Se­nior Lec­tur­er in Haema­tol­ogy at UWI, Dr Ken­neth S Charles, has de­scribed as "un­safe, un­eth­i­cal, ex­pen­sive, per­mis­sive of il­le­gal ac­tiv­i­ty" the chit sys­tem for blood do­na­tion that was re­cent­ly rein­tro­duced in T&T. Charles, in a let­ter to the ed­i­tor, was re­spond­ing to an ed­i­to­r­i­al in an­oth­er news­pa­per on May 9 cel­e­brat­ing the re­turn of the 'chit' sys­tem for blood do­na­tion. Please al­low me the space in your news­pa­per to dis­cuss some of the is­sues raised, bear­ing in mind that Trinidad and To­ba­go is a mem­ber state of the World Health Or­ga­ni­za­tion (WHO) and is oblig­ed to ob­serve its rec­om­men­da­tion.

Ac­cord­ing to Charles, 'blood donor chits' have been is­sued for decades as re­ceipts to guar­an­tee trans­fu­sion for an ill rel­a­tive or as proof that blood used in an emer­gency has been re­turned (re­place­ment blood do­na­tion). Near­ly 90 per cent of blood is col­lect­ed in this way in Trinidad and To­ba­go, he stat­ed. Some per­sons do­nate to trade these re­ceipts for cash or oth­er pay­ment (re­mu­ner­at­ed or paid blood do­na­tion). "Tru­ly vol­un­tary blood donors give blood freely and un­con­di­tion­al­ly. There is no 'link with an in­tend­ed re­cip­i­ent'.

They re­ceive no to­ken that could be con­vert­ed to cash. In re­al­i­ty the do­nat­ed blood nev­er goes to the 'in­tend­ed re­cip­i­ent' but in­to a blood bank for pub­lic use. What goes in could end up in any of our veins." The World Health Or­gan­i­sa­tion es­tab­lished more than 35 years ago, he ar­gued, that vol­un­tary blood donors were much less like­ly than the oth­er types of donor to car­ry in­fec­tions that could harm pa­tients. On the grounds of pub­lic safe­ty, the WHO rec­om­mend­ed blood col­lec­tion from vol­un­tary blood donors on­ly.

"De­vel­oped coun­tries were the first to com­ply but with the dis­cov­ery of the hu­man im­mun­od­e­fi­cien­cy (HIV) virus, many de­vel­op­ing coun­tries be­gan to­tal­ly vol­un­tary blood do­na­tion to keep their blood sup­ply safe." What is the prob­lem with col­lect­ing un­suit­able blood? First, it costs mil­lions of dol­lars per year to col­lect, process then dis­card in­fect­ed blood. Donor blood is test­ed very care­ful­ly in the lab­o­ra­to­ry af­ter do­na­tion, not with the ini­tial skin-prick test as sug­gest­ed. Re­cent­ly in­fect­ed donors may have a neg­a­tive test. This is much more like­ly with re­place­ment and paid do­na­tion.

Charles, who is the for­mer di­rec­tor, Na­tion­al Blood Trans­fu­sion Ser­vice, stat­ed: "The chit sys­tem is un­safe, un­eth­i­cal, ex­pen­sive, per­mis­sive of il­le­gal ac­tiv­i­ty and in­con­sis­tent in­ter­na­tion­al stan­dards for pub­lic safe­ty. A blood trans­fu­sion ser­vice based on vol­un­tary (no 'chit'), reg­u­lar (once or twice per year) by 3% of the pop­u­la­tion solves all the prob­lems caused by re­place­ment or paid blood do­na­tion. As we ap­proach World Blood Donor Day on June 14th, I join the in­ter­na­tion­al com­mu­ni­ty in thank­ing vol­un­tary, un­paid blood donors every­where."