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World Blood Donor Day 2020: Dr Vanshree Singh from Indian Red Cross Society on Blood Donation Scenario Post COVID-19 in India

COVID-19 has had a major impact on blood services across the country. The blood banks are struggling to maintain the bloodstock, putting the lives of patients that require regular transfusions – such as thalassemia patients, dialysis patients – at risk. Dr Vanshree Singh, Director, Indian Red Cross Society, Blood Bank highlights the blood scenario in the country in the wake of COVID-19 pandemic and nationwide lockdown.

Blood donation is not a common practice among Indians. Why do you think that is?

I think the main reason is the lack of awareness. People often have a misconception that if they give blood, they will suffer from weakness or become anaemic. Many people also have this fear of catching unknown infections from the needle. And finally, people do not feel the need for donating blood without reason i.e. they have no concept of voluntary blood donation. They feel that they will donate when the need arises.

How is the rural-urban divide in terms of voluntary blood donation in India?

In urban areas, the population density is higher. This makes it easier to grab the attention of people and gather them for blood donation. Such gatherings ignite chain reactions where more and more people join into volunteer for the camp or to donate blood voluntarily.
In rural areas, the population is scattered. So such chain reactions do not occur. The people in rural areas also lack awareness regarding the importance of blood donation – and it is even difficult to gather them to educate them on it. However, they do not hold preconceived notions regarding safety or side-effects of blood donation. They donate blood with much more ease than the people in urban areas.

The blood deficit is very high in developing countries as compared to the developed countries. What are the reasons behind this?

Many of the developed countries have a National Blood Service system. This means, their system of blood collection, storage and delivery are all integrated at a national level. In our country, the blood service is scattered. There are multiple players – government hospitals, private hospitals, autonomous bodies, channel of blood banks, corporate hospital blood banks – all involved in blood services. Therefore, uniformity across the country is not maintained.
Another thing to note is, in India, the donors have to go to the blood bank to make a voluntary blood donation. It is the blood banks that need the blood despite this, they do not approach the donors. The system is quite the opposite in many developed countries. There, a social worker is appointed who approaches the people, works towards raising awareness on the importance of donating blood and arranges for the collection of blood at the convenience of the donor. The blood service in these countries is proactive. In India, it is passive.

How much is the blood deficit in India?

According to WHO norms, if 1% of the total population of a country donates blood regularly, the blood requirement of the country would be met. The tricky part is, there is a disparity in the blood requirements area-wise. For example, the population of Delhi is around 2 crores. 1% of that would be 2 lakhs. But we collect about 7 lakh units of blood with the help of 70 blood banks. Despite that, there is a deficit. This is because, apart from residents of Delhi, there are many people travelling from different states or even countries to get treatment. Many major surgeries are referred to Delhi from all over the world. The patients travel with one or two family members at maximum – therefore even their own blood requirements are not met by their families. Therefore, the blood requirement does not get fulfilled, since the demand is much higher. For metros, 1% requirement does not suffice.
For rural areas, however, the story is entirely different. Since the infrastructure is not up to the mark, the collection of blood gets affected. In such areas, state of the art blood storage facilities should be installed. In this manner, the collection does not get affected and availability is not compromised.

How is the Red Cross Society India working towards reducing the blood deficit?

The Red Cross Society is involved in every process of blood service. We have 89 blood banks in 15 states across India, that are involved in all the processes such as collection, testing, processing, storage and distribution. We have achieved 100% voluntary donations status in 62 of our blood banks. Rest of our blood banks are also trying to achieve that feat. In addition to this, we are also engaged in maintaining the uniform quality of blood. For this, our blood bank at the headquarters has acquired accreditation from National Accreditation Board for Hospitals & Healthcare Providers (NABH) and we are encouraging the other blood banks to get the same. In addition to this, we are trying to strengthen our blood banks so that they can function round-the-clock and thus, collect more blood. Currently, the blood banks operate only till evening because of lack of manpower and resources. We are working towards changing that so that we can improve the Blood Services in India.

What role can CSR play in reducing the blood deficit in India?

The role of CSR is crucial in conducting Blood Donation camps. It will be even more now, because of the overall reduction in Blood Donation. The corporates with their CSR funds can organise donation drives and ensure that all standard safety measures are fulfilled. Through their expertise in communication, they can also pilot awareness campaigns and build trust among the donors regarding the safety of the procedure. In this manner, they can create advocacy and campaign for safe Blood Collection.
The corporates can also help organise blood donation drives in areas that do not have a fully functioning blood donation facility. For example, some states of North-Eastern India do not have our blood bank centres. Same goes with some areas in Jammu & Kashmir, Uttar Pradesh and even Kerala. Through corporate CSR programs, our blood banks can reach these areas and acquire the blood which in turn can save many lives.

How has COVID-19 impacted the blood donation drive?

Blood donations have been heavily impacted because of the lockdown. Red Cross Society India heavily relied on blood donation drives. With lockdown imposed, we were not able to organize those camps. We collected hardly 30-40% of blood of what we usually do in the first few days of the lockdown imposed in the wake of COVID-19 outbreak.
We realised in the initial days itself that the problem will arise and the blood availability will reduce. To contain that, we started calling our regular donors in-house to collect the blood. We have about 40,000 regular donors in Delhi. We sent our mobile vans to places where there was a group of people that were willing to donate. We gave our donors pick-up and drop-off facility in an ambulance, and for the other donors who were able to travel on their own, we arranged for e-passes with 24 hours validity from their homes to the blood bank from the first day of the lockdown, so that they were able to travel.
Now, we have even started sending vans to localities where either we have some regular donors or to places from where we received requests from organisations or individuals. This is the manner in which we have been coping after the outbreak of the pandemic.

COVID-19 outbreak has inculcated the fear of direct contact among people. How will this reflect in blood collection in the future? And how can this be curbed?

There will certainly be a trust deficit. Because the staff that is responsible for the collection of blood will go outside. That increases their vulnerability towards the virus. And therefore, people might be reluctant to come in direct contact with them. The only thing that can be done in such a scenario is, that the collection centres and the healthcare workers maintain utmost cleanliness and hygiene. They need to assure the donors that all the safety measures have been followed and it is safe for them to donate. Even then, many people might feel reluctant. And you cannot force anyone to donate blood. However, with time this fear will go. We can only do the best from our end.