Red alert

Transfusion confusion: hospitals are running out of blood

In early February, Pu Buzhen was due to start chemotherapy for a rare bone marrow disease known as aplastic anaemia. The 34 year-old had waited a year for treatment. Her family had sold cars and property to pay for it.

But 10 minutes into the first session her doctors learned that the local government was about to ban the so-called mutual blood donation system – where people are permitted to give blood to patients they know personally.

This would leave Pu reliant on the more limited public donation system. Her doctors concluded her treatment was too risky without the guarantee of reliable transfusions from family members.

She left the hospital and took to Sina Weibo. “At any time a nose bleed or brain haemorrhage can kill me now,” she said. “All we ask is that our relatives can give us blood.”

The government is scrapping the ‘mutual donation system’ because it creates a legal loophole for commercial agents (nicknamed locally “blood heads”) to flourish.

Commercial blood donation was outlawed in the 1990s after hundreds of farmers in Henan contracted HIV from a government-backed cash-for- blood scheme. Under the mutual donation system all a donor has to do is say he knows the recipient and that the person is giving blood voluntarily. This is open to abuse and payment is often made privately later via a black market dealer.

Just before the February ban a unit of blood was selling for Rmb600 on the black market, the Beijing News said.

Sixth Tone notes that if the blood group is the much rarer rhesus negative variety, then 525ml of it can fetch Rmb20,000 ($3,159).

However, much of the blood collected from commercial donors like this is unusable because it carries blood-borne diseases like Hepatitis B and C. In 2014, about 60% of all tainted blood donations in Nanning came from “mutual” donors, the Southern Weekend newspaper said. Nanning banned the practice shortly afterwards and several other cities including Wuhan and Hefei also scrapped mutual donations.

The central government has now instructed all cities and provinces to follow suit by the end of March.

In early February the State Health Planning Commission told the Beijing News that voluntary donations to the public blood bank were now of sufficient scale to stop the supplementary channel. Ten people in a thousand now give blood though the public system, the commission says. But the World Health Organisation says the minimum number of donors needed for blood bank sufficiency is double that.

Part of the reason the Chinese have been reluctant to donate blood to the public pool in the past was a fear of infection and a belief that the system probably wouldn’t benefit them if they ever needed it themselves. Several corruption scandals at the Chinese Red Cross over the years have added to this perception (see WiC113) .

The result is that in big cities like Beijing with lots of hospitals, demand for blood regularly outstrips supply. Last year 21% of the blood used in the city’s hospitals was provided by “mutual donation”. Few dispute the need to crackdown on donations for money or the “blood heads” that profit from the trade, but many questioned the way the recent ban was implemented in the capital.

Even Xinhua reprinted a Beijing News article which said it was too “sudden” a policy shift, noting that the “abrupt government decision, announced days before the Lunar New Year holiday, left thousands of patients in limbo”.

It added that dozens of operations had been cancelled and the effects had spread to neighbouring provinces because blood was being diverted to Beijing’s patients.

To make matter worse, the city government didn’t launch a donation drive to make up for the shortfall caused by the snap ban. Most donation points were closed over the New Year break and university students – who are often mobilised to give blood – were on holiday.

“This is typical of the current Beijing government, it has no consideration for the people that live here,” wrote one angry weibo user.

“This really is the coldest winter yet,” said another, echoing a catchphrase used when thousands of migrant workers were kicked out of the capital last December.

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