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Logo of Phnom Penh Post newspaper Phnom Penh Post - When will there be blood? Fight to fix donor shortage

When will there be blood? Fight to fix donor shortage

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A doctor gathers another blood donation at Kantha Bopha hospital. Photograph: Heng Chivoan/7Days

Chea Kimaorn and Long Keara are lying next to each other in Kantha Bopha’s blood bank.

The two middle-aged men don’t know each other, but they have the same fear.

Both of their children are on the third floor, in the hospital’s surgical unit, waiting for their turn on the operating table.

Both fathers lie quietly, waiting until the blood, which could save their children’s lives, finishes running into little plastic bags.

Last month’s de-mining accident in Kampong Chhnang province, which injured four American men and forced the community to pull together in order to source enough blood to save one man’s life, has drawn attention on Cambodia’s blood supply problems.

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Kha Chheng (R) gives blood for the first time. Photograph: Vireak Mai/7Days

The lack of voluntary and regular donors means hospitals’ blood stocks are low, and medical staff and blood banks have to work double time in emergency situations to source blood from family members.

In response to this problem the National Blood Transfusion Centre (NBTC), in conjunction with BBC Media Action, is running a blood drive on Valentine’s Day to encourage people to donate their blood for strangers.

Some have expressed concern that it took an American being injured for the international community to take notice of the situation, and it often takes a critically ill family member before Cambodians will donate their blood.

Just around the corner from Kantha Bopha, at the NBTC, Kha Chheng walks up to the large off-white building and down a corridor to find a registration form. She’s a little nervous, but there are other people around her who have just gone through the same process.

She fills out the form, and waits for her medical examination.

Once the doctor decides everything is fine, she is weighed by one of the nurses, who then lead her into an air-conditioned room lined with beds, and a fridge full of blood at the end.

The nurse tests her haemoglobin levels by pricking her finger and taking a tiny blood sample. Chheng lies down on one of the beds, clutches her bag, and offers her right arm.

With a reassuring smile, the young nurse slips a needle into Chheng’s arm, and dark red blood starts to run through a tube and into the bag beside the bed.

It is Chheng’s first time donating blood, and she is a little nervous, but unlike many Cambodians, she is not worried donating blood will affect her health.

She plans to become a regular donor.

Voluntary blood donors like Chheng make up 30 per cent of Cambodia’s donors.

The rest of the blood comes from family members of sick people who are asked to donate their blood to help their relative through surgery, or if they are haemorrhaging.

Once a patient is in the hospital, waiting for blood, every minute is precious, and it takes time to test the blood, and process it.

If the donor’s blood is not a match, the hospital staff needs more time to find a suitable donor.

The wait can put lives at risk. The most seriously injured of the four demining experts from the NGO Golden West Humanitarian Foundation (GWHF) had the rare blood type O negative.

After he was taken to Calmette Hospital to undergo emergency treatment, staff at the NBTC had to work late into the night to locate compatible donors.

“I sent messages out to donors and they sent the messages on to their friends,” Dr Hok Kim Cheng, director of the National Blood Transfusion Centre, said.

Once the call for help was posted on Facebook it went viral, and twelve donors came forward to give their much needed O negative blood.

Demining NGO Golden West Humanitarian Foundation deputy director of field operations Len Austin suffered second degree burns and puncture wounds and was treated at the capital’s Royal Rattannak hospital before being transferred to the Bumrungrad Hospital in Bangkok.

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Austin is now recovering well and is back at work.

He said the incident highlighted the importance of donating blood, especially for people with rare blood types.

The response to the call for help showed the “great character” of the people who worked in Cambodia, he said.

The NBTC plans to create a database with lists of donors, and their blood types, so in situations like that with the deminers, donors can be found, according to Dr Kim Cheng, also deputy director of field operations for GWHF.

An email alert system could be set up in the future, he added.

“And not just for foreigners, but for anyone that needs help.”

Golden West’s South East Asia general manager Allen Tan said the initial call for help came from Lieutenant Colonel Kristin Means, Chief of the US Embassy’s Office of Defense Co-operation, which he then relayed.

“I am also saddened that the blood bank here is apparently so poor and it took an American in trouble for me to hear about it,” Tan said.

Last year 150,136 severely sick children were admitted to the country’s Kantha Bopha Children’s Hospitals - 28,151 of those children suffered from severe dengue haemorrhage fever, which causes patients to bleed.

