Blood donation in post-Ebola West Africa

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Copyright: James Meiring. Winner HIFA Photography award 2016

What do wellington boots drying in the African sun have to do with blood donation in the post-Ebola era? Tell you later.

But first, as its World Blood Donor Day on June 14th, lets consider the differences between the blood transfusion services in a high income country like the UK with those in Nigeria or Sierra Leone? How has the Ebola epidemic impacted on these services?  

Blood transfusion services in the UK

I think we in the UK probably take our well-established national blood service(s) somewhat for granted and only really give it a second thought when either we need to call on its use or something drastic goes wrong.

Established in 1946, the Blood Transfusion Service (BTS) in England and Wales employs over 6000 people to collect & process the blood alone. All sorts of rules and practices surround the preparation and distribution and use of that blood. We are very fortunate that over 3% of people in the UK donate that blood (1% being the figure recommended as a minimum by the W.H.O. to meet a populations needs) but even then we get regular appeals for more blood and we still suffer shortages for particular blood groups and platelets.

But, have you ever asked yourself why we need continuing fresh donations of blood and who are the usual recipients of that blood?

In 2014, in England & Wales, the 3 major “consumers” of blood were:

  • 67%, to treat medical conditions including anaemia, cancer and blood disorders
  • 27%, in surgery, including cardiac surgery and emergency surgery
  • 6%,   to treat blood loss after childbirth

The most frequently transfused patient group is over 65 years of age.

100% of the blood donated is voluntary. This is important, as the W.H.O. has declared that the foundation of a safe blood supply is 100% voluntary donation. Blood obtained this way has lower rates of infections and so reduces chances of disease transmission via blood or blood products.

How does this compare with a blood transfusion service in West Africa ?

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Finding a balance between equality and safety in blood donation: the 12 month ban for MSM donors

 Blood-732297_1280 image: Give Blood.
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Our guest blogger this month is Harpur Schwartz, an economics/global health student from Connecticut College, USA.  Harpur is interning with Cabi’s Global Health team, learning how information resources can support public health education programmes.

World Blood Donor Day 2016 [June 14th] is quickly approaching, and this year’s theme will be “Blood connects us all”. The goal is to motivate regular blood donors to continue to give blood while motivating new blood donors to start by showing how patients and donors are connected. With the current blood donation crisis, the worry is people do not understand that they qualify to donate. To clear up any blood donation confusion, many countries like the UK have provided specific guidelines [blood donation rules] for who can give blood. Donors have to wait only four months after getting a tattoo or piercing to give blood and a mother only must wait six months after giving birth. Gay and bisexual men [men who have sex with men] who used to face a lifetime ban in the UK, can donate blood if they have not had sex with another man for at least 12 months. This 12 month rule came into force in 2011 in the UK but has only recently done so in the USA (December 21st 2015, FDA revises donor deferral guidelines). It is the reason why many people in Orlando USA, anxious to donate blood to help their injured friends, are not able to do so (Gay Blood Donation Ban Under Fire in Wake of Orlando Shooting).

I have always been interested in how society is responsible for defining disease, and how once a person is labeled as having a certain disease, it frames their very being. In one of my university classes, we discussed how ‘Disease as framed’ is the way in which a person’s image changes as a result of disease. The example we discussed was AIDS and gay men. With the current blood donation policy, my question is if gay men are still being discriminated against because of their association with HIV and AIDS, or if the policy is based on sound evidence?

There has always been a stigma attached to the gay population in regards to HIV and AIDS, mainly because this was where the disease was first identified. [The story of the discovery of the AIDS epidemic is chronicled in the 1993 film “And the Band Played On”. Attitudes began to change in the USA when Mary Fisher delivered her speech, “A Whisper of AIDS”, at the Republican National Convention that took place in Houston in 1992. As a white female, and mother of two, Mary became a new face for HIV and AIDS. She was not a haemophiliac, she was not gay, she did not inject drugs, and yet she still tested HIV positive. Fisher explained to the world how “…HIV asks only one thing of those it attacks. Are you human?”

The gay and bisexual community are still unhappy with being treated differently. A 12 month ban does not take into account if they practiced safe sex, or have been in a committed relationship for 10 years with the same man. However, the 12 month ban policy is based on research evidence and is supported by numerous countries including the UK, the US, and Australia.

 

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