Bangladesh needs 800,000 to 1 million units of blood a year but voluntary donors supply only 30 percent; over 500,000 people wait for corneas

A patient lies in a hospital bed. Blood is needed for surgery, the doctors are ready, but the relatives cannot arrange the blood required. They search for donors among acquaintances and on social media. Elsewhere, a person who has lost their sight to a cornea problem waits for the chance to see the world again — the light can return to their eyes only through a cornea donated by another person after death. Such scenes are nothing new in the country's hospitals.

Bangladesh needs between 800,000 and 1 million units of blood every year. But only 30 percent of it is collected from voluntary, unpaid donors. Meanwhile, the number of people suffering from corneal blindness exceeds 500,000. According to the Sandhani National Eye Donation Society, on average only about 50 corneas can be collected a year.

Behind this crisis of blood and corneas lie a shortage of regular voluntary donors, a lack of adequate awareness, and limitations in the collection and supply system. Against this backdrop, National Voluntary Blood Donation and Posthumous Eye Donation Day is being observed on Monday (November 2). On this day in 1978, the voluntary organisation Sandhani organised a voluntary blood donation programme at Dhaka Medical College Hospital, and the day has been observed in memory of that initiative ever since.

Blood is needed for surgery, accidents, complications in childbirth and diseases such as thalassaemia. For many patients, treatment cannot continue without regular blood transfusions, so the demand for blood lasts all year round.

According to 2025 data from the World Health Organization's Bangladesh office, the country needs an estimated 800,000 to 1 million units of blood a year. Only 30 percent of that comes from voluntary, unpaid donors; most of the rest is collected through patients' relatives and acquaintances.

Because the voluntary donation rate is low, patients' families fall into difficulty in emergencies. Finding donors is especially hard for rare blood groups, and families often have to spend a large share of their time on collecting blood alongside treatment.

The weakness of blood management has surfaced in a recently published study. The research, published in the journal BMC Health Services Research, analysed data from 201 transfusion centres in the country, covering public and private health institutions in 17 districts across eight divisions. It found that the median amount of blood collected through patients' relatives at the observed centres was 774 units, while for voluntary, unpaid donation the figure was 404 units.

The study also found worrying information about the quality of transfusion services. Around 70 percent of the government hospitals and 34 percent of the private hospitals taking part do not follow standard operating procedures, and there are gaps in transfusion committees and in monitoring adverse reactions. The researchers say that ensuring safe transfusion requires more than increasing donors; quality control and oversight must be strengthened at every step of collection, testing, storage and distribution.

To reduce the hardship of finding donors in an emergency, the government took an initiative to build an integrated blood supply system called the 'One Blood Network'. Work on it began in 2025 with the support of the Bangladesh Red Crescent Society. The plan includes a central database of voluntary donors, mobile blood vans, and national transfusion centre hubs in six divisional cities including Dhaka. Work had also begun on an integrated database with information on about 300,000 donors in the initial phase.

According to project information, the plan is to use the central database of registered donors to find donors of a specific blood group in an emergency. Even without a smartphone, the service is meant to be accessible by USSD code on an ordinary mobile phone, with contact also possible by SMS. Mobile blood vans were also planned for large hospitals such as Dhaka Medical College Hospital and the National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR). But there has been no expected progress on full implementation of the network, the mobile blood vans, or launching the planned transfusion centres; the plans have yet to see the light of day.

The cornea picture is grimmer still. According to the Sandhani National Eye Donation Society, more than 500,000 people in the country suffer from corneal blindness, and about 40,000 more are affected every year. Yet the organisation can collect on average only 50 corneas a year. The cornea is the transparent front part of the eye; when it turns opaque for various reasons, sight is damaged, and in suitable patients a cornea transplant can restore vision.

According to the society's secretary general, Professor Dr Mohammad Monir Hossain, from the start of its activities in 1984 until 2023 the organisation collected 4,204 corneas, contributing to restoring the sight of 3,540 people. According to Bangladesh Medical University (BMU), the number of cornea transplants in the country each year is no more than about one thousand.

The biggest obstacles to posthumous eye donation are social and religious misconceptions. Many people believe that donating the eyes or corneas after death disfigures the body, and many also hesitate over whether eye donation is religiously permissible. According to the Sandhani National Eye Donation Society, a person can pledge in life to donate their corneas after death; even if the deceased made no pledge, corneas can be collected with the consent of a legal next of kin. Corneas generally have to be collected within six to eight hours of death, so family consent and quick contact are crucial.

Professor Dr Mohammad Monir Hossain said the main barriers to the posthumous eye donation movement are a lack of public awareness, social misconceptions and the shortage of donors. He said trained counsellors of the Sandhani Eye Bank contact the relatives of deceased persons at Dhaka Medical College Hospital and other hospitals, counsel them on eye donation and help collect corneas.

At a roundtable held on the occasion of National Voluntary Blood Donation and Posthumous Eye Donation Day 2026, the Sandhani National Eye Donation Society placed four proposals before the government: upgrading the day's state observance status from category 'C' to category 'B', ensuring Health Ministry support for collecting corneas from different hospitals, launching a toll-free hotline for eye donation information and assistance, and producing awareness programmes or messages for free broadcast on television.

The organisation says educational institutions, workplaces and social organisations must play a role in creating regular donors for blood donation. For eye donation, families need to be made aware in advance and hospitals need arrangements for quick cornea collection. Professor Dr Mohammad Monir Hossain said that although the country has a demand for blood, the amount collected through voluntary, unpaid donation is still limited, and enough corneas are not available for the vast number of people with corneal blindness. Changing this situation requires building a base of regular blood donors and creating pledges among people for posthumous eye donation. He added that eye donation cannot remain confined to individual pledges; hospital-based systems for collecting corneas quickly after death must be built, and family members must be informed about eye donation beforehand.