PUBLISHED
March 09, 2025
LAHORE/KARACHI/PESHAWAR:
They say life and death is in the hands of God. But sometimes the delicate thread of fate suddenly lands in the hands of distraught family members, who barely have minutes to find, match and trade a few bags of blood in return for the irreplaceable lives of their loved ones.
In a heart-wrenching scene outside a government hospital in Peshawar, Rakhshinda Bibi, an elderly woman, was seen pleading passersby for blood donations for her 10-year-old son suffering from thalassemia. Highlighting the gravity of her situation, Rakhshinda tearfully shared that she was left with no other option. “After facing repeated rejections and delays at both private and public hospitals, I have no choice but to beg random strangers to help save my son’s life,” she cried.
Rakshinda’s pain is deeply felt by millions of families across the country, who in the absence of adequate blood banks and state-initiated blood drives, have to put their blood, sweat and tears into urgently arranging blood for their loved ones. One such mother was Shumaila from Lahore who was struggling to find O negative blood, the rarest kind, for her sick son. “When I brought my son to the emergency, I faced a lot of difficulties since the blood bank of the hospital was vacant,” shared Shumaila.
Down south in Karachi, Gulfam, brother of a patient, faced a similar predicament, when he was unable to find blood for his brother’s transfusion at the New Karachi Hospital. “My brother’s haemoglobin was very low and the doctors asked me to arrange three bottles of blood. Since there was no blood bank in the hospital, I went to a private blood bank to buy blood,” revealed Gulfam, who complained about the shortage of blood at government hospitals.
The donation crisis
As per sources from the Health Department, almost 2.5 to 3.0 million blood donations are required across the country each year to meet the requirements of patients suffering from blood loss following surgery, childbirth, accidents or those with thalassemia.
There are 191 blood banks registered in private and government hospitals across Sindh, including Karachi, of which 80 per cent are private blood banks. According to the Sindh Blood Transfusion Authority, 523,713 voluntary blood donations are made in Karachi annually. Thus, only one per cent of Karachi’s population donates blood voluntarily and the majority of these donations are made by the patient’s family. As a result, there is a severe shortage of blood, particularly the O positive and negative groups in Karachi.
The situation is conspicuously more alarming in Punjab, where the Punjab Blood Transfusion Authority has been inoperational in the absence of a head. In Punjab, blood donations come to blood banks established in government and private hospitals, which are voluntarily given to the needy. Simultaneously, there are illegal blood banks established outside hospitals, which sell blood with the connivance of hospital staff.
Punjab is the largest province in terms of population, and it requires 700,000 to 800,000 blood bags annually. At present, there are 56 registered blood banks at the state level in Punjab, while 60 blood banks are working at the private level. However, despite these blood banks, the demand for blood is met with great difficulty and many a times people even lose their lives.
Sundus Foundation has a private blood bank, which requires 400 bags of blood every day however, only ten percent of this need is met through blood banks and the remaining 90 per cent of people requiring blood urgently have to take help from relatives, friends and other sources.
Up north in K-P, the Blood Transfusion Authority (BTA) K-P revealed that a total number of 485 blood banks were collecting approximately 250,000 donations each year. The Regional Blood Centre (RBC) in Peshawar serves a population of about 4.26 million and provides just 180,000 units of blood to local hospitals and thalassemia centers.
Limited awareness plays a major role in the decline in donor interest. Other limiting factors include a severe lack of motivation, recognition and appreciation for voluntary donors. In addition, the prevalence of diabetes, hepatitis and HIV in Pakistan is very high, due to which patients of these diseases are not eligible to donate blood. Other ineligibility factors include socio-demographic factors such as education, gender, age, marital status and residential area, which also become barriers to voluntary blood donation.
What further worsens the shortage of blood is the fact the even today whole blood is donated in various hospitals, due to which the other three components in the blood are wasted. Dr Usman Waheed, technical expert at the National Health Regulatory Services revealed that whole blood has been banned for patients around the world, while in Pakistan, whole blood is still administered.
“A bottle of blood contains four components, including plasma, red cells, white cells and platelets. All over the world, patients are given only those components which they require while the other components are preserved to save the lives of other patients,” revealed Dr Waheed.
No national blood drives
According to the American Red Cross, one blood donation can save up to three lives. However, research shows that donating a bag of blood not only benefits the recipient but also positively impacts the mental health of the donor. Findings published by the Mental Health Foundation have revealed that people who donate blood experience reduced mental stress, improved emotional well-being, and an enhanced sense of belonging.
Unfortunately, despite the many advantages of blood donation, people across the country have little or no awareness over its importance thanks to the failure of the government to organise a national blood drive and encourage and empower people to play their part in saving lives.
“The tendency of voluntary blood donation is very low among people in Pakistan. Therefore, in case of blood shortage, we have to organise blood camps in universities, colleges and other institutions for collecting blood donations,” said Dr Mazhar Khamisani, manager of the blood bank at the Civil Hospital Karachi.
Sources of the Express Tribune have revealed that a voluntary blood donation campaign has not been launched at the government level in Karachi till date. Hence, voluntary blood donation campaigns are organised by various private blood banks operating across colleges and universities. In these camps, young students are encouraged to donate blood voluntarily.
Similar is the case in the heart of Punjab, Lahore, where no government agency is willing to collect blood for patients. Although the Blood Transfusion Authority and the Blood Transfusion Institute were formed in the past, neither could be sustained and are no longer active.
“These bodies were formed for collecting, preserving and storing blood in government hospitals but due to the lack of planning, they were discontinued. Now, there are blood banks in the hospitals, but they have measly facilities to store blood hence very little blood is available in case of emergencies. If these institutions are made active, it can be a great convenience for the people who are currently relying on private institutions,” said Saeed Ilahi, health minister during the PML-N era.
