A medical worker deals with blood samples in a blood station in Foshan, Guangdong Province. Photo: CFP

Liang Fen, deputy chief of the Maoming Central Blood Station in Guangdong Province, has been working overtime to promote blood donations at schools and organizations for the past several days.

The station declared a critical shortage of blood in all types in April. As of Tuesday, blood types A, B and O were in grave shortage, and AB was in low supply.

"I am under a lot of pressure to collect blood, because the gap between the amount of blood we collected and the blood we used is getting wider and wider in recent years," Liang told the Global Times. The station collected 21,100 milliliters of blood on Monday, but offered 31, 600 milliliters for use.

Several other cities in the province including Guangzhou and Dongguan are also experiencing blood shortages, and some like Maoming have struggled for blood for years.

To cope with blood shortage, family and friends of a patient are encouraged to donate blood to ensure the patient would be given priority access to blood. This plight also has triggered a rampant illegal blood market across China.

Blood in urgent need

Maoming has faced a blood shortfall of 30 to 40 percent for all the four blood types for many years, Liang said.

The station collected a total of 11.7 million milliliters blood in 2014, up 13.6 percent year-on-year, but the blood consumption was 11.17 milliliters, up 17 percent year-on-year. 

The blood shortage is particularly severe each summer, because the only university in the city is closed, which means a loss of at least 20,000 potential donors. The situation for some neighboring cities with more universities and soldiers is better, Liang said.

Fu Chongshui, director of the Guangzhou Blood Center, said that the city experiences a seasonal blood shortage in winter and summer due to extreme weather. Some 70 percent of blood is collected through mobile blood donation vehicles in the streets.

The amount of blood collected by the Dongguan Blood Center dropped by two-thirds due to rainstorms over the previous days, the Nandu Daily reported. Some hospitals claimed that the limited blood supply means they could only cover emergency operations. Patients with chronic diseases have to wait for days for treatment.

"Dongguan started to face low blood levels last year, and the problem is more evident this year," a hematology department doctor was quoted by the Nandu Daily as saying.

Without enough blood, Maoming has to transport blood from other stations in the province and encouraging families of patients to donate in exchange for allowing the patient access to blood, Liang said.

"For now, we can only ensure blood for emergency rescue, all the other patients have to wait or seek help from friends or relatives," she said.

Illegal market

Lai Lishi, 23, suffering from a parathyroid gland tumor, is hospitalized at Maoming People's Hospital. One day before her surgery this May, her friends posted on social media a plea seeking a blood donation of 1,200 milliliters for her. 

"We got enough blood after several good Samaritans came to donate later that day," Lai's father told the Global Times. He explained that the hospital did not have enough blood in storage for her daughter's surgery.

Lai's first surgery went well. She needs another operation, and the hospital is still in need of blood.

Posts of seeking blood for patients in different parts of China can be seen frequently on Weibo and WeChat. Some like Lai are lucky to find donors. Many have to pay illegal blood agents to buy blood.

Media have revealed for-profit chains of blood agents in many places including Beijing, Zhejiang and Guangdong since 2011.

A Beijing agent surnamed Liu told a Global Times reporter posing as a patient's family member that he could find people to donate blood, and customers only need to provide the patient's information including the name of hospital and bed number.  

He charged 1,500 yuan ($242) for 400 milliliters, and said he has been "in business" for three years.

People who organize others to sell blood for profit will be fined up to 100,000 yuan and will be held criminally liable, according to China's law on blood donation.

Beijing seized five blood agents in front of the Beijing Red Cross Blood Center in 2014, and one agent told police that he could earn more than 5,000 yuan each month, the people.com.cn news site reported.

To curb the illegal market, Guangdong health authorities issued a notice in 2013 calling on medical institutions to regulate the policy of demanding blood donations in exchange for receiving blood, and review the information of the donors. The notice apparently did not work well. Seventy-eight percent of Maoming's total population of 7.4 million is rural. They have little knowledge of blood donation, and many believed that donating blood would harm their health, Liang said.

"Sometimes, one blood collecting vehicle cannot find a single donor for two days in villages," Liang said.

The majority of the young adults in the villages are working in other parts of the country. Only the elderly and children remain.

Credibility crisis

Since Guo Meimei, an online celebrity, claimed to be a manager of the Red Cross and boasted about her luxurious lifestyle on the Internet in 2011, China has witnessed the decline in public's enthusiasm of donating blood.

This May, a survey conducted by Nandu Daily and news website gd.qq.com found that 80 percent of the total 639 Net users surveyed believed that the biggest reason for the blood shortage is the low credibility of the health authorities and opaque donation mechanisms.

Health authorities in provinces like Jiangsu and Guangdong encouraged clinics to save patient's blood for later surgical use. But the measure was seldom used in hospitals.

Sun Jun, director of Jiangsu Province Blood Center, told China National Radio (CNR) that saving a patient's blood for later use is the first measure to solve the blood shortage, but current medical insurance mechanisms don't cover the practice, which translates into a high cost.

In some Western countries, about 80 to 90 percent of the patients who need surgery choose this practice. But in some Chinese hospitals, the percentage is less than 10 percent, according to CNR.