A TALE OF TWO CRISES: SARS VS AIDS

BY HU JIA

In this report, sent to HRIC and posted on a number of Chinese Web sites, Beijing Aizhixing Institute director Hu Jia provides a glimpse into the efforts and frustrations of a domestic NGO dedicated to addressing China’s AIDS tragedy, and to keeping the outside world informed of the true situation.

On May 15, the date of the International AIDS Candlelight Memorial, China’s Vice Premier and Minister of Health,Wu Yi, met with World Health Organization Director-General Dr. Gro Harlem Brundtland in Geneva to outline the Chinese govern- ment’s efforts in controlling the SARS epidemic. On that same day,a team of WHO experts observed SARS prevention meas- ures in AIDS-stricken villages in Henan Province’s Shangcai County.Tonight by the light of a candle I record how local offi- cials made every effort to ensure that the truth was concealed from the visiting WHO experts. Beginning on May 15 a number of residents of Shangcai County’s AIDS-affected villages contacted me and reported unusual activities suggesting the imminent arrival of a VIP delegation. On May 16 news circulated from the local health department that a delegation from WHO and China’s Ministry Hu Jia tries to comfort Chen Yue, an AIDS-stricken mother. of Health would be visiting Shangcai County to observe what Photo courtesy of Open Magazine. measures were being taken to prevent the spread of SARS. During the day on May 17 portions of Shangcai County Over the previous two months Chinese officials had hindered were placed under curfew while local officials had village WHO efforts by providing falsified information. Now,in doctors set up SARS inspection points at various traffic inter- order to prevent more such deception,WHO officials had sections, in order to demonstrate the extensive efforts being adopted the strategy of surprise inspections; they had obtained made to prevent SARS from entering the area.All through the permission from the central government to visit Beijing, night of May 17 the Party Secretary of Shangcai County Shanghai, Guangdong and other affected areas, providing no personally accompanied local officials in delivering AIDS more than 5 minutes notice at any location so that local medications to affected households in Wenlou Village.This officials would not be given the opportunity to cover up the was the most significant measure taken on behalf of the actual circumstances. For this trip to Henan the central residents of Wenlou Village to date. Regardless of whether the government had instructed local officials to provide the WHO medication was appropriate for individual patients, it was duly team with unimpeded access to any areas they wished to distributed, with officials instructing the villagers to stay well examine. But what this order actually did was to give local away from the official delegation due to arrive the next day. officials implied permission and opportunity to prepare for On the morning of May 18 more than 200 plainclothes law the WHO team. enforcement officers from neighboring localities surrounded e officers andpublic closely security monitored their 100 yards, but only at adistanceofat least proceedings from theirhomes, and theny “You want toknow what law you broke? you todeath I’llkick Shesaidapoliceofficer toldher, basis shehadbeendetained. police sta the policestation until4p.m.Yang was notwillingtoleave the shewas detainedat afterwhich roughly intoapolicevehicle, off secretaryordered four thecountyparty police deter her, low-leveltell themabout thesituation.When officials failed to visiting VIP delegation shedecidedtowait neartheclinicto andwhen Yangwas ofmedicine, chronically short heardofthe clinic had gonetothevillage clinictoobtainmedication.The how ofMayemotion shedescribed onthemorning 18she examina from an hadjustcomeback and at thetimeofherarrest events.Yang isalready from suffering thesymptomsof AIDS, 40-y the gr andnoonewas able toapproach that itincludedforeigners, thevillagers couldsay littleabout thedelegation except 11:20, r Butfor thewholetime, broadcast ofanevent ontheradio. anditwas like listeningtoalive some villagers at thetime, and lanew andevery street their homesanddidnotletthemmove about, pr than tha but knew nothingmore dozen vehiclesthevillage, entering fire any localofficial whofailed tosealoffthevillage. orders ofCountySecretary whothreatened to Yang Songquan, say4 p.m.Witnesses theseactionswere outunderthe carried until where they were detainedfrom 10a.m. Bureau, Security immediatelythem arrested andtaken away tothePublic but countyofficials had that seniorofficials would bepresent), only tors (thevillagers didn’t know whowas inthedelegation, two more villagers cameouttotalkwiththevisi- delegation, ofthe Halfanhourbefore thearrival WHO threat ofarrest. required two AIDS-infected women toleave immediately under law enforcement officers upsomemedication, clinic topick tospeakthevisitingofficials.opportunity officers whowere preventing actualvillagers from having an was allowed toseewere infact thevery plainclothespolice that the visiting WHO team “villagers” WHO delegation.The officials prevented any contactbetween villagers andthe Wenlou andalongwithaposseofcountyvillage Village, a Nocitizenmay exceptwiththe bearrested inviolable. dom ofpersoncitizensthe People's Republic ofChinais According to home. intothepolicevehicle herback andescorted back ight upuntilthe pproval orby decisionofapeople's procuratorate orby deci- v er vninmaue.Localofficials confined eventionAIDS patients to measures. icers togra nJn 6w nevee n ftepol eand a On June26we interviewed oneofthepeopledetained, Villagers deniedaccesstotheclinicspottedmore thana whenafew villagers went tothevillage On that morning, We would really like toknow what law this woman broke. y mo ear oup closel -old w t somesenioroff tion a vement.We were intelephonecommunication with tion immedia ou’ll kno as guarded. Ar b her t thecountyhospital. oman named y enoughtotalkwiththem. il 7o hn’ osiuin “The free- ticle 37ofChina’s Constitution, WHO inspectionteamleftthevilla ! Four policeofficers thenloadedher w!” y the arms and legs.They loadedher andlegs.They y thearms Some villa ey but demandedtobetoldonwhat tely, icials hadcometoinspectSARS Y ang Nidan, gers w With considerable er to hearherversion of e able the toobserve ge at to sta duty.At theendof afewApril villagers returning were obliged but upthework noonepicked when hewas off of thevillage, off until6p.m.This overseen by avillage official from 8a.m. da couldonly passeach weakened from thesymptoms of AIDS, especially thosealready powerlessmeasures.The villagers, f and knew that shouldbequarantined returnees other places, Beijingand aware SARS situation inShanxi, oftheserious villa ofother tothehorror much ed freely throughout thevillage, andmany circulat- to theirhomesfrom SARS-infected Shanxi, workers were justbefore the directly returning WHO visit, 15, latethem were asMay putunderany ofquarantine.As form their homesinShangcaiCounty’s Shilipu Noneof Village. Guangdongandotheraffected provinces to toreturn Beijing, in China’ theweeksDuring immediately following theoutbreak ofSARS Fake Quarantines m Party isnolongerwhat itwas.”Yang’s husbandhasnever the tw aid hewould secretary.The suethecountyparty couplehas Hesaidthat ifhecouldobtainlegal ill withsymptomsof AIDS. on cr madehisway whoseldomleaves hisbed, theoldman, arrest, of to pay helearned sary hisParty dues.When Yang Nidan’s andtheoldmanborrows money ifneces- ment for anything, but they have never down, asked theirgovern-their homerun familywho participatedintherevolution.The ispoorand isanoldParty member father-in-law, now inhisseventies, neighbors in Her Wenlou andsheisnotanactivist. Village, farmwife whodoesnotstandoutinany way amongher elbowsfrom bruised andaninjured back.Yang isanaverage Constitution andthelaw.” individual may enjoy ofbeingabove theprivilege the “Noorganization or accordingto prohibited.”And 5, Article charge orframe-updirected against citizensby any meansis false libel, Insult, People's Republic ofChinaisinviolable. “Thepersonaldignityofcitizensthe 38states, Article and unlawful ofthepersoncitizensisprohibited.” search freedom ofpersonby detentionorothermeansisprohibited; Unlawful ofcitizens' deprivation orrestriction organ. security must andarrests bemadeby apublic sion ofapeople'scourt, parts of Henanprovince.parts SARS pr but withoutsuccess. totalkcountyofficials, tried to v in Henan’s and AIDS villages, Yang Nidanwishesnomore than gone outtowork.The situation isavery commonone Yangs’ or 12da uster y inf o sonsandadaughter icial alsomannedtw y would not let him in.The oldmanremarked bitterly,y would “The notlethimin.The A quarantinetentontheroad ofShilipu north Village was At thetimeofinterview,Yang Nidanwas stillsuffering A few more examplesshow someofthespecialfeatures of oice theconcer gers nteqaatn etfrtret iedy,but only y inthequarantine tentfor three tofive days, utc ed thecoura ear ofalocaloutbreak. e . hes tothepolicesta vention efforts inShangcaiandother AIDS-affected Village officials inShangcaiCountywere allwell s nor s but they were unwilling tostrictlyenforce these ys, theast, ns ofotherslik ge toha more than50workers leftShandong, o examination andsouth stations north . The daughter v tion tor nHVts,but heisconstantly e anHIVtest, e.More recently e her. Yang has eason withthepolice g 5 hasalready age 15, , ,but

AIDS AND ARTICLE 23 57 CHINA RIGHTS FORUM NO.3, 2003

during the day time – at night they went home to sleep, hardly in Wuhan, Zhengzhou, Beijing and elsewhere, a total of 670 an effective quarantine.A few people were staying in the quar- villagers were eventually found to be HIV positive.A good 65 antine tent when provincial and city officials came to inspect it percent of the villagers who sold blood never took the HIV on May 16, but they all returned home that same afternoon. blood test because of financial or psychological pressures. When the big inspection team arrived, someone made a great Quite a few people went for blood tests only after they devel- show of sterilizing the roadside by spraying it with alcohol and oped symptoms of AIDS. Only in portions of Houyang is the then setting it alight. Once the inspection left, the sterilization number of HIV positive test results reasonably close to the work ended. It appears that this was the only time any such actual number of infected people. Deaths in the village activity was carried out, and it was all a performance for the officially attributed to AIDS between 1998 and the present provincial inspection team, which only stayed in the village for total 260, but this number does not include the deaths of about half an hour. Some of the villagers at Shilipu remarked in some people who, hoping to avoid discrimination against disgust, “Those Communist Party officials aren’t good for themselves and their families, never took blood tests or much, but at least they put on a good show.”When I asked admitted having the disease. them if they thought similar performances were being carried At the time that news began spreading of Henan villagers out in other villages, the villagers replied, “All crows are black!” contracting AIDS from selling blood, more than 1,400 of the Indeed, it seems that similar activities were carried out in 3,170 residents of Wenlou Village in Lugang Township had sold the neighboring Houyang and Wenlou villages. More than blood. Only 550 people (around 40 percent) of those who sold 100 people returned to Houyang Village from SARS-infected blood subsequently had their blood tested for HIV.More than areas, most of them interior construction workers in Shanxi. 