Blood chit system unsafe, unethical

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.”