While progress has been made in Russia's blood transfusion services, experts say they still need a moral boost, as the number of blood donors is still insufficient.

Many are reluctant to give their blood without being paid for it, due to the legacy of the Soviet era when donors were rewarded with food, days-off and honorary distinctions.

According to public opinion surveys, 46 per cent of the country's potential donors expect some kind of reward.

“I don't care whether I'm paid or not, but I'm given a day-off. That's what I care about. To have some rest,” blood donor Vadim Khovansky said.

Not many employers are willing to give staff days off, however, especially during an economic crisis. Blood shortages are more acute during public holidays when stocks usually dip. In cases of extreme shortages, some believe blood substitutes could become an alternative to blood, such as Perftoran.

Perftoran was invented by Russian scientists. Doctor Katunyan has been using this blood substitute for ten years. Often referred to as ‘blue blood’, it is also available in America and Japan.

“Perftoran was mainly created as a blood substitute for cases of severe blood loss, but in our medical centre we don’t have such patients. But working with Perftoran we discovered a number of other qualities it has. For instance, its anti-inflammatory character,” Pogos Katunyan said.

Not all hospitals in Russia can afford Perftoran as it costs more than a $US 100 a bottle. Besides, some experts say, Perftoran can be hard to use in emergency cases.

“It's an emulsion which should be kept frozen, at minus 18 degrees Celsius, whereas it can only be used on patients at plus 20 – 30 degrees Celsius. This can become a technical problem when time is running out,” said Doctor Vladimir Gorodetsky.

Instead of looking for blood substitutes, many in Russia say it's the public's attitude towards donating that needs to be changed, so that a life-saving donation is no longer perceived as needing compensation, but instead as an altruistic act.