Whose blood is cleaner?

When I first heard the controversy over the refusal to accept the blood of MK Pnina Tamano-Shata, along with other Israelis who were born in Ethiopia, I was willing to write the complaints off as grandstanding. As someone who had spent several years working for a large municipal health department, I have seen occasions when public policies put into place to safeguard lives can look discriminatory from the point of view of an layperson. So in order to put any lingering doubts to rest, I decided to do a brief “medical school of Google” search to check on established medical guidelines concerning donations.

I found nothing. No medical literature was available showing that the international community believes blood donations from former Ethiopian nationals to be at significantly higher risk of infecting a blood supply that is already being tested.

Worse, I found credible literature that shows that the risk has already been studied and quantified, and which points to a possible cost, in terms of lives that could be saved, when potential donors are turned away. As far back as 1998, Yale Professor, Dr. Edward Kaplan, published an article in the British medical journal The Lancet, noting that destroying all donations from Ethiopian blood saves perhaps one life every ten years. In 1996, there were public demonstrations in reaction to the revelation that Magen David Adom was destroying blood donated by Israelis who were born, or who had lived for a significant period, in Ethiopia. A commission, headed by former Israeli President Yitzhak Navon, reviewed the procedures that were then in place. That commission recommended that the MDA stop dumping blood based on ethnic criteria and proposed instead strict guidelines for careful, pint-by-pint screening of blood donations from Ethiopian Jews and other high-risk groups.

Some of the people with whom I have discussed the Ethiopian blood donation crisis have mentioned that the practice of refusing this blood is not discriminatory, and have pointed to the ban placed on donations from those who lived for a long period of time in the U.K., for example, or certain countries in South America. What they fail to appreciate is that in other cases where specific countries have been declared ineligible to donate, the reason is because of the lack of testing available to screen for the diseases that have been found in those countries. U.K. citizens may have been exposed to Creutzfeldt–Jakob disease, which cannot currently be detected in blood donations. Other countries may have endemic cases of malaria or leishmaniasis, which are also currently undetectable. AIDS is not in that category. The World Health Organization has created precise guidelines that most countries use to decide when to accept or reject blood. And Ethiopia is not discussed under any of those circumstances. In fact, an article on YNET expressly states that Israel is the only country to categorically reject Ethiopian donations. (Switch to Chrome, people. It has Google Translate built in.)

Others I have spoken with agree that the policy sounds ineffectual, but criticized MK Shata for using the donation system as a way to make a public critique, since she was already aware that she would not be allowed to donate, having been part of the original protest in 1996. I wanted to ponder whether it was necessary to use the press to increase public awareness while eating some cottage cheese near the Western Wall, but it was too cold, so I decided to stay home and read about the cancellation of the Bedouin resettlement plan instead. In my experience, nothing makes people want to take action more than quietly leaving things to take their course. I mean, it’s only been 17 years since this issue first came to a head. L’at l’at.

If Magen David Adom and the Health Ministry have a medical reason for categorically denying Ethiopian donations, they should provide the statistics showing both the expected impact of refusing these donations, as well as the cost, in both lives and shekels, of continuing this prohibition. Simply relying on what appears to be, at first glance, a gut feeling, is worrisome, at best, and dangerous, at worst. Additionally, it is most certainly a discriminatory act, if no medical proof can be produced. Discrimination is illegal in Israel, whether it’s based on race or several other reasons including country of origin. And when any group is singled out for prejudicial treatment without due cause, it diminishes the value of us all.