Red Alert – Illegal Blood Trade Thrives in India

A few hundred rupees, drugs or promise of a good livelihood is all you need to lure a person to the hell hole of illegal blood trade. Here the unwilling victim is kept locked, drugged, chained and is then drained of the only commodity he has – blood.

The unsuspecting victim’s blood is illegally extracted almost thrice a week, along with many more victims who are trapped in deplorable conditions with no escape or hope. These victims are rendered bloodless, delirious, comatose and are sometimes left to die.

Neither the victim nor the blood is screened or adequately tested. These unsafe (and often contagious) pouches of blood  are then sold to hospitals, nursing homes and blood banks for an amount that ranges from Rs.500 – Rs.1500 by the agents of this heinous trade.

Bloody Market of Blood (Pix Credit – Yosia Urip)

Welcome to the world of illegal blood business in India

The recent surge in media reports from various parts of the country such as Varnasi, Jammu, Patna, Jaipur, Gorakhpur, Amritsar, etc shows the widespread nature of this business where bloody agents, pathology centers, doctors, nursing homes, blood banks, hospital boys, drivers, technicians, etc., works as a nexus to procure blood by any means.

The recent media expose of blood trade in Patna were 8 people were arrested for illegal trade of blood and selling to Nursing Homes to the sting operation of procuring illegal blood by Tehelka, highlights the ease with which agents are luring people,  employing technicians to draw, collect, and store blood, and getting to sell them at profitable rate, shows the sophistication of this crude practice.

According to AIDS Action, this illegal trade of blood is not just a third world problem. This is a global, multi-million dollar industry with China, Russia, India, Bulgaria and Africa taking the lead in this illegal and unethical business of life.

Like kidney transplantation, human bone and child trafficking rackets, blood trade too runs deep into the system. Without doubt, this trade cannot flourish and be widespread in the country without the involvement and support of local agents, mafia, police, politicians, and many more unknown entities.

The Victims of Blood Trade

The victims are slum-dwellers, daily-wage earners, migrating population, rickshaw pullers, push-cart thela vendors, shelter-less youth, street kids, or just someone in need of quick money. The unsuspecting victims are illiterate and poor and do not know what they are getting into. And any promise of money or livelihood is good for them to go.

The agents are always on the look-out for potential victims, who arrive to the big-city for earning their livelihood. They track the migrant labourers and job aspirants at the railway and bus stations; get them temporary jobs to make themselves seem genuine. After a month or two, they get them fired and lure them into selling their blood. Even when they are told to donate blood, they do not know that it is going to be a long affair with no escape. They do not know how deep the hell hole is.

“The victims told us they had voluntarily sold their blood in the beginning, but later they had been confined and their blood forcibly extracted. They also said that instead of the Rs 500 per day they had been promised, they were paid only Rs 150.”

On the other hand there are commercial blood donors (CBDs) who are well aware of the requirement for donating blood on a periodic basis and have been doing this for a long time. CBDs are mostly unskilled people who get into this trade and stick to it as a job. They operate through middlemen or agents in contact with the hospital, clinic or pathology laboratory. Each CBD is bled more than five times in a month, and some are donating a number of times a week.

According to Late Dr. Radium Dalwadi Bhattachary, they are also aware that their blood should meet certain specifications like haemoglobin content, failing which they may not be able to give blood or they will be paid less. Hence they keep consuming iron tablets to stay red. Separated from their families, they are likely to have more than one sexual partner and many of them are addicted to tobacco and alcohol.

Blood trade agents and their modus operandi

The agents are the middle men/ touts who lure people into blood trade as well as supply blood to healthcare institutions. There are institutional agents who act for the hospitals attached to medical colleges and those who operate for private clinics, pathology laboratories or blood collecting centres.

After receiving a call from the hospital or private clinic, the agent contacts a blood donor in the required blood group. Each agent works anonymously and has his own group of commercial blood donors. Some agents simply lure innocent people into donating blood – for money or with coercion.

