The Best Gift of All....

Like Winston Churchill said . "“I have nothing to offer but blood, toil, tears and sweat.”....

Sometimes I need to say that too. 

Tears, toil and sweat are almost mandatory in Mumbai, whether one likes it or not. Given the messed up infrastructure, crowds, and the weather.  And when it comes to blood, whether in wartime or peacetime, one way for ordinary folks like us to give blood , is to "donate blood"....

I was initiated into this 42 years ago as a young adult in Pune. My parents recommended such things.  The late 60's  was wartime in the country, our college, one of Pune's finest, had organized a blood donation, and we went in droves.  The experience was interesting to say the least, and some of us  learned that we could withstand the sight of 350 cc's of blood, without falling into a dead faint.  I followed that up    off and on , and today, my children do the same.  It helps if you stay in an institutional area where proper camps are arranged with safeguards, instrumentation, attending doctors, and  adequate patient care and excellent documentation and checking of individuals. 

I have known folks, fairly well educated,  who avoid talking about this. They alarm their kids, albeit unknowingly, with misinformation. Mobilizing blood donors to  contribute for a friends  major surgery, and trying to do the transport arrangements, some folks I knew well, even started crossing the road away from me, seeing me come by.  

A few young folks , curious about all the noise and rushing around, came to ask details . Can you get up and walk afterwards ? Do people faint ? How long does it take ? Does it hurt ?  Will I miss classes the next day ?   What about getting infections through the syringe needles ?  Can I go to work straight from there ?

Yes. Anyone above 18yrs who weighs 45+ kgs and has a hemoglobin count of more than 12.5 can donate. Remember, there is no factory to produce blood except the human body.  Every unit of 350ml blood collected saves 3 lives, the 350ml is buffer blood in our body and is re-generated within 24 hours.  Today, a fresh disposable syringe/needle is used for every person, who is deemed fit to be a blood donor. 

You are queried about your medical history, medications, etc. Your weight, blood pressure and haemoglobin is checked and recorded , your blood group is ascertained, and those satisfying the set criteria are allotted a specialized blood collection bag. You then lie down as instructed, quietly squeezing a rubber ball in the donating hand, and your blood pressure is constantly monitored. I have seen folks nonchalantly messaging away on their phones and playing games with the free hand while the blood donation is in progress.  Nothing dramatic happens, your 350 cc is collected in no time, and they disconnect all the paraphernalia and ask you to lie down for sometime.  Ointments/tiny tapes are put where you were poked by the needle.  

You then relax in an area where they serve you  tea, coffee. fruit juice and biscuits.  You are ready to go.  To work, to school, home , anywhere. I know someone who even went swimming after 2 hours.  The personnel at these places are almost always gracious,polite and grateful to you.   You get a card as a blood donor with details.  Should anyone ever need blood, your card will entitle them to a bag of blood, no questions asked.  Those who have had to mobilize blood for  major surgery at one of the lesser hospitals will know what I mean. 


This time , it was at one of the most upmarket areas near us. A very posh supermarket near  fancy shopping areas and coffee shops, alphonso mangoes cascading on show outside, cars driving up to a hotel , with valet parking happening, and folks in their casual Sunday best ambling in to shop. 


 Those like us who knew about this event and came specifically for it, went ahead with the process. As usual , I was rejected because of age , but the daughter sailed through and donated her blood. 

This was an event specifically to help people who had Thalassemia.  This is a disorder of the blood, where the patient has problems with the haemoglobin in the blood. This affects carrying of oxygen all over the body, and the thalassemia patient needs to have blood transfusions every 15 days. Which causes its own problems with iron stores in the body.   There are 1 lakh thalassemic chidren in the country and a thousand of them are receiving regular transfusions in Mumbai alone.  To know more about this please see this.  


There was a steady stream of folks coming in, mostly young, many of them ladies,  but many in their 50's and 40's too.  And there was a wait for beds. Which was great......


Outside, in the sun, a  midsize car swathed in a huge banner announcing the blood donation event was parked at a vantage point.  There were these young folks standing outside holding placards saying "Donate Blood" in glorious red and white.  Almost marketing the event. 

I've never seen this before.  Real time marketing of the event.  Yes, there are normally welcome arches, and folks volunteering services, but inside the venue, with the documentation, refreshments, assisting the desk people etc etc. I have never seen anyone standing outside  and urging folks to go in.


But this was like advertising the event, looking so much a part of the supermarket ads announcing deals and stuff.  

It can be insensitively abused. 