80 other localities in Shangcai County present similar statistics. Wenlou Village also had a steady stream of at least 50 returnees In fact,Wenlou Village was by no means the worst affected. from Shanxi, Guangdong and Beijing. Each returning villager A better example is Lugang Township’s Chenglao Village.At had his or her temperature taken when entering the village, the beginning of 2000 it was estimated that 188 of Chenglao’s and then was allowed to return home without any quarantine 308 villagers had sold blood in the mid-1990s.This figure or other follow-up precautions. In the opinion of many vil- included women who had come to or left the village through lagers, the examination stations were not so much for passing marriage. Only 14 people who were tested were found to be a health check as they were for passing an inspection by higher free of HIV,and as many as 93 percent of those who partici- officials. Some HIV/AIDS patients observed that during the pated in the blood selling program later tested positive for height of the SARS crisis many doctors and nurses at local HIV,not to mention children subsequently born with AIDS to hospitals were still not bothering to wear masks. infected mothers. Between 2000 and 2003, 30 villagers died At present it appears that the SARS crisis has faded out. from AIDS-related illness. Of these, 5 died in 2000 and 16 in Experts on communicable diseases have noted that respiratory 2002, showing an alarming increase over time.The number of diseases such as SARS tend to die out naturally during the hot deaths is expected to reach its peak in the next three years. summer months. One of the great mercies in the SARS disaster Seven children below the age of 18 and 5 children over 18 was that there were no major outbreaks in China’s villages. In have been deprived of both parents through AIDS-related Beijing, Guangdong and Hong Kong, where medical services deaths.Thirteen more children have lost their fathers to AIDS, are at their best, the disease still hit medical workers hardest. and eleven their mothers.As at least one parent from every With far inferior medical facilities and manpower, the hinter- household in this village sold blood, and in most cases both lands would have been devastated by a major outbreak. Shanxi, parents have tested positive for HIV,the future number of AIDS which has an equivalent economic standard to Henan’s, was orphans is hard to estimate. seriously affected by SARS.We can only thank the hard efforts Let’s look at how the local government took care of these of other provinces for the lack of an outbreak in Henan.Along sick villagers. None of the taxes villagers have to pay have ever with certain preventative measures taken locally,the other fac- been reduced, and if any family fails to pay the taxes in full, tor we must thank is dumb luck. they lose the 100 yuan per month allowance paid to each infected person. Only when all the taxes are paid up is the The Cover-Up AIDS allowance reinstated.The AIDS allowance is not provided Earlier this year there was an inspection of Shangcai County by in cash, but is only exchangeable for medication, and as it is provincial and national health officials, for which local offi- not enough to cover the full cost,AIDS patients are obliged to cials prepared by repairing every pothole in the local road- make up the difference with what little money they have. ways, and by paying each AIDS patient 200 yuan in hush Children who have lost both parents to AIDS are allowed to money.The incorporated village of Houyang comprises five attend school free of charge, but others still have to come up natural villages and 17 administrative villages with a total pop- with all of the necessary fees for school and books. ulation of 3,864. In the mid-1990s more than 1,800 villagers Henan provincial and health officials were well aware that took part in the government-sponsored blood selling pro- the visiting WHO team would be examining the province’s gram.This was 95 percent of the village’s most vigorous popu- handling of both AIDS and SARS.The party secretary of Henan lace aged 16 to 55. Of these, 450 villagers tested positive for Province, Li Keqiang, is said to have at one point telephoned HIV at the Shangcai County Epidemic Prevention station. But central authorities and asked them not to let the WHO experts in fact, taking into account results at other HIV testing centers visit Henan. But by then the Chinese government had already villa Hedidn’t spendany time withthe minutes andthenleft. andanothertimehestoppedfor about five step outofhiscar, K come to Wenlou Village? Henan’s Li provincial secretary, party whowould but ifnotfor AIDS, came here tolookaround, tr But even Yue were felt thearrangements unconvincingly con- “You allknow howand said, itis.There’s noway around it.” mented ontheo thevillagers com- accompanied theinspectionteam.When vilagers soughtoutthetownship whohad leader,Yue Qiaohe, policiesandfigures relating to AIDS andSARS. tate facts, training coursetoensur addition, In docile individualstobepresented tothe WHO delegation. Wenlou leaving only ahandfulofcarefully selected, Village, not seemtohave beenapplied tofigures relating to AIDS. do but similarstrictures curacies infigures relating toSARS, the centralgovernment would nottolerate any inac- further ofHealthannouncedinapressthe Ministry conference that at least1,000cases.We already know that asearly as 20 April theofficially reported figures fall by short their blood tested, inthosewhodidnothave mates ofmore than700.Adding Village was toldtoreport306casesrather thanthelocalesti- Likewise Wenlouonly 450casesrather thantheactual670. healthworkersone official instructed inHouyang toreport But no incidenceofdisease–otherwisethey have