NOVEMBER 13, 2000 VOL. 156 NO. 19

The Cost of Living
The residents of a remote Chinese village are paying an awful price for selling their own blood
By HANNAH BEECH Wenlou

Two weeks ago, soon after his second birthday, Cheng Weiwei got a new hat. But the undersized toddler was too listless to care about the square of white cloth tied around his head to mark his mother's death. Already, Weiwei can no longer swallow the porridge that used to sustain him. When he dies—in a week, or a fortnight or a month—no one will wear a white mourning hat for him. He is, says his grandmother, clasping the feverish boy, too small to merit such an honor.

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But the hamlet of Wenlou has not seen the last of the white hats. For two decades, the village's hearty citizens have made money in the usual ways: growing grain, planting cabbage and herding sheep. But they have also earned modest fortunes selling their blood. It's a question of supply and demand. Chinese typically are loathe to part with what they consider a vital life force, and government clinics suffer chronic blood-bank shortages. But poor farmers cannot afford to be so squeamish: half a pint of plasma brings $5, a sum that is particularly welcome as the prices they earn for wheat, corn and barley have plummeted. When official collection centers ceased to pay for blood in 1998 for fear of blood-borne diseases—preferring instead to solicit donations, on the theory that the pure of heart wouldn't carry germs—illegal operators replaced them. Wenlou's peasants were happy to oblige. Some referred to the day when the rickety, black-market blood vans first pulled into town as "lucky cash time."

But the blood money hasn't paid off. Last year, some of the village's strongest farmers found they lacked the energy to till their fields. Since then, more than 20 people have succumbed to an illness they dubbed "no-name fever." By the time a doctor came to investigate, 96 of the 155 Wenlou villagers he examined tested positive for "no-name fever." Elsewhere, it's known as AIDS.

Throughout Henan province, other villages are facing similar tragedies. They're not alone: health experts say at least 20 million peasants sell their blood throughout the impoverished Chinese interior. According to government studies, they are 10 times more likely to be infected with HIV than unpaid blood donors.

The problem in Henan is both specific—the dirty needles reused by blood collectors—and more general. Local corruption allows the black-market buyers to thrive: cash-strapped rural hospitals routinely purchase plasma from them and resell it to patients for more than 10 times the price. Rarely is the blood screened for disease. "AIDS in China is not about prostitution or drugs," says Gao Yaojie, a retired Henan medical college professor who has started a one-woman crusade to educate the province's farmers about the disease. "It is about corrupt local officials who are worried that exposing the disease will give them a bad reputation."

When Gao, 72, first traveled to Wenlou in March, provincial medical authorities politely but firmly asked her to stop handing out free medicine and informational leaflets. Undeterred, she continued her education campaign and even talked to local journalists. She found an ally in village leader Kong Yunxing, who sent letters keeping Gao up to date. "Cheng Yanling received the medicine you delivered," Kong wrote in one such letter in May, detailing the progress of a village patient. "When he found out that the pills were free, he asked if Chairman Mao had sent them."

By the end of the summer, provincial health authorities had ordered Wenlou's 3,000 citizens not to talk to any outsiders, lest they expose the village's terrible secret. Then, through county party chiefs, they started a whisper campaign to isolate the hapless hamlet. Neighboring townships were told not to buy Wenlou's vegetables, and the village's prettiest girls suddenly couldn't find suitors. The panic spread as far away as the southern boom town of Shenzhen, where migrant workers from Wenlou were abruptly dismissed from their jobs.

When a doctor showed up to offer free AIDS tests, irate villagers pummeled him with sticks and fists for daring to confront a problem they felt was better left unexplored. Even cadre Kong was swayed by the government line. "I don't want to talk about it," he snapped two weeks ago, after returning from the funeral of baby Weiwei's mother. "We can take care of ourselves." But many villagers do want to speak out, if only to learn about how to treat the disease that is ravaging their birthplace. "They tell us we must not talk to anyone outside," says a farmer surnamed Cheng, as he slips down a muddy path to avoid being seen by other villagers. "But can you tell me: Is there any cure for this disease?"

In the months since Wenlou's epidemic was uncovered, there have been no government education campaigns, no extra shipments of medicine, no punishment meted out to the blood middlemen. Says a local doctor: "The officials are hoping that the village will just die out and that will solve their problems." Determined local medics have turned up at least 300 AIDS deaths in the past two years in the southern Yellow River valley, where Wenlou is located. But a health official in the provincial capital of Zhengzhou refuses to provide any official AIDS figures, even denying that the disease exists outside of Wenlou: "That place is an isolated case. It is not a problem in any other villages."

Such short-sightedness at the top does not bode well for China's looming AIDS epidemic. The national AIDS commission is woefully underfunded and the country has no official HIV-prevention education campaign. Still wedded to the notion that AIDS affects only people on the fringes of society, Beijing seems loathe to take major steps to combat the disease. "In February, I made recommendations to the Ministry of Health about what they must do to fight HIV," says Zeng Yi, an epidemiologist at the Chinese Academy of Sciences in Beijing. "But so far, they have not carried out my suggestions." Existing estimates, which are undoubtedly conservative, put the number of Chinese HIV carriers at an alarming 500,000 in 1999. If the rate of infection continues unchecked, China will have 10 million HIV-positive patients by the end of the decade, burdening the nation with one of the largest AIDS populations in the world.

Ignorance among China's hundreds of millions of peasants will contribute heavily to that number. Villagers in the neighboring hamlet of Chenglao no longer buy fresh produce from Wenlou. But only a few realize that the illness they call the "strange disease" is no different from "no-name fever." Even though people now know that selling blood may lead to the "strange disease," they know little about how it is transmitted. "People think that being in the same room with someone with AIDS can give them the disease," says village medic Zhao Pingfu.

Qian Xiulian says she has no plans to have herself tested for HIV, even though her husband, Cheng Laishui, has been bedridden for the past 18 days, propped up in front of a flickering TV set he bought with his blood-selling earnings. "You should get tested only if you feel sick," says Qian. "Otherwise, it's a waste of money." An AIDS test costs $15, and Qian is saving the family money for an HIV remedy that is being peddled in a nearby village. But despite her hopes for a miracle cure, Qian keeps a bundle of white cotton cloth folded under her bed. Ten people in Chenglao have already died of the "strange disease" since January. In China's villages, the mourning has only just begun.

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