Meanings of blood, bleeding and blood donations in Pakistan: implications for national vs global safe blood supply policies

Abstract

Contemporary public policy, supported by international arbitrators of blood policy such as the World Health Organization and the International Federation of the Red Cross, asserts that the safest blood is that donated by voluntary, non-remunerated donors from low-risk groups of the population. These policies promote anonymous donation and discourage kin-based or replacement donation. However, there is reason to question whether these policies, based largely on Western research and beliefs, are the most appropriate for ensuring an adequate safe blood supply in many other parts of the world.This research explored the various and complex meanings embedded in blood using empirical ethnographic data from Pakistan, with the intent of informing development of a national blood policy in that country. Using a focused ethnographic approach, data were collected in 26 in-depth interviews, 6 focus group discussions, 12 key informant interviews and 25 hours of observations in blood banks and maternity and surgical wards.The key finding was that notions of caste-based purity of blood, together with the belief that donors and recipients are symbolically knitted in a kin relationship, place a preference on kin-blood. The anonymity inherent in current systems of blood extraction, storage and use as embedded in contemporary policy discourse and practice was problematic as it blurred distinctions that were important within this society.The article highlights the importance—to ensuring a safe blood supply—of basing blood procurement policies on local, context-specific belief systems rather than relying on uniform, one-size-fits-all global policies. Drawing on our empirical findings and the literature, it is argued that the practice of kin-donated blood remains a feasible alternative to the global ideal of voluntary, anonymous donations. There is a need to focus on developing context-sensitive strategies for promoting blood safety, and critically revisit the assumptions underlying contemporary global blood procurement policies.

South Asian tissue economies

“…Recall the kidney operation, an 'available way for a marginal subject to imagine or to fear a different kind of future…through an operation that promises to turn one's organ into money' (Cohen 2011b, 136). We are thus reminded of the negative promise of South Asian tissue economies: the ways in which 'superstitions' are held to both block and structure them, their augmentation of the flow of dowries (Cohen 2001), rebooting of caste (Mumtaz et al 2012), and so on. Their rhetorical and actual futurial promise draws on and reentrenches features of pasts unconsigned to history.…”

“…Taking our cue from recent studies that have brought questions of the social implications of biotechnology strongly to the analytical fore and drawn attention to the variegated biopolitical milieus of South Asian tissue economies (Cohen 1999(Cohen , 2001(Cohen , 2004(Cohen , 2010(Cohen , 2011a(Cohen , 2011bBharadwaj 2000Bharadwaj , 2003Glasner 2009;Bharadwaj & Glasner 2009;Simpson 2004aSimpson , 2004bSimpson , 2009aSimpson , 2009bSimpson , 2011Sunder Rajan 2006;Reddy 2007;Egorova 2010, Mumtaz et al 2012, this special issue ranges widely -theoretically, thematically and regionally -in examining South Asian variants of and engagements with diverse modes of biological exchange: caste, gender and blood donation in Pakistan (Mumtaz & Levay), DNA testing amongst a former Untouchable community in south India (Egorova) and amongst diasporic Indians in Houston, Texas (Reddy), body (cadaveric) donation in India (De Looze), the use of fake blood in Bangladeshi cinema (Hoek), the mobilisation of blood, hearts and ketones to protest the Indian government's failure to provide redress or care to victims of the 1984 Bhopal industrial disaster (Banerjee), and blood-based political portraits and petitions in south India (Copeman). In considering this complex of issues we seek to extend the parameters of classic accounts of the role of substance transactions in the production of South Asian personhood into investigations of the biopolitics and economies of substance that shape people and communities in diverse parts of the subcontinent.…”

Blood Donation; Knowledge, Attitude and Beliefs of the Female Attendants

“…The hurdles include lack of knowledge about the blood donation process, the financial constraints, the hassle involved, the family and cultural traditions and lack of interest of authorities. 12 Previously many national and international studies have been done on the general population regarding their views about voluntary blood donation. A number of studies have shown that females participation in blood donation process is low especially in the developing world.…”

“…Similar thoughts were shared in the previous studies. 9,12 Others feared that they would not be able to carry their daily routine efficiently after blood donation. In majority of the cases the females were reluctant to donate blood without the permission of their male family members.…”

“…12 Glynn SAet al concluded that fear of the blood donation process including the needle pricks and syncopal attack are other reasons repulsing the ladies from donating blood. 15 Majority of the participants were Muslims and gave the opinion that it is right in Islam to donate blood in order to help others.…”