After a long winter, shopping areas in downtown Beijing began to revive their festive weekend atmosphere in March, as spring returned. Sun Ying joined the hustle and bustle to window shop in Xidan, a commercial district in the heart of the city. But Sun also took the time to donate blood in a mobile blood bank.
　　“I donated blood once when I was a university student and this is the second time,” said Sun, 28, who works for a Japanese company. “My blood type is B. When I read the notice on the window of the vehicle that there was shortage of type B blood, I naturally decided to donate.”
　　Sun said she delights in the idea of helping those in need with her blood, although she doesn’t know who the person will be. “The ability to donate blood demonstrates my health since the blood has to be tested meticulously beforehand,” she added.
　　He Weiguo, a 43-year-old employee of a state-owned enterprise, donated blood on the same vehicle. Compared with Sun, he is a veteran donor. “I have been donating blood once a year for many years,” he said. “Above all, donating blood is good for one’s health. I used to suffer from ‘sticky’ blood, but it has returned to the normal level since I started to donate blood and I feel better.”
　　China enshrined the practice of voluntary, non-remunerated blood donations into law with the promulgation of the Blood Donation Law on October 1, 1998. According to statistics from the Ministry of Health, the number of non-remunerated blood donors climbed steadily across the country in 2005. Last year, blood donated by non-remunerated donors accounted for 95 percent of the total used for medical purposes, and 84 percent of these donations were purely voluntary. This compares with respective figures of 22 percent and 5 percent in 1998.
　　While more and more people are making voluntary blood donations, other statistics illustrate the hazards such donors face despite their goodwill.
　　Minister of Health Gao Qiang told the media last November that around 70,000 people in China contracted HIV/AIDS through blood transmission, either as donors or recipients. China has a population of 840,000 living with HIV, the majority of whom were infected through the intravenous injection of drugs and unprotected sexual intercourse.
　　Safe blood refers to blood that will not jeopardize the health of recipients through the risk of disease. For both donors and recipients, the safety of blood is directly related to their health and life, and it is vital that there are no lapses in the process.
　　
　　Stringent testing procedures
　　
　　Every voluntary blood donor must go through complex testing procedures before donating blood, including an ID check and examination of blood pressure and blood composition, including a check for hepatitis. Besides the strict medical indicators, even something as simple as a sneeze in front of the medical staff could also bar a donor as being unsuitable.
　　“It is out of a responsible attitude toward donors, since ailments might cause a negative reaction. Meanwhile, illnesses might harm the quality of the blood,” said a worker at the Xidan mobile blood bank. “Donors are perfectly safe while donating blood here because all the equipment used to collect blood, such as needles, will be discarded and replaced with new, sterile material each time a procedure is performed. So there is no risk of infection and no unsafe factor for the donors.”
　　The Blood Donation Law clearly stipulates that seven components, including tests for HIV, hepatitis B, hepatitis C and syphilis, as well as blood type, hematin and transaminase, must be strictly examined and no error is allowed in the testing.
　　“Due to the use of advanced imported reagents, we can get the results in three minutes,” said the blood bank worker. “So we can decide whether the blood is eligible for donation on the spot and only collect eligible blood.”
　　The staff confirmed that each of these factors is double-checked later, and if blood is discovered to contain any abnormality, it is destroyed.
　　Stringent tests await blood that is donated. Instead of putting the blood into blood banks right away, collectors store it according to strict procedures. Immediately after the donated blood is delivered to the blood center, the blood type will be tested for the seven mandatory items. To guarantee the accuracy of tests, they are conducted on two samples of a donor’s blood at the same time. The environment of the test labs, including the air and floor, is disinfected every day to make sure it is germ free.
　　After these standard procedures, the accepted blood goes through various processes, such as the separation of blood components.
　　In the final step, the medical staff obtains all the information on every blood donation from a computer scan of the label on each bag, if all results are normal, staff members will affix the blood type to the bag. These bags are then stored in a blood bank for use.
　　
　　Real name system encouraged
　　
　　Zou Zhengrong, Deputy Director of the Shanghai Blood Center, said, “There is no absolutely safe blood. One reason is scientific limitations. The disease must register abnormal figures before you can detect it and kill it. Second, the virus must accumulate to a certain amount before it can be discovered.”
　　He explained that there is a gap between the time a virus invades a healthy body and when it can be detected. He noted that this “window period,” or the time it takes for a person who has been infected with a disease to test positive for antibodies, is 22 days in the case of HIV.
