government, markets, and material well-being

[Alan G Isaac <aisaac@xxxxxxxxxxxx>]

Just to be clear, this post is not meant to pose any
unambiguous judgment on the subject.  Just the opposite.
Alan Isaac


August 25, 2002
AIDS Scourge in Rural China Leaves Villages of Orphans
*By ELISABETH ROSENTHAL*

DONGHU, China---Neighbors remember when young Dong Yangnan
was a "xiao pangzi," or little fatty, the kind of husky,
moon-cheeked child that Chinese grandmothers adore. Today,
at 12, he is orphaned, stick thin and dressed in tattered
clothes.

Last summer, his mother died of AIDS. His father, coughing
and feverish, succumbed to the disease in May. Yangnan lives
with an elderly grandfather, surviving on rice gruel and
steamed buns.

"Before, I had a happy life, and my parents took good care
of me," he said listlessly, his big eyes staring away to a
lost past. "Now I have to look after myself and often have
no money."

AIDS is creating an explosion of destitute orphans here in
China's rural heartland and is driving large numbers of
families into such dire poverty that they can no longer
afford to feed or clothe, much less educate, their children.

At the start of last year, there were no orphans in this
village in southern Henan Province. Today, because of AIDS,
there are nearly 20, and hundreds more are likely to face a
similar fate within a year or two. Residents estimate that
200 of the village's 600 families have one parent dead and
the other ill, often too frail to work or even rise from
bed. They receive little government help.

According to unpublished statistics from the United Nations
Development Program, the number of families living below the
official poverty line in Xincai, the county that includes
Donghu, skyrocketed last year, to 270,000 from 40,000.
Breadwinners fell ill, and families spent whatever they
could scrape together for food and care.

Experts say the blow dealt by AIDS to villages like Donghu
has been sharper and crueler than anywhere else in the world
because of the unusual and efficient way the disease spread
here.

Nearly the entire adult population of some villages was
infected almost simultaneously in the 1990's as poor farmers
flocked en masse to blood collection stations whose
unsterile practices introduced hefty doses of H.I.V., the
virus that causes AIDS, directly into their veins. Now, the
victims---including many married couples---are falling ill
and dying almost in unison.

In other countries suffering epidemics, grandparents or
aunts and uncles have helped the sick or taken in children.
But here those relatives are often themselves overwhelmed by
AIDS. Also, because China's family planning policies have
limited families to one or two children, there is rarely an
older sibling to serve as a surrogate parent.

Ren Genqing, 16, dropped out of school three years ago
because the money that would have gone for his school fees
was needed to buy medicine for his parents.  His father died
of AIDS in 2000, his mother in 2001. One uncle has died of
AIDS, and another is sick. He alone is responsible for his
12-year-old brother.

"I'm growing up, but my brother is still young," he said, a
slightly cocky teenager, old before his time. "Before, the
children here used to play soccer and other games, but you
rarely see that these days. Lots of people are dying, and
nobody's in the mood for that sort of thing."

Some Chinese experts estimate that selling blood was common
in dozens of Henan Province's counties before it was banned
in the mid-90's, leaving at least a million people infected
with H.I.V. In some places, selling blood served as a source
of emergency income---fast cash to fix a roof or pay off a
debt---but in others, like Donghu, most adults sold blood at
least occasionally, and many sold it every week.

Like many of the most severely affected villages, Donghu was
near a blood collection station, one with government ties.
Commercials on local television assured villagers that
selling their blood was safe.

Villagers here estimate that more than half of adults in
Donghu were infected with H.I.V. in the early 1990's. A
decade later, the death rate is gathering steam, with
several people dying each week. The effects are largely
hidden since local officials monitor access to the village
and have warned residents not to speak with reporters.

"The situation is worsening very rapidly because, once a
spouse dies, the burden on the remaining one escalates and,
of course, they are all infected too," one villager said.

Extreme poverty has quickly and predictably followed, as
able-bodied adults can no longer work and families sell
their possessions to pay for basic needs. They borrow to buy
medicine for suffering loved ones, but the simple remedies
they can afford are ineffective against AIDS.

Compounding the financial woes, grain, fruit and vegetables
grown in these villages are almost impossible to sell in
nearby cities, whose residents are afraid of contagion.

"It really brings you to tears," said a medical worker who
has visited villages in the province. "You see these pretty
decent houses, built with the money from selling blood, but
inside there is nothing. They've sold the farm tools, the
animals, even the furniture. People who are dying are lying
on the floor."

For families like Ren Dahua's, it has been a vicious cycle:
poverty begat AIDS, but AIDS has begotten previously
unimaginable poverty.

