Donation denial leaves blood in short supply: Phuket

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Special Report: Donation denial leaves blood in short supply
Phuket Gazette


A nurse holds a bag of newly-donated Rh-negative blood. Photo: Leslie Porterfield

Special Report

Pim Hoogeveen, a 61-year-old Dutchman, offered his blood to save a life. He responded to an urgent call for A-negative blood donations. His donation was refused.

The Phuket Gazette’s Shela Riva investigates the process behind donating blood on the island – the restrictions and the rewards.

PHUKET: -- The recent call by the Phuket Regional Blood Center (PRBC) for A-negative blood during the high season, which is usually spattered with Westerners entangled in motorbike accidents, is reminiscent of a life that was not saved about six months ago.

The man Mr Hoogeveen tried to save was the late Marc Harrington, a 66-year-old British expat who sustained a serious head injury on June 22.

Three weeks after the accident, Vachira Phuket Hospital appealed for blood donors. A second call was made on July 30 (story here), to which Mr Hoogeveen was prompted to respond.

“I called the PRBC, willing to donate some blood. To my surprise, they refused my offer because I am too old according to the Thai standard,” he told the Gazette shortly after the rejection.

“Hopefully they will notify Mr Harrington or his family about this age-standard, so he knows there is A-negative blood available, but he won’t receive it.”

Mr Harrington unfortunately never received this information as he succumbed to his head injuries on August 13 (story here).

Why he wasn’t allowed to donate


The PRBC confirmed to the Gazette that first-time donors must not be more than 55 years of age. Only those who have donated previously may donate after the age of 55, provided they have a doctor’s approval.

“We cannot accept donors older than 55 who have never donated blood before, even if they otherwise fit the criteria,” PRBC nurse Chaleewan Wichadit said.

PRBC Director Pornthip Rattajak explained, “After donating blood, the donors’ bodies compensate for the loss of fluid. If the donor is too old, the compensation mechanism will not be as efficient. There is a higher risk of fainting or unconsciousness, especially for a first-time donor.”

“If you donate every three months, your body will be habituated to compensating. If you donate for the first time and you are older, the body may respond in shock or fear.”

Other reasons for refusal

Other restrictions are in place to protect the health of both donors and recipients, explained Ms Pornthip.

Some of the factors that could put the health of the donor at risk are being under the age of 17, being older than 70, weighing less than 45 kilograms or being pregnant.

There are far more restrictions intended to protect the recipients. They are presented on a questionnaire donors are asked to fill out before each donation.

PRBC will not accept donations from those who: lived in the UK between 1980 and 1996 for a period of six months or more, or have had sexual contact with the same gender.

Donors will be rejected if they have had the flu within the past seven days or malaria within the past three years.

Even healthy people may be turned down if they have consumed alcohol in the 24 hours leading up to donation or taken medications containing aspirin within three days of donating.

The final protective screening takes place at the time blood is drawn, when three test tubes are filled with blood to test for HIV, syphilis, and Hepatitis B and C.

The demand for Rh-negative

Although the PRBC receives about 2,000 standard units (450cc) of blood per month (people weighing less than 50kg may donate only 350cc), it has an almost constant shortage of all four Rh-negative blood groups: A-negative, B-negative, AB-negative and O-negative.

“Only 0.3 per cent of the Thai population have blood that is Rh-negative,” said Vathu O-art, PRBC Public Relations and Blood Recruitment Coordinator.

“If only one person with Rh-negative blood gets into an accident, it can take up to five units of blood to help them, which exhausts our stock quickly,” said Ms Pornthip explained.

Sixteen per cent of the world’s population has Rh-negative blood, 40-50 per cent of which are Europeans, but the PRBC rarely benefits from these statistics.

“Ninety-seven per cent of our donors are Thai locals,” Ms Vathu explained.

Remarkably, given the regular need for Rh-negative blood and the higher incidence of this blood type among Europeans, donations from tourists are generally not accepted.

As a result, Rh-negative donors at the PRBC make up about three in every 1,000 donations.

Why tourists may not donate

Despite the fact that foreigners are much more likely than Thais to have Rh-negative blood, the rules of the Thai Red Cross do not allow the PRBC to accept donations from tourists, Ms Pornthip said.

One reason is that travel increases the risk of exposure to disease.

A second reason is that those who donate blood must have a permanent address in Phuket.

“In rare cases, perhaps under emergency circumstances or if a family member of a tourist recipient is here with them and wishes to donate, the doctor may consider accepting their blood.”

However, the PRBC does accept expatriate donors, but the expat must have lived here for six months before donating.

