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FOCUS: Blood sales alarm Cambodia.

PHNOM PENH, Feb. 13 Kyodo

The sale of blood in Cambodia is driving up both costs to patients in need of transfusion and the chances of those getting a transfusion of also getting blood-borne infections.

Already struggling with poverty on a massive scale after decades of civil war, Cambodia now faces another threat to its economic and physical health.

Professional blood donors, themselves trying to eke out a living however possible, are beginning to be among the few sources of blood outside family members available in the country, at a huge threat to both their own health and the health of blood recipients.

But faced with huge shortages and shrinking stock, officials at the National Blood Transfusion Center (NBTC) say they have no choice but to close their eyes and take blood wherever and however they can get it.

Nhem Thuok, director of the NBTC, admitted that between 35% and 40% of blood donations come from professional donors, and other staff, who asked not to be named, said the rate may be as high at 50% or more, even though selling blood is illegal in Cambodia.

But Meas Soeun, a 45-year-old moto-taxi driver who waits for customers in front of the NBTC, said he knows the blood-sale network very well.

When his daughter needed a unit of blood, he had to struggle to get $50 to buy it -- a huge amount for someone whose daily income rarely exceeds $2 or $3 a day and must feed, clothe and house a family of five.

He added some drivers even sell their own blood.

Oscar Barreneche, an adviser to the NBTC, said the center needs 20 to 30 units of blood a day in stock to meet the needs of patients coming from at least five state-run hospitals in the capital, and dozens more from private clinics.

But blood collection from volunteer donors falls far short of even that modest target.

The NBTC has tried to going around the country to collect blood at Buddhist temples, high schools and government ministries, but even that is rarely enough to meet needs.

Monks are targeted particularly because they supposed to be celibate and less likely to have HIV in a country where donated blood is too often contaminated with HIV, hepatitis, or syphilis.

''As much as 20% of the total blood collected must be destroyed because of contamination,'' Barreneche said.

Military camps and police stations, once thought among the best places to find donors, are no longer even on the list because HIV is rampant among the forces, NBTC staff said.

Poor education, which makes many people leery of donating blood, is another factor behind the dearth of volunteer donors, Barreneche said, and that means professional donors are often the only way for those who need it to obtain a blood transfusion.

''Many Cambodians believe blood never returns to the body after giving a donation, therefore, education is sorely needed to correct this belief,'' he said.

The NBTC categorizes blood collection three ways -- ''internal replacement'' from family members, ''external donors'' found by mobile blood bank collection, and ''internal spontaneous'' donations from volunteers who come to donate regularly at the center.

Internal replacement provides 80% to 90% of the total blood collected, external donors 10% to 15%. ''Internal spontaneous'' donations account for less than 5% of all the blood collected, Barreneche said.

Private clinics and hospitals pay $20 for unit of blood, while patients often must pay up to $50. The money is used to support NBTC activities, including office materials, mobile teams and repair of vehicles used in blood collection, said a center staff member.

Professional donors get $5 to $10 per blood unit, while brokers, who often include hospital staff, get another $10 to $20 or more, according to blood sellers.

Lay Sovanara, 21, from Prey Veng Province about 100 kilometers from Phnom Penh, told Kyodo News he came to the center twice to sell blood for money.

''I do not want to sell my blood, but I cannot find a job and my family is poor,'' he explained, adding a friend who had already sold his own blood told him how to go about finding buyer.

Neither Barreneche nor Nhem Thouk denied NBTC staff are part of a network of professional donors and sell blood. Both said the practice is almost inevitable because the staff rarely make more than $20 month in salary.

Barreneche said some private clinics also buy blood from donors for onward sale.

The only upside to the underground sales of blood from the NBTC, he noted, is that at least blood from the center is safe, while blood from private clinics can easily be contaminated.

Eng Huot, a director general at the Ministry of Health, told Kyodo News he knows blood is being sold, but said the ministry can do little about it because those in need are ready to buy blood wherever they can get it.

''The current policy is acceptable,'' he added, ''because it can secure balance of blood consumption and stocking.''

Nhem Thuok, the NBTC director, said he hopes a new center focus on education of potential donors will help alleviate the shortages.

But until then, it seems clear only those willing to pay the highest prices, or having the most luck, can be assured of getting both safe and adequate blood.
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Publication:Asian Political News
Date:Feb 19, 2001
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