Tackling Blood Donation Challenges in the Dominican Republic: Deferral Rates, Health Conditions, and Voluntary Donation

in matters of blood donationthe Dominican Republic not only faces the challenge of overcoming the high deficit in the face of a growing demand, and to increase the voluntary donation that remains in minimum percentages, but also to achieve better health conditions among potential donors and attention to them.

A high percentage of people who come to blood banks for the purpose of donating is rejected due, almost always, to situations that have to do with their health, triggering almost a 40% deferral feein some cases.

Country data is not consolidated and varies from one organization to another. From the National Blood Centerthe state body that handles the issue under the rectory of the Ministry of Public Health, its director, Pedro Sing, assures that the level of deferral is one 20 % of all the donors that arrive Of those, the majority are rejected during the visual evaluation and interview process that are carried out on potential applicants. donorsprior to the blood count tests to which they must be submitted.

Sing does not specify the exact number of people who come to donate, but it does provide the information that, per day they are collecting between 40 and 70 pints and that per month they deliver between 800 and 1,200 bags of blood to the health centers that request them. .

In the Red Cross Dominican the percentage of deferred is higher. Data presented by that organization as of June 2023, indicate that 30,000 personas who attended their National District Blood Bank, during the first five months of the year, only 18,307 qualified to make the donation. In other words, 11,693 people, equal to 39%, could not be extracted.

Myths and truths

The reasons for not accepting a donation from an interested party seem common between both organizations: small veins, high or low hemoglobin, hypertension, diabetes, positive tests for Hepatitis (B o C) these o that the person is taking some type of medication. The restrictions can be much more, since even the time of the meal, some false beliefs and even the encouragement of the doctor who receives the donor is taken into account.

With regret, Ricardo Batista left the Red Cross, where they rejected him as a donor. The 65-year-old man has been a voluntary donor since he was 20 and that day he was trying to help save the life of a relative with his blood.

“I just turned 65, I can no longer donate. In addition to the fact that the veins have to have a certain thickness (for the extraction) and I have already lost it,” he told Free Dailywhile lamenting that now they would have to go out and find someone else to get the blood they urgently needed.

The experience of Ana Peguero, a frequent blood and platelet donor, was different. A few days ago she went to the Cedimat blood bank to donate platelets for a friend’s father. From the first moment, the staff that attended her put her buts to receive her donation, alleging, first, that it was not the same type of blood that they demanded. She clarified that she was going to donate platelets, so her excuse was that they couldn’t see her veins, even though her arms were still covered. Later, another of her staff examined him, but she decided, just by looking at him, that she did not have the veins for that, despite Ana’s insistence that she has donated platelets before in that same place.

Miguelina Félix is ​​one of the doctors who work at the Blood Bank of the Red Cross. He reported that those who come to donate are subjected to two stages of evaluation. First a visual and interview in which the person must answer about 40 questions. Then it goes on to a blood test to detect any health condition that is at risk for the donor or for the person requesting the blood. Added to this are the tests to which the extracted fluid is subjected.

“He is asked what time he ate, because if he has just eaten, the blood appears with more fat than allowed. You have to wait at least three hours after a strong meal,” explained Félix. They also question if you have drunk alcoholsince it is necessary to wait between 48 or 72 hours depending on intake.

The questionnaire they apply also includes questions about possible illnesses, pregnanciesdepartures from the country of less than six months, use of drugs, tattoosacupuncture or any skin prick that is less than 12 months old.

With this it is sought, points out Félix, that the blood is as pure as possiblebecause the wounds in the body, even in the skin, can generate infections.

A myth that Félix clarifies refers to the members of the community LGBTIQ+. Yeah, that community can donate like any heterosexual who is not promiscuous, since this condition is another risk of contracting infections.

Among homosexuals who were asked about discriminatory practices related to blood donation, some talked about situations they’ve heard of, where someone hasn’t been able to donate because they’ve been told no. In no case did he refer to a particular experience.

On the contrary, Vicente Valdez, who said he was a frequent donor, has never felt discriminated against. Being a voluntary donor who visited a blood bank every six months, he now thinks about it because of the difficulties that arise when donating, but not for reasons related to his homosexuality.

It’s more about the long lines that force him to spend almost the entire day at the blood bank; the business that warns after the donation, since it considers that whoever brings a donor should not be charged.

Leonardo Sánchez, an activist from the LGBTIQ community, says that “there are anecdotes. But I don’t have fresh cases, because remember that when there is a rumor, others stop doing it, so as not to go through that one.”

Deficit

The various reasons for deferral complicate the situation in a country where the population tends to get sick and the donation does not even reach the world averages.

A health day carried out by Public Health in 2021, with a sample of 6,514 adults, found that 36.1% of Dominicans suffer from hypertension, 14.2% from diabetes and 11.4% from high cholesterol, conditions that prevent a donation.

Added to this is the fact that the Dominican is not given to donate either, at least not voluntarily. Of the 30,000 potential donors who received in five months the Red Crossonly 302 did it voluntarily, less than 1.6%.

Although the Red Cross managed to dispatch 17,292 units of blood in that time, it was thanks to the replacement scheme, which occurs when a person goes to donate for another who is demanding that blood.

At the National Blood Center, its director Pedro Sing estimates voluntary donation nationwide at 13%, with a total of 21,214 collections of this type.

Remember that when he came to direct the entity in 2020 he found a list of 140 donors registered and that to date there are already 18,299 and that, only last year, the Hemocentro had 3,293 voluntary collections, which it attributes to its extramural work policy, operations carried out in public and private institutions.

Thanks to these strategies -he indicates- they did not need a single bag of blood when the explosion in San Cristobal that caused the death of some 33 people and injured almost 60.

Sing also notes improvements in the blood deficit in the country, which is calculated taking into account the Dominican population according to the X National Population and Housing Census.

“If we are 10,760,028 inhabitants, the demand figure (for blood) is one 2.5% of that populationthat is, 269,000 pints,” he says.

He points out that last year, among all the blood banks in the country, 157,000 pints were collected. “When you subtract that figure from the demand, you have that the deficit is 112,000 bags. The problem is that, of that collection, 86.5% are replacement.” The voluntary donation was 13.5%.