Serious loopholes in India’s blood banking system have been exposed by a report which suggests that more than 6 lakh litres (2.8 million units) of blood has been wasted in last 5 years.
Shockingly, in a country where blood shortage is faced by many patients, the blood banks wasted around 6 per cent precious units of blood and its components. This amount of wasted blood equals 53 water tankers.
Among the worst offenders were states like Maharashtra, Uttar Pradesh, Karnataka, Tamil Nadu. Not just the whole blood was discarded but components that save like red blood cells and plasma were also wasted, a report in TOI said.
More than 6.75 lakh units of blood and its components were wasted in 2016-17. What is worrisome is the fact that 50 per cent of the discarded units included plasma which has a longer shelf life of one year, unlike the whole blood and red blood cells that have a life of just 35 days.
The National Aids Control Organisation (NACO) has revealed the shocking wastage when responding to an RTI query raised by Chetan Kothari.
Maharashtra, the only state to have crossed one million mark in blood collection, was at the top in this list with maximum wastage of whole blood, followed by West Bengal and Andhra Pradesh. Maharashtra, UP and Karnataka are top three in discarding the highest units of red blood cells.
The maximum units of fresh frozen plasma was wasted by UP and Karnataka. More than 3 lakh units of fresh frozen plasma was wasted in 2016-17. This is most ironic because several pharma companies import the fresh frozen plasma to produce albumin.
"The figures are alarming because blood shortage is a chronic problem in our country. It exists everywhere, right from the most interior parts of the country to metros like Delhi and Mumbai. Delhi alone faces an annual shortage of 1lakh units," said Kothari.
India faces an annual shortage of 3 million units of blood. Shortage of blood, plasma or platelets often led to maternal mortality and deaths in accident cases.
The lack of coordination between blood banks and hospitals and absence of robust blood sharing network have been blamed for the crisis.
A collection of upto 500 units is acceptable and manageable, said Dr Zarine Bharucha of the Indian Red Cross Society said.
"But we have seen and heard of camps where 1,000 to 3,000 units of blood is collected. There is no way to screen a donor or take their medical history. Most importantly, where is the place to store so much blood," she said, adding that what is needed is patient awareness.
"Why can't people walk into regular banks and donate once every three months," she said.
One unit of whole blood contains components such as red blood cells, plasma and platelet. But most government run blood banks lack the fractionalization facility in order to process the blood and break it into components.
"This alone results in a huge wastage as doctors nowadays insist on transfusing components. A physician treating a dengue patient, for instance, would prefer to give a platelet transfusion instead of unnecessarily pumping the patient with bottles of whole blood," said a senior blood bank officer.
States like West Bengal have outdated banking methods given the fact that they mostly issue whole blood instead of the components.
"We have created more than 200 storage centres in interior areas for emergencies. We have takers for emergency blood only once a week or once in two weeks. But we would rather be prepared to save a life than worry about unused units of blood," Dr Satish Pawar, head of Directorate of Health Services in Maharashtra said.
He added that Maharashtra is planning to create more component separation facilities. Dr JS Arora of the Delhi-based National Thalassemia Welfare Society said that needy people are forced to pay multiple times for a unit of blood.
"We have an online system where all the banks are supposed to update their stock status real time but it's under-utilised," he said.
"In 2016-17, there is a near 17% fall in wastage. Also, hospitals have to keep blood in emergency reserve to deal with mass casualties," a senior health ministry official told TOI.