In his influential book The Gift Relationship, sociologist Richard M Titmuss noted that blood donation practices vary widely between countries, depending on whether donation is seen as a gift or a commodity. The UK system of voluntary donation, for example, was set up in 1939 to collect blood needed for war injuries during World War II, and has continued to thrive although the necessity changed. In many countries, however, blood donation receives some kind of compensation, either money, time off or a tax benefit.

In India, blood donors were paid until 1998, when the Supreme Court banned the use of paid donors. As a result, transfusion centres there are working to increase recruitment of voluntary donors. Struck by the paucity of voluntary blood donations by ethnic minority groups, including UK Indians, Dr Mallika Sekhar, a consultant haematologist in charge of the blood bank at West Middlesex University Hospital, decided to investigate further.

"I'll be examining the patterns of blood donation in Indians in the UK over the past three decades, from 1970 till the present time, in the context of their social and cultural evolution in the UK," explains Dr Sekhar. "I'll look at donation practices – and the underlying beliefs, attitudes and conflicts – in both first and second generation Indians."

Blood donation practices within a society can be used as an important marker for broader cultural issues. Titmuss, for example, argued that the altruistic act of blood donation is one of the most sensitive universal indicators of the quality of relationships and human values prevailing in a society. Dr Sekhar's investigation of blood donation practices in an ethnic minority might therefore shed light on questions such as how immigrant populations view themselves as citizens and conform to a new society, and how they realign their family and social relationships.

Many Indians who moved to Britain three decades ago are now beginning to prosper, and the study might reveal some interesting insights into how immigrants engage with the society that they are in. For example, in India, kinship ties are paramount, and Indians would rather donate to a group they can identify with. What are the changes in expression of altruism and generosity when Indians move to the UK, where the state or government takes over a number of functions that, in other countries, the family would have responsibility for?

Hindu Indian concepts of health are shaped by Ayurveda, in which blood is seen as an important component in the generation of semen, and loss of blood is linked with loss of life force and impotence. Such beliefs may prevent first generation Indians from donating blood, but second generation Indians, who have been exposed to Western medical philosophies from a young age may feel differently. A comparison of the two may shed light on how immigrant populations adapt and change their beliefs. "It seems to me that many of them are quite comfortable holding dual or multiple opinions about many things," observes Dr Sekhar.

To inform her research, Dr Sekhar will collect data on blood donation from transfusion centres in catchment areas with a significant Asian population. These data will be complemented by themes emerging from discussions with Asian charitable bodies, key Asian industrialists, and lay Indians – donors and non-donors – to discover how they prioritise charitable donations.

The research itself will focus on pragmatic questions, and the results will inform health education initiatives to increase blood donation in this group. "It might turn out that the reasons for not donating blood are very simple," says Dr Sekhar. "It might just be because travel to India is associated with the risk of transmission of malaria and so they get rejected." On another level, the findings from Dr Sekhar's research may contribute to a broader understanding of how people adapt to a new society.

See also

• Depression in Context: Article on depression in the UK’s South Asian community – another project funded through the Fellowships for Clinicians and Scientists scheme
• Indian psycho: Article on the portrayal of mental illness in Hindi cinema

External links

• West Middlesex University Hospital
• Welfare and well-being: Richard Titmuss’ contribution to social policy