Donating blood, organs and bone marrow stem cells is a form of active citizenship as it shows care, responsibility and looking out for fellow citizens in need.
Doing so can prolong, improve the quality and save lives. Donating blood, organs and bone marrow stem cells is also a unique way to share compassion across race, colour and class.
Donating, a form of altruism, also makes one happy and gives the donor a great sense of belonging, of being part of a community and connected through saving lives.
Active citizenship is critical to make democracy work. It takes many forms. The most basic aspects are for citizens to vote for responsible candidates and parties, speak out against injustice, attend, engage and sit on public governance structures such as school boards and municipal ward committees and protest against harmful political, business and community practices.
However, active citizenship also includes citizens helping each other and neighbours, volunteering in community organisations, donating money to social causes and doing good.
There is nothing as compassionate as donating blood, organs and tissues to others who desperately need it.
I have been involved since 1989 in community campaigns to persuade specifically black South Africans to donate blood and bone marrow through the South African National Blood Service, a non-profit with thousands of donors and volunteers.
I had a life-threatening blood cancer in which I was very close to needing a bone marrow transfusion. Gratefully, in the end I did not require it.
South Africa regularly faces blood supply shortages. Blood transfusions are needed during childbirth and accidents and when patients undergo surgery.
South Africa regularly faces blood supply shortages. Blood transfusions are needed during childbirth and accidents and when patients undergo surgery.
Sadly, less than 1% of South Africans are active blood donors. Of these, black donors make up only 30%. In 2005 blacks only made up 6% of blood donors.
South Africa has a bone marrow stem cell registry of just under 80,000 in a population of 60m. Yet 15% of South Africans are likely to suffer a blood disorder, whether lymphoma or leukaemia.
There is a shortage of black bone marrow stem cell donors worldwide. The shortage of finding a bone marrow donation is highest among black patients needing bone marrow. In South Africa, the black bone marrow donor pool makes up only 10%.
Only 0.2% of South Africans are registered as organ donors. At about 1.4 donors per million South Africans, this is one of the lowest organ donor rates in the world. About 5,000 people are waiting for a life-saving organ and cornea transplants.
South Africans are generally unaware of the importance of blood, bone marrow stem cells and organs. Many do not know how few people donate and why it is essential they do. Many also do not know how easy it is to donate, some think donating is complicated, cumbersome and time-consuming.
Many black South Africans are reluctant, whether for cultural or religious reasons or fear of needles, to donate life-saving blood, organs and bone marrow stem cells, depriving someone who may desperately need it of a life-saving opportunity. Sadly, misplaced superstition is also a factor in some cases, making some people uneasy to donate.
Organ trafficking is at frightening levels in the country. Many potential organ donors worry about whether their organs would be trafficked. Restoring the rule of law, getting the police to be more effective and less corrupt, and government and non-governmental organisations transparently telling the public about the integrity of the donation process are critical to help convince those worrying their donated organs will not be ethically used.
Compounding the problem, there is a lack of accessible information, awareness of the blood, bone marrow stem cell and organ donation processes, importance and facts which perpetuate ignorance, distrust and fear about donating and contribute to some people not donating.
There needs to be a mass education programme demystifying donation, emphasising the importance of donating to save lives, and to dispel misplaced cultural, religious, cultural and superstitious beliefs that hinder donating. Such societal education must take place in schools and communities, as part of government service delivery programmes, in workplaces and by sports, cultural and traditional institutions.
The question is whether on death, if someone had not specifically indicated they do not want to donate because of religious, cultural or personal reasons, health professionals should go ahead and use their organs and tissue for medical reasons.
Some countries, such as Spain, follow what is called an “opt out” system whereby when an adult dies, if he or she did not register as a donor, unless they had recorded a decision not to donate for cultural, religious or other reasons, or belong to a community which officially is opposed to organ donation, they would be deemed as organ donors.
South Africa has an “opt in” system whereby if a person had not registered as a donor before death, it is assumed they are not a donor. It is very likely to be against the constitution to automatically bracket individuals who did not indicate before death that they do not want to donate their organs as agreeing to have the organs donated.
Another tricky question is whether donors should be paid. In 25 countries, including Germany, China and the US, individuals are paid for donating plasma. In the US, many poor citizens donate plasma as a source of income. In other countries they are paid time off work to donate blood.
There is a difference between a blood and a plasma donation. A blood donation is a whole blood donation, which includes all four components of blood, namely white blood cells, red blood cells, platelets and plasma. It is used to treat blood loss. A plasma donation is collecting one component of the four components of whole blood and returning the rest to the donor. Plasma is used to replace proteins in patients with life-threatening disorders and immunodeficiencies.
South Africa urgently needs active citizens who care for others across race, colour, political and class divides. Donating blood, organs and bone marrow stem cells is one form of caring for others.
• William Gumede is associate professor, School of Governance, University of the Witwatersrand, a long-time blood, organ and bone marrow donor and a former director of the South African National Blood Services
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