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Beijing's Blood Shortage Crisis

 
 

China now is celebrating the Spring Festival, the most important holiday of the year for most of the population. However, a group of patients in China’s capital, Beijing, are spending their holiday on the verge of death because of an unexpected — and avoidable — blood shortage crisis.

On February 6, the Beijing Municipal Health Family Planning Commission (BJCHFP) — the city’s health authority — suddenly notified all local hospitals that it would call off family/replacement blood donations from February 10. (The notification wasn’t officially posted online until February 9 — one day ahead of the effective date.)

Family/replacement donations refers to blood donors who give blood only when it is required by a member of their own family or community. According to the World Health Organization (WHO), 100 percent of China’s blood supply is collected from voluntary, unpaid blood donors. A significant proportion of that depends on family/replacement donors — and even then, China’s demand for blood still exceeds supply. The WHO data shows that the proportion of China’s population donating blood was 0.92 percent in 2011. However, the WHO says that in order to maintain an adequate blood supply, 1-3 percent of the population needs to be blood donors.

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Thanks to China’s constant blood shortage, most hospitals request or even demand that a patient’s relatives or friends provide the amount of blood needed for emergency admission to the hospital or planned surgery.

China’s Law on Blood Donation allows for such family/replacement donation. Article 15 reads:

For the purpose of ensuring the supply of blood for citizens’ clinical first-aid treatment, the State encourages any patient who chooses a date for operation to have his blood stored for his own use and provides guidance in this respect, and persuades his family members, relatives, friends, the unit to which he belongs, and the community as a whole to donate blood for mutual aid.

In order to meet the urgent need for blood, a medical institution may collect blood whenever necessary, provided that they guarantee safe collection and safe use of blood in accordance with the provisions of this Law. Donors are not allowed to be paid by the blood transfusion service or hospital.

However, the family/replacement blood donation system led to an underworld of paid donations, in which agents, known as “blood heads,” sell blood to desperate patients’ families. The Beijing authorities’ decision to call off family/replacement blood donations was reportedly in order to suppress these “blood heads,” although the BJCHFP didn’t explain the reasoning in the notification.

Whatever the intention, the abrupt decision has left many patients in limbo. Many patients, together with their doctors, are having to call for help through their social media accounts, pleading with the BJCHFP to rethink this policy.

However, China’s top health authority — the National Health and Family Planning Commission (NHFPC) — appears confident about the new policy.

On February 1, the NHFPC told the Beijing News that the decision was made after a careful assessment of the national blood supply.

“Judging from the nationwide good development of voluntary unpaid blood donations, combined with experts’ research and analysis, China is ready to call off family/replacement blood donation,” the NHFPC said. “Therefore, [we have] demanded that the whole nation should stop the family/replacement blood donation by the end of March 2018, except for remote areas.”

Despite the nod to “experts,” many doctors claim that they were never consulted before this decision, although there have long been rumors that the government was considering ending the family/replacement blood donation system.

On February 14, under public pressure, the BJCHFP finally announced through its official Weibo account that it had asked other provinces — including Hebei, Shanxi, Hubei, and Hunan — to transfer some of their blood supplies to Beijing.

“Through the concerted efforts of many parties, the blood supply in our city is stable… and can meet the clinical needs,” the BJCHFP claimed.

Meanwhile, many local patients’ petitions on their personal Weibo accounts have been deleted by China’s censors.

The sudden public crisis once again exposed the Chinese authorities’ tendency toward arbitrary decision-making. This is not the first time that an abrupt government decision has left hundreds or even thousands of ordinary people out in the cold — sometimes literally.

For example, in November 2017, Beijing kicked thousands of poor residents out from their rental homes in order to demolish “illegal construction.” In December last year, thousands of families, schools, and factories in northern China were left in the cold without any heating system, because the government had imposed a strict ban on coal-heating to curb air pollution without ensuring an adequate alternative.

All these incidents demonstrate how a seemingly well-intentioned public policy can develop into a public nightmare if direct stakeholders cannot have a say in decision-making.

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