nowork. County’s epidemiccontrol are notgoingtosuggestthere is Officials inchargeofShangcai accurate statistics on AIDS. ofHealth. WHO andtheMinistry but toacceptajointinspectionbyHenan hadnochoice the so committed itselfandcouldnotwithdraw itspermission, still noticedsomeser thisman Although hehadnopersonalstake inthesituation, 60years oldandnotinfected withHIV/AIDS. Party member, to seekoutamor sa AIDS patients to in whenshehadbeeninstructed Wenlou, herself hadmadeby stating that there were more than600 w Ifanyone asked people where allofthesick ward tospeak. “Novillagers camefor- manreplied, had seentheirfaces.The had included speak –ifyou tosay try aword they beat you up.” seek tr Represents policycallsfor themassesand officials totrust JiangZemin’s andwe were notallowed tospeak. Three clinic, Nopatients ordoctorswere allowed togothe impose it. Shangcai County’s law enforcement officers onhandto “All of Wenlou Village withallof was putundercurfew, ejiang iv er y 300. After the On June18patients were outoftheclinicin rushed The tendencyinHenanProvince hasbeentonotprovide ie h mtoa epne fmn ilgr,Idecided Given theemotionalresponses ofmany villagers, I toldtheoldParty memberthat thevisitingdelegation “We thismansaid. hadnoideawhothesepeoplewere,” ed. ,Idon’t know how they answered.That e, WHO delegation gers orlistento their views.” uth fr She also worried aboutShe alsoworried theconsequencesof aslipshe a oehr eoe but onetimehedidn’t even hascomehere before, , all ofthemedicalpersonnelhadbeensenttoa om f WHO inspectionteamleft, WHO exper v cs Butnow they stilldon’t letthemasses acts. e objectiv erb lo ious pr wn performance,Yue laughedbitterly e that they couldfaithfully regurgi- s andasked ifany ofthevillagers ts, e obser ob lems. v er , and found along-time se v eral Wenlou WHO inspectionteamra defenses neededtobeerected against thepeopleand especially inShilipu Village and Wenlou themain Village, Butitisequally clearthat inthe eyes ofmany officials, ease. immediately treated thecaseasapossible communicable dis- across anyone with afever orothersymptomsofSARS Medicalpersonnelwhocame official headswould role. thatwarned ifthediseasespread to AIDS-affected villages, having been unprecedented measures toprevent SARS, complete rubbish.” and medicineswere allprovided free ofcharge.That’s for children andthat schooling yuan to AIDS patients, government announcedthat itdonated moremillion 5 than only 58yuantoeach AIDS patient for thewholeyear.The In Wenlouthat everythingfine. is Village lastyear they gave becauselocalofficialssay circumstances are downhere, is noway for officials inBeijingtoknow what the actual follow themhonestly at thelower levels ispersecuted.There but anyone to whotries government’s policiesare good, concer been difficult for localgovernments tomove soquicklyina If notf Localofficials lookfirst totheirown survival. unprecedented. impoverished countytodealwithasinglediseaseis a Given inadequacyofresources thelong-term the equipment. even that thoughitisuncertain anyone knows how tooperate tteedo pi,ShangcaiCountyspent500,000 At theendof April, TreatmentDiscriminatory would have about felt lessworried much thedisease. eff r symptom ofHIV/AIDS. given that feverwere isacommon registered asHIVpositive, his homevilla attention beingdevoted to AIDS? someone withthosesymptoms w high fever Itisamazingthat andhaddifficulty breathing. mansuffered anda from diarrhea fromhis return Shanxi.The la treatment? Two more Houyang residents tothevil- returned Are only ofmedical SARSpatients considered deserving the manwas immediately treatment. released withoutfurther was found that hewas from suffering AIDS rather thanSARS, it upforman picked athorough physical examination.When localofficials were andimmediately alerted hadthe feverish, or withinada intransit which AIDS sufferers have diedindetentioncenters, of diedofcomplications theonly sonofhisparents, young man, examination stations somewhere alonghisjourney home.This espira v ge withf aila AIDS themor r a endrce gis h ooavrs villagers had beendirectedort against the corona virus, It cannotbedeniedthat Henanprovince actually took Ithinkthecentral “Actually, Party This memberadded, On Ma A few weeks ago aworker infected with to AIDS returned There have beenmore thanafew casesinrecent years in ble to treat AIDS, such alarge such national subsidy for an ble totreat AIDS, ted na tors andotherequipmentf or theur y 24a28-y e es but were they senthomeonce itwas learned vers, tion-wide eff y of returning home.y ofreturning ge fr ig ftecnrlgvrmn,itwould have gings ofthecentralgovernment, ning afterhisreturn. om Shanxi. ear-old worker withHIVcollapsed upon ther thana or t. When hewas found tobe Is ther or thetr as notstoppeda e any hopeofsimilar gainst SARS. eatment ofSARS, If asm t oneofthe yuan uc on h

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There has never been a public health policy developed to Every year the Chinese government attacks the “China provide impoverished AIDS patients with the kind of cost-free Human Rights Report” published by western governments, and care given to SARS patients. emphasizes that the most important human rights are survival AIDS patients in Henan’s Sui County have gone two months and development. But in fact these two civil rights are routinely without their monthly medical stipend, and the stock of denied to impoverished villagers, who live and die without medication in the local clinic has run out.The government’s ever knowing that they could even hope for such rights. explanation is that resources had to be diverted to SARS, and Sui County AIDS patients have been left to battle the disease on Related Incidents their own.Two representatives of local AIDS patients went to Let us continue by looking at some related incidents. In early the county