Dr. Shyam P Lohani

Blood transfusion is crucial for healthcare to save lives and improve the health of millions. A vital step in the management of many clinical problems is blood donation for transfusion. The two primary indications for blood transfusion are anemia and acute blood loss. Blood donation is also used primarily for treating a small subset of medical conditions.
Worldwide, about 118.4 million blood donations are collected. Of the total donations, 40 per cent are collected in high-income countries having only 16 per cent of the world’s population. It has been estimated that about 13,300 blood centres in 169 countries report collecting a total of 106 million donations.
A WHO report (2020) revealed that collections at blood centres vary according to income group. It was found that in a blood centre, the median annual donations were 25,700 in high-income countries as compared to 9,300 in upper-middle-income countries, 4,400 in lower-middle-income countries, and only 1,300 in the low-income countries. The same study showed gender variability that globally 33 per cent of blood donations are given by women. In a few countries, less than 10 per cent of donations are given by female donors (WHO, 2020).

Blood group
There are four different blood groups: A, B, AB, and O. Each of which is either Rh-positive or Rh-negative. Blood group “O” negative is considered as a universal donor, and AB as a universal recipient. Moreover, it is always advisable to match the exact blood type to prevent transfusion related hazardous reactions.
During a regular donation, around 470 ml of whole blood is withdrawn at a time which corresponds to about eight per cent of the average adult’s blood volume. The body replaces the donated amount within 24 to 48 hours, and also replenishes red blood cells within 10 to 12 weeks. Donors must meet certain broad criteria that s/he must be healthy and not suffering from a cold, flu, or other illness at the time of donation. The donor should be aged between 18 and 70 years, weigh at least 50-kg, have a normal temperature and blood pressure. Blood donor should also meet guidelines developed to protect both the donor and the recipient.
Donating blood has benefits for both emotional and physical health. It also helps others produce many psychological benefits such as reduction in stress, improvement in emotional wellbeing. It also results in physical health benefits. It not only helps donors get rid of negative feelings, but also provides a sense of belonging, and reduces the feeling of isolation.
A trained person such as a staff nurse or health assistant performs the physical check-up. They will check pulse, body temperature, blood pressure, and hemoglobin levels. This mini-physical check-up can offer excellent insight into donor’s health. The physical exam can effectively detect problems that could indicate an underlying medical condition or risk factors for certain diseases. Blood donation is most often safe for healthy adults as there is no risk of contracting the disease. For each donation, sterile and disposable equipment is used. However, few people may feel nauseous, lightheaded, or dizzy after donating blood. Even if this happens, it should only last a few minutes. This can subside by lying down with feet up for some time.
There are a number of reasons why donating blood is important besides saving lives. A single donation can usually save up to three lives. Similarly, one blood donation provides different blood components that can help up to three different people. In spite of medical and technological advances, blood cannot be made, so donations are the only way we can give blood to those in need. Blood is needed every two seconds somewhere in the world.
Way forward
The blood donation procedure is safe and relatively painless, thus, healthy adults who meet donation eligibility criteria are able to donate blood. Blood scarcity is a challenging problem throughout the world. In Nepal, the nationwide blood collection was 262,439 pints while the supply stood at 344,933 pints in the fiscal year 2017/18 (NRCS, 2018). Despite a huge collection of blood from voluntary donors, a significant number of blood supplies is still needed. This shows that there is a gap between annual demand and supply of blood.
There are chronic shortages of safe blood and blood products in many countries around the world. Therefore, blood transfusion is not available for a substantial proportion of the world’s population. It is important that the number of people who are willing and eligible to donate their blood must increase.
The Voluntary Blood Donor’s Association, Nepal is contributing commendably to meet the demand for much-needed blood in our country. As compared to high-income countries, more young people donate blood in low- and middle-income countries. Therefore, people from other eligible age groups should be encouraged to donate blood voluntarily. Also important is to encourage more females for voluntary blood donation as there is a gender disparity.

(A Professor, Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)