14 February 2015

Blood Donation: What went right?

"Donation" sounds like charity, and many want to donate blood to the poor. Organize a blood donation camp with a private hospital, and the questions pour in, as to "Why aren't we donating blood to the poor? Why to a private hospital that's just going to make money out of it?".

Well people, for starters:

I don't see blood donation as charity. It's a rescue. You're saving a fellow human from dying. Why in the world would you want to check if they're rich or poor?

If you're insistent, then I'd ask you: Have you donated blood regularly to a blood bank where you know the blood is given to the poor, free of cost or for a very low price? Have you even found out anything about such a blood bank? Have you encouraged your contacts to donate regularly?

You donated blood for free, and when you needed blood, the hospital charges you for it! It only sounds outrageous until you realize that the plastic pack that holds blood itself costs a little more than Rs.250. Then there's the cost of the other disposables, blood tests, salaries, preservation costs and so on. The expense per unit of blood, comes up to approx. Rs.1800 or more. I got to know this from the best blood donation volunteer group I have ever known: Sankalp India Foundation. You can still get blood for lower than the Rs.1800, when there's a government subsidy. Asking hospitals to give blood for free, is just not fair.


A trend

The graph below shows a trend of blood donated over a period of two years (4 drives at ~6 month intervals) at a certain place. The number of donors went up steadily and suddenly fell. Nobody knew why, and all that people did, was try to guess.


Although the trend was not too alarming, and could be pictured as an averaging out of the number of donors, a small team of three smart and dedicated volunteers decided to dig deeper. They wanted to know not only what went wrong, but also about what went right the previous occasions, and they were very surprised at what they found.

Knowledge, is one of the foundational corner-stones and surprisingly the most ignored asset in volunteering circles. Knowing people's opinions was the key, and the volunteers didn't have much time to spare on a daily basis. So for the first time in the history of the group, they designed a strategy which would be efficient and wouldn't consume much time:

Strategy decided
  • Each volunteer speaks with a minimum of 30 people in 10 days.
  • Team keeps each other informed so there are no overlaps in people coverage
  • Conversations are restricted to 10 minutes of leisure time.
  • Team could choose to speak to random people or to the donors.
  • Information garnered is anonymous
  • Four common questions asked

Not all volunteers could cover 30 people in 10 days, so the team could cover only 8.5% of the target group of around 600 people. The sample data obtained was small but yet informative.

On reviewing past data, the first surprising piece of info that came up was that people of all walks of life had donated during the drives. The level of education of a person was irrelevant. Everyone knew they had to donate blood. So the target group was expanded from an estimated ~450 people, to ~600 people. Of these, the team spoke with 51 people.

Only 13% of the group on average, had donated blood. That's 87% of potential future donors!


Click to view the image larger

Some specific observations
  • 35% more people would likely donate if just better awareness is given
  • Although 10% claimed to have a permanent health issue, it's likely some were bluffing and were actually in the "fear of donation" category.
  • 17% (quite high) have concerns/misconceptions about the 'system'. Many of them could still be convinced with facts.
  • Not many people have actually been in a situation where they've seen people struggling to arrange for blood or needed to do it themselves. Showing them this by means of a video, statistics or pictures would help.
  • Low haemoglobin is apparently not a big problem (17% of the 51 were female)
  • As suspected, there were people who were forced / emotionally blackmailed to donate and these people didn't donate the next time. Pushing people doesn't help in the long-run.

If you have any observations, you're welcome to post it in the comments.

Why this data is not good enough
  • Only a small percentage of people were covered (having more volunteers would've helped)
  •  The percentages here would change with a larger sample size
  • Categorization was done only as per gender, education level and a certain other factor. Factors comparing donations across drives, the percentage of the 51 people who came to donate etc., weren't taken into account due to lack of correct past data. (maintaining accurate data during a blood donation drive and asking people who didn't donate for their opinions is required)

Why the data is useful
  •  Although data is less, it gives us hope by showing that in a random sample, there are at least 40% more people who would be likely to donate in future with a bit of convincing.
  • With only 9% or less people refusing to donate, it shows a positive public opinion, goodwill and a spirit of generosity toward helping others.
  • Rather than resorting to guess-work, this data gives volunteers a more solid foundation to work with. Now we know exactly which areas require more effort and what kind of effort. At the grass-root level, you get to hear opinions which help in devising a more realistic strategy of convincing people.

Moving forward
  • As you can see, blood donation is not just about organizing a camp and hoping that people donate. It's also not about pushing or dragging people to donate and boasting of a high number of donors.
  • You need to create a culture where people understand the need to donate blood, and spreading awareness in the right way is a large part of establishing that culture.
  • As a volunteer, it is definitely not enough to just make a few posters and make announcements a few days before the donation drive. 
  • A dedicated team has to work on the data analytics, build a connect with the target group of people and this team needs to have excellent knowledge about blood donation.
  • The management of this target group of people also have to be active participants and encourage the culture of proactive volunteering, because to really help society, you have to plan activities for the long-term and do it genuinely.
  • Never focus only on the number of units of blood donated. It's far more important to create a culture of understanding; and this comes only with a sustained, dedicated effort from volunteers.

I'll be sharing more on these efforts in due time. Meanwhile, I'll be happy to hear your comments.

Remember: A city like Bangalore needs 800 to 1000 units of blood on average everyday!

An open letter to hospitals about blood donation.

07 February 2015