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 With hospital blood supplies tight, desperate patients are turning
to agents known as "blood heads", who sell certificates that give
patients access to state blood banks, creating a black market at the
heart of the healthcare system.
"To us patients, buying blood solves our problems," said Hong, a
retired Shanghai civil servant who suffers from myelodysplastic
syndrome, a debilitating blood condition. "If there were no blood
heads, what would I do?"
The blood "famine", as it has been dubbed, is an unintended
consequence of China's attempts to restore faith in the nation's
scandal-stained blood supply and encourage people to donate.
In the late 1980s and 1990s, local officials urged farmers to sell
their blood and plasma, and an earlier generation of blood heads
sold this to hospitals and blood banks. Tens if not hundreds of
thousands contracted HIV through unhygienic practices in the
process.
A second scandal in 2011 further depressed donations. A young woman
who claimed she worked at the Red Cross Society of China posted
online pictures of her lavish lifestyle, damaging the image of a
charity that helps the government collect blood.
In the mid-1990s, China started shuttering commercial blood stations
and in 1998 it introduced a blood donation law, banning the
commercial sale of blood and encouraging voluntary donation. It also
tightened rules on plasma collection and increased blood testing.
Chinese law now encourages patients to present a certificate showing
that they, friends or relatives have donated blood when they need to
tap the national supply. Some hospitals will not provide blood
without these certificates.
The effect has been to penalize chronically ill patients who depend
on regular or large transfusions, as well as those who cannot count
on family and friends nearby. Chinese law also limits individual
whole blood donations to twice a year, and provinces rarely share
blood.
To meet demand, a new generation of blood heads have moved in,
paying people off the street to donate blood at a state blood bank
and selling their donation certificates to those in need.
The blood heads include men like Zhang, a 25-year-old from
northeastern Jilin province who late last year stood in a neon
yellow puffer jacket outside the Red Cross Center in Beijing.
His terms: 1,000 yuan ($160) for every 100 cc (3.4 fl oz) he gets
donated into the blood bank. All he needs - beyond money - is a
day's notice, the name of the hospital and the blood type of the
patient.
CRACKDOWNS INEFFECTIVE
Periodic crackdowns on blood heads appear to have had only limited
effect. "Don’t worry about the police. We're outside most of the
hospitals and we know all the police officers," Zhang said. Two
police cars were parked nearby.
Patients such as Hong, whose son asked that her full name not be
used for fear that the hospital would deny her a bed if its
practices were exposed, are nothing but grateful.
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Denied blood for the regular transfusions she needs at a top public
hospital in Shanghai, Hong moved to a private specialist hospital
that introduced her to blood heads. They deliver the blood donation
certificates to her bedside.
Just under 1 percent of China's population donated blood in 2011,
the most recent year for which figures are available, according to
the World Health Organization – at the lower end of the WHO's
recommended range.
That year, blood donations rose 5 percent to 4,164 tons, according
to China's National Health and Family Planning Commission. The
commission did not respond to a request for comment.
In a country where many are still loath to give blood, most
legitimate donations come from students and members of the military.
But the law also encourages government employees to donate. Chinese
court documents show that government units have used blood heads to
meet annual quotas for blood collection from residents or employees
in recent years. Lawyers involved with these cases confirm that.
Local governments are resorting to unusual public campaigns to
recruit new donors.
A county in eastern Zhejiang province made national headlines in
September for proposing to raise the scores on the high school
entrance exam for the children of people who donated 4,000 cc of
blood.
Hunan province is offering to waive the costs of using the blood
bank to residents who donate 900 cc.
But blood stocks in many places remain stubbornly low, and dip even
lower at times such as the Chinese New Year season just beginning.
In Changsha, in Hunan province, a blood donation center official
said blood stores were currently a third of the levels considered
safe. All but essential surgeries have been postponed.
($1 = 6.2400 Chinese yuan renminbi)
(Additional reporting by Sui-Lee Wee in Beijing and Shanghai
newsroom; Editing by Alex Richardson)
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