Blood business in hospitals, regularizing the unethical

I have read and watched the Joy News exposé on how some individuals in our health facilities engage in the corrupt sale of blood to patients and patient caregivers mostly at exorbitant prices.

I encountered this malpractice in the health sector on the very first day I stepped into the hospital arena. I wish to unequivocally state that this practice is unethical and needs to be modified. The process for securing blood must undergo a paradigm shift.

Blood is an important therapeutic product just like medicines that are given to patients in the course of their treatment.

The shortage of blood and blood products at our hospitals and the unethical practices involved in securing blood or blood components, in my view is the cause of our current predicament whereby blood; a priceless commodity is sold out at exorbitant fees and thus allowing for unscrupulous persons to take advantage of the supply gap to do the unthinkable.

Currently, according to the World Health Organisation's Protocol of which Ghana has subscribed to in matters relating to blood transfusions, only voluntary donations and autologous donations are expected to fund the blood banks. The protocol vehemently prohibits the donation for cash and the sale of blood or blood products.

This has been the protocol of the Ghana health systems and it seems to be working well until this recent change in circumstances.

Some years ago, people could even walk up to the hospital and donate blood freely, with the hope that when they or their relatives are in need, such blood donated to the various blood banks shall be used for them, however, the increase in the demand for blood and blood products overweighs the number of voluntary donors.

Hospitals thus encourage patient relatives to help in the recruitment of suitable blood donors during the donation process, but in recent times, that option is also proving not very effective as demands continue to increase but supply through voluntary donations continue to decline, mostly through the following reason:

Inability to get blood for relatives when they are in need. A voluntary donor, who later after the donation is in need of blood but is unable to redeem their ticket, would understandably feel shortchanged and may no longer have any motivation to keep donating voluntarily.

It is noteworthy to state that the increase in demand for blood has resulted in the blood banks no longer acting as banks as they have very few blood units remaining to meet the demand that comes in from several other hospitals that depend on that blood bank.

Fraudulent activities of some Health Professionals: The Fraudulent activities of selling of blood units which were erstwhile donated freely have also contributed to the decline in the number of voluntary donors since many prospective donors see the act of donating blood without remuneration as a way of supporting the supply of blood to the business chain of healthcare staff who could either be Physicians, Medical Laboratory Scientists, Nurses and sometimes non-clinical support staff such as orderlies and security personnel.

Another factor worthy of note is poverty, the rate of poverty in Ghana has forced a lot of people to stop donating blood freely and rather opt to donate for an agreed sum that would be paid, an amount they can survive on.

Lack of empathy: Generally, the level of compassion towards others is on the decline. People do not see the need to donate blood to help save some other person.

Current Practice

Many hospitals do allow for people to donate and get some form of direct remuneration, this practice became necessary because the life-saving agent(blood and blood products) must be made available regardless of the means of its acquisition.

Thus the unethical practice which is a blatant breach of the WHO protocol seems to be the order of the day.
This practice of recruiting donors with financial motivation poses a lot of risks but these risks can be mitigated by dedicated health professionals.
The risks included but were not limited to collecting blood from high-risk individuals such as sex workers, homosexuals, and drug abusers.

The above-mentioned group of individuals is of concern because they could pass initial testing by producing a negative test result for an infectious disease on a less sensitive method and can thus slip through and hence pose a significant health risk to the recipient/s.

The practice of recruiting commercial donors has resulted in the birth of blood deals or blood business syndicates in our hospitals. This is so because the lack of regulation of these unethical acts can only breed a lot more unethical acts.

An example could be an instance where a non-clinical support staff in a hospital brings in a commercial donor to donate at the hospital blood bank, the support staff could thus pay the commercial donor say 120 cedis, such that whenever a patient or a patient relative needs to arrange to secure blood, the support staff acting in concert with some laboratory professionals sell the blood unit for say 300 cedis so as to obtain a substantial return on their investment so to speak.
Hence the cycle continues.

The unethical recruitment of commercial blood donors needs to be regularised. It has become a necessary evil, Ghana will need to make adjustments to the part of the WHO protocol that stipulates that donors do not require any form of remuneration owing to the peculiarity of our situation and of our people, as such people could walk into health facilities, donate blood and get paid a reasonable sum for that service such that blood donation for a fee will no longer be an unethical act.

The Ministry of Health would also have to employ professionals in the hospitals and designate them as blood donor organizers so that they can be in charge of voluntary donations as well as commercial donations.

Once the practice is regularised, the menace of middlemen and people privatizing blood donation would be a thing of the past, distraught patients would not need to face exploitation since there would be fixed prices for blood and those monies would be paid to the health facilities at reasonable fees, so as to restock the bank in order to prevent the shortages.