Why having a negative blood type can be a death sentence in Asia
Tourists and expats have been urged to find out their blood type, as shortages mean minor collisions or surgeries can quickly turn fatal
The cases, at first glance, have little in common: a Thai woman preparing for a caesarean; a Spanish tourist who’s pneumonia turned septic; a newborn baby on life support.
But the trio all have Rh negative blood types – and in Thailand, that can be a death sentence.
Like much of southeast Asia, only around 0.3 per cent of the population here have Rh negative blood (A-, B-, O- or AB-), compared to roughly 15 per cent in the UK and Europe. The shortage of donors has translated into “concerning” shortages in blood banks.
This means that for expats, tourists and the tiny minority of Thai people affected, a minor motorbike accident (not uncommon among British backpackers) or simple surgery can swiftly shift into a life-threatening crisis.
“There is an adequate supply of blood for use in the medical system – but this does not apply to Rh negative blood,” said Dr Issrang Nuchprayoon, a professor at Chulalongkorn University and adviser to the Thai Red Cross. “There’s always a threat when people need this blood, that we don’t have it.”
And the risk – which exists in countries across the region, including in Laos, Vietnam and Indonesia – is not just a theoretical one.
Thailand’s busy roads are known for being some of the most dangerous in the world
“I should be dead,” said Lucca*, who was rushed to hospital last summer with internal bleeding while recovering from a surgery to remove a stomach ulcer. It should never have been a potentially fatal scenario, yet the Bangkok doctors were not optimistic – they did not have enough O- blood supplies to replenish the amount Lucca was losing.
“It turned out to be a very complicated case,” the French national told a recent panel event. “I thought, what am I going to do? Just sit here and die? But the people around me said, ‘that’s never going to happen’.”
Instead, his family and friends launched an around-the-clock campaign to find donors – asking acquaintances what their blood type was, pleading for potential donors on Facebook groups, and even going to expat hotspots to ask people directly. It took two weeks, but the 10 units Lucca needed were eventually found, from 10 donors.
“Two weeks for ten units, and that was consistent advocacy,” said Nancy Rower, a member of the ‘Thailand RH- Blood Donation’ Facebook group and advocacy network, which helps find potential donors for patients in need. She was also one of those who gave blood to help save Mr Luccatio’s life.
“In this case one of the problems we faced is that Lucca is from France, and the majority of his connections were French, and they were being rejected having lived in France,” Ms Rower said.
At that time French, Irish and English nationals were banned from donating due to concerns that their blood may still contain traces of ‘mad cow disease’, following various outbreaks between 1980 and 2001.
But last year, the United States lifted restrictions on donations and many countries have since followed suit. At the end of February, Thailand became one of the first countries in Asia to also change its policy. The Thai Red Cross, which operates most of the country’s blood banks, now accepts packed red blood cells – though not yet blood plasma – at some hospitals in Bangkok.
“This is a big change, because the preponderance of our expat population is from the UK, France and Ireland,” said Ms Rower. She added that the next step is to encourage more foreigners to come forward to give blood.
But until shortages are lessened, Facebook groups set up to help match patients with donors will continue to be a life-saving tool.
“Accident Victim – needs surgery,” one post from this week reads, calling for O- blood for a young man. “Urgently need blood for a chemotherapy patient”, another says, alongside a picture of a Thai man and his child.
“Mathematically, when you look at the eligible donor pool for Rh negative… [it] is akin to finding a needle in the haystack,” said Ms Rower. “The Thai population is extraordinarily conscientious, but there simply aren’t enough of them… we need more of the international community to donate, exactly as we do in our own countries.”
How to mitigate your risk on holiday
If you’re travelling across southeast Asia, experts say the single most important thing to mitigate any potential risk is to know your own blood type in advance.
They estimate that, because few need to know in the UK or Europe, only around 15 per cent of people travelling in the region are aware of their blood type.
If an accident or health issue arises where you do need blood, reach out to the expat population as immediately, added Ms Rower. Time is critical, and this will give you the best chance of securing the blood you need.
The best way to reach people is through the network of Facebook groups linking patients and potential donors.
*Lucca asked that his full name was not used for privacy