So it is no surprise that it is crucial to have on-site blood banks at three of the NGO hospital’s sites in Cambodia.

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Long Keara (top) and Chea Kimaom give blood, hoping to help their sick children in Kantha Bopha hospital. Photograph: Heng Chivoan/7Days

In 2012 the Phnom Penh Post hospital received 10,741 donations, and carried out 15,445 blood and plasma transfusions.

The donations were sufficient for the amount of children who needed blood for surgical procedures, and mothers giving birth, however, during dengue haemorrhage fever season, from May to August, blood was in short supply.

“It’s not a luxury to have a blood bank,” said Dr Laurent.

The hospital is still fighting against the idea that blood donation is unsafe – a product of the immediate aftermath of the Khmer Rouge era, he added.

“It was not so professional. It was not as safe, and some people got diseases from unsafe blood.”

The hospital runs strict, expensive tests to make sure the blood was safe, and free from HIV, Hepatitis B and C, and Syphilis,” he said.

Unfortunately, these diseases meant nearly nine per cent of the blood gathered had to be thrown away in 2012, however the situation has improved since 2005, when 23 per cent had to be discarded.

These diseases also made people more reluctant to give blood, for fear of contracting diseases, meaning the onus was on the medical staff to run strict tests and explain the procedure to donors.

When people gave blood the doctors and nurses would show the donors they were using fresh needles, Dr Laurent said.

“The hospital is responsible for the safety of the blood.”

In order to collect clean blood the hospital had to fight against private blood donors, who profit by selling their blood to the families of sick relatives. These people were much more likely to have unsafe blood, he said.

Some Cambodians have a “cultural handicap” when it came to giving blood, he said.

“But it is about new education, and new information.

“If you have no blood, you have no hope,” he added.

The NBTC’s Valentine’s Give Love Give Blood campaign, which is organised in conjunction with BBC Media Action’s youth engagement programme Loy9, is aimed at educating people about blood donation, and getting them involved in civic activities, Dr Hok Kim Cheng said.

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“We need to educate the young people about the blood donation because they will be regular blood donors in the future.”

The NBTC receives around 2000 donations every month, but only 30 per cent are from voluntary donors.

“People are slowly starting to understand our need, and that it is safe,” Dr Hok Kim Cheng said.

Some people still believe it is bad for their health to donate, and do not understand that the volume of blood would replenish in a couple of hours and that it would only take three weeks for all blood cells to be replaced, he said.

Dr Kim Cheng said he hoped young Cambodians would become regular donors, and family replacement donors would also, eventually, become regular volunteer donors.

“This is an action to save lives…It’s about giving back.”

The blood drive will be held at the Royal University of Phnom Penh on Valentine’s Day, with about 150 expected to attend.

BBC Media Action project director Colin Spurway said they had the tools to communicate the message about the need for blood, and about the drive itself.

Loy9 incorporates a radio show, television show, website, a smartphone application, a YouTube channel and, with over 15,000 ‘likes’,  a Facebook page with a great following among Cambodian youth.

The blood drive will be a major part of the storyline for this year’s Loy9 drama series, which will explore the idea of young Cambodians organising an event in their community, he said.

Spurway said that if it goes well, another blood drive could be organised later in the year to coincide with the screening of a Loy9 drama episode.

For one woman, the Valentine’s Day blood drive will hopefully be a chance for her to give blood for the first time.

Yen Chenda, 31, tried to donate blood as a teenager to help her sick grandfather, but she was told she was not healthy enough.

“(Now) it’s a time for me to help people,” she said.

“For me, I’m very excited..”

Like many first-time donors, the AB-positive woman was initially a little afraid. But after she researched blood donation, and spoke to her brother, who is a doctor, she said she felt comfortable with her decision to donate.

“Personally I don’t know people who give blood, among my family and friends,” she said. “Cambodians only seem to donate blood if there’s an emergency in their family… most Cambodian people are scared.”

Chenda believes educating people about the safety of blood donation will help tackle this problem.

Back at Kantha Bopha, the blood finishes draining and the two fathers sit up in bed. The nurse helps them into chairs, and passes them a bag full of refreshments.

They eat distractedly, perhaps thinking of their children nearby. For those without relatives to step in, hope may yet be harder to come by.

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