Should blood donors expect rewards?

THE year-end holidays and first few months of the New Year are seasonally a harrowing period for Sarawak General Hospital’s (SGH) blood bank.

It is during this time blood stocks are precariously low as evidenced by the regular public appeals for donors in local newspapers.

The fact is that the blood bank can always use more blood.

It must meet the difficult challenge of creating and sustaining a consistent blood supply all year round.

Failure to do so would be unthinkable.

In this sense, public blood donation drives, organised by non-governmental organisations (NGOs), are literally life-savers.

However, there are those who feel uneasy with some NGOs’ practice of rewarding donors with free gifts such as rice, cooking oil, milk and other goods — courtesy of sponsors, usually corporate companies.

Understandably, offering rewards to encourage blood donations raises a number of uncomfortable issues.

Is it morally acceptable to offer such rewards to encourage philanthropy? Is it morally acceptable to receive these type of rewards for acts of charity?

Do these standards apply in matters of life and death such as making sure hospitals have sufficient blood stocks to save lives?

Changing circumstances

The reality is demographics of blood donors in Kuching have changed significantly over the last decade.

The mobile blood unit now accounts for about 80 per cent of total blood donated while the rest comes from walk-in donors, according to a source familiar with the operations of SGH’s blood bank.

This represents a big shift from just 10 years ago when the percentages were roughly split equally between the mobile unit and walk-in donors.

Apparently, it is becoming less of the norm for the military and police to make up for any shortfall as in the past.

However, thesundaypost was not able to uncover possible reasons for this.

The blood bank now averages 20 walk-in donors daily as compared to 30 to 40 donors before. Thus, the hospital relies heavily on its mobile blood unit to replenish supplies.

During weekdays, the unit targets strategic locations such as corporate companies, government offices, and tertiary institutions and tries to return to those premises once every three months.

However, it is the blood drives on weekends at public spaces like shopping malls and big public events where more people are likely to gather that tend to attract the most donors. During a good weekend, the blood bank can collect as much as 200 units of blood, a significant portion of the estimated 1,300 to 1,500 units needed each month.

Donated blood has a shelf life of 35 to 42 days but it is rare for blood stocks to expire because demand almost always outstrips supply. Due to a limited budget, a small team of trained personnel and rising costs, the blood bank is restricting the number of outings it can organise on its own. The support it receives from NGOs is crucial to maintaining sufficient blood stocks.

Government’s stand

Government policy supports non-remunerated donations. However, some people argue incentives given by the Ministry of Health to recognise the contributions of repeat donors and encourage long-term blood donation, can be taken as a form of remuneration.

Surat Pekeliling KPK 5/2005 dated July 20, 2005, details how blood donors are entitled to receive free outpatient treatment at government health facilities (public hospitals, institutions and government clinics) for a certain period based on the number of times they have donated.

Thus, these same people argue, why the fuss over NGOs using free gifts and other incentives to attract more donors?

Understandably, a number of people approached by thesundaypost were reluctant to comment openly about the subject.

Those that did shared their general uneasiness about making such practices more widespread but acknowledged NGOs-organised public campaigns play a crucial role in cultivating greater public awareness about blood donation, especially among the local Chinese community.

According to the source at the blood bank, ethnic Chinese blood donors now account for 70 per cent of local donors.

This marks a significant change in mindset as blood donation was considered taboo within the Chinese community as recently as a few decades ago, even if it was their own  spouse or relatives in need of blood.

Public service

Assistant medical officer Haji Sulaiman Ediwi agrees offering free gifts is a good way to raise publicity about how donating blood can save lives.

“The blood cells in our bodies only have a lifespan of three months, after which they are destroyed by the liver,” he said.

“So why not do something good and donate blood?”

Sulaiman belongs to an elite group of blood donors who have donated over 50 times. He has been donating blood since he started working 38 years ago – long before the practice of offering free gifts became more widespread.

However, he doesn’t see anything wrong with the practice of using free gifts to attract more donors.

“Of course, people are more motivated to come with free gifts. Blood is always needed, so something must be done (to attract more donors). I think what the NGOs are doing is good.”

The Federation of Kuching and Samarahan Divisions Chinese Association Sarawak is one of the more recognised NGOs in Kuching when it comes to organising blood drives. Thanks to its large network of members, volunteers and sponsors as well as a good publicity team, the organisation is also widely recognised as one of the most successful in recruiting donors.

Welfare officer Chris Kho said offering free gifts and incentives is an effective way to raise awareness about the importance of blood donation and attract more first-time or non-regular donors to blood drives.

