Donors to China's largest charity, the Red Cross Society, worry that their goodwill money might be tucked away in private pockets, and blood donors have the same fears.
A 2011 survey of about 1,000 people in Shanghai asked people their reasons for being unwilling to donate blood. The fear of their blood being used for profit ranked the second, after health concerns.
This mistrust led to a drop in blood donations, according to the Beijing Red Cross Blood Center's director Liu Jiang, who partly attributed the decline to the public's mistrust of the country's Red Cross branches after a series of scandals rattled the nation in 2011.
One major disgrace involved the Red Cross Society of China (RCSC).
The RCSC came under fire after "Guo Meimei," a young woman, who claimed to be a general manager for "Red Cross Commerce," posted photos on the Internet to show off her lavish lifestyle.
Her high-profile actions provoked the anger of Internet users who speculated that she might have funded her extravagant purchases by embezzling money from the RCSC.
Though there is no direct link between fewer donors and the Red Cross scandal, the notorious case undoubtedly exacerbated the trust crisis that is increasingly taking its toll on the country's blood collectors.
BLOOD FAMINE
At about 3:00 p.m on a winter afternoon, a blood station located in downtown Beijing's bustling Xidan Square had welcomed just nine blood donors. A nurse with the station surnamed Liu said the station usually receives 30 to 40 donors each day.
In Chongqing, this year's sizzling summer heat heard alarms ring five times over record-low blood reserves.
In Shanghai, non-emergency surgeries have been postponed as the 175 surgery-providing hospitals are scrupulously budgeting the blood at their disposal during the busy year-end period.
However, the nationwide blood shortage, which has been dubbed a "blood famine" by the media, has gone from being a seasonal problem to a perennial one.
"The pressure on blood reserves emerged near the end of 2010, and is becoming permanent in a few regions," Guo Yanhong, vice director of the Ministry of Health's medical administration department, said in early December.
Tang Weiguo, head of the blood administration section under the blood center of Chongqing municipality, mainly attributed the shortage of blood for medical use to the drop in the number of blood donors.
Official statistics show that after years of continuous growth, donations in Beijing in the first half of 2011 dropped 7.31 percent from the same period of 2010.
Figures released by the blood center in Chongqing showed that 105,487 blood donations were made from January to November 2011, a 5.5-percent decrease year-on-year.
Currently, only 87 out of every 10,000 people donate blood in the Chinese mainland, far less than the 454 in every 10,000 people in high-income countries and 101 in every 10,000 in middle-income countries, according to official statistics.
TRUST FAMINE
To alleviate the "blood famine," Zhu Yongming, director of the Shanghai blood center, suggested addressing the trust crisis head-on.
Following the Red Cross scandal, more Chinese began questioning whether blood centers were profiting from their blood donations, focusing their fire on the "free donation, pay for use" model, which critics complain forces patients to pay for blood that was donated for free.
It prompted several blood centers in various regions to disclose cost calculations for processing blood for clinical use.
Beijing's blood center announced that blood is distributed to hospitals at a price of 220 yuan (about 35 U.S. dollars) per 200 ml, which covers the expenses of blood collection, testing, storing and plasma separation, and patients are charged 300 yuan per 200 ml, as hospital storage costs get factored in.
The blood center in the southern city of Shenzhen organized an open-house tour in December. The center invited citizens to see the complicated steps for processing blood, hoping to justify the costs of blood transfusion.
However, some people still didn't buy it. Luo Xiaojuan, an elementary school teacher in Chongqing, cast doubts on the cost calculation offered by blood centers.
"When my mom had surgeries, it cost us 1,200 yuan just for blood transfusions. I saw blood bags labeled with donors' names. I am really thankful to those donators, but why did the hospitals charge us so much?"
Transparency is the best way to ease suspicion, Zhu said, calling for public disclosure of accurate and timely information by certain government regulators and blood collection and distribution centers.
However, according to a report on the transparency of China's charity work, which was recently published by a research group affiliated with the Ministry of Civil Affairs, only 8 percent of respondents reported being satisfied with the transparency of charity organizations -- 1 percentage point lower than in 2010.
Following its own scandal, RCSC launched an online information platform to provide greater transparency by allowing the public to track donations.
Blood donors hope that one day they will be able to track their donations, and see lives saved by their blood.