　　In order to avoid problems threatening blood safety, such as concealing a disease history or the frequent sale of blood, China stipulates in the Blood Donation Law that the blood for clinical use supplied by all blood centers across the country must come from non-remunerated blood donors.
　　China has two types of “non-remunerated” blood donation. One is voluntary, which means donors do not receive any compensation in the form of nutrition fees or other subsidies from the blood collection agency or the donor’s employer. The other is planned blood donation. Companies and government branches organize their employees to donate blood on a regular basis. This group of donors receives various types of material compensation from their employers.
　　Actually, blood donors working in government branches, public service units and state-owned enterprises usually receive subsidies or long vacations. But these have produced problems for the blood donation system. In particular, the subsidies can give rise to organized blood trade, which is evident in some cities. In these cases, dealers pay individuals, many of whom are farmers, for their blood, and then sell the blood to hospitals or blood banks.
　　“As long as money is involved, it is hard to eliminate the situation where some people are hired to use the payer’s identity to donate blood. These ‘professional’ blood donors have no other job and live on the subsidies,” said Zhu Yongming, Director of the Shanghai Blood Center. “Some of them have failed every blood test and some even test positive for the hepatitis virus. And blood from those who earn a living by selling it cannot show acceptable results on indexes of albumen and red cells. If this blood finds its way into the blood bank, the quality will be tainted.”
　　According to a survey conducted by the Ministry of Health, only 1 percent of the non-remunerated blood donors test positive for hepatitis, but the rate can be several times or even dozens of times higher for blood sellers. This has greatly increased the danger in blood transfusions.
　　A real name system might serve as an effective method to defuse hidden dangers induced by economic incentives, experts say. Therefore, many cities have invested generously in establishing a system so as to identify blood sellers.
　　Zou of the Shanghai Blood Center said all blood banks in the city have been linked to a donor database via the Internet. Therefore, it is very easy to find if the interval is too short for a person to donate blood again, through looking up the archives with his/her ID number. To combat the rampant availability of counterfeit ID cards, every blood bank is also equipped with testing equipment.
　　Aside from cracking down on the practice of paying people to donate blood, a real name system has other advantages. Zou said, “If every donor registers his or her real name and identity, if a rare blood type is badly needed, hospitals could save lives by tracing the donors by record. This solution is quite feasible.”
　　
　　Government investment
　　
　　In the mid-1990s, illegal blood collection generated the spread of HIV/AIDS in certain regions. To address this problem, China has adopted a series of laws and regulations to guarantee blood safety and set severe penalties for organizers of blood trade. Other measures also include cracking down on undocumented blood collectors, intensifying rectification of blood banks, implementing an HIV testing procedure and encouraging non-remunerated blood donation.
　　With such efforts, Wang Yu, Deputy Director of the Department of Medical Administration of the Ministry of Health, said, “The government has been committed to the elimination of the illegal blood trade and will punish those involved according to law. Issues concerning blood safety will be seriously dealt with.”
　　In the year from April 2004, the ministries of health, public security and supervision joined in a campaign against blood trade and carried out a full-scale inspection of 900 blood collection agencies, 36 blood product manufacturers and numerous medical organizations conducting blood transfusions across the country and severely punished illegal blood collectors. According to the Ministry of Health, the campaign investigated 104 cases, arrested 30 suspected criminals, 15 of whom were sentenced to prison terms. Nearly 100 officials of blood stations, medical organizations and health administrations have been punished.
　　The government has also stepped up investment in improving facilities in blood stations. Vice Minister of Health Chen Xiaohong revealed at a national conference in March that in order to guarantee blood safety, governments at all levels invested a total of 2.25 billion yuan in initiating a blood supply system construction project, which includes upgrading equipment for 318 blood stations and 119 blood centers. This project has built the first group of blood stations in the western area and greatly boosted conditions and facilities in blood stations.
　　Chen said the established internal quality control and external quality assessment appraisal mechanisms have significantly improved the testing level of blood collection agencies. It is common practice for blood banks across the country to test every bag of blood twice, strictly following procedures set in law. To ensure the blood safety in underdeveloped areas, the Ministry of Health has installed HIV testing equipment for blood banks in those areas, thus assuring that every sample of blood goes through HIV testing.
　　Meanwhile, this campaign closed down many unqualified blood collection agencies. By the end of 2005, a total of 387 grassroots blood stations and blood banks had been closed or merged. Thus, China has formed a blood supply network consisting of blood centers at the provincial level, blood stations at the prefecture level and local blood banks. Meanwhile, blood donation and collection services are more accessible to the public and the level of blood safety has been greatly upgraded.
　　

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