DONOR DEFICIT

Giving blood, when someone is ready to give their blood freely to save an unknown person's life, is a shining example of human compassion. Blood donation has a long tradition, but recently many warnings have sounded of a catastrophic shortage of donated blood. This is because of a steep fall in the number of people wishing to give blood, especially young people.

Specialists say that less well-off people are the major blood donors. Worrying information is cited about a decline in the health of donors. There has been a significant increase in the number of cases in which offers to give blood have been declined on medical grounds. 

The demand for blood remains and the problem of blood donation is now more topical than ever.  Patients need blood when they undergo various types of surgery, especially amputations and cardiac surgery, and women need blood during childbirth. Sufferers from thalassaemia and haemophilia cannot survive without regular transfusions, which they will need throughout their life. 

Cancer patients also need donated blood. Although a diagnosis of cancer was practically a death sentence in the past, nowadays more and more oncological diseases can be treated. Modern treatment for malignant tumours is impossible without blood transfusions - cancer is treated with chemotherapy which kills the tumour and restricts the production of blood within the body. Transfusions can be required even daily and for more than a month at a time. 

Around 30,000 blood donations are made in Azerbaijan every year, which is a minuscule amount. It allows us to say that there is now a real lack of blood donors in our country.

Is giving blood good for you?

It's not possible to give the exact number of blood donors in Azerbaijan, as only the number of donations is calculated, and some donors give blood several times a year, Dr Azad Haciyev, director of the Haematology and Transfusions Scientific Research Institute, said. 

"After the collapse of the USSR there was a sharp drop in blood donations across the former Soviet Union. At present around 30,000 blood donations are made in our country every year, but this is nowhere near enough and we need a large number of donors. For comparison, in the Soviet period 170-180,000 blood donations were made every year in our country, while the figure barely reaches 30,000 today, which represents a six-fold drop.

"Our institute has a centralized database of donors. This is the first time that this type of network has been set up in Azerbaijan inside a blood bank. The Norwegian government helped us to do this as part of their humanitarian assistance to Azerbaijan. Donors can come to the institute of their own accord and sometimes we get together teams of volunteer donors in state and private institutions, religious organizations etc. Our institute has a publicity department which works to bring in donors. There are no donors without publicity campaigns and that's no exaggeration. Publicity has to explain that giving blood is completely harmless and even has health benefits. Giving blood is seen as honourable abroad and blood donors are greatly respected in society. Unfortunately, this is not the case in our society. We have signed a memorandum of cooperation with the Board of Muslims of the Caucasus in order to ensure blood supplies for thalassaemia patients and another memorandum with the Red Crescent. 

"We should note one characteristic of our people, which is their readiness to respond in emergencies and to help people in trouble. Remember 20 January when people wanting to give blood to help the victims queued outside the Haematology Institute. Moreover, many give blood for their relatives, who may need it for various reasons.

"The shortage of blood is especially acute during summer and the religious fast during the holy month of Ramadan, as people are weaker during this period and it is better not give blood at this time for medical reasons."

Before giving blood, a potential donor is interviewed by a doctor, Dr Haciyev continued. Their blood pressure is taken and their haemoglobin count is measured, as sometimes a person may feel perfectly well, but not in fact be healthy.

"After the interview the donor fills in a form, drawn up on the recommendations of our Norwegian colleagues, which shows what illnesses the donor has suffered," Dr Haciyev said. "With the best of intentions a doctor cannot examine someone absolutely thoroughly in just a few minutes, so they have to trust the donor to some degree. I should say that under new legislation a donor bears responsibility for giving false information. After the blood has been taken, a small amount is placed in a special test tube and sent for examination to the laboratory. The blood is quarantined until the results come back and then it is either given to patients or rejected. Throughout the world and here in Azerbaijan blood is tested for four main infections: HIV, syphilis, hepatitis B and C. We also sometimes test blood for malaria, as there are quite a few sources of this disease in Azerbaijan." 

Does the popular view that giving blood has health benefits have any real foundation? "Of course, it's absolutely true," Dr Haciyev replied. "If a healthy person regularly gives blood, their organism is renewed which has a positive effect on well-being. This can be explained by the fact that the organism takes every instance of giving blood as a loss of blood and then begins to stimulate the bone marrow and all the cells, as a result of which blood is rejuvenated. The interval between giving blood must be at least two to three months."

The doctor said that donors can have different motivations. Altruism is the main reason why people give blood. "I was impressed by the blood donation service in Iran. There people queue in order to give blood; we are still a long way from this in our culture of blood donations."

Giving blood for free or a fee?

The director of the Institute for Haematology and Transfusions said that blood donations can be both free of charge and for money in Azerbaijan, but specialists prefer donations made free of charge. 

"In 2005, when the new law on giving blood and the blood service was passed, this issue was fiercely debated and suggestions were made that Azerbaijan should follow the example of many countries and stop paid blood donations," Dr Haciyev said. "Free donations are justified on many grounds. A person who does not mean well will never come to give blood for free. A free donor will never hide what illnesses they have suffered, as they have no material interest in giving blood, which cannot be said of the paid donor. For example, it's very difficult to find HIV in the blood soon after infection, as the virus has an incubation period. Regular donors are preferred, in other words people who have proved themselves to be reliable, and people with a stable social status. Going back to paid donations, I would like to say that if someone gives blood for money, this shows that all is not well financially and this person is not in a stable social position. Most of the paid donors fall away and this happens for the simple reason that many are not in good physical health. We have come to the conclusion that it's not possible at present in Azerbaijan to do away with paid donations completely, as crises could arise at any time when blood is needed urgently for transfusions."

As for the age of blood donors, the upper age limit for donors has been raised to 65, in line with Council of Europe recommendations, while in Soviet times the age limit was 60. The lower age limit has remained unchanged - 18.

"In the Soviet era an employer was obliged to give his employee time off to give blood. Now, however, it all depends on whether or not the employer wants to give time off, but according to the law a donor has the right not to go into work on the day that they give blood," Dr Haciyev said.

Is it safe to give blood in Azerbaijan, as the media often carry reports of children being infected with such terrible diseases as HIV and hepatitis by donated blood? Dr Haciyev said that this is all just rumour. If they had any real foundation in reality, such incidents would have been publicized and those guilty would have suffered severe consequences. There have been incidents in different countries - in Russia, Kazakhstan and France - and they were tackled at the state level. For example, blood was taken from prisoners in France and without any preliminary laboratory checks was given to patients. Fortunately, such incidents have not occurred here, and this is not just because HIV is less prevalent in Azerbaijan than in many other countries.

"The many children in our country suffering from haemophilia or thalassaemia who are now carriers of hepatitis were infected before the laboratory testing system was introduced," Dr Haciyev said. "Several years ago we used glass containers; we did not have special packs for collecting blood."

The problem of the safety of donated blood is acute worldwide, not just in Azerbaijan. Initially, different chemicals and equipment were bought with humanitarian aid from different countries. In 2005 the Norwegian UN assistance programme finished and the state programme "On donating blood and its components and the development of the blood service" came into effect. Thanks to this programme, all the necessary equipment is now available, but there are not enough donors. "The insufficient number of donors is not just a problem for our institute but is a state level problem, and until we realize this, the serious issue of the lack of donated blood will remain. People must be reminded that they do not need to carry out superhuman acts in order to save lives, it is enough to go to the clinic and give blood," Dr Haciyev said.