20 July 2012

BEIRUT: While Ramadan is often marked by multi-faceted generosity on the part of fasting Muslims, blood donations tend to decrease. In extreme cases, blood shortages due to a lack of donations can delay vital surgical procedures, as was reported in the United Arab Emirates last year.

Indeed, in order to avoid shortages, numerous organizations in predominantly Muslim countries, including the UAE, Indonesia, and Malaysia, have established special initiatives to encourage blood donations during the Muslim holy month.

While there is no consensus among Islamic scholars concerning the permissibility of giving blood while fasting – partly due to the lack of clear injunctions within the Quran or Hadith that can be consulted as a basis for judgment – the majority hold that it is allowed in the case of an emergency.

However, medical professionals caution against donating blood if one is fasting, as the procedure could deplete the donor’s strength. It is preferable to eat a meal before donating blood and imbibe plenty of fluids both before and after the session – making donations problematic for people shunning food and drink from sunrise till sunset.

The problem is perhaps not as acute in Lebanon, due to the country’s mixed religious demography. Nevertheless, numerous hospitals register a marked decrease in blood donations during Ramadan. And because Ramadan will coincide with summer for a few years, the decline in donations comes when they are sorely needed.

“There is an increased demand for blood in the summer because it is holiday season and there are more accidents and emergencies in addition to people taking time off work to have surgery,” observes Yorgui Teyrouz, founder of Donner Sang Compter, an organization that links potential blood donors with those in need of their services.

“Donations here during Ramadan tend to go down between 30 and 40 percent,” says Rita Seghrali, head of the blood bank at the Rafik Hariri University Hospital in Bir Hasan. “People sit down to break their fast at eight in the evening and afterward they are often too tired to donate.”

Seghrali notes that during Ramadan, the Hariri Hospital’s blood bank is kept open a couple of hours later than usual to accommodate donors who must sit down to iftar before coming to the hospital. The hospital also adjusts the staff rotation so as to ensure that a higher number of medical personnel are on call during the final shift.

While Seghrali observes that in critical cases the family members of a patient usually step in as donors, she points out that a lack of donations during Ramadan causes complications that delay blood transfusions.

“The lack of donations means we are not self-reliant,” Seghrali explains. “We have to call other units at other hospitals and contact organizations like the Red Cross. It can lead to delays in procedures. The situation is not ideal,” she adds.

It’s not just Beirut that’s hard hit during Ramadan. For example, a decrease of around 40 percent in blood donations during Ramadan is reported by the Jabal Amel Hospital in Tyre. And in a survey carried out by the Lebanese Red Cross in June of this year, fewer donations were made in the organization’s Tyre branch than in any of its nine other blood banks.

Only 53 units of blood were collected in Tyre, which ranked just below the Chouf with 58. To put this in perspective, in Antelias 777 units were collected, in Tripoli 671 and in Jounieh 419.

Hala Jabre, president of blood banks at the Lebanese Red Cross, notes that these figures can be misleading, as political parties have their own blood donation centers separate from those of the main hospitals and the Lebanese Red Cross. She is dubious of reports of decreases in blood donations during Ramadan and points to cultural attitudes in Lebanon as the main culprit behind problems with donating blood.

“The spirit of donation has been corrupted by a lack of confidence in the hospitals,” argues Jabre. “People will give blood in the case of emergencies, but otherwise they will not,” she adds.

The Lebanese Red Cross does not work directly with hospitals but rather on a referral basis, whereby hospitals recommend the Red Cross to patients if they are unable to match the patient’s blood type. Jabre says the system does not work due to a lack of transparency on behalf of the hospitals.

“If they can’t match the blood, they will tell the person to contact their families. They will attempt to ensure the patient stays in the hospital because they are earning money like this while the Red Cross service is free,” explains Jabre.

“They will contact the Red Cross as a last resort – and even in this situation, if they need one or two bags, they will ask for six,” she continues.

“We are not a supermarket for the hospitals,” she adds.

Jabre further notes that blood donations in Lebanon are often governed by sectarian considerations, a phenomenon that stymies the establishment of a European-style system with one central bank from which blood is distributed throughout the country.

“This is still a very religious country,” Jabre sighs. “When they donate, Muslims want to know where their blood is going; the same with Christians,” she adds.

She acknowledges exceptions to this general pattern will occur every now and then – but it quickly becomes clear that such occasions are bittersweet.

Recalling the upsurge in donations by Christians and Muslims during the 2006 Israel-Lebanon conflict, and the uncharacteristic lack of concern on the part of donors regarding the identity of recipients, Jabre notes wryly: “They will only donate to each other during times of war. We only love each other during war.”

Copyright The Daily Star 2012.