Translated material
Bloodless
Donor blood disappeared from Russia
For Russian medicine, the long May holidays threaten to turn into a humanitarian catastrophe. On the eve of the holidays, experts sounded the alarm: there is no donor blood in the country. The New Times dealt with the possible consequences and causes of the shortage
Do not offer me any more alcohol, please, never at all, even in minimal quantities. Fatty, fried, dairy and bananas too, ”Anna Egorova writes in her Internet diary. And the reason is not that the day before the girl had some "excesses". Anna is a volunteer of the Donors for Children group. She used to wait for the onset of any holidays with great anxiety. In the days of general fun, it is very difficult to find those who are willing and, most importantly, can donate blood. Sometimes it's impossible. First, blood mixed with alcohol is not good. Secondly, the shelf life of all blood components is important. “Platelets, for example, are stored for a maximum of 3 days, so consider that May 4 will be,” says Evgeny Zhiburt, chairman of the board of the Russian Association of Transfusiologists. “If there are 3-4 days of holidays, especially in a small town, then, apart from prayer, there is little to help here.”
Blood and flesh
Kolya Isaev, 14, from the village of Kumzhara in the Republic of Mari El, died in the Yoshkar-Ola hospital on April 4. Although just a month ago, the boy and his parents lived in hope: Kolya, a patient with aplastic anemia 1 found a bone marrow donor. The guy was waiting for a transplant, the doctors decided on the date. All this time, Kolya was regularly transfused with platelets and erythrocyte mass. Returning to his native village after a long treatment in Moscow, the guy led an almost full life.
 |
 |
“On Friday, March 28, he was walking on the street,” recalls Kolya’s mother Galina Isaeva. - But then I look: red specks have gone on my legs, blue dots on my face have begun to appear. On Saturday morning we get up - it seems to become brighter. I immediately called the hematology department in the city. I ask, can we come now? They answered that they had donated blood only on Tuesdays and Thursdays, that they would not transfuse anything, and that he would just lie there.”
Kolya Isaev got to the hospital only on Monday morning, and he received a transfusion only on Tuesday afternoon. “But only red blood cells were transfused, there were no platelets that day,” says Galina. - I ran around the hospital and asked why there were no platelets, why? But they were found only on Wednesday afternoon. It was too late. A little more than a day passed, and Kolya had a brain hemorrhage. “I don’t even know who to blame, who to blame. Yes, I don't blame anyone. I just can’t, I can’t,” Galina cries.
Permanent residence in the hospital
Inna Shiritova is almost six years younger than Kolya Isaev, she turned nine in February. Inna has exactly the same diagnosis - aplastic anemia. Inna and her mother Zarema came to Moscow from Nartkala, a small town near Nalchik in Kabardino-Balkaria. “We only lay there for three weeks,” says Zarema. - As soon as the diagnosis was made, the doctors immediately said: look for donors wherever you want and take them to the transfusion station, we have no blood. We raised all our acquaintances ourselves, 11 of them came up, for the first time it was enough. Fortunately, the Republican Ministry of Health sent a referral to the Russian Children's Clinical Hospital.
For a year and three months, Inna and her mother have been living in Moscow in a hospital building. For the first three months, Inna spent all her life in the hematology department, then she was transferred to the so-called hospital boarding house. The "boarding house" is actually a small room right in the building of the RCCH, allocated for the residence of sick children who cannot do without constant supervision. Parents settle with them, leaving their former life. “When we were going to Moscow,” says Zarema, “the doctors from Nalchik said that at most we were going for 2-3 weeks. We came here with a checkered bag and a package.”
Zarema walks around the room barefoot. Small, thin, she is not much taller than her daughter. In the morning I took Inna for tests, then left her to study with a school teacher - that day, together with another boy, cases went through cases right in the hospital corridor. During the day, together with the rest of the mothers, Zarema stood in the kitchen, preparing dinner. She always cooks it only in small portions, because it is impossible to store food for the sick Inna for more than an hour.
The girl is sitting on the bed and picking up stickers for the album about Shrek. Then she gets tired of it, she takes the doll and changes clothes. The whole room is a huge warehouse of toys that volunteers brought to the girl. Mother and daughter seem to have gotten used to the fact that they are tied to the hospital, that it is impossible to go anywhere, to leave for a long time. Zarema says she tries not to even think about the day when she and her daughter can finally leave the hospital: “Who knows. There is no guarantee that everything will be fine. In general, we would go home, we have not been there for a long time. And there we will watch, get used to it. It is very difficult to guess something. We understand that it will never be the same again. Planning is impossible, dreaming is impossible. We don't know what's ahead of us." The girl needs regular transfusions of platelets and red blood cells. Inna's bone marrow doesn't work at all. There are many hundreds of people like Inna in Russian clinics.
