by Okwuanya Pius-Vincent

The million dollar question then is, why would you give away for free what you will spend money to buy when you need it and if a pint of blood is N6000, who keeps the profit?

Dan Tracy, a reporter working for the Orlando Sentinel, a newspaper in Florida, United States once noted in an informative piece that Blood is big business. The unconventional and the esoterically inclined might see his submission as having some ritualistic and occultic dimensions. Their misconception is not entirely their fault, if one follows the home movies, we are consistently regaled with the same tired storylines of how one had to shed blood to become rich (Nollywood, it is your fault). His implication as he explained in his article is simpler than that. The fact that blood is obtained by unpaid donations and sold at quite a steep price is already lucrative. Therefore, inside each and every one of us are diamonds, liquid reddish diamonds called blood. The WHO (World Health Organization) in anticipation of the escalation of this “liquid red gold” has sternly discouraged the commercialization of blood. Indeed, in Nigeria, one can get arrested for the buying or the selling of blood at the black market, yes black market.  The only legitimate way to get blood is from a blood bank (some hospitals have blood banks). The blood banks get the bloods for free from donors who have in recent times been discouraged from selling the liquid. However, the blood banks do not give these life-saving substances away for free. In the United States, blood and its components may sell as high as $500 depending on the need and the uniqueness of the blood substance under review. In Nigeria, a pint of haemoglobin (red blood cells) the most common blood cell sells at between N6000 to N10000 depending on one’s location and the level of desperation. Thus, for the donor who donated two pints of blood, someone may have just made N12000 while giving the donor a bottle of malt, meat pie and a wristband. I do not want to delve into the mathematics of exploitation but one thing is certain, the blood banks make money from a substance they do not buy. The case where two blood banks (Roault and Chinoba) in United States entered a bidding war involving some stupendous amounts to get the “contract” of hosting blood drives in a group of schools clearly debunked the fallacy that the blood banks do not make money from the blood they collect for free. It is not my aim to demobilize the teeming number of altruistic Nigerians who venture into blood donation with the positive sentiment of saving a new mother or an accident victim. Morooph Babaranti, a spokesperson for the Evidence 4 Action (E4A- an Organization trying to reduce maternal deaths) had in an interview stated that 26% of the maternal deaths are due to haemorrhage. Blood donation is important in saving lives too. Thus this piece does not aim to discourage or just criticize, it is my aim to walk the fine line between cynicism and altruism and in the process point out the truths, the half-truths and the outright falsities involved in the Blood game and so account for the reason blood donation in Nigeria has been an uneven and mostly unpatronised procedure.

The truths. Blood is a very vital substance. It is life itself and donating your blood is a gift of life to whoever needs it whenever he should need it. Most of the critical procedures in medical sciences and the hospitals require the availability of blood. The issues of childbirth and Caeserean Section, surgical procedures and serious accident cases are all blood-intensive scenarios. In such scenarios, the presence or the absence of a matching blood is the difference between life and death. However, blood is not just obtained and transfused in the same short order. It is processed and five parts are extracted and the five parts possess varying degrees of utility and are used depending on the peculiar needs of the patients. The most popular components of the blood are the platelets, the blood plasma and the red blood cells. The procedures involved in the processing of these blood substances are often grueling. The Blood bankers argue that the processing of blood is capital intensive and informs the reason why the sell the blood substances. They even opine that most of the bloods that pass through this intensive process are not healthy.

A Lagos Haematologist, Dr. Akanmu pointed out that some of the bloods processed are found unfit for transmission. He went further to say that most “touts” that sell blood scarcely have healthy blood. Truthfully though, the bloods pass through a rigorous process where strains of HIV, hepatitis and malaria are checked and rechecked to ensure that a solution doesn’t become problematic when these blood substances are transfused into those that need them. It is also true that the level of sensitization and mobilization on the issue of blood donation is very low. This reality was not helped by socio-cultural and religious factors. The world health organization has made it a point to ensure that countries all over the world obtained 100% of their blood reserves from voluntary unpaid blood donations; however, only 62 countries have met that criterion. It is expectedly, most unfortunate that Nigeria is not among the 62.

In a report submitted by a reporter working for The Punch newspapers, the team told of their encounter with blood merchants who are slowing forming a cartel to “assist” those in need of blood. According to the report, an advert and phone number of a “Baba fix it” was strategically placed in a conspicuous section of the walls in Lagos State University Teaching Hospital (LASUTH). The story of these investigative journalists uncovered a network of connivance and contrivance and served to underline the depth of the squalor in our society. Furthermore, it must be said that these blood merchants offer competitive services and prices when juxtaposed with the blood banks. At least “Baba Fix it” will always have one of his “boys” available unlike the oft-witnessed paradoxical scenarios of blood banks that has no blood. Evidently, the scarcity of blood in the blood banks is linked in a complex web of socio-cultural and religious factors and an unfortunate mix of mistrust and outright cynicism but who owns the blame? You cannot beat a child and ask him not to cry.