seat to explain to officials the difficulties AIDS March the central government began considering the problem patients are experiencing, but they were barred from entering of AIDS orphans.The Beijing Aizhixing Institute the county council building by more than 10 security officers submitted a report to the National People’s Congress and the enforcing SARS prevention measures.All they could do was Chinese People’s Political Consultative Conference, which keep returning day after day in hopes of being granted an caused considerable nervousness in the Henan provincial gov- audience with an appropriate official. ernment.The Henan authorities sent the vice-director of the Henan Health Department’s Epidemic Prevention Center,Wang Long-Term Planning Zhe, who had met us before, to meet me along with the new Another issue that has arisen among Shangcai County’s AIDS vice-director of the provincial Center for Disease Control.The patients is whether the results of villagers’ HIV blood tests Henan government was very worried that our work would have any legal effect. If there is a positive HIV reading from a harm the province’s image.Their meaning was plain: they did blood test in Henan’s Zhengzhou Disease Prevention Center, not want us revealing the Henan provincial government’s this is stated explicitly on the test results. But the blood test flaws, but wished for us to communicate with provincial certificate from the Shangcai County Disease Prevention health officials first and give them an opportunity to solve the Center only states that the patient needs to take adequate problem. Because Wang Zhe has spent a lot of time in the field, nutrition and rest, accompanied by the center’s official seal. and has always been relatively frank, I was inclined to accept their suggestion of going to them first and seeing if they could Some villagers compare their situation handle the problems locally. with the Nanking Massacre, and feel On March 5 the National People’s Congress began their meeting.We were expecting a petition signed by people with that it is important for them to have HIV/AIDS from Shangcai County’s Shilipu Village calling solid evidence so officials cannot for free schooling for their children. One of the villagers, after evade responsibility. collecting the signatures, had taken the petition to the Shangcai County post office to send it by express mail to our office in There is no explicit acknowledgement that the patient is HIV Beijing.While at the post office the villager ran into the head positive. Some AIDS patients suspect this is to limit legal liabili- of Shangcai County’s AIDS Prevention Office, Feng Shipeng. ty in case they decide to sue the government blood drive cen- Feng asked the villager what he was doing, then warned him ters. Many AIDS patients have already died, but because of the not to cause any trouble around the time of the two meetings lack of information on their certificates it is hard to have their in Beijing or there would be serious consequences.The villager deaths officially attributed to AIDS. I have personally con- was speechless with anger.As it turned out, we never received firmed that several HIV-positive villagers carry certificates that the petition from the Shangcai post office. advise them to improve nutrition and rest, but state nothing On April 16 an elderly resident of Shangcai County’s about HIV.Some villagers hope to go to Zhengzhou to have Shilipu Village brought his daughter, Chen Yue, and her four- their blood tested, but lack financial resources for the trip. year-old daughter to Beijing to petition the central authorities. Others compare their situation with the Nanking Massacre, The mother and daughter had both been infected with AIDS, and feel that it is important for them to have solid evidence so and Chen Yue’s husband had recently died of complications officials cannot evade responsibility. from AIDS.A Party official responsible for distributing the Every major blood testing drive in Shangcai County discov- monthly stipend to villagers infected with HIV/AIDS had ers another batch of HIV positive villagers, causing a statistical brutally beaten Chen Yue. Chen Yue had reported the assault to headache for government officials. Recently some villagers the Public Security Bureau, but the police were familiar with who previously tested positive for HIV have been told they are the Party official, and in the end Chen Yue received only 1,500 HIV negative.This has lead some villagers to believe that test yuan in compensation, including the stipend money that was results are being falsified in order to reduce the number of due to her. Chen Yue suspected corruption and decided to take officially recognized cases.That has made villagers feel it is even the case to Beijing. more important to have their blood tested in Zhengzhou The family came to our office for help and brought along a before going for another test in Shangcai County.If many of photographer who was recording their journey.But as a local these cases are found, then there will be evidence of the civil society organization we were unable to offer much sub- Shangcai County government’s attempts to evade responsibility. stantive assistance. I decided to refer the case to Wang Zhe, and

