Lack of healthy blood donors causing unnecessary deaths

A severe shortage of blood is having an impact on health care in Kyrgyzstan and in particular on maternal mortality, the government says. The son of Marina Tshai, a young designer from the Kyrgyz capital, Bishkek, could have been an orphan today if his mother hadn’t received a blood transfusion after giving birth to him. His mother urgently needed blood and not a single hospital in the city had the required type, even though it was from a common group. Her relatives reverted to radical measures to obtain the blood: they put out an urgent request on local radio in order to find a donor. Over the past 15 years, the number of voluntary blood donors in the Central Asian republic has decreased more than five times, according to the National Blood Centre (NBC). In a country of 5 million people there are only 600 regular donors. “In 97 percent of cases, the donors are relatives of the patients. We are constantly in need of all types of blood groups and very short of the rare types. It’s even worse when we have to look for blood with rhesus negative. It’s a disaster because Asians rarely have this type of blood,” Sagynbek Abazbekov, NBC director, said. In the northeastern town of Kara-Kol for example, hospitals report they are chronically short of certain blood types: the impact on maternal mortality is devastating, the government has said. In May, Deputy Prime Minister Adahan Madumarov said that 82 out of every 100 women who died while giving birth could have been saved by timely blood transfusions. After the collapse of the Soviet Union in 1991, the new government was slow to take over the national blood donation programme. Previous donors fell away in their thousands, citing concerns over safety and the slashing of the US $10 fee paid per donation during Soviet times. Maya Saifudinova, a Bishkek cleaner, used to give blood during the Soviet years. “Then we had pride in the health services and we wanted to help people,” she said. Now she is afraid that local nurses with low qualifications will give her some kind of infection and complains that donors today do not receive any remuneration. The centre pays those who give blood less than US $1 per session. “It’s a very small amount of money, but it’s all we can offer,” Abazbekov explained. It’s not as if there are no advantages to giving blood apart from the knowledge that you have helped someone in need. According to Kyrgyz law, people who have donated blood 45 times receive the title of “honorary donor” and are entitled to priority at state medical institutions, free public transportation and can buy drugs for half their normal price. Ramazan Jhuzumaliev, a 56-year-old honorary donor who has donated blood since 1968, told IRIN that although he is called to donate every month, he does not receive any benefits. In hospitals and pharmacies, nobody acknowledges his status by offering discounts. “They look surprised when I demand it,” he said. There are about 2,500 honorary donors in the county. Most are retired people who used to donate blood during Soviet times. They are growing old but are not being replaced by younger donors. Aiganysh Satybaldieva, in charge of recruiting new blood donors at the NBC, is concerned the country is at risk of having dangerously low levels of blood in the years to come. “I do what I can, but my budget to bring on new donors is minimal. I shudder to think what would happen if there was a major accident or disaster where large quantities of blood would be needed immediately.” Another problem is the low level of health among the general population in this poor Central Asian nation. Among potential donors, only 10 percent are fit enough to donate blood, according to the NBC. Bishkek municipal workers decided to donate blood to mark International Donors Day recently, but out of 43 people who came forward, only 17 were judged healthy enough to make a donation. Rustam Baigaraev, deputy head of a regional hospital in Talas, 400 km west of Bishkek, said that most donors, including patients’ relatives, come in with a hangover due to widespread alcoholism and their blood cannot be used. Even if it could collect enough blood, the NBC does not have the resources to deliver the life-saving fluid to the regions due to a lack of specialised transport and equipment. “Most of the time we have to split one portion of blood between two patients,” Baigaraev said. In order to save lives, doctors in the regional maternity hospital in the southern city of Osh sometimes transfuse blood from random donors without making a proper preliminary analysis. “We need to perform blood transfusions daily because women in the regions have in general weak health. We need donors, donors and donors! And healthy ones!” said Gulnara Kenzhebaeva, chief doctor of the hospital.