Visions of "Donate blood and get 1 dozen mangoes free" or what is worse, some unscrupulous educational institution coming up with  "Show cards for 2 blood donations and get 10 marks added to your total" .......  (I've known of people who showed up 5 times for some  social service class in Dharavi as part of NSS, in the late 90's,  and added 5 marks (or was it 5 percent?) to their already outrageous totals , now exceeding 100 as a result. Happens only in India....)

There are no deals in blood.

Donating has to be completely voluntary. 
 
But we are a country where folks are blind to blood when its a matter of their life, death or surgery, but very much aware of it when they query the biological background of an adopted child of marriageable age. 

So much of  educating of the public still required .....

Banking of a different type.....

Many years ago, almost 12 or so, my father was scheduled for a major surgery of the prostate gland. We were asked to ensure that a certain amount of the required type of blood was available. Most Indian hospitals and blood banks, at least then, had a system, where you mobilized ,for them, the required amount of blood (never mind the blood group), before they released the necessary amount of the correct blood for your surgery.

I had been a blood donor several times in my relatively younger days , in several blood donation camps, but this was the first time I was seeing how the stuff is used by people in need.


I went around the various recommended reliable blood banks, and offered to give blood. I should have remembered, that donated blood had to have a certain quality level. The haemoglobin level in my blood, was disastrously low, thanks to years of menorrhagiaic problems,. They summarily rejected me as a donor, my mother was barred due to her age (late seventies), and there was no one else .

I had to hunt around for blood donors in a hurry, and was gratified to find a nephew and his cousin, who promptly got on to their two wheeler, and rushed to the blood bank, to donate blood for my father. The entire blood donation went off in a perfectly ordered manner, I was given a receipt paper to present on the day that the surgery was and they would release the required blood.

In my childhood, my father, who was in the civil services, would be posted at various district headquarters as the head, and he and my mother would always participate in the various health drives, inoculations, and checkup camps that would be held, as a means to encourage others to do so, and to indicate that it is a safe thing. These camps were always conducted by well equipped doctors from well known hospitals.

I learnt from observing them, and have been a blood donor several times in my college days and even much later after the children happened. And it was very natural, that as adults, my children too continued this tradition. I have always gone along just to confirm the facilities, and organizer credentials, and generally be around.

Since then, my children too have followed up, and one of them, who is in India , donates blood every year.

The place where I stay, has a tradition of celebrating a Founder's day. A blood donation camp is always organized then. By those who are deemed second level employees.

Doctors from one of Mumbai's most well known hospitals conduct this event in one of our vast halls, and what is amazing is to see students, both girls and boys pouring in throughout the day, to donate blood. The ones missing are always older middle aged men and women, so many with sedentary jobs, many of them well settled in life. Some, of course, have a health problem and are aware as to why they cannot be a blood donor. Some stay away knowingly, some, knowing my enthusiasm for this, kind of cross the road to the other side when they see me, and some are just convinced that something terrible will happen if someone pokes them with a needle.

I write this to explain the whole procedure.

You fill up a standard form on arrival where among several other questions, you indicate if you have had any serious sicknesses in the past, and when; if you take any regular medication and if so, then for what ; if you are a woman, they also ask if you are pregnant. They take your weight. They then prick your finger and a drop of your blood is dropped into a Copper Suplhate blue solution of a known strength. The rule is that a drop of blood with haemoglobin levels more than or equal to 12.5, sinks in the solution. Which makes you acceptable as a donor. (For years and years in my fifties, I used to curse the red drop of my blood that refused to sink, and they would apologize and reject me . Now the drop of blood happily sinks in the solution, but they shake their heads and reject me due to age restrictions. ).


Once this is done, they give you a sterilised small test tube, which you take to another person, who makes some notings of numbers, names, and stuff, stores the test tube , and hands you, what, is a blood bag, marked with your reference details.

You are then assigned a doctor and a station where you lie down. After the necessary checks like blood pressure etc, the doctor sets up the blood donation paraphernalia, and about 300 cc of your blood gets collected in a short time in the blood bag. It must be added that this amount of blood does NOT impoverish your body, and is made up by your clever body in a short period of time.

There are several doctors keeping an eye and attending to the donors. Once the stuff is done, they clean the needle perforation on your skin , and put a decent bandaid , fold your forearm towards your shoulder (like you do after a blood test) and ask you to lie down, relax for a while, holding your hand in that position. You get up after a while, and they offer you refreshments tea, coffee etc, at a table, where you sit with the other donors.

