The story really begins a while back: I realised I would be here at a good time to give blood and so, given some things I had heard when my grandmother needed an operation, I decided to give blood here rather than in the UK. I was in Glasgow at the time of the decision and primarily in touch with people who did not at the time reside in Bulgaria. So I took to the internet, hoping to get the basics of where and when to go donate sorted ahead of time, so I would just show up when I arrived.
That sounded like a very good plan in theory, but in practice the only information readily available was "You can donate blood in any hospital with a [blood transfusions++] ward." (Please pardon my non-existent medical terminology.) Some more extensive searching and requests for help led me to a couple of places that not only had such, but even had websites and (after more searching and more help from other people) I finally came across the website for what is essentially the biggest blood donation centre in the country. It even had a small FAQ regarding giving blood on its website. Sadly, it did not have its opening hours listed there.
After bravely planning to visit one afternoon without being able to confirm they would even be open then (as nobody answered their listed numbers as the days leading up to our visit were official holidays), my friend and I were rewarded with a confirmation of the place being open until 1830 that day upon me phoning earlier that morning. I only managed to convince one more person to come with me, but I'm glad that there was someone at least. We headed in, knowing roughly where we were going to be greeted by the following scene as we approached:
It's not a perfect photo, but the surroundings looked distinctly dodgy and were not at all helped by a half-to-full dozen people standing in a very loose crowd around that area, looking almost-homeless. Odd as that was we continued, I repeat, to the main blood donation center in the country. They even guided us to where the entrance was, confirming our suspicions that they were in fact waiting purposefully in the center's vicinity, rather than coincidentally being there for another reason.
Following that was our encounter with the security guard by the gate, which my friend thinks is probably the most representative of the state of blood donations in this country. I'm not sure I agree 100%, but it's definitely up there. (No, I'm not sure why there was a guard in the first place - perhaps to open the adjacent car gate for personnel.) He came out of his booth with a questioning look in his eyes and we had the following exchange (loosely translated):
me: "Hello, we're here to donate blood?"
guard: "Oh, right, to donate for a close friend or relative, it's through that--"
me(concerned we might get sent to the wrong place): "No, I meant just donate."
guard: *pauses, looking very confused* But... You know you won't get paid or anything, right?
my friend: "Well yes, that's why it's called 'donating' blood."
The guard continued looking perplexed and directed us to the building's door after another half minute. It seemed to genuinely not make sense to him. What might not make sense to you, I suspect, is what he asked about. Given previous experience and what happened later on, I worked out that the blood shortage in this country is so severe that, even as part of the nationalised healthcare, if you need a procedure done that will require a blood transfusion, you may be required to provide some certificates in addition to any money the operation costs that the gov't does not cover. More specifically, these should be notes certifying the donation of as many banks of blood as you may need during your procedure. It doesn't have to be the same type, merely the same quantity. You can't pay to avoid that, they simply do not have enough actual blood available. The guard's reaction only served to prove that pretty much all blood donation activity has died down to this "mandatory" sort... one way or another.
We went in, following some signs to an office where we got some forms to fill out: very similar to the UK questionnaires, they basically take some basic details about you, followed by a health questionnaire to ensure you're okay to donate. You then go in to talk to, I assume some nurses who go over your answers with you and check your pulse and BP. Assuming that's okay, they lead you to another nurse that does the haemoglobin test, much like in the UK, and does a quick ABO test as well.
I mostly expected all of that to happen. What I didn't expect to happen was to be approached by a lady between 50 and 70 (I'm very bad at estimating age) who asked whether my friend and I were simply donating for the sake of donating. When we said we were, she said her son was in the hospital and needed two blood banks donated in his name and basically asked how much it would cost her for us to basically put her son's name as the person we want to donate for. I asked her to give us a moment to discuss this in private and we both immediately decided that we had come to help anyway and this would clearly help someone who was in need (and realistically the blood could not be misused as far as we were concerned). We called her back and said we were happy to do it and would take no money for it as we had basically come in to do exactly that, but for free. It took a lot of arguing and she wouldn't relent, so I thought I'd simply delay her and asked her to wait for us to donate first (which it turns out she needed to do anyway to get the certificates). I spoke with her on several occasions throughout this as I was waiting for my friend: she also confirmed my suspicions that the group of people I had seen outside were basically the black blood market I had heard about embodied outside, milling about shamelessly. Her original offer when we insisted we'd take no money was 50BGN to both of us, implying that was a small amount for our troubles; that and further things she said made me wonder how much the blood of the people outside was being sold at... A strange thought at best. I was glad we both managed to donate, so her son could get surgery, despite some irregular pulse and nervousness issues on my friend's side: I have to say, I'm really proud he pulled through, giving quite how terrified he seemed.
Note: This next paragraph will be about the actual blood donation process. I will try to not be too graphic, but if you have a squick about needles or related be warned; it will be just this paragraph.
After the checks, we then got sent on to the separate donation room. Having donated in the UK I was struck by the setup: there are iron frame beds that look like they might fold up - they're bare pipes. On top of those is laid a thin layer of black, PVC-wrapped cushioning. (Maybe it's not PVC, but it looks black and rubbery.) There's a layer of what seems like super-sized kitchen roll covering these and yes, they look as old as they sound; my brain is picturing WW field hospitals with beds like these. I was led to one and had to half-undress due to my own stupidity of wearing a shirt with a sleeve I cannot pull up high enough. I lie back, looking away from the needle jab which I expect to be the usual pinprick done with the unnerving accuracy of nurses, while the nurse gives my inner elbow a couple of quick wipes with a spirit'ed ball of cotton. I remembered the fastidious cleaning of several seconds of rubbing that the nurses in Glasgow treated my skin to, but I figured it would be okay. Next followed probably the most painful needle jab of my entire life. Not the worst pain, but definitely the worst needle. Closely followed by the last time I had blood taken in Bulgaria. I tried to relax and get my BP up at the same time, hoping to fill up the bag quicker. After a short while I peeked curiously, only to find the needle they used appears to be twice the girth of the one I had blood taken with in the UK. No wonder it stung. But the pain subsided and I filled the bag with no incident.
The main issue my friend had with the actual process of giving blood was that he had very little information about what was going on, what he needed to do now and later on at home, etc. I assured him this had not been my experience in the UK, but I could see what he meant about here. I may have convinced him to maybe come with me just to watch when I donate in the UK to see how much better their setup is; I hope this settles his nerves about donating again.
All in all, today's experience made me primarily sad (with a pinch of outraged) through witnessing the state of Bulgarian health care with regards to blood. Something we can donate at no huge discomfort to ourselves is so scarce that... You get this. The woman's husband even dropped by for a bit and ask me why I did it: whether I got days off work or some other csh for it or something; he couldn't understand why I would donate. he asked if I thought such acts of kindness would "fix" Bulgaria and I responded honestly: no, I don't think they will, but I had the opportunity to do some good at very little effort on my part.... Why not?
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