Flank dreams
Pasha Agalakov from the village of Yurya, Kirov Region, is Inna's neighbor in the "boarding house". Since January, he has been living with his mother Valentina in the hospital. His diagnosis is medulloblastoma of the cerebellar vermis. 2 , relapse. Before that, two years ago, he had a tumor removed and radiation was given. Pasha has no toys in the room, a huge poster hangs on the door with the words: "Dreams come true." But this Pasha will never see the poster - because of his illness, he is completely blind. He can't go anywhere. There is no chance of recovery. In June, Pasha will turn 16. He arrived in Moscow a few weeks later than planned: his own platelets did not rise, there was constant bleeding from his nose, a long road would be dangerous. But they couldn't find donor platelets in Kirov. It coincided with the long New Year holidays. They say that on holidays in many hospitals you can see mothers running around and going crazy, who give the guards 500 rubles each, if only they would go and donate blood.
Pasha sits on a chair in the middle of the room and knits. He does not need any schemes, he collects loops and patterns from memory. “I have been knitting since the age of six,” Pasha smiles. “In our village, when there was an exhibition, a whole table was allocated for my work.” In the first two months in the hospital, Pasha mastered the Braille alphabet for the blind, and now he is creating a book for blind children. At the exit, the same poster about "Dreams Come True" is again found.
Non-medical diagnosis
“The most difficult thing is to realize this problem for all people,” Professor Evgeny Zhiburt tells The New Times. “Our people are generally kind. When some kind of disaster happens, there are a lot of donors. And it is paradoxical that it is at this moment that so much blood is not needed, but every day it is very necessary. In Moscow alone, in various clinics, more than a thousand people need transfusions every day.”
A survey conducted by the Public Opinion Foundation in March showed that almost all respondents (95%) believe that donation should be rewarded: primarily with money (74%), free vouchers (56%), benefits (52%), as well as time off at work (46%) and the guarantee of an increased pension (45%). They also mentioned ensuring “safety when donating blood”, creating new points (at enterprises, in villages) and mobile teams for blood donation (2% each), and pursuing a state policy that favors the development of blood donation (1%).
According to the law “On the donation of blood and its components”, on the day of blood donation, the donor must be provided with free food and be released from work. Also in Art. 186 of the Labor Code of the Russian Federation states that the next day after the procedure, the employee must be given another day off. However, rarely anyone is released for two days.
In Soviet times, honorary donors 3 relied on free transport, a 50 percent discount on utility bills, benefits for dental prosthetics, the purchase of medicines, extraordinary services in medical institutions, etc. At the same time, the code of ethics for donation (developed by the General Assembly of the International Society for Blood Transfusion) says: blood should be voluntary and free of charge under any circumstances.
The reason for the shortage of donors, a researcher at the Institute of Pediatric Oncohematology Marina Persiantseva, calls the lack of information: “There is no popularization, few people say that it is an honor, good. The situation has not been adjusted at all, even there are very few transfusion points in Russia. And they are open at an inconvenient time for a working person. In Germany, for example, blood donation points are literally on every corner, there are posters everywhere, an express analysis has passed - and you can donate blood.” In the diary of volunteer Anna Egorova, there is an entry: “We need to give people another chance. Always. Because it is not yet known, in fact, whose chance it is - theirs or yours.
The total number of donors in Russia has more than halved in fifteen years. In 1985, the total number of donors was 5.6 million people, after 10 years, in 1995 - 2.9 million, by 2005 it decreased to 2.2 million. The number of donations per 1 thousand population in 2004 was 25, 4, while in the USA - 109.9, in the countries of the European Union - more than 50. Theoretically, 10-15% of the population can be donors, but in practice in Russia they are 10 times less - 1.6%.
The first successful blood transfusion in Russia took place on April 20, 1832 in St. Petersburg. House of Raginskiy. Good Friday. A woman in labor bleeding. Her pale husband. The young obstetrician Andrey Martynovich Wolf decides on the unheard of. He does what he learned abroad and that no one in the country did before him. Wolf persuades her husband to become a donor. He simultaneously does not trust the doctor, and hopes. Wolf takes blood from a man and pours it into a woman in labor. The woman is saved.
From the diary of volunteer Anna Egorova: “One of the largest Moscow hospitals, department of hematology. The head of the department tells us about a twenty-two-year-old guy who has leukemia and a blast crisis, says: “Intestinal bleeding, blood in the urine. He will throw us out any day. And he will throw it out because there are no platelets. Throw it out - it dies. He will die because there are no donors in this hospital at all. I met this guy. He is from Dolgoprudny. He sits in his ward, blogs and tries to find donors and money for treatment himself. He is twenty-two years old, I could meet him.
_____________
1 Aplastic anemia is a disease of the hematopoietic system.
2 Medulloblastoma is a malignant tumor of the brain.
3 Those with the title of "Honorary Donor of Russia" (citizens who donated blood forty or more times or plasma sixty or more times for free) receive 6 thousand rubles annually (in 2008 - 7522.85).