Blood: SOS

China is suffering from a severe shortage of the fluid of life By Yuan Yuan

Blood: SOS

China is suffering from a severe shortage of the fluid of life By Yuan Yuan

On the evening of February 9, a micro-blog post pleading for type-A blood platelets was posted on China’s twitter, Weibo.com, and within a day,the message was forwarded thousands of times.

Cheng Yuntao, who wrote the post, is the father of a 3-year-old boy who suffers from leukemia and needed the transfusion of type-A blood platelets urgently.

“There was insuf fi cient blood of this type in the hospital, so we had to rely on blood donation,” said Cheng, a Beijing resident.

“Almost all the city’s hospitals are suffering from blood shortage at the moment,”said Yang Pingdi, a senior doctor at the Blood Center in Beijing Daopei Hospital, where Cheng’s son was receiving treatment.

According to Yang, the treatment of more than 100 patients in Daopei Hospital had to be delayed due to the shortage of blood. Cheng had to turn to netizens for help. Within 10 days, six people volunteered to donate blood and only one volunteer’s blood was a suitable match.On February 19, Cheng’s son received a blood transfusion and his condition stabilized.

Not every patient is as lucky. Wang Chaoqun, another child at the same hospital,didn’t receive a transfusion in time and his disease is now too serious to cure.

Some patients, after being informed that blood was unavailable in the hospital, transferred to other facilities but found the situation is the same throughout the capital and in other parts of the country.

“It has become a nationwide problem,”Yang said. “Every hospital is in urgent need of blood.”

Fewer donors

The blood shortage began in China as early as 2007. At fi rst, the shortage was regional and seasonal, but gradually it became regular.

In October 2010 the blood bank in Kunming,capital of southwestern Yunnan Province, was almost empty. The same problem occurred in many other cities as well. In big cities such as Beijing and Shanghai, where major hospitals are clustered, it is much more severe.

At a press briefing on December 13,2011, Deng Haihua, a spokesman for the Ministry of Health, admitted that there was a widespread blood shortage in China.

“The blood donation rate in our country is only 8.7 percent, which lags behind the 45.4 percent rate in high-income countries, the 10.1 percent rate for middle-income countries and even the 10 percent recommended by the World Health Organization,” he said.

China was able to meet its demand for blood relying on a compulsory blood donation regime until 1998 when voluntary blood donation was introduced. According to the Ministry of Health, from 2006 to 2010, the annual number of volunteer donors in China increased from 6.75 million to 11.8 million,and the yearly volume of blood donation rose from 2,295 tons to 3,935 tons. Last year, the volume of blood donation reached 4,164 tons.

Sun Dongdong, a professor at Peking University, said that a major reason for Chinese people being reluctant to donate blood is that they believe the whole body should stay intact and blood is supposed to be a part of the body. Even if young people are willing to donate blood, parents often stop them as they are concerned that blood donation is bad for the health and might even cause infections. “Some college students dare not tell their parents after they donate blood,”Sun said.

However, in the past two decades, the volume of blood needed has increased at a higher rate in China, as more surgeries involving blood transfusion such as liver transplants are being performed. Supplies at blood banks in many places were at critical levels at the end of 2010.

In 2011, the situation got even worse.A 21-year-old woman, Guo Meimei, who claimed to be the manager of a branch of the Red Cross Society of China (RCSC), showed off her luxurious lifestyle on Weibo.com,causing people to lose faith in Red Cross organizations. Although Guo was later found to have no connection with the RCSC, Red Cross blood centers across China have witnessed a sharp decrease in blood donors.

According to a report byThe Beijing News, the volume of blood donation in Beijing declined by 5 percent during the fi rst half of 2011, and by a further 13 percent in October and November last year.

Ren Xuemei, Director of the Emergency Department at Beijing Chaoyang Hospital,revealed that tighter restrictions have been imposed on the use of blood. As a result, patients can only be given transfusions if they are suffering from life-threatening illnesses.

