The story behind Ruby Yang’s 2006 Oscar-winning short documentary is not a plotline but a decades-long public-health calamity: beginning in the 1950s the Henan province developed a state‑run blood collection system that, by the 1990s, had been repurposed as a cash cow for cash‑strapped localities. Impoverished villagers were encouraged — and sometimes organized en masse — to sell blood and plasma to supplement family incomes. Unsafe methods became routine: donors were bled multiple times in a day, plasma was routinely pooled from many people and the recovered red blood cells reinfused, and sterilization protocols were ignored. These shortcuts enormously increased the risk of bloodborne infections. Although China reported its first AIDS case in 1985 and the central government banned some imported blood products that year, the spread of HIV in inland provinces such as Henan went unacknowledged by local officials for years. Healthcare workers began linking rising infections to plasma donation in Henan in the mid‑1990s, but provincial denial persisted until around 2000, when large numbers of infections and orphaned children made denial impossible. By then estimates — cited repeatedly in international reporting and public‑health analyses — ranged into the hundreds of thousands (commonly cited figures are 500,000–700,000) who had contracted HIV because of these unsafe blood‑collection practices.
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