Beirut, Lebanon: When disaster strikes, citizens are quick to respond to calls for blood donations. But it’s when things are calm that blood banks get empty, say hospitals and charities working to bring about a culture of voluntary donations in Lebanon. "When there’s a bombing, the response is awesome. We’re overwhelmed by calls," said Yorgui Teyrouz, president and founder of the blood donation non-governmental organization Donner Sans Compter – French for "give without counting."
Throughout the rest of the year, however, there aren’t nearly enough regular donations for those in need.
Teyrouz blames this phenomenon on the outdated "replacement system" relied on in Lebanon and most of the developing world, which involves hospitals asking patients in need to solicit donations from friends and family in order to keep blood stocks replenished, sometimes putting undue pressure on the patient’s family. These people are not technically considered volunteers because they are being asked to do it.
"The problem in Lebanon is that everything is based on the replacement system," Teyrouz said. "It’s the easy way out for hospitals. It means there’s no need for [blood donation] campaigns."
As a result of the current system, people sometimes lie about their medical history, mistakenly thinking they’re helping the patient. In other cases, donors simply aren’t aware that it takes 30 days for HIV to appear in the bloodstream after exposure, such as unprotected sex or needle sharing, and they don’t think to mention recent risky behavior.
In addition, the lack of a centralized blood bank in Lebanon means smaller hospitals often don’t have a variety of blood types available, particularly problematic at times when roads are jammed following a car bomb or other disaster.
Teyrouz came up with the idea of Donner Sans Compter in 2006 after a friend died when there was no match available for his rare AB negative blood type.
The solution, say medical experts, is to develop an ongoing national campaign for voluntary blood donations, something that has been gaining ground but that still has a long way to go.
Rita Feghali, a doctor at Rafik Hariri University Hospital, was so frustrated with the way blood donations were done in the country that in 2011 she set up the National Committee of Blood Transfusions in the hope of improving the process.
"The actual situation, as it is, is a fragmented system," she said. "Every hospital has its own transfusion center. It works on a system of replacement, in which relatives of the patient come. It’s supply and demand."
In 1975, the World Health Organization adopted a resolution encouraging countries to have an all-voluntary, unpaid blood donation system, with the aim of establishing it worldwide by 2020. For Feghali, it would be an accomplishment for Lebanon to have just 10 percent of donations done on a volunteer basis by the deadline in six years.
Although Lebanon is currently able to find the 100,000 blood units (1 unit is around 450ml) it needs yearly through collections, the process is far from ideal.
"We’re managing, but at the expense of a lot of stress," Feghali said. "The system works, but there are problems and it’s very difficult for patients to find donors. Sometimes it’s difficult and painful. It adds stress to an already stressful situation."
She would like to see more public awareness campaigns to increase volunteer involvement in a country where she noted there was already "a real spirit of helping people."
Key to attracting more volunteers, she said, was giving them a good experience when they donated blood, something that would make them more likely to do it again and recommend it to their friends.
As things are now, potential donors usually have to go through an unpleasant and bureaucratic experience at their local hospital.
"We need to create nice blood centers," she added.
"People need to have a pleasant experience when they give blood so that they’ll do it again."
Like everything else these days in Lebanon, however, if the problem can’t be solved through public institutions then there’s an app for it.
In an effort to bridge the gap, Hussein Sleiman, an instructor at the American University of Beirut, developed Students Donating Life, a database for blood donors that encourages them to donate at least once a year.
The app won first place at the Arab Innovation Network in 2012.
"The basic problem is education," he said. "We need a database with donors and blood banks. And we need a different strategy to recruit donors. What we have right now isn’t effective."
For now, the spontaneous goodwill of blood donors will continue to be counted on when disaster strikes – whether that’s natural or manmade.
"People need blood not only when there’s a bomb," Feghali pointed out. "They need blood all the time."
© The Daily Star 2014.Mar 2014