Mr. Ren started selling blood to patch his mud and brick
hut, to keep his children dry when it rained. He also used
the money to repay debts incurred from the purchase of an
ox, fertilizer and wheat seed.

When the blood stations opened in 1992, he and his wife
rushed to sell their blood, for about $5 a bag. He regarded
it as an opportunity and sold blood more than 30 times.

When two more blood stations opened nearby---one affiliated
with the local Red Cross and another run out of a hospital
less than 100 yards from his front door---he sometimes
visited daily.

At the time, blood from several farmers was pooled and
centrifuged to skim off the plasma, which the blood stations
sold to companies to make medicines. The remaining red cells
were pooled and transfused back into the sellers, providing
a gruesomely efficient method for transmitting blood-borne
diseases, including hepatitis and AIDS.

By 1993, both Mr. Ren and his wife, Diao Yuhuan, were
disqualified from selling blood because they had obvious
symptoms of hepatitis C: jaundice, swollen waists and almost
constant nausea. They did not know that they had also
contracted H.I.V., which often takes years to show symptoms.

Last year, Ms. Diao fell ill with tuberculosis, an infection
that is often severe in people who have H.I.V. Selling his
possessions, Mr. Ren scraped together 3,500 yuan, which
covered a brief---but useless---hospital stay in Beijing.
His wife died at home in January.

"Because I spent so much money when my wife was ill, my
children cannot go to school," said Mr. Ren, who also has
H.I.V. "My son passed the high school entrance exam, but
there's no money for him to go."

In some families, like that of Wei Zhanjun, two generations
of adults are dead or dying, leaving a single child carrying
an unimaginable burden. Mr. Wei, whose wife died of AIDS in
2000, is so short of breath he can barely walk. His body is
covered with painful sores. His parents, in their 50's, are
bedridden with similar symptoms. Only his 8-year-old son,
Wei Zhicheng, is healthy.

"He is a good boy, but ever since my wife fell ill, there
has been no money in this home and not enough food," he
wrote in a letter describing his plight.  "Now, nobody farms
our family's land, and we have heavy debts that we cannot
repay." Money donated by neighbors to pay his son's school
fees was quickly diverted to buy painkillers.

There is really nowhere most families can turn for help.
Most people die in horrible pain with little care. Their
children leave school and go hungry.  Although a few
villages have been given simple medicine and a bit of
financial aid, some by private groups and some by the
government, overwhelmed health officials have been slow to
react.

In some villages, dozens of children have dropped out of
school because their families can no longer afford the fees,
and proposals to offer such children discounts have proved
ineffective. Some children from homes where a family member
has H.I.V. say they have been barred from school. Others say
the discounts are often so small, about 20 percent, that
school remains unaffordable.

Wang Beibei, 10, a star pupil from Suixian, a county in
northern Henan, was expelled from third grade last year
after school officials discovered that her father had died
of AIDS.

"They were afraid to let me in, and my friends stopped
playing with me," she said by phone, from the home of a
sympathetic neighbor. About a third of the families in her
village had sold blood---fewer than in Donghu---in large
part because the village was farther from blood stations.

In June, Beibei's mother died of AIDS. School is out of the
question. There is no one to work the family's land, and she
and her brother struggle just to look out for each other.
"My brother cooks for me, and we eat noodles," she said.
"We have no money for eggs or meat."

In Donghu, the school still admits such children if they can
pay but offers no significant tuition breaks.

Likewise, though government plans have called for families
unable to farm because of AIDS to be exempt from grain
taxes, families here and elsewhere say they are still
required to pay in full.

"The government doesn't do anything for me, and likewise it
didn't do anything for my family," said Gao Li, 14, an
orphan from Donghu, with cropped hair and a quiet,
matter-of-fact voice.

"I'm responsible for my brother, who is 10," she said.
"Nobody among my relatives can help. My dad had brothers but
one is dead, and the others are sick, too. My biggest
difficulty is, I have no future."

Indeed with so much death and so little reason to hope, many
poor farmers with AIDS have shifted their focus from
securing treatment for themselves to ensuring a future for
their children.

Since late last year, Xie Yan, who is in her late 30's and
is H.I.V. positive, has had an obsession: She wants to find
someone to adopt her 4-year-old son, who is not infected, as
well as someone to support her two daughters, 13 and 9.  Her
husband died of AIDS last year, and last winter she watched
her best friend bleed to death on a hospital's doorstep
while the friend's 4-year-old watched in terror.

"I try not to think about myself since I know I won't be
cured," she said. "But at night I can't sleep---I have
nightmares and wild thoughts---worrying about what will
happen to the kids."

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