•    HOME   
•    NEWS   
•    BUSINESS   
•    INTERNATIONAL   
•    TECH   
•    SPORTS   
•    LIFE & TIMES   
•    OPINION   
•    MY JAKARTA   
•    BLOGS   
•    EYEWITNESS   

Few acts of solidarity have the humanitarian effect of a blood donation: A single donor can help save the lives of three patients.

But in a country as vast as Indonesia, maintaining adequate donor numbers and ensuring the safe distribution of blood is no easy task.

Every day, Indonesia’s blood transfusion service fights against tough odds and a limited budget to help hospitals access the right amount and proper quality of blood when they need it.

The blood transfusion service must also worry about shortages. According to the World Health Organization, each nation needs 2 percent of its population to donate blood on a regular basis. In 2011, Indonesia collected 30 percent less than the four million bags required to meet demand, meaning that only 1.4 percent of the population donated.

However, while the shortage might seem like an abyss in a country of almost 240 million people, the Indonesian Red Cross (PMI) is slowly closing the gap.

Branching Out

The PMI manages 211 collection centers nationwide and its donors accounted for about 90 percent of all blood donations in 2011, said Dr. Yuyun Soedarmono, the PMI’s national director for the Blood Transfusion Unit.

“Indonesia is a very big country,” she said. “We don’t have PMI centers in all districts.”

In 2007 the government passed a regulation encouraging hospitals to set up their own blood collection centers if no PMI centers were available in the area.

“There are now 192 hospital-based blood centers, which means almost half of the blood collection centers in Indonesia are under the government,” Yuyun said.

The higher number of collection centers, however, has had a very limited impact on donation numbers. Hospital-based centers only collect about 5 percent of the national annual blood intake, or 123,000 bags.

“And they aren’t able to divide blood into different components,” Yuyun said. “[The PMI] can divide whole blood into red cells, plasma and platelets, so one bag of blood can help three patients.”

Breaking down whole blood donations into those components, is a costly process that requires expensive equipment.

“We cannot provide them [hospital-based centers] with the necessary equipment — it’s too expensive,” Yuyun said. “But we help them recruit donors by informing the public about the benefits of donating blood.”

Yuyun believes these hospital centers, not the PMI centers, should fill the 30 percent gap to the four-million donation mark.

“It should be the government’s responsibility,” she said.

However, she conceded that hospitals are not ideal places for blood collection centers.

“The concept of blood centers inside hospitals is not really appropriate,” she said.

“Hospital staff are already busy with their respective health services.”

Unlike blood centers, she said, hospitals are not exactly “donor magnets” because people visit when they are sick, “not because they are healthy and willing to donate blood.”

Blood Drive

To reach more donors and boost blood intake, the PMI created a fleet of 60 buses, or mobile collection units, which is set to grow to 100 buses in the coming months.

The benefit of these units is that they can be stationed in areas with a high density of people, such as outside shopping centers. Each unit then distributes the blood to a local PMI center.

Yuyun predicts that by the time this bus fleet reaches 100 vehicles, mobile unit collections will account for 30 percent of the total blood intake.

In addition to this fleet, the PMI also aims to expand its donor base by integrating its efforts into companies’ corporate social responsibility activities, opening two permanent blood collection centers at university campuses and setting up six more centers at shopping malls.

“In Jakarta, for example, we have one at the Senayan City mall and another in Bekasi,” Yuyun said. “Our shopping mall centers help us tap into more middle-aged donors, while the university campus centers help us reach the younger generations.”

Handling and Equipment

Meeting donor targets is just one objective for the PMI’s Blood Transfusion Unit; trying to use and transport the blood more efficiently is another.

“In some areas, not all of the clinicians know how to optimize the use of blood and blood products; they only use whole blood,” Yuyun said.

The Health Ministry recently made hospital blood banks compulsory to ensure the supply in every hospital, but Yuyun estimates that only about 10 percent of hospitals in Indonesia have one. As a result, blood must be transported quickly from outside donation centers when hospitals need it.

In some cases, when a blood transport unit is not available, blood is transported by replacement donors such as a patient’s friends or family members.

“They don’t know how to transport the blood correctly and it may get damaged or contaminated,” Yuyun said.

Hospitals may also lack a blood specialist who can test the compatibility of the donated blood and the patient’s blood, making the procedure even less reliable. Nevertheless, Yuyun said all blood donations are tested for HIV, hepatitis B, hepatitis C and syphilis.

“That in fact is one of the most expensive procedures in the transfusion chain and makes up a big part of the cost,” she said.

The cost of each bag is about $30, of which the government subsidizes $5 and the patient’s family pays for the rest.

Extra training and equipment for medical staff are also crucial, Yuyun said.

“We need to train more doctors and nurses in the correct use and handling of blood,” she said.

The only impediment so far has been insufficient funding, she said, though she added that things have improved considerably since she became the PMI’s national director in 2004, “particularly over the past two years.”

“We are now holding more talks with the government,” she said. “Subsidies have increased and the government just established a national committee for the blood service with people from different areas.”