While doing a feature on the helicopter rescue squad of the Dubai police a couple of years ago, I witnessed two major road accidents on the same day.
The victims were airlifted to the Rashid Hospital Trauma Centre almost immediately. As there was no time to complete even the paperwork, they were wheeled straight into surgery.
Mohammad, a labourer from South Asia, was one of the victims. Trapped in the innards of the mangled car, he was gently and expertly extricated from the vehicle at the crash site but the accident had taken its toll. His forearm was beyond repair and had to be amputated. The extensive surgery called for more than 10 units of AB positive blood.
John K, a businessman from Eastern Europe, was involved in another accident, which necessitated brain surgery. An extremely delicate and complex operation, John required 15 units of O positive blood.
Luckily for both, the hospital managed to arrange nearly the full volume of the blood types, the shortfall being collected from the Blood Donation Centre at Al Wasl Hospital and from the blood donations of the relatives.
It is no exaggeration that both John and Mohammad were saved by blood.
***
Outside the Thalassemia Centre in Al Wasl Hospital, 7-year-old Razia chuckles with pleasure as she plays with her toys awaiting her turn for blood transfusion. Two years ago, Razia's parents discovered that she was suffering from Thalassaemia Major (a genetic disorder that results in haemoglobin deficiency, which leads to anaemia and requires the patient to undergo regular blood transfusions). Without her regular dose of haemoglobin-rich blood, Razia would not likely live long.
***
From the simple ouch of seeing a drop of blood being drawn by a kitchen knife to the unimaginable agony in life-threatening situations of trauma and pain, where blood can be a life-saver, this red liquid that popcorn westerns have ketchupified beyond ridicule is the stuff of life. In many societies the collective health of its people depends a lot on a rather less understood concept - the presence of a good number of blood banks and, more important, blood donors.
While the larger picture of blood banks, healthy reserves and management is rather an academic arena to fully comprehend, the simple truth that works for you and me is that to make Razia smile, you need to understand an even simpler truth. If you are cleared as a donor, your donation could make a big difference to her quality of life.
Here is some more simple maths: every unit of blood (480 to 500ml), which is roughly a pint in measure, can actually save three to four lives. Donating blood transcends barriers of race, culture and status. There is a need for blood every two seconds of the day in hospitals. Every day events pounce on people and make them lose blood - accidents, life-saving surgeries, rare genetic disorders… Each of these situations requires the life-saver, blood.
Blood donation is, therefore, not a well-intentioned whim nor should it be postponed till it becomes a desperate act of help. It also has nothing to do with generosity or grandiosity. It is a simple humane act that should be a part of every individual's life to keep society and people healthy.
So have you donated blood this month? If you haven't, find out how you can and why you should.
Friday spoke to Dr Laila Mohammad Al Shaer, a consultant molecular haematologist and head of Dubai Health Authority's (DHA) Blood Donation Centre (BDC) at the Al Wasl Hospital complex, to spell out blood facts for you.
First let us understand how and why we need blood.
Blood chemistry
What is blood? Lexically speaking blood, the viscous scarlet liquid that courses through our hearts, arteries, veins, capillaries and pounds through every organ is a living tissue that transports all kinds of nourishment, antibodies, hormones, electrolytes, heat and, above all, oxygen to every tissue of our body. Therefore every drop counts. When you donate whole blood it is divided into four components, namely:
Red blood cells
These contain the iron protein called haemoglobin that carries oxygen to our tissues. A couple of drops of blood contain a billion red blood cells. The shelf life of RBCs is 35 to 42 days after donation. RBCs can be treated and stored for up to ten years.
Platelet
It is the small blood component that helps with the clotting process by sticking to the lining of the blood vessels. It is generated in the bone marrow and survives for nine days in our body and only five days outside. For every 600 red blood cells, there are 40 platelets. These are required by patients undergoing treatment for leukaemia.
Blood plasma
This is the liquid protein content of our blood in which the RBCs, WBCs, and platelets are suspended. Plasma also contains albumin (a protein), fibrinogen (clotting factor) and globulins (antibodies). It has a shelf life of one year.
Cryoprecipitate
This is yet another protein component that's harvested from the plasma and is a primary source of clotting factor VIII used in haemophiliac patients. When you donate a unit of blood, it's separated into its respective components using the centrifugal technology and used in at least four cases of transfusion.
The need of the hour
The need for efficient collection of blood is ever increasing and the government holds the importance of well-run blood banks and a coordinated distribution of blood as a top health priority.
Dr Al Shaer clearly emphasises these needs as she spells out the working of her centre and points out that the Blood Donation Centre in Dubai has been in existence for more than 20 years and accounts for more than 50 per cent of the total blood collection in the UAE. There are four more centres located in Sharjah, Abu Dhabi, Red Crescent, and at Al Ain.
"The health of a society is directly linked to the amount of healthy blood stored in banks around the country," says Dr Al Shaer, impressing on the rising needs of our city.
"There are so many incidents happening around the city and the requirement for blood transfusion is so high. The minimum amount of blood required for a road accident victim is at least 50 units, for a severe burn case we require at least 20 units of platelets, a thalassaemia patient requires two to three units every three weeks or so and an anaemic patient requires several units of transfusion every month. Similarly, there are demands from patients undergoing radiation who require 120 units of platelets and about 20 units of red blood cells each month.
"Then there are rare genetic disorders like haemophilia that require specific blood components. Besides that, there are numerous regular surgeries being conducted in city hospitals every day which require several units of blood and varied components. We don't encourage paid donations. Blood is a component that cannot be manufactured and we have to be sure of collecting safe blood and for this reason we always insist on voluntary donors."
