BANGALADESH: Law for Safe Blood From Professional Donors

DHAKA (IPS) - Alarmed by the high incidence of serious infectious ailments spread by contaminated blood, the government of Bangladesh is enacting rules to ensure safe blood from professional donors.

Various studies have found that at least one out of every three patients getting a blood transfusion in the country, picks up a disease that is often incurable.

In the past two months, more than 14 patients who underwent surgery at a big hospital in Dhaka, contracted diseases like hepatitis B and syphilis. Investigation by puzzled hospital authorities found that all had got blood from sick professional donors.

According to the Bangladesh Red Crescent society, about 80 percent of the annual estimated need of 300,000 units (of 450-millilitre bags each) of blood comes from professional donors. However, most of the blood from professional donors is not screened for safety.

Bangladesh also has to be careful because blood transfusion is one of the main ways for the spread of the AIDS virus, say experts. According to World Health Organisation (WHO) estimates, Bangladesh has some 20,000 HIV-infected persons.

A recent investigation found that nearly a third of professional blood donors surveyed were infected with hepatitis B and another 15.8 percent had syphilis.

It has been estimated that unscreened blood from professional donors is exposing nearly a quarter million patients to the risk of contagious diseases every year.

Of the more than 120 bags of blood used by the Dhaka Medical College Hospital (DMCH) every day, 100 are supplied by professional donors, said a DMCH doctor, who did not want to be identified.

This is why the government is going to strictly regulate blood donations in future, says Health and Family  Welfare Minister Sheikh Fazlul Karim Selim.

Selim said his Ministry is preparing a law for this that will be tabled in parliament soon. He also disclosed that the government is setting up modern blood banks in 97 hospitals in the country, with funds from the U.N. Development Programme (UNDP).

These would make it possible to avoid wasteful use of blood that is in short supply by tailoring infusions to the exact needs of the patient, he added.

The government will also train doctors and paramedics to ensure safe blood collection, proper screening of donors, storage and clinical use of the blood, he said.

Health professionals have criticised the government for lacking a policy to discourage commercial blood banks that have sprung up in all cities and towns.

Some clinics have their own blood banks that are known to buy from professional donors at the rate of one or two dollars per unit, while charging patients up to 15 dollars per unit. The price is much higher if the blood group is rare.

A third of the stock of blood banks in nearly 100 hospitals and clinics all over Bangladesh, is contaminated either with hepatitis B, hepatitis C or the syphilis virus, according to Nazrul Islam of the Department Virology, Bangabandhu Medical University.

In most cases, the haemoglobin level in the blood from professional donors is below normal because these people sell blood frequently, he said.

The  hepatitis B virus causes cirrhosis and liver cancer in 10 percent of cases. The hepatitis C virus is more dangerous, causing such cancer in 50 percent of the cases said Islam.  

Medical experts also want blood transfusion practices in the country's hospitals to be updated. Blood has many components and a patient may need only one of these and not 'whole blood'. Most hospitals in Bangladesh still use whole blood in  transfusion.

According to officials of the Red Crescent Society who did not want to be named, whole blood is used in 99 percent of transfusion cases in the country's medical institutions. They compared this to the situation in Thailand where whole blood is used in only two percent of transfusion cases. However, the government says that the new blood banks to be set up with UNDP support will make it possible to ensure that transfusion patients get only the right blood component and not those which he or she

does not need.

According to Selim it will then be possible to use one unit of blood for three patients.

Meanwhile, health professionals have emphasised the need for a vigorous nationwide motivation campaign to encourage healthy people to donate blood. They said that many people wrongly believe that donation of blood is harmful to the donor's health.

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