Common myths on blood shortage in India

The article is authored by Dr Parth Sharma, researcher, Ranita De, researcher in Lancet Citizen's Commission on Reimagining India’s Health System and Dr Vaikunth Ramesh.

Devi left no stone unturned to arrange blood donors, at times paying up to ₹5,000 in the black market for one ‘professional’ donor to donate blood for her 25-year-old husband, who was battling a dreadful blood cancer. This so that the bleeding from his bowel stopped. One missed donation is all that took for him to exsanguinate, with the blood parameters that he had, owing to the chemotherapy. She was lucky to have the means to ‘buy’ donors. What do millions of other ‘Devis’ do?

The shortage of blood products has been a major public health problem in India. It is estimated that nearly 12,000 people lose their lives every single day due to the lack of blood products.(Twitter Photo)

The shortage of blood products has been a major public health problem in India. It is estimated that nearly 12,000 people lose their lives every single day due to the lack of blood products. Supporting a population of 1.4 billion, the present blood transfusion service is fragmented with a little over 3,700 blood centres of which about 70% are located in eight states only. As of 2020, 63 districts in India do not have a blood centre. Space crunch and a burgeoning population have led to the establishment of health care facilities without blood centres on their premises, which in turn depend on nearby blood or storage centres for access to safe blood.

Unfortunately, India has one of the largest shortages of blood supplies globally, while several diseases requiring blood transfusions are on the rise. This shortage became even more evident during the Covid pandemic due to reduced transport and social distancing rules, further decreasing the number of voluntary donors. Despite guidelines released by the National Blood Transfusion Council for safe donation of blood, fear and prejudice among donors regarding the possible risk of infection have led to the cancellation of outdoor blood donation drives, further worsening the situation.

A recent study by Joy Mammen, et. al. estimated the shortage to be around 2.5 donations per 1,000 eligible donors which equals a shortage of 1 million units. Blood products are required not only for surgeries but also for patients suffering from various medical conditions causing severe anaemia. At present, the source of donated blood is a combination of voluntary donors and replacement donors. Although professional donors are forbidden by law, they still continue to persist in our system under the guise of replacement donors. Voluntary non-remunerated donors, who donate based on altruism and a sense of doing greater good for the community, unfortunately, account for only 80% of the donors in India.

All fit and healthy people who have completed 18 and below 65 years of age with a weight of more than 45 kgs can donate. Fifteen minutes of your life can add years to somebody else’s life. One unit of donated blood can be used to save three lives. The major factors for blood shortage include lack of awareness, misconceptions regarding blood donation, inadequate infrastructure, and improper storage and transport of available products leading to wastage. Fear of being poked, contracting chronic diseases, and lack of time were identified as the commonest barriers to donation in a study done in Telangana. An interesting observation was that a majority of non-donors simply were "never asked to donate blood". This highlights the need for extensive blood donation campaigns to increase awareness among people, dispel common misbeliefs and motivate them towards contributing to this noble cause.

In this article, we aim to debunk some of these common myths related to blood donation.

Myth #1 - Donating blood is painful and time-consuming.

Fear of needles and pain is one of the commonest reasons why people do not donate blood. A local anaesthetic medication is given prior to poking, which significantly reduces the pain, which is minimal and short-lasting. The entire process of blood donation, including the check-up, takes an hour with blood donation taking about 15 minutes only.

Myth #2 - I could contract long-standing infections if I donated blood.

Blood donation is a controlled process with extensive use of disposable needles, bags and sterile procedures; therefore, one cannot contract an infection while donating. This is especially true in context of the ongoing pandemic, where one can safely donate blood while following necessary safety protocols.

Myth #3 - People on medications cannot donate blood.

Not all medications that you take, bar you from donating blood. One should consult with their doctor to check if they are eligible for donation. Here is a list of a few medications to keep in mind before you donate blood, which are timely updated.

Myth #4 - Donating blood makes you weak and sick and can lead to infertility/impotence.

Healthy eligible donors are not at any risk due to blood donation. The body normally replaces the donated blood cells with new cells within 6-8 weeks. Regular work can be resumed following donation but experts advise avoiding heavy work. There is no evidence that suggests frequent blood donation could lead to infertility or impotence.

Myth #5 - People with tattoos and piercings cannot donate blood.

Blood can be donated if tattoos and piercings are done in safe and licensed parlours. If not, then blood can be donated after a wait of three months, as advised by the American Red Cross society.

Myth #6 - People with diabetes and hypertension cannot donate blood.

As long as your disease (diabetes or hypertension) is under control with no complications and no recent change in medication, you can donate blood. People on insulin and with organ dysfunction should permanently defer blood donation. The attending doctor or nurse should be alerted if symptoms such as dizziness or light-headedness develop during the donation.

Myth #7 - There are enough donors and I can always buy blood and blood products.

There will never be enough donors. To meet the ever-expanding need for donors, hospitals rely heavily on replacement donations. The shortage has led to professional donors, which although illegal is a common approach to get blood products in most parts of the country, posing additional risks of infections to patients.

Myth #8 - I can only donate once a year.

Blood can be donated every three months by males and everyfour months by females. That means, three to four donations a year if you are healthy.

Myth #9 - One cannot donate blood if they are vegetarian or if they smoke and consume alcohol.

Lifestyle choices like alcohol consumption, smoking, and being vegetarian do not bar you from donating blood. However, donors are advised not to consume alcohol a day before and after donation as it can lead to dehydration. The donor should always inform the doctor if they use any recreational drugs.

Myth #10 - Patients with thyroid disorder cannot donate blood.

People with benign thyroid disorder with normal blood thyroid hormone levels can donate blood. Defer blood donation if under evaluation for a thyroid disorder or if thyroid hormone levels are abnormal.

Under the Ayushman Bharat Digital Mission, the e-Raktkosh app helps donors to locate nearby blood centres, blood donation camps and check blood availability. If you come across any blood donation camps or drives being conducted on common social media platforms, you can do your bit by volunteering and passing on the message to others to help them do the same.

The article is authored by Dr Parth Sharma, researcher, Ranita De, researcher in Lancet Citizen's Commission on Reimagining India’s Health System and Dr Vaikunth Ramesh.