The blood supply

To ensure there is enough blood available for all recipients, particularly Rh-negative blood types, the PRBC maintains a wide network of sources across Thailand.

“If we don’t have a particular blood type in stock, we can request it from other provinces. Here in the South, we have 12 blood banks distributed across three provinces: Phuket, Nakhon Sri Thammarat and Songkhla,” said Ms Pornthip.

“We can also request it from the Bangkok blood center and the Thai Red Cross.”

The Rh Negative Club also plays a role in making sure those who need blood receive it.

“The Rh Negative Club is a local group of donors who have supplied us with their contacts. When Rh- negative blood is needed, we can contact them,” said Ms Pornthip.

“On paper, there are about 150 members in the club. We now have about seven Rh-negative club members who come in regularly to donate.”

Between club members and other donors, the PRBC receives an average of 10 units of Rh-negative blood per month.

When these donations are not enough, the PRBC appeals to the public for donors.

Blood matches

Ms Pornthip explained that it isn’t always necessary to match recipient and donor blood types, and that every donation is valuable.

Type-O blood can be given to a patient with any blood type, as long as the Rh-factor matches. That is why those with type-O blood are called ‘universal donors’. O-negative blood can be given to patients with A-negative, B-negative and AB-negative blood.

“We try to save O-negative blood for O-negative patients, because O-negative patients can only receive O-negative blood,” she said.

“However, in an emergency, the doctor may decide to use O-negative blood.”

Just as O blood is the universal donor, type AB is the ‘universal recipient’ and can receive blood from any blood type as long as the Rh matches. However, type AB cannot donate to any of the blood groups except its own.

Rewards of donating

For those who are eligible to donate, giving blood is rewarding in many ways.

The PRBC often expresses its gratitude by giving gifts, and Vachira Phuket Hospital offers incentives to those who donate often.

Announced in October last year, the Vachira deal is as follows: donating 18 to 23 times cuts medical and hospital room expenses by 50 per cent; donating more than 24 times cuts 100 per cent of medical expenses and 50 per cent of hospital room costs. This program aims to draw in more expatriate donors – which may be the much needed solution to the persistent Rh-negative dilemma.

Source: http://www.phuketgazette.net/phuket_news/2014/Special-Report-Donation-denial-leaves-blood-in-short-supply-24394.html

-- Phuket Gazette 2014-01-25

[chooka]

I always donated blood 3 times per year in Melbourne but since coming to Thailand it is quite true, they won't accept my blood. I know it is clean and free from desease giving the amount of times of have previously donated. I have given up trying. Maybe they think farangs stink and are dirty or maybe because I am a common type B+ I don't think I am to old at 47

Edited January 25, 2014 by chooka

[simon43]

Wow! That's a lot of conditions for donating blood. It must exclude a hell of a lot of people who are fit and able to donate.

I donated blood for 20 years in the UK, but apparently my blood is not good enough for Phuket, (they seem to think we all have Mad Cow Disease)

Simon

Edited January 25, 2014 by simon43

[Greer]

I was surprised to see this homophobic condition included :

"or have had sexual contact with the same gender"

This is not related to disease as they test for STD's, especially HIV...so whats going on?

[firefox999uk]

I always donated blood 3 times per year in Melbourne but since coming to Thailand it is quite true, they won't accept my blood. I know it is clean and free from desease giving the amount of times of have previously donated. I have given up trying. Maybe they think farangs stink and are dirty or maybe because I am a common type B+ I don't think I am to old at 47

Well they took an arm full from me yesterday in MahaSarakham and im 60 in 3 weeks time...

I think i recall seeing a sign saying 18-70 years old is OK to give blood.

This was my fouth time and never had any problems donating, always welcomed by the nurses.

[belg]

there prefer 20-30 year old something , possible on yaba or with HIV

thai rak thai, you know

[Mario2008]

Some info on blood donations by the Thai red cross:

http://english.redcross.or.th/node/49

[Benmart]

Too bad. At 62 I guess my blood will remain with me.

[Seelow]

What's the rational for the UK inhabitants between 1980 and 1996 being excluded?

[simon43]

What's the rational for the UK inhabitants between 1980 and 1996 being excluded?

We all have Mad Cow Disease.......

[Tywais]

What's the rational for the UK inhabitants between 1980 and 1996 being excluded?

Mad cow disease. Note the 'theoretical risk' as there is no substantive proof.

1. Why have donor restrictions been placed on individuals who have spent five years or more in Europe between 1980 and the present?