The aforementioned test tube will later contain some of your blood, which will be tested for severe infections like AIDS, Australia Antigen Malaria, Dengue etc. Your blood will be accepted only if there are no infections found, and only then, will it enter the blood bank.

There are people who are frightened of needles, there are people who are upset at seeing blood. It's not a permanent condition, and it is possible to change this. The first effort takes a huge amount of initiative and guts, then it is very simple. Think of all those who join medical colleges each year. Many of them cannot stand actual cadaver dissections, and they faint, and throw up. But that changes, or you wouldn't have so many doctors passing the final year.

Then there are those who have been told that weakness pervades the body if you donate blood. So they don't. Typically, a worried mother tells that to her son. And he believes it, till he goes away to college, sees his friends donating blood, takes an initiative, passes the initial checkups at the blood donation camp, and never really looks back after that.

Then you have people who suffer from unimaginable excesses of superiority. So much so that they associate superior with pure and subordinate with impure. They doubt and suspect every cup of tea from the office canteen (because the hoi-polloi drinks from it), they make a huge fuss about cleaning and smells and stuff. Someone gives them a book and they wipe it with a disposable tissue , before they open it. They suspect all injection needles, all doctors except those at 5 star hospitals, and ignore the fact that disposable syringes, and other sterilised stuff is routinely used everywhere .....

These types often have exalted ideas about their own blood, and are given to making insensitive comments about adopted children. These folks run miles from anyone talking about blood donation, always claim to be busy, unless of course the conversation is happening with people who count greatly in the scheme of career type things. In general, these folks are not worth the trouble.

I have always admired the armed forces , the police and railways when they hold camps. Their top man comes to inaugurate , and then quietly rolls his sleeves up , lies down on a makeshift patient bed, and donates his share of blood. The subordinates follow the example, and you get a whole lot of motivated people; more important, large volumes of blood collections. There are photographs. Some appear in the press. And you feel good when you read that report.

But what gets me really upset, is some boss types, that come smiling into the enclosure with measured steps, walk around the layout, hands behind, minister style, observing the foolish buggers donating their blood. They nod their heads at the folks enjoying a tiny plastic cup of tea/coffee, with the standard glucose Parle G biscuits, in a plate on the table. They then sit down, a noticeable distance away, someone offers bouquets, then tea and coffee, someone takes pictures. No questions about the volume of donors this year, the details of the collaborating hospital and so on. No speeches. Due to a severe lack of interest and knowledge.
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This time there was an old lady sitting away from all this, to one side, waiting for her daughter, who had just donated blood. The youngster was resting a bit and having a cup of tea with biscuits, and waiting to collect her certificate before leaving . That would enable her to collect a free bag of blood from the state blood bank, should anyone need it in an emergency.

The old lady has been going every year, so they know her. An elderly person from the organizers came up to her, and offered her tea and a bouquet. For being a regular, it seems.

She politely declined, saying this was not a free for all social event, and that it should be restricted to those donating blood. They insisted. Then she insisted. No blood, so no tea, and no bouquet.

The voice must have carried a bit. The elderly organizer's eyes twinkled a bit.

And then some folks quietly made an exit. Sedate, powerful, ministerial style......

Bloody Tradition......, कुणा एकाचे रक्त कुणा एकाचे दान

My fascination with blood goes back a long way. 


Possibilities of me being a valiant warrior type being absolutely nil, my first awareness of blood happened when , as a child of 8 or so, I witnessed an accidental injury caused by someone who was running around with a paper windmill on a stick, and managed to pierce my brother in the ear with it. Shock and awe at the expanse of red , growing by the second across his ear, we recovered fast enough to rush to our neighboring doctor with him, where he was examined and correctly treated, as a result of which, he has no hearing problem , till today.

Mercurychrome, in school, was a kind of "desired" accessory. You played hard, you stumbled, streaks of blood appeared, and a bunch of overexcited kids hovered around, and there was a lot of hissing ,as your teacher applied a lashing of mercurychrome. For some reason the bandages never stayed in place, and the orange yellow stain on the knees was a highly prized prestige item. Our school had plenty of sports, and growing up in a family with a male majority, I learned to be fairly nonchalant about blood; mine, that is. 


Voluntary community events were the norm in my childhood, and we were encouraged to participate , more when it was about giving, than when it was about getting a certificate or prize.