Y Nie responsible for thecounty vice-chairman Yong, AIDS. fees for AIDS families.Wang Zhepassedthematter ontoNie a andInotified thevillagersCounty, ofShiliputhat they should w thing Idonotregret was that my tothemabout warnings SARS Butone there may benothing leftfor themtoseekbut death. intheend we repeated couldhave disappointments, done.After but there was nothingelse Iwas very sorry, remaining hopes. that we Ilearned haddashed allofher villagers ofShilipu. f I couldgive thembut my own facemask and my bestwishes yuan the the hellof AIDS have already death andpain that seensomuch Butpeoplewhocomefrom on thefamily thedangerofSARS. to solv ing at family my hadnoconfidence feet.The in localofficials e But Chen the family toShangcai Countyassoonpossible. inreturning will ultimately speedthedemiseofpeoplewith AIDS. we feel itisinevitable that infection withSARS both diseases, butally given very remains that low, unknown much about the rate ofinfection by SARSamongpeoplewith AIDS isactu- Somemainlanddoctorshave notedthat deficiency from AIDS. a devastating effect amongthosealready immune suffering where SARSmighthave totheirhomevillage, itback and carry they mightunknowingly contracttheillness Even worse, tion. might easily todeliver contractSARSwhiletrying theirpeti- age andtravel,that already thefamily, weakened by illness, few peoplealready wearing aface mask.We were very worried andIwas oneofthe how theproblem serious hadbecome, we were by that timewellcommunicable aware diseases, of but becauseourgroup regularly dealswith SARS crisis, municipal government was stillcovering uptheextentof that timeBeijing’sfinancial home.At assistancetoreturn Heasked settled locally. Aizhixing toprovide thefamily with Wang was oftheopinionthat asalocalmatter itcouldonly be spoke aword. w tear.The She smallgirlwatchedhermother’s travails insilence. smokingandoccasionally sighingand wipingaway a tree, m Chen the gardenofanearbyYue temple. continued tobow at soIledthemoutofouroffice to Imyself hadtoleave, p.m. v Later hepri- presence andhealthworkers. oflocalreporters Possiblycontracted Niefelt hehadlost face inthe AIDS.” ur “Ifnotfor the then you were villager paidfor it.”A said, “Whenyou soldblood back Niesaid, some timetoresolve. or theirsaf ppr e huhi a led :0pm Insteadshekneltplead- ven thoughitwas already 8:30p.m. ately for that arranged villager andtaughta to bearrested ong toldthevilla er as as y f ging oflocaloff y nolongerr On 20ithappened thatApril Wang Zhewas inShangcai A few days later Iinquired about Chen Yue amongother For that reason we agreed with Wang Zhe’s advice toassist I ga e gen eet, oach himfor assistanceinsolvingtheproblemoach ofschool that was Ineededtotake nothingelse thebus home.There e theirpr v et rgtee hl,andthewholetimeshenever bright-eyed child, weet, e themallthemone nsieo ypoet.Herelderly father sat undera in spiteofmy protests. ie andnotameansofdeceivingthemintoleaving. uine, Y ue w e jour as unwillingtolea ob egard dea ney. cas we wouldn’t haveicials, soldourblood and gers that the school feegers that situation theschool would take lem. My collea th asaser y Ihadwithme gue and I tried toimpress gue andItried v e the Aizhixing office, ostra.Finally at 9 ious threat. , except f or three conflicts withlocaloff thistimewe someideological During experienced winter. residents tohelpthe ofShangcaiCountypassthe AIDS orphans weLast Christmas brought someclothes donated by Beijing Some StrangeOpinions and medicalf hadfailedbecause ofitsdeceptionandwhich togive people hadlostthepeople’s which trust the government itself, it w goodsorfleeingthecityindroves.The factstockpiling isthat andbegan People were horrified, had leapt from 37to339. Health announcedtha On of 20theMinistry April most seriouslyaffected by SARS. with theresult that Beijingsoonbecameone oftheplaces Ministr make one’s blood boilwithanger. the aspectofpeople’ simply from make itvery clearthat AIDS isnotastate secret, from thefact that thelaws relating tocommunicable diseases Quiteapart situation ofthe AIDS epidemicisastate secret. the Shangcai County’s Feng Shipeng: AIDS Prevention Office, perhaps they are notfar from demons.” tha “Ifwhat you mean is Isaidtothat official, from therest ofus. that infact they were effectively livinginadifferent world na officialAccording toacountysecretariat responsible for liar conclusionstha tion withtheirvisit? greater efforts that hadgoneonbehindthescenesinconnec- How know didtheexperts much about theeven effective. Zhengzhou andproclaimed Henan’s efforts against SARS May 20theteamof heldapressWHO experts conference in executive committeemeetingofthe On WHO in Vienna. Everythingput onitsown went show. smoothly. examination station andclinic Each township secretary. party townshipcomposed ofthevillage headand secretary, party for awelcomingShangcai Countyleadershiparranged party an advance SARSinspectionteamtoShilipu andthe Village, to know what law that villager broke. thevillager andterrified andhisfamily.Welesson, would like the conditionstha Buthaving seen the peopleeffectively an attitude. with such Onecanonly wonder how anofficial canserve but demons. Everything went smoothly. and clinicputonitsown show. Shilipu sent anad On May 16theprovincial government tional secur t peopleinf The SARS epidemic started outasasecretThe SARSepidemicstarted kept by the Another interesting opinionwas voiced by theheadof On May 19SARSwas oneoftheleadingtopicsat the56th theprovincial government sent On May 16at 10:00a.m. as nottheepidemictha y ofHealthandtheBeijingm Village. Each examination station Each Village. acilities adequate toprepare opportunity a ity ected with v , ance SARSinspectionteamto f t some or example,AIDS patients were notpeople, or example,AIDS t hadbeendrawn regarding AIDS. t then icials s r AIDS pa ISlv nahl nerh then AIDS live inahellonearth, ight tokno asdsca ho,but rather t causedsocialchaos, . W umber ofcasesSARSinBeijing e hadheardse tients liv unicipal government, w, this assertion canonly thisassertion w, n Ihadtoconcede e in, veral rather pecu-

