June 13, 2017, 3 a.m.
On June 14, World Blood Donor Day, politicians, officials, civic activists, and other public figures will be donating blood en masse, taking selfies with their hands bandaged, and then posting them on social media. IzbirKom explains why such campaigns have no real results and where the donated blood goes.
Society in our country has the following peculiarity: we remember the existence of certain problems only on clearly defined calendar dates. For example, HIV/AIDS is actively discussed on December 1, and tuberculosis and its threats are discussed on May 24. Similarly, the need for blood donation will suddenly be remembered by everyone on June 14, World Blood Donor Day. It is safe to assume that on this day, politicians, officials, civic activists, and other public figures will be donating blood en masse, taking selfies with their hands bandaged, and then posting photos on social media. Some of them will definitely organize one-time events with a call to come and donate blood together on that particular day. At first glance, it seems like a great initiative that will help many people. But in reality, there are many "buts" behind it. Once you know about them, it may be easier for you to distinguish between a demonstration campaign and a real call for help. IzbirKom continues its series of publications on donation.
Advantages of mass events: recruiting and informing donors
The official motive for holding such campaigns - to replenish donor blood stocks in medical institutions - is absolutely noble and justified. The shortage of blood is really felt all over Ukraine, and this is despite the fact that the state provides donors with many benefits and privileges. Therefore, we have to look for various ways to encourage citizens, draw their attention to the problem, convince and inspire them to become donors.
This work is carried out, in particular, by the Association of Young Donors of Ukraine. Today, this public organization is the only structure that has an all-Ukrainian electronic database of donors - DonorUA. The Association conducts extensive outreach activities, has its own telephone hotline, creates campaign videos, organizes various events, etc. Probably the most high-profile campaign in recent times was the one carried out together with one of the retail chains. According to the terms of the campaign, those who donated blood within one week could participate in a drawing and win one of 15 iPhones. The excitement was incredible. There were so many people who wanted to get an expensive phone almost for free that they decided to extend the campaign for another week.
- "I am very pleased with the results," says Iryna Slavinska, President of the Association of Young Donors of Ukraine. - "This campaign is popularizing the donor movement throughout Ukraine. People heard that it is possible, necessary and useful to donate blood. This is the first thing. Secondly, if they visited our website DonorUA, they saw those children who are in need of blood component transfusions and read information about donation. During the campaign, we had a very large number of donors register. And now we have the opportunity to keep in touch with them.
According to Iryna, the main task here is to draw attention, to make sure that people learn about donation and come to donate blood. Whether or not they will stay in donation afterwards is another question. It is not material motives that play a role here, but moral values. And if the first (material) motive succeeds in awakening a person's consciousness, the goal is achieved. If a person does not want to come a second time, then the fact that he or she has donated blood at least once in his or her life can be considered positive.
- We are a country of many millions. If a million of these people heard about the campaign... Believe me, we will not have any problems with blood shortages if they come and donate blood at least once," assures Iryna Slavinska.
Disadvantages of the campaigns: long lines and excess blood
Now let's try to see what this action looked like from the inside. For example, how it took place in Odesa, at the regional blood transfusion station. Throughout the campaign, it was a real sell-out. There were so many people that from time to time the station accepted donors with only the rare fourth blood group. On other days, there were huge queues. First, to the registration office, then to the therapist, then to the laboratory for testing, and then directly to the coveted donor chair. Many people's impressions of this whole procedure were something like this: "Once you go through all these hellish circles, you don't want anything else. Especially to share a part of yourself." The newcomers kept asking if this always happens here. The longer they had to stand in line, the more nervous they became and argued with the medical staff.
The situation was further complicated by the fact that the blood sampling process at the station had been changed. As a result, the procedure, which usually lasts an average of 10-15 minutes, took at least 30-40 minutes. During this time, the doctors separated the donor's blood and then returned one of the blood components, plasma, to the "owner". Now imagine how long you have to wait if you are fifteenth or twentieth in line, and it takes half an hour for each person in front of you? Even if two or three donor chairs are involved in the process, it will still take several hours. It is not surprising that in the end some donors simply walked away. All this obviously calls into question the incentive function of the campaign.
There is almost no room for plasma storage anymore...
