|
Asia Times, June 26, 2002
India: Get your upper-class blood
here
By Ranjit Devraj
NEW DELHI - India's notorious social distinctions based on caste
and class have spilled into the blood donation sector. Even
reputable blood banks now advertise blood that is guaranteed not
to come from the dregs of society.
A pamphlet distributed by the Rotary Blood Bank operated in the
national capital by Rotary International describes the pathetic
situation of blood banking in India. It is marked by acute
shortages, lack of volunteer donors, an unimplemented
six-year-old Supreme Court ban on professional donors and, worst
of all, unscientific social prejudices against certain classes of
donors.
Says the pamphlet, "We understand that a large number of
replacement donors are paid donors. We want to discontinue
clandestine sale of blood. It is well known that several
semi-nourished people, rickshaw pullers, drug addicts and other
people short of money for smack donate blood."
The Rotary International facility was inaugurated in March by Lal
Krishna Advani, home minister in the right-wing, Bharatiya Janata
Party (BJP)-led central government.
The "better" blood offered by Rotary comes at US$18 a
unit, which is twice that charged by the Indian Red Cross Society
(IRCS) that runs the capital's biggest blood-banking facility and
accounts for up to 45,000 units of transfusable blood annually.
Volunteer groups involved with the blood-banking sector say that
in spite of the high prices and socially discriminatory attitude,
the Rotary facility has been accorded the status of a Regional
Transfusion Center (RTC) and granted more than $1 million from
government sources.
Questioned about the about Rotary's maverick attitude, the Delhi
State Blood Transfusion Council has promised action. "We
have told Rotary that they should coordinate with other regional
blood centers and also reduce their prices. If they do not
conform we can withdraw their RTC status," said Dr Bharat
Singh, member secretary of the council.
But rights organizations think that the RTC status accorded so
far to the IRCS Blood Bank and to government facilities should
never have been given to an openly elitist organization like
Rotary International in the first place.
"The Rotary Blood Bank is setting a precedent for the
commercialization of blood banking in a country where the
official policy is that blood should not be traded in," said
Purushottaman Mulloli, convenor of the Join Action Council (JAC),
an umbrella organization for rights groups that focuses on issues
related to public health and HIV/AIDS.
Indeed, it was such a view that was supposed to have guided the
Supreme Court into passing an order five years ago banning
professional donors from selling their blood.
Buying blood from professional donors goes back to colonial times
and was institutionalized during World War II when large
quantities of transfusable blood were required and few Indians
were willing to donate what they considered to be a precious
fluid.
The Supreme Court ban did not appreciably change things and
several volunteer organizations have brought out detailed reports
showing that the bulk of blood available for transfusion
continues to come from professional donors, with the trade going
underground and prices shooting skyward.
Iqbal Malik, who runs Vatavaran, a non-governmental organization
(NGO) that had the trade videotaped and televised three years
ago, says Delhi alone needs an estimated 300,000 units of blood
annually and less than half of that is legally collected by
various blood banks while the rest is still sourced from
professional donors.
The Rotary International pamphlet, apart from outlining social
prejudices, testifies to the fact that dependence on professional
donors is widespread.
Such are the prejudices that last year, when large quantities of
blood were needed for the survivors of the devastating January 26
earthquake in the western state of Gujarat, the IRCS refused to
accept blood from the inmates of the Central Jail. Prison
authorities complained to the National Human Rights Commission
(NHRC) of an attitude that was "highly discriminatory"
toward prisoners as well as "derogatory and in violation of
human rights", but the NHRC upheld the IRCS decision.
That came as a blow to the prisoners because under existing
rules, if they donate blood twice a year they are entitled to a
month's remission on their sentences for that year.
But the discriminatory attitude of the NHRC and the IRCS jibed
with findings of a study conducted by a leading firm of chartered
accountants, A F Ferguson, which opined that professional donors
were mostly poor people, many of whom were likely to be drug
abusers and engaging in unsafe sex.
Said Mulloli: "What is required to be known is that donated
blood is scientifically safe and tested rather than its
antecedents and that when the country is facing severe shortages
of transfusable blood."
Ramesh Sharma, an activist for the influential Gandhi Peace
Foundation, said the real problem was that after the Supreme
Court order the government never cared to carry out an awareness
campaign to remove prejudices and create a reliable cadre of
donors that could be depended on for steady supplies of blood, as
in other countries.
In fact, the National Blood Transfusion Council, the nodal
regulatory body set up after the Supreme Court directive has not
met in the past two years. "Even when meetings are held
nothing seems to move. Many decisions have been taken but most
remain on paper," said J G Jolly, a council member.
A report published by the International Federation of the Red
Cross three years ago on the blood-banking situation in South
Asia noted that several factors in the region "frustrate the
principle of voluntary non-remunerated blood donation".
The report also noted that recruitment and retention of voluntary
blood donors for adequate and safe blood supply presented a
tremendous task that called for a massive communication campaign
aimed at involving all sections of society in building a reliable
transfusion system.
To date no such thing has happened in India, where total
requirements are now estimated to be about 8 million units of
blood while actual availability is about half that figure. It is
not uncommon to read news reports of patients waiting for weeks
to get an operation done or actually having died for lack of
transfusable blood.
At the All Indian Institute of Medical Sciences, the capital's
largest medical facility, doctors look the other way as patients
who desperately need blood make deals with "vampires"
who arrange the "replacement blood" that is sourced
from a network of professional donors rather than from relatives
or friends as approved by existing law.
Volunteer agencies such as JAC expect blood shortages to worsen
as a result of a new policy announced by the government in April
under which blood banks will no longer be allowed to accept
replacement blood from even genuine relatives or friends but must
get supplies purely from voluntary donations.
"This is next to impossible because of existing prejudices
regarding blood and the result will be that India, a country of a
billion people, will have to increasingly depend on imported
blood or blood products that can only help multinationals in the
business," said Mulloli.
Official figures available for the year 2000 show India now
importing annually $540 million worth of blood products, mostly
from France and the United States, and the trend steadily rising.
"In all this no thought is being given to ordinary people
who already cannot afford the prices charged, say, by the Rotary
Blood Bank, or those living in rural areas where there are no
blood banks and a large number of patients depend on unbanked
direct transfusions," said Mulloli.
(Inter Press Service)