At the same time, blood banks in Nanjing,capital of eastern Jiangsu Province, have capped supplies to the city’s hospitals, resulting in an acute shortage of type-A and type-O blood. It’s reported blood banks in the city can meet at most one third of demand.

Questionable regulations

Shortly after the Guo Meimei scandal, Larry H. P. Lang, a Hong Kong-based economist,wrote on his micro-blog that he suspected the RCSC of receiving free blood donations but selling them to hospitals at a high price.

Since then, the oft-repeated phrase “donating blood doesn’t cost money, but using blood costs money” has become a common manifestation of public distrust.

Web portal Sina.com conducted an online survey in 2011. Nearly half of the 6,800 respondents said they were concerned that their blood would be used to make money.

OUT OF STOCK: The blood storage cabins are all empty in the Yunnan Kunming Blood Center on October 27, 2010

“If my blood is used to make a profit,I will definitely not donate money,” said Zhang Nana, a college student at the Renmin University of China in Beijing.

But Tian Xihui, a spokeswoman for the Beijing Red Cross Blood Center, said the public has misunderstood the blood supply system. “The patients actually pay for the testing, transportation and storage procedures, not the blood itself,” she said.

China’s Blood Donation Law specifies that blood costs are broken down into two parts, covering operational costs of blood donation centers and blood tests and storage in hospitals.

Tian revealed that blood testing includes many items, such as cross-matching before it’s used. First of all, workers at mobile blood donation units conduct a medical consultation to exclude people who are not eligible to donate blood, and then they do a preliminary test to examine whether the donated blood is good. After the blood is sent to a blood center,lab technicians will do a comprehensive blood test that covers twice as many items as the preliminary one.

“Hospitals are always blamed for charging money, but the standard price for using 200 cc of blood in China is 220 yuan ($35),which just covers the cost,” Tian said. “It is really necessary to show the public clearly the process and the costs from the moment blood is donated to when it is transfused.”

Professor Sun believes health authorities are primarily to blame for the public’s distrust in the blood supply system, which he said has been focusing more on the techniques of blood collection than the transparency of blood centers’ operations.

He suggests that the law on blood donation should be updated.” China’s blood donation law, since being put into practice in 1998, has not been modi fi ed for 14 years.Many articles do not conform to current situations.”

According to the Blood Donation Law,a donor as well as his or her relatives are eligible to receive a volume of blood that is the same or greater than the amount he or she has donated free of charge. But blood donors sometimes find it difficult to receive this bene fi t if they donate blood in one place and undergo a surgery somewhere else.

In fact, different places have different rules on how blood donors can benefit from donation. In Shenzhen in southern Guangdong Province, as long as a person donates 200 cc of blood once, he or she can receive as much free blood whenever necessary throughout their life. In Shanghai, after a person donates 200 cc of blood, he or she can consume 1,000 cc for free within fi ve years. After fi ve years,he or she can use only 200 cc for free.

Furthermore, the blood donation system is still separate from medical insurance programs in China, which causes dif fi culties for donors to get refunds for using blood themselves.

To meet the current blood demand in China,the Ministry of Health estimates that 70,000 people need to donate blood daily. By 2015,that figure is expected to surge to 120,000 people.

On January 8, the RCSC organized blood donation campaigns in Beijing and called for emergency measures such as blood drives in Beijing and provinces of Yunnan, Shandong,Jilin, Hubei and Guangdong.

Health Minister Chen Zhu, along with nearly 500 people from the Ministry of Health, donated blood that day in hopes of encouraging others.

Some mobile blood donation units in Beijing also prolonged their working hours and provided fruit and juice to donors.

“China’s population base is very big and we should focus more on inspiring more eligible people of the right age to donate blood,so as to meet the increasing demand,” said Deng, who said that the government planned to widen the age range of healthy citizens eligible for blood donation.

ROLE MODEL: Hou Yifan, Women’s World Chess Champion, donates blood at the Beijing Red Cross Blood Center on February 27, when she turned 18, the eligible age for a person to donate blood in China