Up north in Khyber-Pakhtunkhwa, Shahid Khan, an employee at a government hospital, explained that although blood banks were established in public hospitals, there was an alarming discrepancy in the allocation of blood. “When relatives of patient’s demand blood, the hospital staff asks for blood bags, but during the surgery, the same blood is often not used and instead ends up being sold in the black market,” revealed Khan.
Women and barriers to donation
In spite of endless debates highlighting gender difference, the solid proof of the shared humanity of men and women is evident in the fact that the same blood flows through the veins of both. However, when it comes to donating blood, women are generally discouraged from playing their part in serving humanity due to various social and health barriers.
Shumaila, a student at Jinnah University, expressed her willingness to donate blood. However, she believed that myths and a lack of available information on blood donation acted as major barriers. “Young women are often made to believe that donating blood might lead to complications during their future pregnancies and deliveries. Furthermore, there are no awareness campaigns at the government level to promote blood donation. Therefore, women do not know where to donate blood,” said Shumaila.
Similarly, Amna, a homemaker, felt that the burden of household responsibilities including childcare and daily chores often left women too exhausted to even consider blood donation. “Furthermore, family members, particularly husbands, discourage us from donating blood since they fear that it may cause weakness. Therefore, voluntary blood donation is extremely rare among women in our society,” opined Amna.
According to sources of the Express Tribune, the overall rate of blood donation in Pakistan stands at 18 per cent, to which women, who comprise 55 per cent of the country’s population, rarely contribute. These figures are alarming when compared to 70 countries around the world including the US and Canada, where the tendency of donating blood voluntarily is 100 per cent.
Although myths around donation could partly withhold healthy women from saving lives, the reality is that the high incidence of anaemia among women across urban and rural areas means that a significant percentage of the female reproductive aged population is more likely to be the recipient rather than the donor of blood.
As per the guidelines issued by the Punjab Blood Transfusion Authority, women can donate blood however, those who are pregnant, breastfeeding, recovering from miscarriage or childbirth or suffering from heavy menstrual bleeding or cramping are advised against donation. Due to the aforementioned reproductive conditions, many women develop low haemoglobin levels and are unable to donate since their levels fall below 12.5 g/dl.
According to the National Nutrition Survey of Pakistan 2018, 40.2 per cent of women in urban areas and 44.3 percent women in rural areas suffer from iron-deficiency anaemia also known as low haemoglobin. Deputy Director of Health Services Karachi, Dr Pir Ghulam Nabi Jillani revealed that malnutrition among women was a leading factor contributing to anaemia.
“This is particularly the case in rural areas, where women face a plethora of health problems due to food shortages. Furthermore, many rural women suffer from parasitic infections, which also contribute to anaemia. Additionally, the consumption of harmful substances such as betel nut, chewing tobacco and clay too contribute to blood deficiency,” emphasised Dr Jillani.
Selling or saving lives?
Blood donations are often seen as noble acts of kindness aimed at serving humanity. However, when heartless profiteers start capitalising even on people’s misery, it is hard to tell whether they are actually saving lives or simply selling them.
Tariq Iqbal, husband of a pregnant woman, had to deal with a similar blood bank mafia when he was unable to find blood for his anaemic wife requiring a transfusion. “The doctors asked me to arrange two bottles of blood. However, the private hospital’s blood bank demanded Rs8,000 to Rs10,000. There is no uniform policy for taking blood in exchange for a donor, due to which the patient’s family has to face countless difficulties,” regretted Iqbal.
Shahid, the brother of another patient requiring a transfusion, revealed that people in need of blood bags from private blood banks were required to first present a donor. “The blood bank demands Rs8,000 to Rs20,000 for a bag of blood and other components including platelets,” said Shahid.
The situation was not much different in Punjab, where government hospitals commonly ask the relatives of patients to arrange blood of another group in exchange for the required blood group. In other instances, the relatives themselves are expected to make a direct donation. Blood is stored at blood banks in government and private hospitals and families can buy the required blood bag for Rs10,000 to Rs15,000 but if A, B and O negative blood is required, then the banks charge their desired price. Unfortunately, there is no check and balance and if someone complains, the police take minor action but no crackdown is organised by the health department regularly.
Dr Murad Ali, a medical practitioner from Peshawar, pointed out the fact that private blood centers had turned into a highly profitable business. “Apart from a few reputable private blood centers, many are operating illegally. They set up blood donation camps on the streets, only to take the donations and sell them at inflated rates,” he said.
Zakir Khan, a medical storeowner from Peshawar, also highlighted the rampant exploitation in the city’s medical sector. “Sadly, many medical stores are involved in the black market, selling blood bags to patients at exorbitant prices, ranging from Rs10,000 to Rs20,000. If the blood is O-negative, then these dealers make even more money,” disclosed Khan.
“We have imposed bans on several private blood centers for unethical practices. Our authority is committed to taking strict action against those involved in this illegal blood trade, which can lead to the spread of diseases,” said a senior official from the Khyber Pakhtunkhwa Blood Transfusion Authority, on the condition of anonymity.
According to the instructions of the Sindh Blood Transfusion Authority, any donor who donates blood must first undergo a screening for HIV, Hepatitis B, Hepatitis C, syphilis, and malaria before their blood can be given to the patient.
Speaking to the Express Tribune on the matter, Dr Waheed revealed that the country’s safe blood transfusion policy was formulated back in 2014. “This policy is now being reviewed, and amendments are being drafted. Uniform kits are also being devised for blood screening under the new policy,” said Dr Waheed.
