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Blood Donations and the Compensation Controversy

Rakhel Mulongeni

Last week the Namibian Blood Transfusion Service (NamBTS) appealed for blood donations.

News headlines said the nation’s blood bank only had enough blood to cover transfusions in the country for two to three days.

A positive appraisal of Namibia’s blood donation service is needed, especially to point out the systemic problems that contributed to the current crisis.

However, news of the shortage led to unhelpful accusations against NamBTS.

Overall, they lacked understanding on how a blood transfusion service operates.

At worst, certain social media users bullied NamBTS and discouraged Namibians from donating, risking losing the lives of Namibians who need transfusions.

Bloody hell – stop harassing the NamBTS.

As members of the Namibian HIV Clinicians’ Society, we would like to address the disinformation that has contaminated the discourse surrounding blood donations.

COMPENSATION

A national blood donation service should not compensate people handsomely for donating.

Blood is a human tissue. Paying a substantial sum for blood, such as “even a N$200”, as cited in one post, would be tantamount to the commodification of human tissue.

This would be unethical.

Granted, there are countries where donors receive non-trivial remuneration, as another social media user noted.

But these countries – such as Nigeria, China and others in Central Asia – are often deficient when it comes to several robust democratic institutions.

Why are EU member states, or Australia or Canada not on that list?

Which countries does Namibia wish to emulate?

Paying N$200 to potential donors would border on coercion in our country, where a large number of the population might donate because they live below the poverty line.

This would be unethical as it ceases to be done out of own volition.

Also, poor people often have poor diets and might develop anaemia or be unable to recuperate the iron lost after a blood donation.

Untoward effects of this include a condition known as pica – remember when pregnant women would crave soil?

This is because of an iron deficiency. Pica, naturally, holds a host of health risks that require no more elaboration here.

BIGGEST RISK

To understand the biggest risk that paying for donations poses, one needs to understand the history of the AIDS epidemic.

In his book, ‘The Origins of AIDS’, Dr Jaques Pepin traces how HIV reached the United States (US).

Evidence points to the collection of blood plasma – the clear component of blood – in Haiti, a country that also sent United Nations peacekeepers to central Africa – where HIV arose; originally a virus jumped from chimpanzees to humans.

In Haiti, American companies paid locals for blood plasma donations.

The demand for plasma from haemophiliacs in the US meant this was a profitable affair for the companies, which further cut costs by not testing donated blood for transfusion transmittable infections (TTIs).

At the time, HIV was a novel virus, yet testing for Hepatitis B was at times accurate.

The result?

A considerable number of HIV cases in the US came from haemophiliacs who received transfusions of plasma contaminated with HIV. 

Since then, blood transfusion services worldwide have developed strict protocols to safeguard against contamination with HIV.

Deferring or barring would-be donors at risk of living with HIV was a common strategy for countries in the Global North.

In the long term, this did not prove effective as donors from these communities would lie about their sexual behaviour on screening questionnaires in order to donate.

Now, blood transfusion services focus on the sexual behaviour of all individuals, regardless of who they have intercourse with.

SAVING LIVES

Paying individuals to donate would upend safeguards.

While NamBTS screens all blood for HIV and other TTIs, the screening and testing comes at considerable cost.

Offering monetary compensation for blood might increase the percentage of donations that have HIV beyond what is sustainable for NamBTS. 

Valentine’s Day is around the corner.

Namibians, go on a blood date and show you are not just in the mood for love, but that your heart bleeds red for other people. That you are ready to save the life of a fellow Namibian. 

  • – Rakhel Mulongeni writing on behalf of The Namibian HIV Clinicians’ Society

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