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Paying in blood

Sunday, March 20, 2011

Earlier this month, at the opening of the Eye Theatre and Eye/ENT Ward at the San Fernando General Hospital, Minister of Health Therese Baptiste-Cornelis declared that there was no shortage of blood at the National Blood Transfusion Service, long colloquially known as the Blood Bank. “The amount that we used to have when people were paying is not there, but it does not mean that we have a shortage either. So we are looking into it” the Minister declared. The Health Minister explained that the chit or diary system in use for decades at the Blood Bank led to some people selling their capacity to give fresh blood or previously donated blood for sums as high as $1,100 per pint. Clearly, any system that led to a black market in blood was a system that was being abused in ways it wasn’t designed for and the chit system was formally abandoned on December 31, 2010. In adopting the recommendations of the World Health Organisation, the Ministry of Health moved from one system that was prone to borderline criminal abuse to another that hasn’t been fully articulated to the public. At the opening of the Eye/ENT Ward, Minister Baptiste-Cornelis promised that a campaign would soon be announced to increase voluntary donors.

Unfortunately, that gap, and the lack of clear communication with the medical community and the public, has led to shortfalls in the supply of blood that appear to defy the Minister’s pronouncements. Within hours of the Health Minister assuring the public that the supply of blood was adequate, Acting Medical Director of the San Fernando General Hospital, Anand Chatoorgoon was telling another story: “We are having problems with the availability of blood and therefore surgeries that require blood may well have to be postponed.” Despite the claims of value to the chit system, Trinidad and Tobago has long been chronically undersupplied with blood at the Transfusion Service. The Blood Bank collects 20, 000 pints of blood annually for a medical system that the Ministry of Health estimates requires 65, 000 pints. To reach those levels, one in 20 citizens should give blood at least once a year, though healthy persons of median age can donate up to three times per year. On June 14, 2010, the Ministry of Health held a walkathon in observance of World Blood Donor Day and announced that a fully voluntary system would be coming later that year. That sort of general awareness building is fine when a system is functioning and reminders are all that are needed to keep the supply of blood adequate, but the situation facing the health sector now demands a much smarter, more focused sales pitch.
The immediate challenge facing the Health Ministry and the National Blood Transfusion Service is dispelling the negative perceptions of blood donation and the expectations of the previous system in which donors “owned” blood. A new attitude, particularly among young people, about offering their most precious resource as a civic duty to their fellow nationals should be encouraged.

This, as can be readily imagined, won’t be particularly easy. It isn’t widely known that blood has a short shelf life of just 30 days, and the supply must be replenished constantly. Donating blood involves needles and the loss of, well, one’s blood in a clinical environment. There is no immediate payback beyond a sense of having done a good deed and for some, momentary dizziness that soon passes. Blood donors are a critical component in the business of medical practice, and the Ministry of Health would be on sound ground in pursuing campaigns that leverage their regular, committed donors as evangelists on their part. The Ministry should further begin discussions, and join in others already in progress online and in social media, about the new blood donation methodology. Stories of lives saved by the intervention of an adequate blood supply might bring a welcome humanity to these discussions and reinforce the critical nature of an informed community of blood donors. Those conversations should begin soon, because donors need to be informed by the dynamics of this new process, and the medical community must more fully understand the challenges facing them in explaining the need for donations to reinvigorate the flow of blood from the healthy to the ailing who need it as a matter of life and death.


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