The growing demand for blood transfusions to meet medical emergencies in Sri Lanka has led to the National Blood Transfusion Service (NBTS) which is the main Authority providing blood to hospitals, to be constantly flooded with requests to save lives of critically ill patients. Blood collected by the NBTS are all voluntary donations. However, there are concerns and fears among the public regarding the quality and safety of the blood stored in the bank. With two days following World Blood Donations Day, the Sunday Observer sought to allay their fears by talking to Senior Consultant Transfusion Physician National Blood Centre, Dr Senarath Jayasekara who assures them that all precautions are taken to make donations as safe as possible and debunks common myths surrounding blood donations..
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Q. In Sri Lanka, blood is required for a variety of medical reasons. What is the estimated number of donors you have at present?
A. There are approximately 800,000 blood donors island wide. Last year’s total blood collection was about 425,000 pints.
Q. Are they all voluntary donations?
A. Yes. NBTS of Sri Lanka collects blood only from voluntary non-remunerated blood donors. We have been doing that since 2014
Q. If a person is desperate for blood, can he/she buy blood from your bank?
A. The NBTS has 105 hospital based blood banks island wide. They provide blood and blood products to all patients in need of blood transfusion, as prescribed by a physician. No Blood can be sold.
Q. How much blood is taken from a patient at a single donation?
A. At a single donation, 450ml of blood is taken.
Q. What is the procedure?
A. Healthy individuals aged between 18-60 are eligible to donate blood. They can donate either at a blood bank or at a mobile blood donation campaign. They are given a questionnaire to be filled by themselves and thereafter a doctor will counsel the donors for a brief medical examination. If the donors pass the examination, haemoglobin content of the blood is checked and if it is above 12.5g/dl, the donor is fit for blood donation. Blood will be drawn into a sterile blood collecting bag which takes only about 10 minutes. The donor is then offered a drink and observed for about 20 minutes for any adverse effects such as fainting.
Q. Does it require hospital admission?
A. No. it is a minor procedure.
Q. How long does the procedure take?
A. About 30 minutes.
Q. Is it done under medical supervision?
A. Yes. All blood donations are done under the close supervision of a doctor and trained nursing staff.
Q. Are preliminary investigations required before you donate blood? If so, what are they?
A. First the weight of the donor is checked. Their weight has to be above 50kg to be eligible. Haemoglobin of the donor’s blood is also checked, which has to be above 12.5 g/dl.
Q. How do you know that the blood donated is safe? What are the tests done to ensure this?
A. With the questionnaire and the interview with the doctor, we try to prevent donations by people who are at a higher risk of having diseases that can be transmitted through blood. Blood samples collected at the time of donation are tested for HIV 1 and 2, Hepatitis B, Hepatitis C, Syphilis and Malaria. All tests are performed using highly sensitive tests. Blood will not be released to patients until these tests are complete and found to be negative.
Q. Where are these tests conducted?
A. The NBTS has 18 testing centres with all facilities for testing, and blood collected all over the country are tested at these centres.
Q. Where can one donate blood in a safe sterile environment?
A. There are 105 hospital based blood banks where donors can walk-in and donate. They can also donate at mobile blood donation campaigns, organized by volunteers.
Q. How long does it take for a person who has donated blood to recover?
A. Donors cannot engage in strenuous activities on the date of the donation but can go back to their regular activities after 24 hours.
Q. In some countries, blood donations are done in mobile clinics. What is the situation in Sri Lanka?
A. In Sri Lanka, almost 90% of blood donations are collected at mobile blood donation campaigns.
Q. Can a person donate blood excessively?
A. There should be a gap of at least 4 months between two blood donations.
Q. After donation, it is said the human body has an amazing capacity to replace all the cells and fluids that have been used. Do you agree?
A. Yes. The fluid is replaced within a day and in several weeks, all cells are also replenished.
Q. What is the ideal age group for blood donations?
A. Healthy people between 18 – 60 years are eligible to donate blood. However, the young are the ideal group to donate blood, as the prevalence of non-communicable diseases in this age group is low.
Q. Can children under12 years donate blood? If not why?
A. No. The minimum age limit is 18. To donate a standard volume of 450ml blood, the donor has to weigh at least 50 kg as only about 13% total blood volume in the body can be withdrawn at one donation. Legally, someone under 18 years cannot give consent for blood donation and many are unlikely to fulfil the minimum weight requirement.
Q. Elders who are healthy?
A. In Sri Lanka, regular blood donors can donate till 60 years of age if they are healthy. If donating for the first time the maximum age limit is 55.
Q. Obstacles that prevent voluntary donations?
A. There are many myths prevailing in society regarding blood donation. Some believe they gain weight when they donate blood while others think they would become weak. Donating blood is a humanitarian act which has many health benefits.
Q. How does it save lives?
A. From a single blood donation, up to four blood components can be separated. Red cell concentrate, platelet concentrate and plasma are the main three components. These components can be used as indicated depending on the patients’ clinical condition. Therefore, a single blood donation is beneficial for at least three patients.
Q. Who is responsible for the overall management of blood donations island wide?
A. The NBTS has the overall responsibility from the time of blood donation until it is issued to a patient. This includes purchase of equipment and consumables, training of staff, issuing of guidelines, etc.
Q. Is blood donation part of a strategic national development plan?
A. Although it is not specifically stated, timely access to a sufficient supply of blood and blood components for transfusion is an essential part of a successful health care system.
Q. Does the NBTS have a goal?
A. Our goal is to ensure the quality, safety, adequacy and cost-effectiveness of the blood supply and related laboratory, clinical, academic and research services in accordance with national requirements and WHO recommendations.
Q. Your vision for the future?
A. To be a unique model to the world, securing quality assured blood services through a nationally coordinated system.
Q. How do you plan to reach those goals?
A. The field of Transfusion Medicine is rapidly developing in the world. We, as the National Blood Transfusion Service of Sri Lanka, are observing the global trends and assess national requirements and feasibility for adopting new technologies to the system.
Q. Your latest activities?
A. Blood collection in Sri Lanka has increased almost every year. Now we can meet the demand for blood without depending on replacement donations.
We have introduced new technologies including latest methods for testing for diseases that can be transmitted by blood transfusion. We can also freeze very rare blood types for ten years among other activities.
Q. I understand that more young people would be encouraged to participate in the future. Your comments?
A. Promoting youngsters to donate blood is important as they are in the low risk category for non-communicable diseases. At present we perform youth advocacy programs in schools to encourage the young to donate blood. The promotional program carried out from the NBTS, “Celebrate your 18th birthday by donating blood” was very popular among youngsters.
Q. How can the media help to boost blood donations?
A. Media can play a vital role by making the community aware of the importance of donating blood and debunking myths prevailing in the community regarding blood donation.
Q. We now see many different communities coming together at all levels, including schools to organise their individual blood donations. Do you have a problems with this?
A. Donations from all communities in society are welcome as our collections won’t be adversely affected when one group is having their festivals while others fill the gap. All blood units collected are screened before issuing to patients irrespective of the source of collection.
Q. Any gaps in the safe efficient delivery of uncontaminated blood donations in the country?
A. Currently safe delivery of blood is ensured all around the country to the optimum achievable quality standards.
Q. Your message to the public?
A. Donate safe blood, It is a lifesaving gift.