Illegal blood trade is flourishing owing to the involvement of hospital employees. Lower rung staff of both government and private hospitals play a key part in the thriving blood trade.

Most of the time the agents are found roaming on the hospitals campus keeping track of people who need blood. They lure patients or their attendants to buy blood from them. In an investigation, a web of touts were discovered around the city’s major hospitals who kept track of patients in dire need of blood.

The agents have all the paraphernalia required for this bloody trade. Blood collecting technicians, basic equipment, empty blood pouches, syringes, fake stamp seals, stickers, authority letters, et all. There are no blood tests performed before taking the blood.

In a media report from Uttar Pradesh, the agents used to take the donors to a hideout where the blood was collected in plastic bags, mixed with some chemicals and kept in ice in pressure cookers, where chances of contamination (of already untested blood) is very high and unsafe for any use.

What happens to the victims of the blood sucking agents?

Here is an excerpt from Scott Carney’s latest book, The Red Market, which talks about illegal trade of blood, kidneys, bones, and more. Scott Carney is an investigative journalist who has witnessed this illegal blood trade from close quarters. He describes the condition in which the victims of blood trade were found:

“They sprung the lock and revealed a medical ward fit for a horror movie. IV drips hung from makeshift poles and patients moaned as if they were recovering from a delirium. Five emaciated men lying on small woven cots could barely lift their heads to acknowledge the visitors. The sticky air inside was far from sterile. The sun beating down on the tin roof above their heads magnified the heat like a tandoor oven. One man stared at the ceiling with glassy eyes as his blood snaked through a tube and slowly drained into a plastic blood bag on the floor. He was too weak to protest.

That evening police rushed the men to the local Civil Hospital to recover. The doctors there said that they had never seen anything like it. Hemoglobin supplies oxygen to various parts of the body, and low levels of it can lead to brain damage, organ failure, and death. A healthy adult has between 14 and 18 grams of hemoglobin for every 100 milliliters of blood. The men averaged only 4 grams. Leeched of their vital fluids to the brink of death, all of them were gray and wrinkled from dehydration. “You could pinch their skin and it would just stay there like molded clay,” said B. K. Suman, the on-call doctor who first received the patients from police custody.

Their hemoglobin levels were so low that the doctors were worried about bringing them up too quickly. One told me that they had become physically addicted to blood loss. To survive, the doctors had to give them iron supplements along with a regimen of bloodletting or they could die from too much oxygen in their circulatory systems.”

Read more or get a copy of his latest book, The Red Market: On the Trail of the World’s Organ Brokers, Bone Thieves, Blood Farmers, and Child Traffickers, to read more on the gruesome trades in healthcare.

What is illegal about the blood trade?

  • The blood is mostly collected without the consent of the person. Blood is collected illegally and unethically by unauthorized setups/ agencies/ agents/ centers.
  • The unwilling victim donor is sedated, threatened, harassed, lock-up, assaulted, and drugged to extract blood. They are also kept in deplorable conditions like cow-sheds, abandoned rooms, etc. These unwilling donors are drained of blood, and are often left to die.
  • The blood is not tested or screened before supplying to the blood banks, nursing homes and hospitals.
  • Blood is collected many times a week whereas the law stipulates that there should be a gap of 2 months between the blood collections.
  • Healthcare organisations such as nursing homes, pathology centers, blood banks, etc violate the Gazetted rules to profit from this unethical and illegal business.
  • Professional donors sell their blood, which is of very poor quality and can transmit very dangerous diseases to the recipient. It is illegal to take blood from any professional donor.

The moment the minimum basic rules of blood donation are flouted, it ceases to be the humane-compassionate act. When any trade violates the gazetted rules and norms, it is illegal.

