Spread of AIDS in Rural China Ignites Protests

December 11, 2001
ELISABETH ROSENTHAL


SUIXIAN, China - As China's central government takes steps to address its growing AIDS problem, officials in some of its most seriously affected areas here in central China are
doing little to help patients or to curb the spread. In fact, many are redoubling their efforts to suppress any discussion of the problem.

In late November, as China for the first time marked World AIDS Day in Beijing with some fanfare, officials in Suixian County detained poor farmers wasting away from AIDS, as well as Chinese journalists who had come to interview them.

At the height of the standoff, officials from Chengguan township held three journalists in a government guest house and 11 peasants infected with the H.I.V., the virus that causes AIDS, in the township's headquarters. Fifty villagers, most also infected with H.I.V., gathered in protest outside the gates of the crumbling two-story building.

"We weren't allowed in, so we just stood there shouting," recalled Xie Yan, 35, a soft-spoken mother of three whose husband died this spring and who has been told that she will be dead within two years. "We screamed: `People are dying and you do nothing but detain them,' and `What sort of officials are you?'

"To them we are like bubbles. They know if they turn away and ignore us, we will soon pop and be gone."

But ignoring such people has become an increasingly difficult task as poor farmers, boldened by desperation, are beginning to protest and speak out. The government media have also started to report more on the issue.

In three incidents in November, sick and destitute farmers with AIDS from different villages here in Henan Province were detained by the police after they tried to protest their abandonment.

Many more are seething with anger, even though rural officials throughout the province have warned residents not to make trouble or speak to journalists.

"All of us want to appeal, but most don't dare because they're too afraid," said one elderly woman with AIDS. "People who have tried at all are under surveillance. It's even hard for them to leave the village."

People interviewed for this article spoke in different locations, all outside their rural villages.

Although the government says a vast majority of people with H.I.V. in China became infected through intravenous drug use, the large but poorly defined AIDS epidemic among poor farmers in central China - whose epicenter is Henan - started in the 1990's when poor farmers sold their blood to companies using unsterile collection methods. In some villages more than half the adults are now believed to be infected.

In general the blood buying schemes were geared toward collecting plasma, a component of blood used in making medicines. The collectors would remove about a pint of blood from each donor, pool it with others and later spin it in a centrifuge to separate out the desired element. The leftover, mostly red blood cells, would be divided up and reinfused into the donors - preventing anemia, but also spreading AIDS.

The epidemic is still shrouded in silence, because local officials were often involved in the profitable blood business. So while the authorities in Beijing held a big international conference in November and are airing television dramas on the subject, repression and concealment continue here. Some Chinese AIDS experts contend that at least a million people in Henan Province are infected. But a leader of the provincial health office said in an interview with a local government-owned newspaper in early December that there were only 1,495 cases of H.I.V. in the province. "At present the AIDS disease situation in our province remains at a low epidemic level," he said.

Chinese health officials estimate that 600,000 people nationwide carry the virus, although many experts say the real number is much larger.

The fear that has maintained the rural victims' silence is lifting these days as villagers learn more about the disease that afflicts them.

In villages like Dongguan South, home to the sick farmers who protested in November, the fear of a miserable death, the fear of leaving orphans behind, has trumped the fear of persecution.

"Why stand up now?" said Zhao Yong, a thin man with a deep cough and sallow skin. "Because before we had no idea of what was going on. My wife died in April. My best friend's wife died in May. At that time we had not heard of AIDS. We were using up our family's saving on useless treatments."

A majority of adults in Dongguan South sold blood to collectors affiliated with the local hospital and the local disease prevention station from 1994 to 1997. In 1997 local health officials suddenly advised villagers to stop, giving no explanation, they said.

That was about the time that the first villager died of a mysterious pneumonia, and today, in a village with 600 adults, 200 are showing serious symptoms of AIDS.

While Dongguan South had only scattered deaths from 1997 to 2000, at least 14 young people have died since spring. H.I.V. generally incubates silently for at least a few years.

The villagers learned about AIDS only this year, when a Chinese reporter clandestinely delivered some copies of a book published privately by Gao Yaojie, a retired doctor who has championed AIDS awareness. There has been no official AIDS education here.

The quickening pace of death in the village has also moved farmers to action. "At first, if it was in the family, people kept it a secret," said Ms. Xie. "They didn't dare talk about it. But now we can see that it's so widespread. We're in this together."

