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."
