The Core Problem
Like many parts of the healthcare system in Lebanon, blood transfusion is subject to heavy de-centralization. With the lack of proper laws and regulations to organize this vital sector, private and public hospitals have each adopted different systems and procedures for blood transfusion starting from working hours, to donor selection criteria and finally processing the blood units. Apart from hospitals, other instituations (NGOs, Laboraties,etc) have also developed their own procedures. Despite many efforts done to re-organize blood transfusion, Lebanon has yet to reach a centralized system that tackles blood shortages on a national level.
Types of Blood Donations Around the World
There are three main systems for donating blood around the world:
Safety of the Blood According the World Health Organization (WHO)
Comparing the three types, the WHO clearly classifies the VNRD as the safest types of donations, as donors giving blood volontarily are less apt to hide any suspicious behavior in their medical interview. The Family/Replacement donations, again according to the WHO, are less "safe" as donors come under pressure to donate for someone they might know, thus the tendency grows to hide any suspicious behavior (or medical history). Also, the replacement donors increases the risk of "paid" donors and black-market. Paid donors are mostly the least safe when it comes to blood donation, as any monatary compensation will push them more and more into "outsmarting" the system, jeopardizing the entire safety of the blood.
The Case in Lebanon
In Lebanon, and under the de-centralized system that causes blood shortages all over the country, it is up to the patients' relatives and friends to search for the needed blood units/donors to fulfill their demands. Hence, more than 90% of the system is based on Family/Replacement donations. This system puts a lot of stress on patients, blood donors and blood banks to secure the need based on urgency; Donner Sang Compter (DSC) was born as a result.