Blood From Paid Donors a Hidden Problem in Cambodia

Crouched on the sidewalk at the corner of Ang Duong Street and Norodom Boul­e­vard, near the National Blood Tran­sfusion Cen­­ter, Chheang Sa­ry said he hoped to sell his blood for extra cash.

“Friends told me that I could come here to sell blood for $5 a li­ter,” he said on Monday.

Chheang Sary came to Phnom Penh a month ago from Svay Rieng province to find construction work. But now the 32-year-old is trying to earn cash at the trans­fusion center.

Unfortunately for donors like Ch­heang Sary who seek payment, the center does not accept blood from paid donors, said Huk Kim Cheng, center administrator.

“Normally, paid donors are high risk. It is very difficult to ask questions and believe their answers re­garding HIV/AIDS,” he said. In Cam­bodia, blood transfusions are on­ly accepted if they are from un­paid donors, Huk Kim Cheng said.

Last year, the center received 11,160 donations. Roughly 4 percent of the blood originated from spontaneous donors, who came to give blood of their own accord, he said.

An additional 19.1 percent was col­lected from external donors at schools and pagodas’ mobile blood centers. The remaining 77.2 per­cent was received from re­place­ment donors, Huk Kim Cheng said.

The replacement system consists of having a relative or friend of the person in need of a transfusion donate blood to the center in ex­change for screened blood, he said.

But too often, family members and friends refuse to do it, believing that giving blood is unhealthy or makes people sick.

This is where paid donors like Phan Doeun—who says he regularly gives blood at the National Blood Transfusion Center—offer their services, Phan Doeun said Mon­­day.

The 20-year-old alleged that people at the center have paid him as much as $5 per liter for his blood. Over the past year, he has given 10 liters of blood, which the staff offers at a much higher fee to pa­tients and families not wishing to do­nate their own blood, Phan Doeun said.

Huk Kim Cheng denied Phan Doeun’s claims.

“We have no system to pay for blood donations,” he said. “Any staff at the bank here or at the hospital will not be forgiven if they [take advantage of] families or do­nors,” he said.

However, families have been known to pay strangers who then pose as a relative or family friend, Huk Kim Cheng said. These fake replacement do­nors are interviewed before they do­­­nate blood, but it is difficult to de­­­tect who is who, especially since family members have been known to accompany the paid per­son, he said. “Sometimes we are not clear if they [are] family do­nors or people who were paid by relatives,” he added.

Kaye Vickson, blood safety advisor for the World Health Or­gan­ization, agreed, saying that it is difficult for blood centers to monitor paid donors who lie during interviews.

“If a family is asked to give blood, and if they go on to pay someone to give blood, that is completely out of the control of the blood transfusion service,” she said.

Regardless of who is paying re­placement donors, Kaye Vickson said that blood from these do­nors is discarded more often than blood from voluntary donors be­cause it is more likely to be infected with HIV and hepatitis B.

According to 2004  figures from the National Blood Center, last year 4.1 percent of the blood re­ceived from replacement donors tested positive for HIV/AIDS, compared to 0.4 percent received from external donors and 1.7 percent from spontaneous donors.

Blood from replacement donors was also more likely to have hepatitis B, hepatitis C and syph­ilis.

Both Vickson and Huk Kim Cheng said that Cambodians’ re­sistance to donating blood is medically unfounded.

“It’s a good thing to do and it won’t make them sick,” said Vick­son, adding that historically, Cam­bodia has had a low number of do­nors.

“Anywhere in the world, your best donors are voluntary, non-paid donors,” she said.

 

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