Curbing blood black market

Busting of an illicit blood-selling racket in Gauhati Medical College and Hospital (GMCH) could be the tip of the iceberg. Touts running similar rackets in other hospitals in the state cannot be ruled out without a thorough investigation. The demand-supply gap in blood banks in the state, coupled with a lack of awareness on voluntary blood donation, has allowed touts to run such rackets, extorting money from patients and attendants seeking blood for transfusion. Alertness of blood bank staff at GMCH led to busting of the racket as they found that one of the two blood sellers was confirmed to be HIV positive during screening. While such alertness reassures patients and their attendants of the strict safety protocol being followed at GMCH for accepting blood for transfusion, investigators exploring all angles, including an unholy nexus between hospital staff and touts, is crucial to ensuring that all mandatory tests are performed at all blood banks in the state. The blood bank policy formulated by the National Blood Transfusion Council stipulates that there should be at least one blood bank in each district. The blood banks are mandated to update the daily stock position of blood in the e-RaktKosh portal. Touts selling blood at Rs 2,000 per unit to attendants in GMCH speak volumes about ignorance among the people about the blood availability in blood banks in different hospitals and lack of awareness about the portal. Lack of awareness among the people about the provisions of the national blood policy is one of the reasons behind the illicit business of selling blood to needy people. The policy prohibits the sale and purchase of blood, stipulates that blood donation must be 100% non-remunerated, and there is no coercion in enrolling replacement donors. It also envisages gradual phasing out of replacement donors to achieve a 100% voluntary non-remunerated blood donation programme by encouraging replacement blood donors to become regular voluntary blood donors. “A Handbook on Blood Centre Practices in Assam,” published by the Department of Health and Family Welfare, states that recruitment and retention of voluntary donors is the key to a safe and sufficient blood supply. The goal to be achieved is a panel/registry of repeat donors who are well informed, committed, and regularly screened for markers of transfusion - transmissible diseases, it adds. It further states that “one key secret of the success of blood donor recruitment is to go to the donor, rather than expecting the donor to come to the blood centre.” The requirement of blood being much more than availability in blood banks, replacement donors, who are mostly family members, friends, or members of voluntary blood donation groups, account for the majority of blood donors in the state. For some critically ill patients requiring many units of blood or blood components, getting replacement donors from among family members or friends often becomes difficult. While people having access to the internet can seek help requesting for replacement donors through social media networks, often poor and marginalised people not aware of the blood bank procedures fall prey to touts and end up purchasing blood from blood sellers. This is not the first time the existence of a black market of sale and purchase of blood has come to light in the state. This implies that awareness of blood donation rules could not be built to achieve a key objective of the national blood policy—phasing out replacement donors. Hospitals need to put in place strong monitoring mechanisms against touts and blood sellers. Easy availability of blood for attendants of patients who do not have relatives or friends in the city or town where the hospital is located is crucial to saving lives. Hospitals will have adequate blood stocks only when their blood banks get blood donations regularly from healthy donors who voluntarily visit the hospital every three months to donate blood. For some replacement donors, often family bonding or friendship are crucial factors to come forward for blood donation, but they may not be keen to become a regular voluntary blood donor. However, examples of voluntary blood donation can motivate youth to come forward and take part in blood donation camps if they are presented with all necessary information about how it can save the lives of needy people. Explaining the safety protocols, procedures associated with blood requisition in detail to participants in voluntary blood donation camps is essential to motivating them to become regular blood donors. Educational institutions, panchayats, and municipal authorities can play the lead role in spreading awareness about blood donation as they can reach out to wider sections of society. Blood banks ensuring transparency on available stocks and requirements will motivate these institutions to voluntarily fix targets to gradually increase the number of voluntary donors for the nearest blood bank. States having more blood banks is a must to cater to the increased number of voluntary donors.