‘It’s gamified’: inside America’s blood plasma donation industry

“The backs of both my hands are a spider web of tiny white and pink scars,” writes Kathleen McLaughlin, “a roadmap showing where dozens of nurses in several cities on both sides of the Pacific have punctured the thin skin with a needle, leaving inside the vein a tiny plastic tube that allows medication to flow directly into my bloodstream.”

McLaughlin has a rare chronic illness (Joseph Heller, the author of Catch-22, had a similar condition) that can cause her immune system to attack the wrong parts of her body, threatening her hands and feet and ability to walk. She requires periodic infusions of a treatment made from the immune particles in other people’s blood plasma.

“It works like a charm,” she says by phone from Butte, Montana.

But McLaughlin, 51, has come to understand that the blood that sustains her is drawn from some of the most economically vulnerable people in America. For the past decade, the journalist has researched and reported on the global trade in plasma and all it says about class, race and inequality.

The result is Blood Money, a book that combines the personal and political to examine a for-profit medical industry literally sucking the blood of the American underclass. It also adds to a body of literature about deindustrialised towns and hollowed out communities that have haunted political discourse since Donald Trump and Bernie Sanders stormed the national stage in 2016.

But the tale begins in China, where McLaughlin went to work in 2004. Aware of virus risks in the blood supply in China, where outbreaks of hepatitis were routine, she decided to bring her own. She smuggled American plasma in her luggage as she passed through Chinese airports and was never caught.

She admits: “China is a very different place today, much more repressive. I don’t think that I’d be able to do this today and I wouldn’t do [it] today. When I was there, things were a lot looser and the rules were a little fuzzier. China felt a bit like a free-forall back then. I was never that afraid of smuggling blood products into China. I thought that if I ever got caught doing it, that maybe I’d get a fine or something like that.”

During her years in China, McLaughlin was keenly aware of the risk to people who, like her, needed others’ blood to survive. “There’s never been an official accounting of what the death toll was caused by the blood plasma industry in China during those years. There was an immense amount of stigma around people from those [poorer] parts of China because, even though the government worked very hard to cover it up, stories got out and people throughout China knew about it.”

On one occasion she travelled to north-east China and interviewed people who, exposed to chemicals, needed infusions of immunoglobulin. “I asked them about the risk and their response was, ‘Yeah, we all know about