The needs of the society are always increasing. The BDC's annual report points out that in 2001 the requirement for donated blood was 17,660 units while in 2008 it rose to 33,103 units.
The centre expects the figure to increase for 2009 and will only know how much has been used at the end of the year. Of the total blood donated in 2008, nearly 48 per cent went to the thalassaemia unit, Rashid Hospital required 23 per cent, Dubai Hospital required 14 per cent, Al Wasl Hospital required 10 per cent and about 5 per cent went to private hospitals.
The centre has to constantly look at augmenting its reserves and trying to have at least two camps per day.
"Our daily target is 150 units per day. We plan our monthly time table and make advance bookings," says BDC's campaign organiser Nadia Kalantar.
She contacts companies and other academic and commercial institutions, organises educational seminars to disseminate information on the importance of blood donation, dispels myths people have about donation and tries to get these groups to collectively run a campaign at their premises for at least 70 people aiming at collecting one unit of blood per person.
Besides this, the centre maintains a large database of donors, especially when they require a specific blood group. There are about 60,000 donors in their database. In cases of rare blood types, this helps them contact specific donors.
"Every morning we get an idea from various hospitals about their requirement for the day and also check our stocks. In summer, especially during Ramadan, our studies indicate that there is always a shortage of blood. It is in these months when our blood donation camps whittle down due to a large number of people being on vacation or unable to donate due to fasting. We then get into our database and request donors to come forward to meet our targets for those months."
Dispelling myths
There are many misconceptions people have about blood donation. Many believe that donating blood will weaken them and cause a permanent deficiency in their body. Dr Al Shaer says that it is imperative to educate people that blood donation actually helps the body regenerate its blood cells because the bone marrow is stimulated to produce more blood cells.
"There are eligibility criteria [mentioned later] and those who qualify can donate whole blood once every 56 days, which allows plenty of time for your red cells to be replenished. Our body contains about 10 to 12 pints of blood and when you donate one pint, it is replenished immediately. Platelet donors may donate more frequently, as often as once every 7 days and up to 24 times per year. This is because the body replenishes platelets and plasma more quickly than red cells.
"Platelets will return to normal levels within about 72 hours of donating. Plasma [the liquid portion of your blood] will return to normal levels within a couple of days. Red blood cells [the oxygen-carrying cells] will take approximately two weeks to reach their normal levels.
"If you donate once every two months, you don't lose anything. In fact you're reducing the iron load in your body and too much iron is known to damage the heart and circulatory system. In any case if you don't donate, most blood cells that are generated in the bone marrow end up in the spleen and are eventually flushed out. Your act of donation can use the same blood cells to donate life to someone.
"As a donor you receive a free mini-physical health check once every two months when you donate blood because the screening procedures are stringent. You will have your temperature, iron levels, blood pressure and pulse checked in order to protect your health and well-being. Also a variety of screening tests to rule out infectious diseases are carried out.
"You burn about 650 calories by donating one pint of blood."
Dr Al Shaer also explains that in some cases where only platelets are required, they conduct a selective transfusion called apheresis. In this case, the donor's blood is put through the apheresis instrument where it separates the platelets and returns the rest of the components to the donor.
"Platelets don't have a long shelf life. They survive for barely five days and that is why we request such donors to donate platelets only as and when there is a need for them. There is no point storing platelets as they cannot be used after five days," she says.
Dos and don'ts for blood donors
Dr Al Shaer also provides a list of ideal donors and those who may be deferred temporarily or permanently from donating blood.
Those who can donate blood should:
Be between the ages of 17 and 60
Have a minimum weight of 45kg
Not have donated blood in the last 90 days
Not be suffering from any infectious diseases, influenza or taking antibiotics
Those who can never donate their blood are:
Hepatitis B and C patients
HIV positive patients
Diabetics who are insulin or pill dependent. However, those who can control sugar levels through diet and exercise can donate
Alcoholics and drug addicts
Then there are temporary deferrals on people who:
Have had dental work done in the last five weeks
Are taking antibiotics
Have smoked or consumed alcohol in the last 72 hours
Have had tattoos or ear piercing done in the present year
Pregnant women
Anaemic patients who can replenish their haemoglobin can come back for donation later
"In general we encourage those donors who have a healthy lifestyle, stay away from junk food, soft drinks and so on. We always insist on complete honesty and transparency from our donors and go through a detailed examination before accepting blood. Besides that the blood we receive is screened for all kinds of infectious diseases under stringent conditions," says Dr Al Shaer.
When you visit a camp for donation, you should have:
Had plenty of fluids
Eaten nutritious food
Had a good night's sleep
Refrained from smoking or drinking
At the centre, they'll register you as a donor, take a quick medical history, do a medical examination, get you to donate and finally provide you with a place for brief rest and some refreshments to replenish your energy.
After donation
You must continue to lie on the bed with your feet raised above the level of your body for ten minutes
Leave the bandage on for four hours
Drink extra fluids for the next three days, especially the first four hours after donation
Have a protein-rich diet and rest, which means not taking extra stress of work or driving
If you're willing to barter some momentary discomfort for a lifetime satisfaction of doing your bit to save lives, call 04 219 3221 to volunteer for blood donation or contact campaign organiser Nadia Kalantar on nkalantar@dha.gov.ae to organise a donation camp at your office. You can visit www.uaedonors.com for more information about blood donation in the UAE.
After donation
You must continue to lie on the bed with your feet raised above the level of your body for ten minutes
Leave the bandage on for four hours
Drink extra fluids for the next three days, especially the first four hours after donation
Have a protein-rich diet and take adequate rest, which means not taking extra stress of work or driving a vehicle
