Indonesians have an extremely low percentage of rhesus-negative blood compared to others – almost none. With two million foreign visitors arriving in Bali each year, scarcity of rare blood might not meet demand and in some cases transfusions cannot be carried out. Carla Albertí de la Rosa spoke with Dr A.A. Gede Sudewa Djelantik, director of Sanglah Hospital’s blood bank since 1973 about the need for blood and the importance of donations from tourists.
The Red Cross Unit at Sanglah sends donates blood outside Bali. What percentage of donations are sent out and where to?
We send blood all around Indonesia, and sometimes Singapore. Especially rare blood. We send less than one percent outside of Bali.
How do you cope with blood requirements for locals and foreigners in Bali and how much is needed compared to how much is given?
For our people in Bali we don’t have any problem. In Bali we have an organisation of blood donors, PDDI.
The problem is that in Indonesia we don’t have rhesus-negative blood. Indonesians are 99.9-percent rhesus positive. In other countries they have 10-percent rhesus negative. Bali is a tourism area and if foreigners need rhesus-negative blood it’s very hard to get it.
We also have the rare blood organisation donor, so we organise expats who work in Bali. If they have rhesus negative, we take their name, address and telephone number and if we need their blood we just contact them.
In one donation they give 300ml. We have enough blood. That’s why we can send it outside sometimes. But the problem is that sometimes there’s an emergency. We tell expat donors to keep the blood in their body until someone needs it.
What kind of screening is done by blood banks in Indonesia and do all follow similar standards of screening and storage?
We follow the standard of the World Health Organisation (WHO). We screen for HIV, Hepatitis B and C, for syphilis. We can keep the blood in the blood bank in good condition for up to five weeks, but it’s normally used after two weeks. It is kept between 2 and 10 Celsius.
But in the rest of Indonesia, it’s not like that. They must follow the recommendations of WHO; they try but not all follow them.
Is there a centralised information centre in Indonesia that can tell which blood bank has what stocks, so that in an emergency this information can be used to procure blood and save time? If not, what would it take to have one?
In Bali we have it. It’s at Sanglah Hospital. We are the centre and get information from the districts, to know how much they have and how much they need.
But in the rest of Indonesia it’s not like that. We keep pushing the Indonesian Red Cross in Jakarta to have it.
How has technology helped blood banking?
Before, they extracted blood and gave it to the patient directly. Now, we screen and, for example, if somebody is ill and they need only the red blood cells, we don’t give them the plasma but only the red blood cells.
What type of blood is most needed and how many blood banks are there in Bali?
O negative, like everywhere else. There are nine blood banks in total.
In places like Bali, where healthcare is not the ultimate and where some foreigners fear getting treatment at local hospitals, how can you promote blood donation, and is it a safe practice?
In Bali we have PDDI. We ask members to spread information and we also give information to donors who come here. We put signs in hotels and we go to the hotels to collect blood, only if it’s rhesus negative. We need help for rhesus-negative blood. We ask people who come to Bali to visit to please give blood. It’s very important for us. Many people are scared but it’s perfectly safe.
Why does former vice president Jusuf Kalla, now head of the Indonesian Red Cross, say the Sanglah unit is a “model for the country”?
PDDI is the organisation of volunteer donors that has 400 units of organisation in Bali. In each unit they have a certain number of fixed donors. There are 23,000 regular donors in Bali. Every day we have around 70 to 100 people donating. We are very well organised.
Is there a difference between blood-donation requirements of foreigners and that of Indonesians?
No, there isn’t. We use international standards for everyone, although foreigners are generally bigger than Indonesians and they can give 500ml. But we still collect 300ml. The only difference is that if someone comes on holidays, then we are more flexible if they want to donate, as we can go to the hotel to extract blood.
Some foreigners in Bali have told this newspaper that they would like to donate blood regularly – say, every month, because they do this at home and would like to keep up the practice. Is this possible?
If they are rhesus negative we ask them to keep the blood in their body until we need it. Wait for us to ring. Rhesus positive can give their blood every three months. But it’s better for people to give when we need it because we can only keep blood for five weeks.
For what kind of accidents and illnesses do foreigners require blood transfusions?
Traffic accidents are very common. But also people with thalassemia, leukaemia, anaemia or when a mother has a miscarriage.
Are there some cases where blood supplies are simply not available and the patient can’t get a transfusion?
Sometimes it happens because in one day everyone needs the same type of blood. Then we contact PDDI and tell them what we need. For example at Galungan, no one gives blood so we might not have enough.
What have been the most challenging times for the Sanglah unit?
Even if we have a challenging moment like during the Bali bombings in 2002, we still have good communication with PDDI, and we receive more donations. We are just very busy collecting blood.
The problem we have is finance. Some donors have to pay. If government helps then it’s not necessary, but screening costs money. If they’re poor people they don’t pay.
Looking ahead, how do you see the Red Cross in Bali developing?
We have to move together, cooperate with the Red Cross and PDDI. We will continue developing our good organisation and have good communication. We just need to keep informing foreigners about the shortage of rhesus negative. If you live in Bali and you want to help people who need it, give us your details we will contact you when we need your blood.