Eighteen-year-old Pol Piseth from Prey Veng is one of the professional blood-sellers waiting for a customer outside the blood bank

IMPOVERISHED Cambodians who sell their blood for transfusion through brokers or directly

to patients are worrying the World Health Organization (WHO) and National Blood Transfusion

Center (NBTC) who say the practice could spread diseases such as hepatitis and HIV/AIDs.

WHO blood safety expert Dr Oscar Barreneche said there is a high demand and low stock

of blood available for transfusion, partly due to a local belief that donating blood

weakens the donor.

This has prompted the emergence of professional blood donors, which Barreneche said

was a worrying trend because the people who are so desperate that they sell their

own blood are also likely to be in poor health.

"To buy blood is not safe, because people who sell the blood are people who

are more likely to be infected with HIV," he said.

He told the Post it was difficult for doctors to prevent the practice because most

of the donors are presented to medical staff as a member of the patient's family

doing a good turn for a relative.

"They tell us they are family of the patient, but actually they have been paid,"

he said.

Barreneche said the deal is usually negotiated outside the hospital so there is no

way of knowing if the donor is legitimate or not.

Nhem Thourk, a Director of the National Blood Transfusion Center, said the Ministry

of Health banned the sale of blood in 1991. But he said a chronic shortage of blood

available for transfusion meant doctors turned a blind eye.

He said the NBTC needed to collect at least 500 units of blood a month, but only

managed to collect 20 to 30 percent of that.

The balance is made up of donations from patients' families.

But he said in about half the cases in which a blood transfusion was needed no-one

in the family would give blood; instead they offered a professional donor, which

puts the doctors in an awkward position.

"How can the doctor say no? Even if we recognize the professional donor?"

said Thourk.

Barreneche said donors can earn on average between 20,000 riel ($5) and $50 depending

on the family of the patient and the patient's condition.

Nhanh Broh is a regular blood donor. He said he came to Phnom Penh from Kampong Thom

after the election in 1998 to find work laboring, but a shortage of employment meant

he has eked out a living between jobs by selling his blood.

He said he had given blood more than 30 times. It made him feel dizzy and weak, but

he was desperate.

"I have no choice; I have no money and only sell blood for the cash," he

said.

"I know I am weakened, but I was told that three hours after donating blood

it will be automatically produced again.

"When people like us want to sell blood we just go near the National Blood Transfusion

Center and look for a customer."

The way the system is supposed to work is that a relative of a person who needs a

transfusion donates blood to the NBTC. In exchange the family gets blood from the

center which is screened for HIV, syphilis and hepatitis B and C.

But when family are unwilling to give blood, they turn to people like Broh who provide

blood directly to the patient unchecked.

Experts say there is great risk of disease by paying someone off the street for their

blood. Cambodia has the highest incidence of HIV among blood donations in Southeast

Asia and the Pacific Region, according to the NTBC.

As for any risk to donors from giving blood, Thourk said healthy adults can donate

blood four times a year safely but more than that is not advised.

"When people give blood several times a year they are putting themselves at

risk," he said.

"We should not ignore people selling blood, but we need to educate the families

of patients to understand how to find safe blood."