A sad story had it that in one of the private hospitals, a new mother died due to his husband’s inability to immediately provide money for the two pints of blood the wife needed seeing as the couple belonged to different blood groups. The husband was asked to provide the sum of N12000 (about $80) for two pints of blood, however, he was still sourcing for the funds when the wife bled out and gave up the ghost. The woman, I was told was a regular blood donor and took great pride in the fact that her blood saves lives. She had the plates, the t-shirts and the wristbands to show for it. The disillusioned husband later swore that on no account was he to donate or allow any member of his family to donate blood. It is certainly too much to take when a man discovers that he cannot buy what his wife gave away for free and with joy to save her own life. It is one irony too many. In as much as we are meant to believe that the processing of bloods cost an arm and a leg, would there be any blood to process if there is no blood in the first instance? The tail does not wag the dog. The more rankling question is; just how much does the processing of blood cost? The secrecy surrounding the cost implications as well as the procedures of blood processing is a sharp contrast to the openness and benign smiles adorning the faces of the health workers and the nurses while they are inserting the needle at the crook of your arm and placing a soft small ball in your hands. Looking at their faces, you would think that there is nothing better than blood donation and in a way that is true. However, the openness ends there. The rest is shrouded in secrecy. Hardly do you hear from them again and the tests they promise as incentive are as certain as Pilate’s judgement, they hardly say the truth. As the blood hunters prevaricate, their truth changes.  Thus, in the case of the “blood merchants”, “blood banks” and the “blood donors”, the fluid nature of truths in this field has meant that there is nothing like black or white, the pervading colour is grey. This complex mish-mash underpins the laissez-faire attitude of a large majority of the population towards donating as important as blood. It also triggers the collective misanthropy thatb has become the “modus-vivendi” of the Nigerian society. The million dollar question then is, why would you give away for free what you will spend money to buy when you need it and if a pint of blood is N6000, who keeps the profit? Countries all over the world from India to England has  often pleaded with the blood banks to be non-profit oriented, however, the pleas and conscientizations of the state authorities have often fallen on deaf ears as blood business continues to boom.

A year ago, a Florida state senator who was bothered by the blood business as it unfolded in Florida commented that it bordered on the unseemly that blood blanks now war over people’s blood. Senator Don Gaetz R-Niceville consequently tried but failed to pass a bill in the legislative house that would have compelled the blood banks to be more open with their finances. The secrecy, he implicitly agreed, is suspicious.

Seeing as the process of blood sales and its profits are shrouded in secrecy, the legislation against individual blood merchants becomes a dance without tunes; baseless. What makes it wrong to sell a substance you have no need for at the time but would certainly end up buying when you need it desperately? It sounds like banking to me. Why are governments all over the world stressing individual liberalism, giving individuals rights to decide what happens to their own bodies, from abortion to euthanasia and from gay unions to organ harvesting while ironically restricting the sale of a fluid that he owns and which haematologists agree would be better taken out of him occasionally to improve his quality of life? Governments’ reason for placing restrictions on the sale of blood may be for the preservation of the society and decency. The criminal ingenuity of some frustrated Nigerians makes it possible for people to harvest blood from others without their consent or even from themselves when they might not have enough to sustain themselves.

The bottom-line is,  I may not be campaigning for the commercialization of blood at the level of the individual donors, I am merely advancing that for a substance the blood banks obtain at no cost, it is perhaps not too much to ask of the blood banks to dispense the same substance with charity and sacrifice and when it is impossible due to the running costs of blood processing, they should endeavour to dispense it with a measure of sacrifice and charity. What is good for the goose should be good for the gander. The introduction of blood credits whereby donors earn the ability to use blood in emergencies by donating blood should be encouraged to ensure that sad stories of consistent donors who met their demise because they cannot purchase blood or get blood should be summarily halted. Blood credits will certainly encourage blood donations. Altruism is always a good reason to donate blood but in some cases, it is not enough. Thus an individual needs a more concrete reason (apart from the heavenly rewards) why he should give blood. The process of blood donation is time-wasting and the immediacy of the need is not evident in the environment of the blood drives. It takes something worthwhile to encourage someone even if he had enough blood to give, to lie down on a bed and gaze at the ceiling or the sky for a minimum of fifteen minutes (depending on the pints) and answer some exam-like questions, in order to save a life he does not know. Transparency of the blood banks is a step in the right direction. The outrage and disbelief that followed the confirmation that the Red Cross (U.S) sold blood shows the deep concerns surrounding the issue of blood. The onus lies on the haematologists and the blood bankers to enlighten the citizens on just how much it costs to process blood. The people are interested in just how much profit they make from our blood and whether they buy cars with it. If they are to encourage people to volunteer for unpaid blood donations, they must be ready to work unpaid sor at most for a minimum payment. The era of lucrative charities should be checked. At most, the profits accruable to the sales of blood should be controlled by the government who will reinvest the profits in the “blood industry” that will help to fashion out interesting and creative incentives that will make the donation of blood worthwhile. While I agree that the individual donors should not be allowed to hawk their bloods to the needy, I submit too that the blood banks must learn to be truly charitable with the blood. An Igbo adage has it that “ofia na-aso nkata agaghi epu ero”. If you live in the glass house, you should not throw stones. The blood banks should practice what they preach else we fear that we are missing a trick. We are not their fools neither should we be their cash cows.

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Op-ed pieces and contributions are the opinions of the writers only and do not represent the opinions of Y!/YNaija.