Blood transfusion in the Caribbean: a case study of Trinidad and Tobago

Abstract

The Caribbean islands form an archipelago connecting North and South America. They have all been colonised by European countries and share strong historical, social, economic and diplomatic links with North America. However, their blood transfusion services have evolved differently, using predominantly family/replacement rather than voluntary non-remunerated donors as has been the practice in England and America since 1926 and 1970, respectively. This article uses the case of Trinidad and Tobago to examine the history and current state of blood transfusion services in the Caribbean and to present early results of an initiative for improving blood safety and adequacy in the region.

Blood donors' attitudes towards voluntary non‐remunerated donation in Trinidad and Tobago

“…The donor credit goes further by empowering the donor to grant this advantage to any person of his choice with no time limit for doing so. In addition, an undocumented proportion of donors receive hidden payments from patients or relatives (de Verteuil, ; Charles, ). Donors' linkage to the beneficiary is not confirmed, and this could facilitate strangers masquerading as relatives.…”

“…The remainder of blood is obtained from individuals who hold a personal blood bank account and receive a credit for each donation. A credit can be used at any time to obtain a chit in the name of a beneficiary of the donor's choice (Charles, ).…”

Blood utilisation in a developing society: what is the best index of efficiency?

“…TTO is a two‐island developing country with a segmented, hospital‐based blood transfusion service that relies heavily on family/replacement (F/R) and remunerated donors (Charles, ). This arrangement has survived decades of recommendations from the Pan American Health Organization (PAHO)/World Health Organization (WHO), which advocate voluntary non‐remunerated blood donors (VNRD) for safety, adequacy and equal access (World Health Assembly, ; PAHO, , , , ).…”

“…Following this study, a voluntary non‐remunerated blood donor programme has been introduced with favourable results at the EWMSC (Charles, ). In addition, a multidisciplinary hospital transfusion committee has been established at the institution to monitor and evaluate transfusion practice.…”

A follow‐up survey of knowledge, attitudes and practices surrounding blood donation in Trinidad and Tobago

“…Its main ethnic groups are Indo-Trinidadian 37Á2%, Afro-Trinidadian 36Á3% and mixed race 18Á8%. Most of the population are Christian (51Á8%), Hindu (22%) or Muslim (6%) [Central Statistical Office of Trinidad and Tobago, available at www.cso.gov.tt, last visited 19 November 2016]. Primary school education is mandatory, 85-90% of citizens receive secondary level education, and tertiary level education uptake was 15% in 2004.…”