and childcare, and during emergency response to man-made and natural disasters.

The organisation said that although voluntary blood donors were essential for all these to happen, their number remained low in many countries, leaving blood services with the challenge of making sufficient blood available. “An adequate supply can only be ensured through regular donations by voluntary, unpaid blood donors; however, in many countries, blood services face the challenge of making sufficient blood available while also ensuring its quality and safety.

“This year our campaign aims to highlight stories of people whose lives have been saved through blood donation as a way of motivating regular blood donors to continue giving blood. It also aims to motivate people in good health who have never given blood to begin doing so particularly young people,” the statement read in part.

WHO said that the organisation adopted the slogan “Be there for someone else. Give Blood. Share Life”, to draw attention to the role voluntary donation systems play in encouraging people to care for one another. It said that the 2018 theme highlights the fundamental human value of altruism, respect, empathy and kindness, which underline and sustain voluntary unpaid blood donation systems.

The organisation appreciated individuals who donate blood and encouraged those who have not yet donated to start doing so. It called for the need to ensure committed, year-round blood donation in order to maintain adequate supplies and achieve national self-sufficiency of blood. The theme for the 2018 commemoration is “Blood Connects Us All”.

Also worried about the daily reduction in the number of blood donors across the country is the National Blood Transfusion Service (NBTS). Through its Donor Care Manager, Jane Akubuiro, who made this known to newsmen recently, in Abuja, about 30 donors were expected per day to be able to cater for the needs of the public. She was, however, worried that they only recorded about five walk-in donors on the average per day recently.

She assured would-be donors of safety, saying “there will be adequate medical test for them to ascertain whether or not they are fit to donate or not. “There will be Haemoglobin level test, pulse rate check, blood pressure check, weight check and other body checks. Blood is also tested for blood group and screened for some major blood-borne diseases which the donor is immediately informed in strict confidentially if any of these tests show positive results.”

Worried that there may be misconceptions that blood donation is dangerous, she said: “When blood is withdrawn the donor’s body immediately begins to replenish the lost blood. New cells are produced by the marrow within 48 hours of donation, and all of the red blood cells the donor loses during donation are completely replaced within one to two months. Therefore, donating blood helps to stimulate the production of new blood cells which helps the body stay healthy and work more efficiently.”

Akubuiro said NBTS would organise a donor’s week to host and entertain donors at the Institute of Human Virology, Nigeria (IHVN), Abuja, as part activities marking the World Blood Donor Day on June 14.