Kyrgyzstan: Blood Supply Crisis

A shortage in blood supplies has led some doctors at the Aksy central district hospital in the south of Kyrgyzstan to make the donation of 200 grams of blood a condition of discharge for patients.

At a round table organised by IWPR, deputy director of the hospital Erkin Dolonbaev admitted that families of patients and even the patients themselves are sometimes forced to give blood, but he insisted that it was not standard practice.

“We don’t force every single patient to do this. Out of 10,000 patients, only 531 people offered to donate blood, so we were forced to introduce an element of compulsion because no one wants to give blood voluntarily,” he said.

He added that plans were being drawn up to ensure that each hospital department should provide a certain quantity of blood to be used in emergency situations. "We need this to save people whose lives are in danger," he said, adding that severe post-natal anaemia and serious injuries require blood transfusions for which extra donor supplies are needed.

Patients who have been affected by the directive are outraged. “After I giving birth, I already felt terrible, then my doctors diagnosed me with anaemia. When I went to get discharged, both my clothes and the medical certificate I needed to provide at work were witheld until I gave 200 grams of blood,” said Elnura Begalieva. Eventually, her elderly mother managed to pay some doctors to provide a certificate confirming blood had been given.

Other patients at the hospital, which is in the village of Kerben, confirmed to IWPR that nurses warned them throughout their treatment that their final discharge from hospital would be conditional on giving blood.

Kyrgyzstan is certainly facing a serious shortage of blood. A centre responsible for attracting donors has virtually no funds and a staff of only 150, who are not capable of mounting a mass campaign among the population. Director Toktogazy Kutukeev told IWPR, “In Kansas, for example, three million dollars are allocated to encouraging voluntary donation, but we don't have any budget for this."

During Soviet times, the centre employed 600 people, who were assisted by 400 Red Cross employees. The Soviet system attached certain rewards and privileges to blood donation, which was the subject of large-scale publicity campaigns. The actual collection of blood was carried out by volunteers organised through party regional committees, who drafted in factory workers and university students. Quotas and targets for the year ahead were set centrally. “People who gave blood and people who filled the quotas, received government awards,” said Kutukeev.

Indeed, large amounts of blood were wasted through the Soviet system of collection. “In 1988 to 1989, 200 tonnes of blood were stored in Kyrgyzstan,” said Kutukeev. “Out of these, 40 tonnes was written off, and 60 tonnes went to manufacturing blood preparations and another ten tonnes were written off after processing because the shelf life of 21 days had expired.”

After independence, Kyrgyzstan abandoned the Soviet system of storing blood, but now finds itself facing serious shortages. The country needs around 20,000 donors, which it doesn't have. "This year we began working on a state strategy to attract donors," said Kutukeev. "But it won't involve strict forward planning."

In the meantime, patients claim that some doctors are using the compulsory donation directive to run a racket. “Of course, you don’t really have to give blood, instead you can pay the doctor for a certificate which confirms you have done so. And of course no receipts are given for the money collected,” said Dariya Abdyraiimova, a voluntary worker for the Kerben civil society organisation Law and People.

Anara Temirova, a resident of the village of Karajygach, told IWPR that she ran away from the hospital the day before her discharge after learning that she would be expected to either donate blood or pay money, which she did not have.

Not surprisingly, payments to doctors in lieu of blood donation are not official practice. “This is a gross violation on the doctors’ part,” said Kutukeev. “I will contact the head of the Aksy hospital myself and try to investigate this situation.”

Kumar Bekbolotov and Asel Sagynbaeva are independent journalists in Kyrgyzstan.