The question also arises as to why complicate the blood donation process and return the donor's plasma to him or her. After all, it is an important and precious blood component. So why not take it and use it for its intended purpose, as it is always done? The fact is that today blood transfusion stations have a surplus of plasma. There is so much of it that there is actually no place to store it. However, due to legal conflicts, the stations are currently unable to process plasma into albumin on their own or sell it to special companies for processing.
- We can work somehow for another 3-4 months: we still have freezers for plasma. But we'll see what happens next," comments Mykhailo Bartko, chief physician of the Odesa Regional Blood Transfusion Station. - " The plasma is accumulating. Perhaps we will buy another refrigerator for it, or perhaps the issue of selling plasma will finally be resolved. Because according to our legislation, plasma can only be stored for three years, and then it has to be disposed of. If you don't need the plasma, you can just pour it out.
...and other components cannot be stored for a long time at all
So what does this mean? Is there a need for donated blood in Ukraine or not? The answer remains the same: blood is needed. But donations should be planned and constant throughout the year, not massive once or twice a year. Such sharp fluctuations between "empty" and "thick" lead to sad consequences: blood that is not used in time is simply disposed of as unusable. And then they start looking for donors again to replenish their stocks.
For example, red blood cells, which are considered the most valuable component of blood, can be stored for just over 40 days, because then they lose their properties. Platelets should not be frozen at all: their storage temperature is +22 degrees Celsius (+/-2 degrees), so they must be used fresh. As mentioned above, there are more than enough plasma reserves. Therefore, if donors donate too much blood, the station will simply not be able to use it in time.
The situation is even more ambiguous in transfusion departments at hospitals, where blood is also taken from donors. While the regional transfusion station cooperates with various medical institutions, these departments focus only on their own hospital. That is, there are even fewer chances to use the large stocks of blood in time for the intended purpose.
- We do not write off anything specifically. We sell everything like hot cakes. But in the districts... Sometimes up to 30-40% of the blood is poured out, because they collect as much as they don't need," says Mykhailo Bartko. "For example, if blood is needed for a three-year-old child, and activists bring a hundred donors as part of the campaign, I ask: how much blood do you want to pour into this child? If you want to organize an action, you have to go to the chief doctor and ask how many donors are needed and with what blood type. But they announce campaigns on their own and drive people to us...
- I always remember the example of Mechnikov Hospital (Dnipro - Ed.), where blood is collected for ATO soldiers. For example, there are 20 ATO fighters, but they collect blood from a thousand people. Tell me, what will they do with that donated blood?" asks Oleksandr Sergienko, an expert of the Coordination Working Group on the Development of the Blood Service of the Ministry of Health of Ukraine. - "And you should also consider that this means a meal for each donor, medical supplies and salaries for medical staff. This is all money that is wasted.
So choose: a show or a real need?
Once I had a chance to talk to a female volunteer who is looking for donors for children with cancer. At that moment, she was closely watching one of Odesa's politicians give an interview to several TV channels. The politician was saying that on the occasion of the Donor Day, he had not just donated blood, but had organized a whole campaign, inviting other Odessans to come. At this point, the woman could not resist and said to me: "I hate these events! I just hate them! Because after them it is even harder for me to find donors for my children!"
Of course, this is an overly emotional reaction, but it has a serious basis. After all, if a donor donates red blood cells, then his body needs at least two months to recover. That is, he will not be able to help anyone for two months. Today we are responding to the call: "Let's celebrate Donor Day!", tomorrow he will not be able to respond to the call: "Help a person who needs an operation!".
This is another important aspect that donors should pay attention to. Usually, doctors do not say such things in order not to discourage people from donating blood. But these phenomena exist, and the donor has the right to know what happens to his blood. Only then will he be able to approach the whole process more consciously. He will be able to assess and understand how urgent the need for donation is. And then he will be able to learn to donate blood not on the occasion of a "red date" in the calendar and not for the sake of reward, but for the sake of real help to people.
To be continued...
Iryna Umanets
The preparation of this material was made possible by the support of the American people through the USAID U-Media project implemented by the international organization Internews. The contents of this publication are the sole responsibility of IzbirKom and do not necessarily reflect the views of USAID, the U.S. Government, or Internews.