In our experience, rates of blood donation among some black and other ethnic minority groups are currently very poor, increasing the difficulty of finding matched blood for people from these groups who need emergency transfusion. We have found that less than 2% of people attending blood donation sessions in the West Midlands—an area with a high proportion of people of Pakistani and Bangladeshi origin—were from ethnic minority communities.

The National Blood Transfusion Service is introducing a question on ethnic origin in its health check forms for donors. This development is to be welcomed, for at least two reasons. Such categorisation should make it easier to find blood for people who have rare blood types. And, with the implementation of the Race Relations (Amendment) Act 2000, for the first time there will be the means to monitor service delivery to ethnic minority groups, thereby providing some assessment of opportunities for people from these communities to donate blood. While we welcome this development we feel that in itself it is unlikely to promote blood donation in these communities. What is needed is far more insightful interventions that are informed by a working appreciation of the various barriers against blood donation.

Recently we began a campaign to promote blood donation among Walsall's large Muslim population. Through informal discussions with community leaders, elders, and members of the general public we have begun to identify at least some of the key conceptual and practical obstacles. The concern we most commonly encounter is an uncertainty as to whether or not blood donation is against the teachings of Islam. Other barriers included a lack of awareness of the existence of facilities for donation, the belief that being too old or taking medicines precluded eligibility to donate, and a fear of becoming infected while donating.

Central to our campaign has been a willingness to work with local communities and their representatives. We have established a donor centre in a state of the art building in the heart of Walsall's Muslim community, and we have embarked on an education programme to dispel some of the myths concerning blood donation. With the help of imams of local mosques we have begun explaining the fluidity and in-built dynamism of Islamic law. Thus, while emphasising that life and our bodies are most certainly a sacred trust from God, we have also been able to highlight how the preservation of life is a higher order objective (indeed, the Arabic term shar'iah means "the path leading to the well of life"). Hence we can explain that many Muslim jurists have ruled that in cases of need it is acceptable—indeed commendable—to donate blood.

On our inaugural day we were pleasantly surprised, with over 30 donations. Another 15 people who were willing to donate had to be turned away, however, because of recent visits to areas where malaria is endemic. As this was for many of them their first visit, this may unfortunately discourage further attendance.

Through talking to donors we have been able to better understand some of the practical strategies that could facilitate blood donation. For example, we have learnt about the importance of making it possible to donate in the late afternoon and at weekends—such times being better suited to the working patterns and lifestyle of people in this community. Some times, such as Fridays and the month of Ramadan, are inconvenient and should perhaps be avoided when planning donation sessions.

Most gratifying of all has been seeing a small but dedicated group of people become regular donors. We believe that by involving key stakeholders in strategic discussions, such as the development of suitable educational resources, many of the barriers to blood donation in this community can be overcome.

Certainly, our experiences suggest that by connecting with the populations they serve health providers can do much to promote health, wellbeing, and social inclusion, even among the most marginalised sections of our society.