CHINA: Thousands are dying, thousands more are orphaned. Corrupt blood bank schemes are to blame. The government appears to be finally listening. Mark Godfrey reports from Beijing
Shuangmiao is a remote village in central China's Henan province. "It's a poor town. We have a big population but not much land," says Zhu Longwei, a village leader and AIDS activist. Each year however there are fewer people to farm the village's land.
Nature hasn't been kind to Shuangmiao but an official act of criminal recklessness was much crueller. A blood collection scheme organised by the local government a decade ago has left hundreds of villagers infected with HIV/AIDS.
Mr Zhu laces the tale with black humour. "From 1994 to 1995, our county set up several blood donation stations. Everyone followed government's call by getting up at four or five in the morning and rushing to the blood donation stations in the city. Local people used to think they did not have to do anything but stretch out their arms, by which they could make 45 yuan (€4.40) each time. In fact, quite a number of families were able to pay for their basic needs, their children's tuition fee and family planning fee if they'd had more than one child. The scheme helped the government to pick up a lot of overdue bills."
Many poorly-managed blood donation stations neglected to do a required liver exam or HIV test on donors, says Mr Zhu. "There was no disinfection. One blood donation station in a farmer's yard was in fact an illegal blood donation station banned by the government back then."
Ten years on, HIV carriers in Shaungmiao village of Zhicheng county have set up a mutual help group to care for sufferers. "We originally wanted to prevent the spread of AIDS in the communities. We wanted to eliminate discrimination and show more love to HIV positives."
Henan health authorities reported 11,844 HIV-positive cases in March this year, a huge jump on the 2,200 patients it reported in February 2003. Of the current total 6,310 have full-blown AIDS. Seventy-five per cent of the primary school students in Wenlou village are victims of HIV/AIDS and rely on care from relatives, charities and government orphanages. Of Wenlou's 3,172 residents, 100 people have already died from AIDS and 900 people are infected with HIV.
Members of Mr Zhu's self-support group learn about AIDS and basic family nursing knowledge from books donated by charities and government agencies. They learn about other ways to prevent AIDS too and some educate locals about the transmission of HIV and how to control the disease with medicine. Patients are educated about the importance of taking HIV-control medicines, when the medicines are available. Leaflets on AIDS prevention from non-governmental organisations are handed out. Most recently, the group has begun helping AIDS sufferers' families with financial aid and work in agricultural co-operatives.
The recklessness of what happened haunts Mr Zhu. "None of the staff members there were real doctors, the facilities were not clean enough, let alone disinfection. Our village had over 1,000 blood donations every day. In the same year, 90 per cent of all the blood donors were tested HIV positive. You can imagine how many were infected in the whole county. There are now more than 700 HIV positives in Shuangmiao. About 200 died between 2000 and 2003. Many people don't want to do the HIV test. Most of the infected are young men who have lost their work ability, and now death is approaching them day by day. Their families' situation is much worse. Children are unable to go to school. The most urgent problem is the treatment of children HIV positives."
Mr Zhu wants more medicine and help from the government. "There are no anti-HIV medicines suitable for children and \ funds for poor children's living expenses and tuition fee. There's a severe fear of AIDS/HIV and not enough education. Condoms aren't publicised."
Prodded by Beijing, local governments appear to have owned up to the seriousness of the AIDS problem. The country's first law on AIDS prevention came into effect in Yunnan province on March 1st. Under the law, Yunnan, a southerly province bordering Vietnam, will support needle exchange programmes, make condoms available for free and promote public awareness of AIDS. The state's police are also allowed more powers under the new legislation to curb prostitution and drug use. The law has made HIV/AIDS control a specific legal obligation of the provincial government. Also badly hit by AIDS, Yunnan with a population of 42 million, has reported 14,905 HIV-positive cases and 907 AIDS patients, the highest figures of any province in China.
The turning point in China's fight against AIDS was undoubtedly Premier Wen Jiabao's much-photographed visit to AIDS patients in Beijing on International AIDS Day earlier this year. Unlikely allies too have been roped into the central government's fight against AIDS. Outspoken AIDS activist Dr Gao Yaojie was selected as one of state television's 10 most influential people of 2003, even though hitherto she'd been black-listed by state-controlled media for her efforts to inform and educate people about HIV/AIDS in Henan. Vice-Premier and Health Minister Wu Yi met Dr Gao for three hours late last year.
Well-respected and China's only senior female leader, Ms Wu has been selected to head the government's new AIDS Prevention Committee. At the committee's first meeting in February Ms Wu emphasised the need for urgency and called for a publicity campaign to fight prejudice against AIDS sufferers. She also promised free AIDS treatment for farmers and urban poor, as well as free, anonymous blood tests in areas hit by AIDS. AIDS orphans meanwhile will be allowed free education, while pregnant women in AIDS-hit areas will get free treatment to reduce mother-to-child transmission.
In another well-publicised move by the government, scores of Henan provincial officials have been placed for a year in 38 villages. The same 38 villages have been handed cash to build new roads, schools and orphanages, according to the government-published Health News weekly.
The change in attitude towards AIDS sufferers isn't ubiquitous, however. A non-governmental AIDS orphanage in Henan was recently closed by the Ministry of Civil Affairs because its founders hadn't gone through government approval procedures. AIDS campaigners were angered earlier this year when several Beijing schools rejected four orphans of AIDS-infected parents, even though the children themselves didn't carry the virus. The barring of the children was reported unusually forthrightly by the Beijing News, which warned that public perceptions of AIDS wouldn't change without government intervention. The article urged the government to launch awareness campaigns which would help the public "abandon prejudices and . . . respect people with disabilities".
Zhu Longwei's village volunteers plan to build a small library in the next two years. "We want to popularise knowledge of AIDS/HIV prevention and infection. We want to promote scientific knowledge, and make use of modern technology to help HIV-positive people to help themselves. We need to provide more prevention knowledge for young people . . . they must be the main force in preventing HIV and AIDS."
Mr Zhu's group also plans to make a film about some of the village's AIDS patients. "We need to use language that is easy for local people to understand and the forms that they love to hear and see to promote the prevention and cure of AIDS and HIV. This will eliminate the fear and discrimination. People should care about AIDS patients and help HIV positives. That will not only prolong HIV positives' life, but also increase their life quality and greatly reduce the spread of AIDS/HIV among people."