  • Indian Constitution: Article 21 under part III of Indian Constitution spells out that no person shall be deprived of his life. Safe blood transfusion comes under legal protection as it is life-saving and also fatal.
  • Drugs & Cosmetics Act: Human Blood is covered under the definition of ‘Drug’ under Sec. 3(b) of Drugs & Cosmetics Act, which establishes regulations for blood banking and transfusions.
  • The Consumer Protection Act of 1986 also covers blood as a commodity.
  • Indian Panel Code chapter XIV, sections 269 and 270 provide for protection against spread of infectious diseases due to negligent and malignant acts.
  • National Blood Policy: Additionally all aspects of blood donation, collection, storage, use, etc come under the purview of the National Blood Policy that strictly bans sale and purchase of blood.

With the Blood banks and hospitals across India reporting an acute scarcity of blood after a Supreme Court order to ban payment to donors came into effect on 1 January 1998, the blood trade which was already a flourishing business, went underground. With no alternate arrangement in place yet, to ensure regular supplies of blood, the government is forced to ignore the many illegalities that dangerously flourish around blood banks here and elsewhere in India.

Why is the blood trade thriving in India?

India’s annual demand for blood is about six million units but blood banks manage to collect only about three million units each year. Nearly a third of this comes from paid (professional) donors. The recent ban by Supreme Court in 1998, stopping payment for blood donors has failed to stop the trade in blood and has driven these businesses underground, far away from the eyes of law and healthcare authorities.

“All it did was to drive the trade underground and raise the price of blood beyond the means of ordinary people,” says Dr Iqbal Malik, an activist.

Most donations are from “replacement donors”— the relatives or friends of patients who replace blood needed in emergencies. People do not donate blood voluntarily unless their loved one is in need of it. The annual demand for blood in India is increasing by the day.

Lawyers say it’s difficult to prove an illegal blood transaction because that requires an official complaint lodged by the person who pays the donor – and families are so desperate they consider the black market blood donors lifesavers.

“I don’t think it is a crime to help people who are in need,” one told an journalist, refusing to give his name for fear of prosecution. “I haven’t been able to find a job for years now and selling blood is a way for me and my family to survive.”

As hospitals, blood banks are forever starved of blood; they are in no mood to cross check the source or mode. For them, blood is needed to save someone’s life, hence a lesser evil. Something is better than nothing policy makes them turn a blind eye  to these agents who somehow seem to conjure up blood in the unlikeliest and dire situations.

Here is a report on the illegal trade of blood in India:

What can we do about it?

According to the National Blood Policy, an integrated strategy for Blood Safety is required for elimination of transfusion transmitted infections and for provision of safe and adequate blood transfusion services to the people.

The main component of an integrated strategy include collection of blood only from voluntary, non-remunerated blood donors, screening for all transfusion transmitted infections and reduction of unnecessary transfusion. Therefore, we as individuals and healthcare representatives, need to act to curb this menace:

  • Donate blood whenever possible. This dire deficit of blood availability is fueling the trade all over the world. Just do it legally.
  • Deal with authorized blood banks only. Satisfy yourself thoroughly with their blood donation, transfusion, storage procedures. Here is a list of blood banks registered with Indian Society of Blood Transfusion & Immunohaematology.
  • Hospitals and their administrators need to keep a track of these illegal activities that thrive in and around their premises. Strict action to be taken against the criminals of blood trade.
  • Educate patients and those in need of blood to be wary of the blood trade peddlers.
  • Increase public awareness about the risks in using blood from commercial Blood Banks and professional donors. At the same time, educate about safe blood donation practice.
  • Expand voluntary and replacement donor base, so as to phase out professional blood donors.

Above all, educate yourself with a list of recommendations made by M.L Sarin, Senior Advocate and Honorary Legal Adviser to The Indian Society of Blood Transfusion and Immunohaematology and The Blood Bank Society. This document lists down the multi-pronged strategy to address the problems associated with blood donation, including the illegal trade of blood. Download a copy of here for an understanding of the comprehensive approach that is required to curb the blood trade menace.

Whilst blood trade in India is widespread and it needs a lot more than Government machinery to tackle it. Some legislations are simply waiting to be made and need that extra push from the informed public. It makes a difference when each of us tackles it in our individual capacities.

As citizens and healthcare professionals, what do you think is the best way to curb this blood trade menace? Lets Discuss.

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