Ms. Xie found herself forced into activism just this year, when her husband fell ill with severe headaches and nausea - signs of meningitis.

After his death two months later, the local disease prevention station notified her that her husband's illness had resulted from AIDS. She was then tested.

"When I got the results I knew right away I was going to die," she said, with tears in her eyes, a small thin woman with chapped cheeks, suffering from diarrhea. "Ever since then I've been preoccupied and depressed.

"If I can't find a hospital to give me free treatment, I should put my kids in an orphanage," she added, beginning to weep.

The recent protest in Suixian County, so far the largest by people with H.I.V., is in some ways an outgrowth of the international AIDS meeting in China. At that time, a small group of farmers from Suixian went to Beijing, hoping to get treatment and also to shed light on the local situation by contacting journalists and presenting a petition.

They never achieved their larger goal. They were admitted to a government hospital in Beijing for "testing" on the day the meeting started and were released on the day it ended.

But their presence put Suixian on the map, and in the week that followed, more than half a dozen curious Chinese journalists set out to visit.

A crew from an influential government television program on women's issues called "Half the Sky" managed to meet with a number of villagers, though they soon found themselves trailed everywhere by plainclothes police officers, a person who was there said. When they tried to leave the county, they were detained and held in a government guest house for two days.

A second group of journalists, from smaller newspapers, spent several days in a game of cat and mouse with the local authorities in Suixian and the next county, Weishi, which also has a serious AIDS problem. The police searched hotels and farmers' homes in an unsuccessful attempt to find them.

In the wake of those visits, the local authorities hauled in farmers who had been interviewed, warning them "not to speak out," said Wang Zhiguo, a villager who was detained.

Meanwhile, a shouting crowd of people with AIDS gathered at the locked gates of the whitewashed government compound, chanting and demanding their friends' release.

After a few hours the farmers inside were let go, temporarily defusing the situation. But the crowd reassembled again the next day to protest, this time demanding financial assistance.

Wheat and corn farming are the main income source in Dongguan South, a village of small unheated mud-brick houses. In a number of families, all adults are dead or ailing, unable to tend their fields or feed their families, let alone pay for treatment.

The size of the protest in Suixian County is extraordinary, but it is not an isolated phenomenon. Recently, farmers from the villages of Chenglao and Wenlou have been detained in the city of Zhumadian, where they went to press local officials for more help.

Wenlou, the only village in Henan that the government has acknowledged by name to have an AIDS problem, has become something of a showcase for the disease, its AIDS victims visited by officials from Beijing and given a clinic and a modicum of free medical care.

But villagers say the drugs dispensed there are worthless against their disease, and at the end of November eight villagers with H.I.V. marched into the Zhumadian health office and refused to leave without a promise of more help.


After a two-day sit-in, officials sent them to a detention center in nearby Shangcai County and charged them with "disturbing order of a government office." Three of the men served sentences of 15 days.

[Officials told them it was illegal to leave their village and that they would be detained again if they tried, the three said in a phone interview after their release on Dec. 8. The jail was cold, and they were given only bread, soup and gruel to eat.

[One of the men, extremely ill with high fever and diarrhea, went three days without any care. When help came, "The guards wore masks and gloves and handed me the medicine in a bag on a pole," recalled the man, Wang Hongxiang. "I won't try this again."]

It is hard to know if other villages will try go down the path of protest, which brings publicity at least, and in some cases medicine. But the reservoir of desperation created by AIDS in rural China is potentially vast.

Residents of rural Henan, and experts who have traveled there extensively, can tick off dozens of places in the province with AIDS problems, most of which have received no publicity.

They add that over the course of the 1990's, people from adjacent provinces also took part in blood selling schemes, seeding satellite epidemics. For example, Yucheng in nearby Shanxi Province has a serious H.I.V. epidemic related to blood selling, the government press has reported. More surprising, so does Zizhong in Sichuan Province, more than 500 miles from Henan.

Doctors from distant Sichuan said farmers there traveled to Henan to sell blood, especially during winter when farming was slow.

"The villages that have been written about are just the tip of the iceberg," said a Chinese researcher who has studied the problem. "These were the ones that started earliest, so we're aware of the problem. In other places it will break out in a couple of years."

This article came from the New York Times.com has been sent to you by japclark@virconn.com.

Article received through e-mail from Janice Clark - World Federation Secretary. You can reach Janice at japclark@virconn.com.