Donating Blood and Saving Lives - An Interview

by Thilaka Ravi on  June 13, 2009 at 12:37 PM Medindia Exclusive - Interviews and In depth Reports
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Medindia interviewed Dr. P. Srinivasan MD, Chairman and Managing Trustee of Jeevan Blood Bank and Research Center and Jeevan Stem Cell Center. Jeevan Blood Bank is a non-profit community blood bank which was started in Chennai, India on 24th September 1995, aiming "to provide on demand, safe blood and blood components collected from non-remunerated voluntary blood donors (NRVBD) using appropriate international standards." Apart from being one of the finest blood banks in India with total commitment to ensure sterility, viability, quantity, quality and safety of blood and blood components, Jeevan Blood Bank continues to provide services free of any charge to organizations like Cancer Institute in Adyar, Tanker Foundation, Children's' hospital, Egmore to help treat children and adults with cancers, thalassemia and prolonged kidney disease.

Ques. Who can and cannot be a blood donor?

Ans. Any healthy adult with a clean medical history between 18 years and 60 years of age weighing more than 45 kgs can donate blood. The person must have a hemoglobin count of 12.5 g/dl and the blood pressure should be minimum 110 / 70 mmHg and maximum - 180 / 100 mmHg.

Blood donation will be collected only after a temporary deferral period from people who have had malaria, typhoid, jaundice, TB, or after surgeries, or during medication or from those under the influence of alcohol and such conditions.

People who have tested positive for Hepatitis B & C or HIV, syphilis, gonorrhea, malignancy (cancer), drug abuse and who have taken growth hormone injections are permanently disqualified from donating blood.

Dr.Srinivasan in the British 10km Charity Run for Jeevan Blood Bank

Ques. Is blood donation generally on paid or voluntary basis?

Ans. A landmark Supreme Court judgment on January 1, 1996 banned paid blood donation in principle, but possibly there are many small centers where paid blood donation still thrives on the sly.

The first and the best type of blood donation preferred is the non-remunerated voluntary blood donation prompted by the donors' purely altruistic motives. This kind of donation guarantees the highest level of safety in the procured blood.

The second layer of blood donation covers blood donated by family members and friends of patients. Doctors and donors work under pressure in this category to make blood available on an emergency and chances are that some information is deliberately or inadvertently withheld by the donor in the pre-donation evaluation.

The third category is Replacement donation done in most hospitals where, though there is a stock of blood - it has become customary for hospitals to ask patients to procure blood which is stocked in the hospitals for another patient at a later date.

Ques. You were previously heading a center that provided excellent lab services. What drew you to Blood banking? 

Ans. I started a Blood Bank when I realized that people who needed blood were running from pillar to post in a time consuming and frustrating exercise to procure blood, the safety of which was sometimes compromised. In 1995 our lab services detected that a large number of people tested positive for Hepatitis Band C. My colleague Dr. Saranya Narayan and I decided to investigate and found that more than 70% of those who had contracted Hepatitis B and C had received blood transfusion for coronary disease.

Similarly, a one year-old child tested positive for HIV in our lab and the angry father revealed that his wife tested positive for HIV after receiving a blood transfusion and died delivering the child that carried on the fatal infection.

On December 24, 1995, a railway employee from Rajkot who had admitted his wife in Railway hospital in Chennai was frantically searching for blood to save his wife. An autorickshaw driver who had a list of donors took him around Chennai and luckily they chanced upon where we were providing lab services. Notable film producer and philanthropist AVM Saravanan who is a ham enthusiast immediately arranged for 3 reliable blood donors through his ham network.

I am a regular blood donor myself and a press friend of mine once informed me of a freedom fighter with aneurysm of the aorta who needed blood urgently and I rushed a to a blood Center and offered blood without revealing my identity as a doctor. There I saw first hand the absolutely rude and callous manner in which blood donors—even first time donors were treated by the blood center's personnel! The desperate need for blood in India and the gross inefficiency with which blood is collected and stored and the crying need to streamline this noble service finally hit me hard. What followed was a conscious decision to give up my lab services and devote my full time to Jeevan (meaning Life) a community non profit blood bank, research center and subsequently a Stem Cell Bank. There has been no looking bank ever since.

Ques. How do you rate the blood banks in our country? Are they generally safe and do they all follow similar standards of screening and storage?

Ans. The drug controller general of India works as the regulatory body to monitor blood donation services currently in India. Quality in blood transfusion services (BTS) is an important concern for all health care professionals. We cannot have blood units of high and low quality. With the AIDS outbreak in the eighties and the dreaded ramifications of transfusion associated infections (TTI), especially HIV, Transfusion Medicine gained greater importance in medical community and the quality in blood transfusion services has increased ever since. Following initiatives taken by National Aids Control Organization (NACO) and State Blood Transfusion Councils, prospects of proper screening and storing of blood are looking bright.

