Some people refuse blood transfusions, signing forms indicating that, in an emergency, they should never receive blood. Others are unaware of the requirements for donating. According to health officials, these decisions are influenced by fear, safety concerns, and religious beliefs.
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The implications vary between adults and minors, and in certain cases, the government intervenes to ensure that children receive a transfusion.
According to Dr Thomas Muyombo, the Blood Transfusion Division Manager at Rwanda Biomedical Centre (RBC), resistance to donating blood comes mainly from religious beliefs rather than cultural traditions.
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"There are a few religious organizations that discourage their congregation from donating and receiving blood. When someone signals that they are not supposed to be transfused, then there’s nothing else to do in that situation,” Dr Muyombo said.
He explained that while such decisions are respected when made by adults, a different approach is taken when children are involved, as the government becomes part of the decision-making process to protect the child’s health and life.
"For minors, the government reviews each case individually, and when caretakers do not want them to receive a transfusion, the government engages the family and becomes part of the decision on whether they should receive blood or not. The government takes care of its people.”
Dr. Muyombo said these refusals are not based on culture and noted that communities continue to take part in blood drives.
"The religious teachings that influence some people to refuse blood are not unique to Rwanda. In the end, it is a personal choice, because you cannot force anyone on what to believe or how to practice their faith,” he said.
Dr. Muyombo noted that fear for personal safety is one of the biggest barriers to blood donation, with many people concerned about side effects or long-term health risks, despite the procedure being performed by trained medical professionals. He explained that blood donation is a simple, carefully regulated process designed to protect both donors and staff, preventing adverse reactions.
He also cited long-time donors as evidence that giving blood does not weaken the body.
"Many people have been donating blood for 20 to 30 years without any unwanted outcomes. The procedure is completely safe,” he said, explaining that blood cannot be manufactured, and only comes from the bodies of healthy people.
"Whenever someone receives blood, it’s because a compassionate person donated, and that’s why we should give when we are healthy, so blood will be available if we ever need it,” he said.
Dr. Muyombo emphasized that blood donation is a responsibility and warned against donating only when a relative is in need. In such cases, donors may provide inaccurate information, and the blood could be found to carry infections or other conditions that make it unusable. He encouraged voluntary donations from donors who are not under pressure and stressed that blood should be given without expecting anything in return, noting that regardless of a country’s wealth or resources, it will always rely on healthy people to donate.
Blood donation is voluntary and does not bind anyone for life; donors can choose to stop at any time without any consequences.
"To donate blood safely, you need to be healthy, between 18 and 65 years old, free from transfusion-transmissible infections like HIV and hepatitis B and C, and not taking medications such as drugs that prevent blood from clotting.”
The health expert added that donation frequency is carefully limited to protect donors’ health.
Whole blood can be donated up to four times per year, while platelets – cells that help blood clot – and plasma, the liquid component that carries cells and nutrients, collected by means of a machine, can be donated every two weeks, with a maximum of 24 times per year.