proved one of the key resources of World War II. It was only logical,
then, that as nations rebuilt themselves after the conflict, establishing
blood systems became a priority. In doing so, each nation embarked
on its own course, influenced by its particular experience and philosophy.
The United States, which showed that blood could be managed on an
industrial scale, continued to employ it as a medical commodity. Throughout
the nation blood banks and the Red Cross collected blood from volunteers.
Yet even they could not meet the growing demand. Soon a new breed
of blood collector took up the slack -- the freewheeling, for-profit
collection center that paid people for their blood.
Meanwhile, the pharmaceutical industry began to manage the plasma supply. Using paid plasma donors, the industry collected, processed, and distributed plasma products throughout America and much of the world. The combination of non-profit and for-profit blood and plasma collectors, hospitals, universities, government labs and research institutes made America the powerhouse of the blood world.
The politics of transfusion were simple for the British: Having nationalized their health system after the war, they considered blood a resource for the people, and placed it in the hands of the government. Blood and its derivatives were managed by to the newly established National Blood Service, part of the Ministry of Health. The nation maintained 14 regional Transfusion Centres. Each Centre collected, preserved, and distributed blood to blood banks and hospitals in its region. The system seemed so effective and fair that it shone for many years as an international example.
For sheer idealism no country approached France, where blood donation had become associated with the Resistance. In the years following the war the nation established an annual Day of Blood, in which whole communities would come out to give. Later they developed a national blood policy, the keystone of which was a concept called "benevolat" -- meaning blood should be voluntarily given, with no payment to donors or commercialism of any kind. Under this concept blood was not merely a resource, but part of a nationwide social contract. Even prisoners were encouraged to give, as participating was seen as a humanizing influence. The French saw their system as a model of efficiency and idealism, part of an enduring social bond in which all French people could feel uplifted and proud.
The Soviet Union
In the Soviet Union, as in many Communist nations, transfusion became a state enterprise. Blood was collected in factories or in the military and paid for with money, food rations, or vacation days. Despite the rewards, people saw the system as coercive: "You will give blood" became an invitation that the citizens could not refuse. People saw blood as so coupled to repressive regimes that when Communism fell, blood systems throughout Eastern Europe temporarily collapsed.
Germany and Japan
Blood banks were established haphazardly in the wreckage of post-war Germany. Doctors throughout West Germany would grab any materials available and establish little facilities wherever they could put them. (Sometime they'd collect the Coke bottles discarded by American GIs, sterilize them, and use them to store blood.) The staff at many of these makeshift blood banks paid for donations with money and food.
Meanwhile, the German Red Cross tried to establish a nationwide voluntary system. With commercial collectors in most of the cities, the Red Cross focused on the rural parts of Germany. This was the most volatile period of the Cold War, so they built processing centers well away from major cities in case of an atomic attack. Red Cross vans would travel through the countryside, collecting blood from volunteers at factories and small towns. Thus, a dual system evolved: paid clinical centers in the cities and the voluntary Red Cross stations in rural areas.
In war-ravaged Japan, an improvised blood system developed that had more in common with the black market than with a system devoted to health. Hospitals obtained blood through independent blood brokers who, for a commission, would supply them with donors. Aside from a cursory examination for blood type, many hospitals did not test for disease. Blood-borne syphilis caused several scandals until the country began to modernize its blood system in the late 1940s.
-- Douglas Starr
Photos: Courtesy of the National Library of Medicine (top right) and the Library of Congress (bottom right).