By Amado Viera
HAVANA TIMES – Between 2002 and 2022, voluntary donations of plasma and blood in Cuba were cut in half. At the beginning of the century, official statistics compiled 563,204 extractions of this type per year; two decades later, the number dropped to 285,645.
Alongside this trend, the origin of donations has also changed. Until the mid-2010s, Cuba prided itself on being among the few countries in the world that met its blood and blood-derived product needs solely through voluntary donations, while “direct donations” (intended for specific patients) made up a marginal percentage. In recent years, this proportion has reversed.
Statistics from the Ministry of Public Health (Minsap) do not reflect this new reality, although local media reports highlight it.
Last September, the newspaper Ahora revealed that nearly two-thirds of blood donations made in Holguin during 2024 were “direct.” Interviewed by the newspaper, the director of the provincial blood bank, Maria Eugenia Castro Batista, tried to downplay the issue by stating that the donation plan was based “on the history of the province’s needs.” However, records contradicted this: in 2022, the Holguin health system used 20,635 donations, 25% more than all those planned for 2024. At that time, three out of every four transfusions came from voluntary donors.
Voluntary donations have the advantage of being discretionary. They can be allocated to patients who lack relatives or friends who are able to provide donations, or to others who require frequent transfusions due to their health condition.
An example is children undergoing cancer treatments. In the Ahora newspaper report, Betty Suarez, the lead specialist at the transfusion service of the Pediatric Hospital, acknowledged that “availability [of blood] is affected because there aren’t enough donations to support the needs of certain blood groups.”
Many more donations are needed
Maydelis Solano, from Bayamo, is familiar with the Holguín pediatric hospital, where she has traveled countless times as part of her activism within the Facebook group Blood Donations in Cuba. There, she has witnessed how often “blood banks ask families to find donors because they lack reserves.”
For many of these children, regular transfusions are a matter of life or death.
In recent times, the lack of willing donors has been compounded by disorganization. Maydelis always recalls the case of a girl suffering from coagulation problems due to chemotherapy, for whom they had managed to find the required donation through social media. “But then they didn’t transfuse her, despite our request. It was necessary to make another post appealing to people’s humanity, who thankfully donated again.”
According to Alier Proenza Verdecia, one of the administrators of the Christian ministry Dar Esperanza y Alegría, also involved in solidarity activism in Holguín, the issue of blood donations has become more complex.
“Every day, more people ask us for help. Patients and their families write to us… even doctors, but the problem is that there are many more who need donations than those willing to give them. In this regard, we have also encountered the inconvenience of different diseases circulating in the country. To donate, a person must be healthy and not have had any illnesses in the preceding months, requirements that are difficult to meet in areas with a high incidence of diseases like oropouche or dengue.”
In his opinion, one alternative that could help alleviate the crisis would be for people from one province to donate to others in different territories.
Fewer donors, worse “care”
Two donors from Camagüey interviewed for this report, on condition of anonymity, pointed out material shortages and disorganization as other causes contributing to the decline in voluntary donations.
“Despite being called a prioritized program, it has become common lately for us to be scheduled and then not enough blood bags are brought, or the blood bank personnel arrive late or simply don’t come. Now there’s even a rumor that donations will have to be made at the provincial blood bank, which is on the outskirts of the city, because they don’t have transportation to come to the clinics. It seems that nobody cares that those of us who donate don’t live off this,” said one donor.
Precisely due to resource limitations, by the end of last July, Holguín had failed to meet its already meager donation target by 9%. This meant 599 fewer transfusions there, which on a national scale could represent a figure up to 14 times greater, considering the “weight” of that province in the national statistics. Following this proportion, up to 8,000 donations may not have been made in Cuba during the first seven months of 2024.
One of the interviewees also warned that the number of voluntary donors decreases as many exceed the age limit of 65 years and are not replaced by younger people. “In these processes, one meets people who are in the same ‘cycle’ (men can donate every three months; women, every four), and there’s room for comparison. The impression is that there are fewer of us every time.”
Both agreed on several probable causes for this trend. Foremost among them, “no one guarantees that one will have blood available in a moment of need.
Imagine that you voluntarily donate three or four times a year and that one day there’s a medical emergency for one of your family members. In that situation, you probably won’t be able to donate because you’re not due, but you also can’t request a transfusion based on all the ones you’ve done before. I know donors who have told me, ‘I won’t donate voluntarily anymore because I have elderly and sick family members, and I don’t want to risk not being able to help them when they need me,’” one explained.
Another string of difficulties faces those seeking transfusions of rare blood groups. A government official involved in the donation program in Ciego de Ávila, who also requested anonymity, recalled how “in the past, the Ministry of Public Health exercised more effective control over donors, especially those with rare plasma and blood groups. Now, it’s up to patients and their families to take on a responsibility that should be the institution’s.” Agreeing with the other interviewees, the official noted that in recent years, the attention received by voluntary donors has decreased, ranging from moral recognition to subsidized sales of food and other items. “In several provinces, we haven’t even had identification cards to give them,” she lamented.
In the hands of opportunists
While awaiting surgery in a hospital in Havana, Bricella Hernandez divides her time between treatments for her ailments and her activism in solidarity groups.
That’s how she learned about the difficulties affecting transfusions and decided, along with several of her faith, to create the group Blood Donations in Cuba. The mission of this digital space is to connect patients and donors, under one premise: their connections cannot be mediated by money. “This group is for donating, not selling,” Bricella has had to clarify to more than one opportunist.
Unfortunately, current circumstances favor those interested in profiting from others’ needs.
In a context of accelerated population aging and a health system full of deficiencies, such as those affecting the transfusion program, many people have been left with no choice but to pay up to 10,000 pesos for a transfusion.
“But how can an elderly person alone or a single mother cope with a situation like this?” wondered the Minsap official consulted. Many older adults have pensions below 2,000 pesos per month.
To make matters worse, some hospitals often demand that patients and their families replenish donations of the same blood group to be transfused, “something that goes against established norms and is simply an abuse,” the same source pointed out. “Finding a donor for groups like AB, which represent less than 10% of the population, can be an ordeal and shouldn’t fall on the shoulders of the sick. It’s one of the responsibilities that used to be handled by the State and from which they withdrew one day, without explanation.”
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