China's Blood Drought

China is running out of willing blood donors as citizens grow wary of the ill effects of donation on their own bodies and question the competence and integrity of the country’s health system.

Age-old fears based in traditional medicinal beliefs are being joined by a wide range of new and sometimes outlandish rumors spread across internet message boards. Health officials in several cities and provinces have raised the prospect of a “blood drought,” and are taking action to prevent vital stockpiles from going empty.

Maintaining the country’s blood banks has long been a challenge for China’s health services. Blood has traditionally been regarded as closely linked to the vital bodily essence known as qi. Believers hold that any loss of blood can seriously weaken the body, leaving a person susceptible to a whole host of ailments and requiring anywhere from a few days to several weeks of rest and special diet. While traditional Chinese medicine specialists have routinely testified to the safety and even health benefits of donation, many deeply-entrenched misgivings remain.

A new wave of health concerns emerged with the contaminated blood scandal of the mid-1990s, when HIV-AIDS infections were spread among donors and recipients in several rural areas in central China. Despite the passage of nationwide reforms and regulations in 1998, for many blood donation is still regarded as unhygienic and unsafe.

Such concerns would have made little difference in the days when blood donation was part of the planned economy, with each work unit assigned a quota of blood to be collected from its members. Some donations continue to be organized on a group basis by government departments and private companies, and universities and high schools periodically hold campus blood drives. However the vast majority of donors are individual walk-ins who arrive unscheduled at one of the many bloodmobiles that make up the bulk of China’s blood collection sites.

As such, China’s blood donation rates are treacherously volatile. Unseasonable changes in weather such as blizzards or heat waves can keep pedestrians away from the public squares and shopping centers where bloodmobiles are most often parked. Many areas experience periodic shortages each year, with the worst coming in the late winter and early summer, when university students – who make up a significant proportion of frequent donors – return to their homes on vacation.

In this atmosphere, it is not uncommon for local authorities to declare a “blood drought,” prompting urgent appeals to the public and even forcing some hospitals to delay surgeries until adequate supplies of blood can be guaranteed.

This year began with hopeful signs that such drastic measures would be, for now at least, a thing of the past. According to statistics released by China’s Ministry of Health, in the first six months of 2011 blood donors increased nationwide by 5.4 percent from the same period in 2010, while amounts donated increased by more than 6 percent. But much of this increase came from more remote, less developed regions such as Inner Mongolia, Guizhou, and Shaanxi. In major cities such as Beijing and Shanghai, donors dropped by 3.6 and 4.4 percent, respectively. A similar trend was reported in the prosperous coastal province of Zhejiang, with donors declining by 1.6 percent and the amount of blood donated by almost 5 percent.

And in the time since these statistics were collected, new and unexpected developments have thrown blood banks back into crisis mode, and raised the possibility that shortages this year may be more dire than usual.

Many heath officials have placed the blame for declining donations on what has become known as the “Guo Meimei incident.” In late June of this year, a young woman calling herself by that name and claiming to be a high-ranking official in the Red Cross Society of China posted pictures online showing her posed beside luxury cars and sporting designer handbags. The photos rapidly sparked controversy, raising questions about corruption within the Red Cross and the possibility of misspent donations.

Growing distrust of the charity quickly spread to the blood collection centers that prominently display its insignia. Blood donation workers in several cities have reported being accosted by passers-by accusing them of selling blood for profit. Such charges have spread rapidly across online message boards, often accompanied by alleged evidence of the health services’ shady accounting.

In the months since the scandal emerged, blood donations have markedly declined. The Beijing Municipal Health Bureau reported in August that donors had dropped by more than 10 percent in the previous two months. In the coastal city of Shenzhen in southern Guangdong province, the local blood bank has declared its reserves to be at emergency levels three times since June, with the most recent announced on Sept. 29. Shenzhen’s problems have been made worse by a series of fierce tropical storms that have battered the region throughout the summer, keeping pedestrians off the streets and away from bloodmobiles.

The Guo Meimei scandal has since been joined by a wide range of further accusations and rumors to dissuade potential donors. Netizens writing on popular online forums have spread messages warning of the health risks of blood donation, while individual donors have posted accounts of their experiences with domineering blood collection workers and their own post-donation illnesses.

In August, an article simultaneously posted on several major forums claimed that over a thousand bags of blood sent out to Beijing hospitals contained blood that had not only passed its expiration date, but had been contaminated by chemicals released by low-quality blood bags. The post was influential enough to prompt a response from the city’s blood bank, which denied that it had sent out any expired blood, but admitted that several hundred of their plastic bags had passed their expiration date. While they assured the public that there was no risk of any leaking chemicals contaminating the blood within the expired bags, the news did little to assuage public fears and distrust.

Across the country, China’s blood banks have gone on the offensive to keep dwindling supplies from running out. Both official and commercial media have featured appeals from local blood donation centers highlighting the severity of the shortage and addressing popular concerns over health risks and questionable accounting. In some places, blood centers have taken a different track, appealing to donors less philanthropic instincts by offering rewards ranging from restaurant coupons to raffle tickets for prizes worth several hundred yuan.

For now, the risk of a blood drought has been deferred. This is due not to any long-term lessening in public reluctance or the success of official appeals, but to another seasonal trend that forms the opposite of the summer and winter slack months. The week-long holiday marking China’s October 1 National Day has been marked with the annual tradition of widely-publicized blood drives playing on patriotic themes, with Communist Party newspapers displaying photos of students, soldiers, and government workers rolling up their sleeves to contribute.

The sudden influx of tourists and local pedestrians passing their vacation in public spaces has also brought crowds of passers-by to impulsively walk into waiting bloodmobiles. In Shenzhen, a local TV station reported that more than 2,000 people had donated blood over the seven-day holiday, causing the city’s blood bank to declare an end to the emergency they had announced the previous week.

But since the end of the October holiday, the vacationers have returned home while public doubts and distrust remain. Whether blood banks can regain donors’ confidence and replenish their much-needed supplies is a question that has yet to be answered.