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defense against the disease.This lost opportunity resulted in a total of 2,065 infected persons identified, 335 ill and 238 the greatest and most visible price Beijing has had to pay for an dead. It is very suspicious that there should be such a wide error in public health. But in fact,AIDS is yet another invisible variance in these figures, especially between external and killer, and serves as an even better example of the disastrous internal sources. Officials of Henan Province, you should consequences of secrecy.With China facing a cost of AIDS 10 recognize your guilt! or 100 times greater than that of SARS, who will take the This is a good place to remind officials, when you start responsibility for this fatal error? lying and deceiving the people, your soul begins to distort. Another conclusion reached by Feng Shipeng was that You have embarked on the slippery slope of public loathing news of the illness would cause anti-China sentiment and for which you will ultimately bear the consequences. damage China’s image abroad. It is true that the highly conta- Listening to the villagers leads me to wonder if there is any gious nature of SARS led to calls overseas for a quarantine on hope for Shangcai County.The impression this place gives to China. But we need to recognize that because of the limita- people with AIDS and to outside observers is of a hell on earth tions placed on news issued by the national health system and where snow falls in June. Don’t keep asking why it is that we the Guangdong provincial government, the international always make trouble for the Henan government. It is because spread of SARS put unprecedented pressure on the public you have so horribly wronged the people of Henan. Only health facilities of the mainland, Hong Kong and Taiwan and if we lose our conscience, or become deaf and blind, can we added extra frost to an already chilly world economy.I cannot possibly consider leaving you in peace.We are supporting the understand why China gives the world so many pretexts on villagers in their efforts to record the visit of the WHO delega- political, human rights, environmental, religious and now tion to Shangcai County,and we will continue by passing this public health grounds, to corner and isolate it.As a Chinese record on to the WHO office in Beijing.We have also assisted citizen I feel that I and the entire country have lost face. On the some of the more daring villagers to install phone lines and go other hand, can we say these are only pretexts, rather than onto the Internet, and we are helping with the education of good reasons? The fact is that the people driven to cries of AIDS orphans.We have provided cameras and computer ultimate despair are China’s own citizens, those most equipment to the villagers so they can record the tragedy oppressed of all people. around them and become witnesses to history against officials According to Article 27 of China’s Constitution,“All state who attempt to evade the truth. organs and functionaries must rely on the support of the peo- We make the following short-term recommendations: ple, keep in close touch with them, heed their opinions and 1) The WHO team of experts should return to Shangcai suggestions, accept their supervision and work hard to serve County and other AIDS-affected areas of Henan Province them.”And Article 41 states, “Citizens of the People's Republic to examine precautions against SARS.The Beijing of China have the right to criticize and make suggestions to Aizhixing Institute will assist people with HIV/AIDS in any state organ or functionary.” Henan to organize, and will also lead WHO officials Government officials, you must face the fact that your through AIDS-affected villages and put them in contact fiercest critics are your own citizens, who are most hurt by with villagers, in order for them to understand the true your actions. Because local media are too tightly controlled to situation of AIDS and SARS. provide all of the necessary information, the overseas media 2) If another trip to Henan is too difficult to organize, we have been extremely helpful to us on many occasions. For could arrange for villagers from AIDS-affected villages to example, Dr. Jiang Yanyong’s interviews with CCTV and visit the WHO office in Beijing and testify regarding the Phoenix Satellite Television exposing the extent of the SARS local situation.We could find truthful witnesses from crisis were like dropping a stone into the sea. It was only after Shangcai County’s Houyang Village, Shilipu Village and Time Magazine on April 8 alerted the whole world to the actu- Wenlou Village, including villagers who have been arrested. al situation in Beijing that the government began mobilizing 3) The central government should remove from office all the public. Should this be considered anti-China? I believe the local officials who have been responsible for covering up people who hurt China the most are those cruel local officials the true situation of AIDS in Henan Province all these who treat the people like so much grass. years, including the general secretary of Henan Province, Li Kejiang, the director of Henan Province’s Health Numbers Games Department, Ma Jianzhong, the former health director, Let’s look again at some figures. In August 2002 the Henan Liu Quanxi, deputy director Liu Xuezhou, the general Province Health Department passed a secret report to the secretary of Shangcai County,Yang Songquan, the county provincial government.The report states that 23,100-33,500 vice-chairman, Nie Yong, the director of the AIDS people have become infected with AIDS in Henan Province as a Prevention Office, Feng Shipeng and others. result of selling blood. In August 2002 the Shangcai County We make the following long-term recommendations: government said that 48,000 people had sold blood in 22 1) SARS has brought about the greatest economic and villages, and estimated the number of infected persons at political crisis to China since the events at Tiananmen in 14,000.And around the same time, the Henan Provincial 1989. Even June 4th