In some parts of the world, a fatal brain disease called Mad Cow Disease has infected cattle. In these locations, primarily in parts of Europe, people have been diagnosed with a new disease called variant Creutzfeld-Jacob Disease (vCJD), which is also a fatal brain disease. It is theorized that vCJD is a form of Mad Cow Disease that has been transferred to humans by eating infected beef. While there have not been any documented cases of vCJD being transmitted by blood transfusions, the Food and Drug Administration, the federal agency that regulates blood collection in the United States, has recently placed restrictions on whether an individual may donate blood based on how much time they have spent in countries where cows have been affected by Mad Cow Disease. The restrictions are based on a theoretical risk of transmitting vCJD by a blood transfusion.

Source

[Docno]

What's the rational for the UK inhabitants between 1980 and 1996 being excluded?

Just guessing, but could it be mad cow disease that hit there in the 80s? People still dying of it in the late 2000s (presumably with the 'bug' in their system for years). Apparently it can only be reliably detected from brain tissue samples. Not sure how many prospective blood donors would want to provide such

[Old Croc]

I have a genetic condition called hemochromatosis (sometimes called iron overload). The only treatment is to donate blood on a regular basis to keep iron levels down. There's nothing wrong with my blood, it can be used for people in need.

I have donated more than 160 times and have also been a bone donor twice. My system has had the hell tested out of it for disease, and donating is about as stressful for me as brushing my teeth. However, when seeking to donate at the Red Cross in Thailand I was greeted with blank stares and shaking of heads. Too old, despite my plea that it was necessary for my own well being.

[Docno]

I was surprised to see this homophobic condition included :

"or have had sexual contact with the same gender"

This is not related to disease as they test for STD's, especially HIV...so whats going on?

Appears to be general Red Cross policy. This is from the US Red Cross Site:

The top priorities of the American Red Cross are the safety of our volunteer blood donors and the ultimate recipients of blood. On June 11, 2010, the Department of Health and Human Services Secretary's Advisory Committee on Blood Safety and Availability voted against recommending a change to the Food and Drug Administration (FDA) policy of a lifetime deferral for men who have sex with other men.

http://www.redcrossblood.org/donating-blood/eligibility-requirements/eligibility-criteria-alphabetical-listing

[skorchio]

I was surprised to see this homophobic condition included :

"or have had sexual contact with the same gender"

This is not related to disease as they test for STD's, especially HIV...so whats going on?

Maybe, in the opinion of the Thai medical profession, healthy blood from a homosexual could 'turn' the recipient, for example a practicing and stable hetrosexual, into a raving homosexual. And perhaps the authorities are aware that Thailand is over supplied with raving homosexuals ......

[harrry]

What's the rational for the UK inhabitants between 1980 and 1996 being excluded?

Just guessing, but could it be mad cow disease that hit there in the 80s? People still dying of it in the late 2000s (presumably with the 'bug' in their system for years). Apparently it can only be reliably detected from brain tissue samples. Not sure how many prospective blood donors would want to provide such

Or could.

[hansgruber]

You guys should be happy. Once you donate and your suitable, they call and harass with text messages for more donations.

[harrry]

Giving blood is a goodthing. You should not feel harrased just pleased you have the oportunity to save someone'e life if you do.

It is a pity they cannot make an exception to the rules about age etc where it is inevitible that the patient will die without that blood.

[MMarlow]

I was surprised to see this homophobic condition included :

"or have had sexual contact with the same gender"

This is not related to disease as they test for STD's, especially HIV...so whats going on?

Maybe, in the opinion of the Thai medical profession, healthy blood from a homosexual could 'turn' the recipient, for example a practicing and stable hetrosexual, into a raving homosexual. And perhaps the authorities are aware that Thailand is over supplied with raving homosexuals ......

It's not just Thailand...

Appears to be general Red Cross policy. This is from the US Red Cross Site:

The top priorities of the American Red Cross are the safety of our volunteer blood donors and the ultimate recipients of blood. On June 11, 2010, the Department of Health and Human Services Secretary's Advisory Committee on Blood Safety and Availability voted against recommending a change to the Food and Drug Administration (FDA) policy of a lifetime deferral for men who have sex with other men.

http://www.redcrossblood.org/donating-blood/eligibility-requirements/eligibility-criteria-alphabetical-listing

[harrry]

At least Australia shows balance by only requiring no contact for 1 year....Then all tests would be OK.

I think risk has to be looked at but lifetimes bans seem to be the result of predjudice.

I am sure when I needed blood I would have not refused it just because of the sexual orientation of the donor.

Edited January 25, 2014 by harrry

[easybullet3]

What's the rational for the UK inhabitants between 1980 and 1996 being excluded?

We all have Mad Cow Disease.......

but that was about 20 years ago.

so, if we are still functioning today (20 years later), then surely we don't have mad cows disease!!!