Staying away from home in college, one got engulfed in extracurricular stuff, and one day found me at the College Blood Donation camp. It was the Simple Sixties in Pune, a fairly conservative traditional town then, and going for this camp held in one of the halls in the boy's dorms, was a challenge enough. While some conservative types, acted as if we were entering the portals of Sin City, a bunch of us went, and were happily welcomed by the doctors, nurses, and organizers. Basking in a sense of systolic and diastolic importance, as they checked our blood and fitness, we admired those who single mindedly poked into our veins, to, as my friends said , "fix the tap and get the pipes going".

Eureka! We gave blood!

Arose. Nothing happened. All visions of stumbling across the hall, eyes dimmed, hands outstretched, supported by nurses etc, came crashing down. We were offered crackers and some beverage, asked to relax, The only excitement came when one of our classmates fainted , possibly out of seeing bags of blood getting slowly filled with this really dark stuff, and folks lying on tables.....

One more belief that immediately  hit the trash was the conviction that transfusions happened like they showed in Bollywood movies : two desperate chaps lying on two beds alongside each other, with an actual pipe leading from one guy to a bottle of blood, from where it was delivered to the other guy through another pipe, as assorted relatives, villains, molls, former enemies et al ,stood around with miraculous looks on their faces. We started hearing about packed blood, platelets, plasma and the like.  Life went on. My friends and I donated blood several times after that  Happily.  And the  folks organizing these camps were grateful and appreciative.  

By and by , we all got busy with children, careers, and family matters, and voluntary donation of blood , kind of took a back seat. But blood remained somewhere in the subconscious.  Organising  requirements of blood , for a friend's husband , scheduled to undergo major heart surgery,  and various people at work started crossing the road when they saw us approaching.  Applauding the concept was one thing. Actually getting poked and drained was a different thing altogether." And think of the diseases. "  

The Internet had just begun, and although Google hadn't been born, Yahoo must have then  been swamped with bloody searches from certain IP addresses.

But we tried. A lot of people listened.

 

The hospital authorities were overcome with the sheer number of people who came. A lot of young people , students , donated blood for the first time, and felt good about it. Some of them even insisted on donating blood for other patients in the hospital who needed it,  now that my friend's husband's need was fulfilled.  I went up to do my stuff, and came back a disappointed person. I was told my blood was not rich enough in iron, and needed to improve before I could donate again. 

 

But age was catching up. If haemoglobin didn't get me, age would.

That's where the children came in. Both were now adults. In a world with glitzy contraptions,knowledge factories ,dot-coms, MTV and charmed lifestyles, there needed to be a realization that giving was "cool", more so, than acquiring. And so they came one day, to a blood donation camp with me, and learned how to be useful, while I struggled to understand why I was being rejected , yet,once again. Poor blood. (I don't get published anywhere, but certainly know what a rejection feels like).

 I now  have a year left before age  debars me from donating blood. I recently went with my daughter to a blood donation event on campus. Wide smiles, roses being presented, and incredulity that both of us wished to donate.(With sideways glances at me . Hmm)

 

I was coming after years. The gentleman who did the preliminary checks, nonchalantly pricked my finger, and dropped a drop of my  poor old doubtful blood into a beaker of copper sulfate. Peered at it, and motioned me to go ahead. I had made it ! The Haemoglobin was behaving itself. After so many years , I was lying on this couch, hands outstretched, and several folks were trying to look for veins, which hitherto had been fairly visible in my arms. 

The mind was at peace. My blood wasn't special, but it flowed on, right into the pack that collected it, and soon joined a large set of anonymous blood bags in the bank maintained by one of Mumbai's biggest public hospitals.

My daughter and I, were both pleased. Me due to my haemoglobin, and she because she was given a special bouquet in honor of being the first woman donor that day. All donors that day received wristwatches with the logo of the company sponsoring the days activities at the hall. I am not sure this commercial intrusion is a welcome thing; but it is a clear indication, that blood is sorely needed by blood banks, they are trying to attract the younger crowd, and there are some folks who are pleased to help to publicize everything.... 

  Over the years, I have had occasion to rush around trying to organize blood for a sick little child as well as for an elderly parent scheduled for a major surgery.

 

In Mumbai, they will release blood from the blood bank, only if you organize an immediate substitute donation, to keep their supply replenished. Its either you, if you qualify, else, you seek out donors within the available extended family.  But if you have donated blood earlier, and received a data card regarding that, this saves you time, as blood may be obtained against it. What is even nicer, is that this card may even be used  by someone else if you have no use for it .

They will disqualify me in a year. The haemoglobin will find it harder and harder to reach the correct levels. But one thing is certain. There will be some folks within the family, to carry on , er, this bloody tradition......