That said, there are currently 2455 blood banks/centers in India and the number is too large and raises questions regarding the quality of blood procured and stored in many of them. In fact in blood banks with less than 3000 donations, the safety of the blood is questionable. The need of the hour is to centralize most of the operations and have fewer and more efficient blood banks.

Ques. What kind of screening is done by the blood banks in India?

Ans. It is mandatory for all blood banks to collect blood donations only from healthy, volunteers. At Jeevan Blood Bank all donors are subjected to a complete pre-donation evaluation. Prior to donation, donor blood is tested for ABO group (blood type) and Rh type (positive or negative).

Screening tests are performed for Hepatitis B (HBsAg and Anti HBc), Hepatitis C (Anti HCV), HIV 1 & 2 (HIV Antigen & Antibodies), and Leptospira (IgM antibody) by ELISA Test, Malaria by Chromatography, Syphilis and SGPT (Photometry)

In addition Jeevan has also implemented Nucleic Acid Test (NAT), approved by FDA, to detect viral DNA/RNA in donor blood for Hepatitis C, Hepatitis B and HIV1. NAT is the most sensitive form of testing available in the world that tests the DNA/RNA of the blood unlike testing antibodies or antigens in blood as is usually done. The window period where viruses could be in the blood but don't show up, is considerably reduced.

Ques. How has technology helped blood banking?

Ans. Advanced technology has helped faster connectivity in procuring information about availability of blood in emergencies. Jeevan Blood Bank has a tie up with AirTel communications network wherein a person who needs blood has to just punch the number 960097000 and the blood group needed and within a minute complete details of the blood group's availability will flash on the screen. Online registration also facilitates more blood donations. Technology has also helped improve methods of screening and storing of blood.

Ques. Is there anything Medindia can do to promote Blood donation - we already have an online blood donor's registry?

Ans. A leading health portal like Medindia can sensitize the public about the need to donate blood because the demand for safe blood for transfusion never stops. A frequently updated registry that records and keeps track of donors willing to donate blood twice a year would serve the cause effectively. You can also periodically flash news and information about local blood donation camps in order to remind people that the least they can do to save a life is to step out and give blood.

I am looking at a time when more such facilities with online registration for blood donation can pool in their information to arrive at a central database that provides an accurate list of serious, altruistic blood donors who can donate repeatedly to help maintain a steady supply of safe blood.

Ques. Why is there not a centralized information center in India which tells us which blood bank has what stocks, so that in an emergency this information an be used to procure blood and save time?

Ans. A centralized information database is still a pipe dream because there is unfortunately no unity among those involved in dealing with blood transfusion services. It is of serious concern that even non governmental agencies (NGOs) are reluctant to join hands in terms of standards, tests and technologies and sharing information in one platform. There is a certain unhealthy competition in this area and there is a crying need for all those involved in procuring and supplying blood to unite and work together for the common cause of ensuring the availability of safe blood to save lives.

Ques. Has Jeevan any innovative campaign lined up for this year's Blood Donor Day to raise public awareness on blood donation?

Ans. Jeevan Blood Bank along with Ad Club Chennai set off a competition among all ad agencies in Chennai to put up the best posters to create awareness on voluntary blood donation. In India we have earmarked yet another date i.e. October 1, each year to promote blood donation. We have many campaigns and promotional activities to encourage blood lined up for this year in different phases.

Ques. What are some of the challenges you face in Jeevan blood bank?

Ans. Jeevan blood bank being a non-profit organization there is a fight for survival in terms of generating funds, most of which come from Jeevan's trustees. We have actually a liability of over 32 lakhs accrued over the years and we hope to mobilize funds to address this issue and enhance the performance of the blood bank to serve the community more.

Though there are voluntary blood donors who give their blood free of cost, recipients of the blood have to pay for the blood because of the cost involved for the special bag to carry blood, mandatory testing, additional advanced tests like NAT done to ensure blood safety, processing, storage, purchase and maintenance of expensive equipments, and other overheads that cost money.

Jeevan's dream is to get enough patrons to sponsor blood free of cost to recipients so much so, there would be no "billing section" for blood in Jeevan.

With society getting predominantly consumerist in modern times, where even blood is dismissed as a commodity that can be bought, Dr. Srinivasan underlines the fact that voluntary blood donation is indeed altruistic because it is done to save unseen lives. Gratitude for blood received is so scarce that Dr. Srinivasan has carefully preserved the only 3 letters received from grateful people who wrote to thank for the blood received and the life saved in all the 14 years of Jeevan's existence, supplying 125,000 units of blood. Medindia wishes Jeevan Blood Bank all success and takes this opportunity to encourage people to donate blood and save lives.

Source: Medindia
Thilaka Ravi/L

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