did not so directly harm China’s government reported through the China News Service that international relations. SARS is a disease without bound- Henan Province discovered its first case of AIDS in 1995, with aries; because the Chinese government did not under- accept fullresponsibility. Iwill Ifany ofmy facts are wrong, will behappier thanI. tion Off County again anddirectly asktheheadof AIDS Preven- we willvisitShangcai haspassed, Once theSARScrisis oftheIceberg Tip mor who knows how many Ifnotfor this, efforts tofight SARS. thegovernment’s andthislaunched the cover-up, genuine deputy par Health MinisterZhang Wenkang andtheBeijingmayor and andinfact hisefforts undoubtedly saved manyworld, lives. pub is anational secret. )A ihSR,public healthofficials needthefullpartici- 3) As withSARS, but mostofthose 2) SARSisanacuterespiratory disease, Dr fiil fHnnPoic,I am willingtoenterintoa Officials ofHenanProvince, lic dialoguewithy epewudhv id IsShangcai Countytoosmall e peoplewould have died. . public healthandecologicalcrises. would helppreventof thepeople.This future social, m andthemediashouldbegiven fullautono- expression, trolling organization roadblock tofree that isanotorious ban theCentralPr thegovernment should Inaddition, ment ofcivilsociety. r make the (NGOs) andnon-profit organizations (NPOs), tions for non-government registering organizations go especially important.We recommend that thecentral Civilsocietyorganizations andthenews mediaare AIDS. pa should besimilarly applied tofighting AIDS. pub effects thanSARS.The morelong term are serious much tiv who contractitcanbecur rather thandiscarded. make sure thepoliciesare preserved andcontinued must ofthegovernment increase theirmonitoring to community andtheinternational and overseas media, domestic institutions, research China’s people, price. preserve thepoliciesthat cameabout agreat at such promising fullcooperation withthe WHO.We must Zhang and Wenkangtwo officials, andMengXuenong, sacking more extensive precautions against itsspread, was forced tobemore openabout theepidemicandtake andthegovernment China for itsirresponsible actions, community theinternational roundly blamed ment, ofHealthandtheBeijingmunicipalMinistry govern- surgeon Jiang Yanyong revealed thecover-up by the SARS becamewidespread inBeijingandmilitary Chinese allover theworld were treated unfairly.After withtheultimate result that methods were toopassive, procedures were inadequate andinitialprevention public health ofthediseaseat first, stand theseriousness egistra Jiang Yanyong revealed Beijing’s situation tothe true y inr ice tion ofallsegmentssocietyinthef v l omn,adteei ocr o ta hstm.Its andthere isnocure for itat thistime. ely dormant, er lic mobiliza , ty c nment immediately eliminate thepresent restric- egSieg ifhedares tosay again that Feng Shipeng, AIDS e tion system more open, and support thedevelop- andsupport tion systemmore open, vealing socialproblems andreflecting theviews hief MengXuenonglosttheirjobs becauseof tion eff u fyucnpoem rn,noone Ifyou canprove mewrong, ou. opa ganda Depar or ts deplo ed. AIDS, yed against SARS tment, b y contrast, ight a the ne gainst ws con is rela- - T begin itsrecovery. r advance?country These officials are like a cancer.They must be officials? How undersuch can ourpeopleflourish canour full offr an accurate record ofallthat thevillagers are so tellme.They going onat thelocallevels.These few days Ihave beenmaking the inter possible thehandsofseniorofficials that itmightreach and andif hope anyone whoreads itwillpassalongtoothers, help containitsspread. improve thepublic’s knowledge regarding thediseaseand thiswould greatlyprovide fullandopeninformation on AIDS, Ifthere were somesysteminplace to tion paidto AIDS. the mediaonsituation.We would like toseesimilaratten- every day Health heldapress tobrief conference at 4p.m. r bite of AIDS. long ter But recede from memory. AIDS willremain withusfor the come undercontr “HIV/AIDS: released himfrom suffering. knowing whetherhesuffered indeath orifinfact death and afew isnoway hourslater hebreathed hislast.There of parents thefireworks tookhimtowatch inanearby town, year onFebruary 15his battling thediseasesincebirth.This The 5-year-old was aboy namedZhouMaowhohadbeen twoaged monthsallwere 5to60years old.Within dead. we visitedseveral villagersAIDS-stricken inHouyang Village, theendoflastyear inthenextlane.At rise ofmourning cries AIDS inoneday.A isnoteven corpse coldinonehousebefore given day. InShilipu Village sometimesthree peopledieof Many villages seeseveralworldwide. deaths from AIDS onany Shangcai Countythanthetotalnumber whodiedofSARS More peoplehave diedof AIDS in height oftheepidemic. ber ofpeoplewhodiedSARSinthewholeworld at the more peopledieof long term AIDS every day thanthenum- overofficials? the The fact isthat inShangcaiCountyalone, measures disciplinary against towarrant any ofits too weak, voices toofar away and are itsresidents’ and unimportant, emo epor ranslated by StacyMosher SARS AIDS I kno uigtehih fteSR rss thenews media theheightofSARScrisis, During Last summertheUnitedNations published areportcalled, e oorcutywl o olpe but willbeable to ved willnot collapse, soourcountry ted thor m. w tha ustra na 5%-15% 100% Death Rate tional community sothey canunderstand what is SARS ismer China’ inta hycno odayhn ak How tion that they cannotholdanything back. oughly onSARSevery of day, andtheMinistry t thisr ol internationally by July andwillquickly s pr slkl ohv iteefc,but I islikelyeport tohave littleeffect, Titanic P el May 27) ofHealth, by Ministry 5,322 (asannounced nationwide Health estimate) of (2002 Ministry More than1million Infected y abeestingcompar er il.”We believe that SARSwill ed withthecobra 26 provinces nationwide Distribution

AIDS AND ARTICLE 23 63 CHINA RIGHTS FORUM NO.3, 2003