[cornishcarlos]

What's the rational for the UK inhabitants between 1980 and 1996 being excluded?

We all have Mad Cow Disease.......

but that was about 20 years ago.

so, if we are still functioning today (20 years later), then surely we don't have mad cows disease!!!

My Mum lived there between those years and she is still a mad cow !!

But I do love her

Edited January 25, 2014 by cornishcarlos

[Konini]

Wow! That's a lot of conditions for donating blood. It must exclude a hell of a lot of people who are fit and able to donate.

I donated blood for 20 years in the UK, but apparently my blood is not good enough for Phuket, (they seem to think we all have Mad Cow Disease)

Simon

Not just Thailand - I've had meningitis so I'm considered toxic but my husband wasn't able to give blood in Australia because we didn't move away from England until 1987.

One thing I always wondered but never asked was if people had lived in UK during the early 1980's but had donated blood in Aus prior to the mad cow thing coming to light, were they able to continue or told no longer welcome at the blood donation centre?

[Docno]

What's the rational for the UK inhabitants between 1980 and 1996 being excluded?

We all have Mad Cow Disease.......

but that was about 20 years ago.

so, if we are still functioning today (20 years later), then surely we don't have mad cows disease!!!

There's a chance it can take more than 50 years to develop in some cases: http://en.wikipedia.org/wiki/Creutzfeldt%E2%80%93Jakob_disease#New_concerns

[Docno]

At least Australia shows balance by only requiring no contact for 1 year....Then all tests would be OK.

I think risk has to be looked at but lifetimes bans seem to be the result of predjudice.

I am sure when I needed blood I would have not refused it just because of the sexual orientation of the donor.

I suspect if they had such stringent requirements in Oz, it wouldn't leave many left to donate! JOKE...

[harrry]

At least Australia shows balance by only requiring no contact for 1 year....Then all tests would be OK.

I think risk has to be looked at but lifetimes bans seem to be the result of predjudice.

I am sure when I needed blood I would have not refused it just because of the sexual orientation of the donor.

I suspect if they had such stringent requirements in Oz, it wouldn't leave many left to donate! JOKE...

I do not think it is a laughing matter. I owe my life to someone who gave a little blood.

[Docno]

At least Australia shows balance by only requiring no contact for 1 year....Then all tests would be OK.

I think risk has to be looked at but lifetimes bans seem to be the result of predjudice.

I am sure when I needed blood I would have not refused it just because of the sexual orientation of the donor.

I suspect if they had such stringent requirements in Oz, it wouldn't leave many left to donate! JOKE...

I do not think it is a laughing matter. I owe my life to someone who gave a little blood.

Relax, please. I've donated a lot of blood in my lifetime. The joke was not about blood donations, it was about Australians. It may surprise you to know I'm Australian citizen born in Sydney... so a harmless joke with the barrel also aimed at myself.

[cornishcarlos]

At least Australia shows balance by only requiring no contact for 1 year....Then all tests would be OK.

I think risk has to be looked at but lifetimes bans seem to be the result of predjudice.

I am sure when I needed blood I would have not refused it just because of the sexual orientation of the donor.

I suspect if they had such stringent requirements in Oz, it wouldn't leave many left to donate! JOKE...

I do not think it is a laughing matter. I owe my life to someone who gave a little blood.

Hope they didn't live in U.K during Mad Cow mania JOKE

[harrry]

At least Australia shows balance by only requiring no contact for 1 year....Then all tests would be OK.

I think risk has to be looked at but lifetimes bans seem to be the result of predjudice.

I am sure when I needed blood I would have not refused it just because of the sexual orientation of the donor.

I suspect if they had such stringent requirements in Oz, it wouldn't leave many left to donate! JOKE...

I do not think it is a laughing matter. I owe my life to someone who gave a little blood.

Hope they didn't live in U.K during Mad Cow mania JOKE

Even if they did I have had 10 years I would not have done without.....

Edited January 26, 2014 by LivinginKata
religous remark removed

[pistachios]

Despite the fact that foreigners are much more likely than Thais to have Rh-negative blood, the rules of the Thai Red Cross do not allow the PRBC to accept donations from tourists, Ms Pornthip said.

One reason is that travel increases the risk of exposure to disease.

A second reason is that those who donate blood must have a permanent address in Phuket.

This doesn't make any sense.

In Europe, you can't donate blood if you have travelled in a tropical country in the last 6 months. Yes, travel increases the risk of exposure to disease, especially in a tropical country, but what about people living there? Expats are far more likely to carry some disease than the average tourist coming from more sanitised countries...