Survival is cold comfort in AIDS-stricken rural China

CHINA: With the familiarity of a long-married couple, Leng Zhijin lifts his wife Wang Xiangying’s ragged blouse to show raw rashes and she grasps his shoulder, gaunt after 20 days of diarrhoea.

Like an estimated 300,000 farmers across central China’s rural Henan province, including some 100 in their brick-and-mud Leng Village of 800, they caught the HIV virus through state-promoted schemes offering poor farmers easy money for their blood.

“I’m glad we have medicine so we don’t die, but living is also hard,” said Leng, 43 and haggard beyond his years.

“Look at us. Is this really called living?”

Since 2003, a flow of state-funded drugs has driven back the tide of AIDS deaths that engulfed rural Henan from the 1990s, making it the centre of China’s HIV epidemic, which the United Nations estimated last year has killed about 31,000 Chinese.

But in afflicted places like Leng Village, which means “Cold Village” after its main surname, the survival of HIV-infected farmers has itself brought adversities for which they and the government have been ill-equipped.

About 40 villagers here have died of AIDS, including five last year, leaving about two dozen children without one parent or both, residents said.

Those reprieved from death face poverty and threadbare medical care, forcing many to eke out lives that distil all the hardships of China’s poor farmers.

“These problems ultimately reflect the problems of the rural medical system and countryside in general,” said Zhang Ke, an AIDS doctor at Beijing’s You’an Hospital who has studied Henan’s epidemic. “Treatment often isn’t available or is flawed, education is inadequate and illness and poverty are inseparable.”

Many of the farmers, weakened by their illness, are unable to farm effectively and must subsist on meagre crops and incomes far lower than those earned by healthy farmers.

Things are nevertheless better here than they were.

Until four or so years ago, thousands of AIDS-stricken Henan farmers died in agony, lacking all but the crudest care as province officials refused to acknowledge the epidemic.

Many local officials had reason to want silence.

They and their kin held stakes in the deadly commercial “blood stations” that thrived across Henan in the mid-1990s, Gao Yaojie, one of the first doctors to expose the epidemic, said in a recent interview.

The farmers sold blood by volume and — to squeeze payments and speed their recovery to sell more — the stations took the valuable plasma from the blood and transfused donors back with a brew of left-over corpuscles, mixed together with the corpuscles of other donors in batches that were too often infected with HIV.

“There’s never been pursuit of culpability for what happened. It was a crime pure and simple,” said Gao.

Now the mass blood-harvest has stopped and 253 state-funded village clinics across Henan give HIV-infected residents free drugs to keep the retrovirus at bay.

The spartan clinics also stock aspirin and other simple medicines to fight the effects of AIDS, but villagers such as Leng and Wang said those often did not help against the complicated disease.

The help that is available appears to be skewed by politics.

Henan named 38 villages as “key” ones to receive more drugs and help. The most famous Wenlou Village is a tightly guarded showcase, visited by leaders including Premier Wen Jiabao in 2005. But other villages across Henan with many AIDS patients have been left off the list, leaving residents in deeper poverty and often beyond the reach of newer treatments.

In Ruanlou Village, Sui County, an hour’s drive from Leng Village, Han Fujiang hunkered in his tumble-down hut. He sold blood and contracted HIV, and the free medicines he has been taking seem to be losing their grip.

Complaining of rashes and constant tiredness, Han, 34, said he wanted the better drugs. But his village is not a key one, so they are out of reach.

“What help do we get? Bad medicine and that’s all. That and a bag of flour for Spring Festival.”

Reuters