Blood brokers: A source for needy patients [Archives:2007/1106/Health]

Hamed Thabet
“The job of blood brokers, who can be found waiting outside Jumhury Hospital in Sana'a, is to donate blood for needy patients in return for money via their own methods and process. For example, when a patient requires blood, his friends or relatives go to the blood brokers and ask them for blood,” one doctor at Jumhury Hospital explained.

He continued, “Such brokers go to the laboratory with a patient's friend or relative and pretend that they are the patient's relative, swearing repeatedly in order to convince the doctor that he's a real relative.”

Another doctor comments, “It's illegal to take blood from brokers because donors may only give blood four times a year whereas brokers donate every week, if they get the chance. In fact, by donating numerous times via unhealthy methods, their blood is useless, so instead of helping patients, they become a risk to them.”

Abdulrahman Al-Junaid, head director of Jumhury Hospital's blood bank, notes, “Of course, the doctor doesn't know if someone's a broker. After giving his blood to a patient, the broker receives between YR 600 and YR 1,400.”

However, Al-Junaid adds, “If we see the same individual [broker] again pretending to be another patient's relative, we discover that he's a liar. In this case, they are asked to leave, sometimes by force.”

Another doctor notes, “Very often, those in authority at the hospital, such as doctors and administrators, with one phone call, they demand it, and ask for blood for their friends and relatives who are in the hospital. Blood bank authorities accept their request without insisting upon any type of guarantees from them in turn. The blood is given to them with their promise to replace it, but the truth is that 99.99 percent of the time, they just ignore that.”

Yet another doctor explains, “We sometimes encounter difficult situations, such as when patients immediately require blood in an emergency and the quantity is insufficient, while at the same time, we receive an order from a high authority to give blood to their relative. This is a big problem because we must satisfy both, so we go and ask for more blood, getting it by any means.”

Ahlam Khalaf, general director of laboratories and the blood bank at Jumhury Hospital, further explains, “In emergencies, when an unknown patient comes to us, we just give him the necessary blood in order to save his or her life. Poor people sometimes come and tell us they have neither money to buy blood nor anyone to donate blood for them, so in this case, we give the blood free of charge. Certainly, in some cases, we ask either a doctor on duty or one who knows the patient's situation. If he [or she?] tells us the patient is poor and has no resources, we give the blood directly to the patient. In fact, 40 percent of our blood goes free of charge to those in need and in an emergency.”

She adds, “Even though there's a shortage at our blood bank, we give blood for free to those who can't afford it and are really poor. When patients swear in God's name and say they don't have money, we must believe them and give them blood without requesting any guarantee or making them replace it because in the end, it's our duty to help people.”

However, a source at Jumhury Hospital says, “Doctors and labs contract with clinics outside the hospital and ask patients to do their testing there, which is completely illegal because blood testing must happen at the hospital's blood bank. Doctors do this simply to take a cut of the profits from such clinics.”

The source continues, “When this happens, we can't ensure whether the donated blood is clean and free of disease because these clinics don't care. They don't examine blood properly because patients sometimes are in hurry and have no time to wait. In this case, doctors at such clinics sometimes just write anything on the test paper and let the patient go to the hospital, where the doctor there accepts it without question.”

The same source adds, “When we've asked doctors, 'Why are you doing this because it's illegal to play with people's lives?' they reply, 'It's ok. We trust these clinics, so there's no need to worry. We don't send all patients there, only some. We do that so as not to raise doubt because we must write in the record books whoever donates or receives blood.'”

Khalaf notes, “Many times, we experience blood shortage at our bank. We're sometimes asked to reserve blood for a patient who's scheduled for an operation the following day; however, an unforeseen emergency arises and we must provide that reserved blood for another patient. We then must find blood to cover the operation. Most of the time, patients don't understand when we tell them that we had to do this because someone else needed the blood. They always believe that we sold it.”

She continues, ” Even when there is a blood shortage, we go to other banks, arranging to get it at any cost because it's our responsibility to manage the blood supply or we'll be in trouble.

“In some emergency cases when we need more blood, we go to the bank blood next to Al-Kuwait Hospital or the National Center on Al-Saba'een Street. We'll provide the patient's relative with a letter from the hospital mentioning that the bearer requires blood and to give him what he needs.”

She adds, “Also in times of shortage, we'll go to camps and ask soldiers to donate blood. They like donating because they receive holidays by doing so.

She continues to say “There's neither financial support from the government nor any other authority to improve the blood bank. Moreover, medical equipment is old, outdated and not useful as it must be. Also, the room for taking blood from donors isn't up to required standards.”

She goes on, “It's a known fact that donors must receive special treatment, such as informing them about the process and giving them juice in order to gain energy. However, we don't give them courage to come again because due to being uneducated, upon seeing their blood drained from their bodies, many donors think they're going to die and instead of calming them down by explaining the process to them, they are ignored. For sure, if donors don't receive good treatment, they won't come again and then we'll keep needing blood.

Al-Junaid explains, “We're doing our best for the safety and security of donors' blood and patients, as we must satisfy both parties. There are some basic conditions in order to donate blood; for example, donors should be aged 18 to 60 and weigh 50 to 85 kilograms.

He notes, “Those from countries such as those in Africa are handled differently because of the prevalence of diseases like HIV and malaria; thus, we monitor them more closely than others until we determine whether they carry any diseases.

Al-Junaid continues, “Before accepting their blood, we ask donors background questions, such as, 'When was the last time you gave blood?' and 'Do you have any allergies, especially those of the skin?' Men may donate four times per year, but women only twice a year.

“After inquiring about their background, donors are asked to provide their name, age, gender, address and reason for donating. Most of the time, we perform basic testing before taking their blood, but we sometimes take their blood and then examine it,” he explains.

“After examination, if we discover that a donor's blood reveals some disease such as HIV, syphilis or anything else, we call and tell him or her, 'You have some type of infection in your blood, so please come in for testing again.' When he or she returns, certainly we do another test just to be sure. If we discover that he or she is carrying a disease, he or she is handed over to the authorities in charge of such diseases. Of course, dirty or unclean and expired blood is destroyed immediately.”

Al-Junaid continues, “Sometimes, due to the overcrowding, we just take their blood and test it later because we can't make donors wait four to six hours to see if their blood is usable or not. Because we don't have modern equipment, it takes a long time to perform a test because we must do it the old way.( the blood is not exposed to all tests”

The head director says with satisfaction, “There's no way for a mistake to be made during a transfusion because the blood results and information are written on the front of the bag.”

Moreover, he says, “We use two different refrigerators: one for usable blood that's ready for patients and the other for untested blood. Usable and untested blood can never get mixed with each other because we work carefully to separate them.”

Al-Junaid further comments, “Due to illiteracy and being uneducated, citizens don't know the value and importance of donating blood for others. The media also plays no role in this regard. We suffer many problems at the blood bank, the main one being lack of volunteer donors, who average about four per month. Most donors donate for their friends and relatives. This type averages 200 to 300.”

As an example, 27-year-old Mubarak Al-Abadi was at the Jumhury Hospital blood bank, explaining, “I'm donating because one of my relatives needs blood.”

After finishing and carrying his blood outside, he angrily recounted, “I waited here for an hour before they led me to a small room. The way they took my blood was so bad; however, the worst thing was that once the bag was full, they handed it to me and simply said, 'Take your blood.' I have no doubt that this way of dealing with this is wrong because it's blood! Someone will die if I don't give him this blood, so it must be in good condition.” The donor said.
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