A very small percentage of black people are contributing to the national blood service.
More than a quarter of a million South Africans are regular blood donors, but only 10% of them are black. At the same time, black people constitute 80% of those needing transfusions.
The South African National Blood Services (SANBS) has found that black people still believe their blood is discarded because of the high HIV infection rate among black people.
Black donors are desperately needed not only to boost the supply of blood, but because genetic differences mean that better matches between donors and recipients tend to occur within ethnic groups. The more precise the match, the better for the patient. This is particularly important for people who require repeated transfusions and those who have rare blood groups.
More than 3 000 units of blood are transfused to patients each day in South Africa. Apart from the blood that is needed in trauma units around the country during the festive season, blood in large amounts is always needed for other reasons. Blood loss during childbirth creates a major need for transfusions, according to the SANBS.
“Twenty to 25 women die during childbirth every year in the country because of blood loss,” says Dr Sam Gulube, the national medical director of the SANBS. Especially with the festive season looming, the SANBS is under pressure to maintain supplies.
“Only 34 000 of the 350 000 donors around the country are black,” says Gulube, “and the irony is that 80% of patients needing blood transfusions are black.”
But a safe donor is a regular donor, says Gulube. “We no longer judge blood on the basis of race, but rather on whether it is from a regular donor or not.” The most trusted regular donors are schoolgoing teenagers aged 16 to 19. These make up 20% of blood donors in the country.
In October the SANBS launched a campaign called the Big Blood Bash to get corporate workers to donate blood. “We went to corporate companies to educate staff members about the importance of donating blood as a way of getting them to donate,” says Justice Mohale, SANBS spokesperson.
Advances in blood transfusion technology in South Africa have made it possible to receive donations not just from various racial groups, but also from donors of different sexual orientation. “We are the only country in the world that allows donors who have had male-to-male sexual intercourse to donate blood,” Gulube says.
The qualification is that such intercourse should not have occurred within six months of donation. “Together with multiple partners and one-night stands, male-to-male sexual intercourse is high-risk behaviour for HIV infections,” Gulube says. Also, there are “more risk infections through anal penetration than through vaginal penetration”.
But the Nucleic Acid Amplification Testing System, introduced in 2005, detects different strains of pathogens which cause HIV, hepatitis B and C and syphilis—while other tests detect merely the presence or absence of these.
Blood is a non-profit business, says Mohale. The SANBS bills the department of health for all the blood needed by patients using public health facilities and medical aid companies are billed for patients who receive private healthcare. “We don’t sell blood,” Mohale says. “We are a company with a duty to collect, transport, test and store blood. Our staff, who make sure that blood transfusions take place, need to be paid, so we do need to bill the various stakeholders.”
Universal blood type O is always difficult to find; because it can be transfused to patients of all blood types it becomes scarce, Mohale says. “Even in emergencies doctors order this blood so, on average, we would have two days’ supply of type O blood, while sufficient supply is normally seven days.”