“People donate blood because they want to give back to society,” he said.

“The gifts are meant to say ‘thank you’ only. This is for charity – not business. We are always in need of new donors.”

Growing practice

However, not everyone shares Sulaiman and Kho’s views.

Amy (not her real name) admits these days, it seems so many NGOs are offering incentives and rewards to encourage blood donations. She has expressed strong reservations, believing offering rewards goes against the spirit of volunteerism.

“I don’t think it’s advisable. Some people may be in it to make a name for themselves and not in the spirit of true giving.”

The NGO Amy now works with prefers to give small tokens of appreciation such as certificates and souvenirs as they want to encourage people to donate for humanitarian reasons — not because they are thinking of physical rewards.

“People should be proud to be able to give something back to society instead of thinking what I give, I should get something back,” Amy said.

“If I do something and expect something in return, it becomes a barter trade instead of charity. But different people do things for different reasons. We cannot condemn them if they think this is the best way to get people to volunteer to donate blood.”

Against the flow

Kuching Life Care Society (KLCS) secretary Hung Sung Huo also thinks the practice of giving free gifts should not be encouraged except for small tokens such as key chains, bookmarks or t-shirts to acknowledge the donors’ contributions.

KLCS is a Kuching-based NGO set up with the expressed objective of encouraging people to donate blood and pledge their organs for donation to save lives. The society used to give free gifts such as rice to donors but discontinued the practice two years ago.

Happily, despite this, the society still manages to maintain an average of 30 to 50 donors per campaign.

“There are still a lot of people who come forward to donate and not because of the gift,” Hung said.

“We really appreciate these donors because they know what they are doing.”

One of the main drawbacks in using incentives to attract donors is that it can bring out the worst behaviour in some people.

Hung said he had come across individuals who tried to donate blood more than the recommended once every three months because they wanted the free gifts.

He has also seen situations where some individuals chose to attend blood drives offering free gifts instead of the ones which didn’t.

Hung thinks a more viable long-term solution to encouraging blood donations is through greater public education about how donated blood and organs can save lives, and by focusing on intangibles such as the spiritual and moral commendability of charitable acts and the priceless value of a human life, instead of emphasising benefits given by the organisers or the government.

Disrespectful to donors

“We need to be very careful about the sensitivity of this topic,” cautioned Samuel (not his real name).

His company organises and sponsors charity events – including blood donations – on a regular basis.

Samuel pointed out that since his company first started sponsoring blood donations several years ago, the nature of goods they sponsor has remained unchanged.

However,  the number of donors they manage to recruit every year is increasing despite the fact that the relative value of the gift has not increased — suggesting people are not motivated to donate blood because of material incentives.

He feels people who comment that blood donors can be influenced by the offering of free goods are not respectful to the donors and that such comments can turn off potential donors.

“We have to respect the donor as not everyone who shows up comes for the free gift,” Samuel added.

“People donate because they understand the life-giving value of blood. Some donors even refuse to take the sponsored gifts.”

Hung (from KLCS) shares similar views.

“For donors not looking for gifts, I sometimes feel giving them free gifts is an insult to them because it (act of donating blood) becomes like trading and commerce.”

Samuel also highlighted that not every sponsor who participated in blood donations was motivated by publicity.

The gifts his company sponsors are meant to be tokens of recognition and appreciation for donors for their charity.

According to him, some sponsors see their involvement as an opportunity to give back to the community and are quite happy to remain anonymous.

“They just want to help but they don’t want the recognition.”

He feels there’s little truth in the allegation that some people may compare different donation drives to see what’s being offered before they decide which to participate in.

Citing his colleagues as an example, he said whenever his company organised a blood drive, not only will they donate but also freely volunteer their time to help publicise the event as well as recruit family members and friends to donate.

However, Samuel acknowledged using material incentives to attract blood donors was probably not the best way to encourage philanthropy.

“Sometimes it can be difficult to say no to requests for sponsorship for blood drives,” he said.

“Some organisations say they need many sponsors for their event otherwise they will not get a good response. However, I think this perception is untrue because when our company organises our own blood drives, the response is always good.

“Personally, I don’t think it’s worthwhile using material incentives to attract donors. It can lead to some NGOs trying to compete and fight among themselves to attract donors. This defeats the purpose of organising blood drives in the first place.”

However, Samuel feels those who want to sponsor blood drives should be encouraged.

“People want to sponsor because it’s their way of contributing, their way of charity. What’s important is their main objective, their motives behind it.”