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December 2, 2010

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The harsh social costs of AIDS

SOME families in an isolated, mountainous region of Sichuan Province have been ruined by AIDS. Local governments and NGOs are trying to help, but a lack of education and funds make it difficult. Bai Xu, Yang Di and Sun Yang report.

When the white powder got him high, the man from the Yi minority group didn't know it would be the start of a dreadful spiral that would include poverty, disease, shame and, eventually, death.

Qubisuobu had a decent job at a lumber yard in the mountainous county Zhaojue County, Sichuan Province.

In 1995, some of his fellow villagers who worked out of the county returned to Dawenguan Village, where Qubisuobu was from. When they got together, they offered him cigarettes.

"At first I didn't know that they put drugs in the cigarettes to give them 'a better taste'," he says. Three months later, Qubisuobu found himself addicted. He was diagnosed with AIDS in 2002.

"Living with this disease is even worse than being a dog," says the 39-year-old.

His adobe house was in a valley. When winter came, temperatures dropped to below zero and the wind howled outside. Squatting down by a fire-pan to warm himself, Qubisuobu coughed from time to time. Lesions began appearing on his legs, which suggested that his disease, AIDS, was no longer dormant.

In his 20-square-meter room there was a desk and two wooden beds, on one of which lay his blind wife. These were all the possessions he could leave for his three sons.

His addiction cost him his savings.

"I would even take the eggs just laid by the hen to trade for drugs," he says.

During a medical check in 2002, Qubisuobu was found infected with the disease.

Yesterday was the World AIDS Day.

His wife Liewuguoguo became so desperate that she drank pesticide to kill herself. While she survived, she lost her sight. Drugs and AIDS brought the family disgrace.

People from the Yi minority respect relatives, but Qubisuobu was expelled from the clan. Fellow villagers suddenly looked down on him.

"When the local government sent me relief food, they gossiped scornfully," he says.

What hurt the most was that his three sons were isolated. His youngest son was a toddler without many playmates and stayed at home most of the time.

Qubisuobu says he had no idea whether his wife was infected, or his youngest son, who was born after he found out he was infected.

He had thought of having him checked but "the hospital which could offer the examination was too far away."

In fact, there was another reason for his reluctance: He was afraid that the boy might be HIV positive.

The father kept repeating that his youngest son shared something in common. "When it rains, we both feel pain in the joints," he says, weeping.

The Liangshan Yi Autonomous Prefecture, which administers Zhaojue County, is next to Yunnan Province and borders the Golden Triangle.

Since 1995, when the first HIV positive case was found from a drug abuser who was sent back from Yunnan, the prefecture, with 4.73 million people as of 2009, has recorded 20,856 HIV patients as of October, with 1,474 deaths.

Of note, thorough screening is extremely difficult as funds are limited and roads are poor in the mountainous region. But local officials generally agree that the real number of HIV cases could be much larger.

Drug abuse was recognized as a major cause of infections, according to Xu Wenqing, an AIDS program officer with the United Nations Children's Fund (UNICEF).

When several people share syringes to inject themselves with drugs, blood from the needle can be injected into another person's body. The virus then spreads within the blood.

Statistics from health authorities showed that about 80 percent of the infections were the result of drug abuse.

The prefecture recorded 11,262 drug abusers as of September 2009, among whom 83 percent were people between 18 and 35 years old.

Sexual transmission of HIV is also on the rise. According to Jin Sheng, vice director of the Health Bureau of the Zhaojue County, most of the HIV infected people in the prefecture are young and middle-aged men.

"The Yi people in the rural area had the tradition of free pre-marital sex," Jin says. "Many people hadn't developed the habit of using condoms, even after their partners were already infected.

"With less education, they had little knowledge about AIDS."

The official gives an example: He asked a woman from Sikai Village in the county why would she marry a man infected with HIV? The woman responded that she would marry him because he had a government subsidy.

Many children were orphaned after the death of their parents.

Yiguayi and Yigushigan (not their real names) lived in Muzhaluo Village of Zhaojue County. Their father died in 2005 and their mother was a drug addict in the rehabilitation center.

This 13-year-old sister and 8-year-old brother were living in a 7-square-meter adobe house in which cracks began appearing on the walls. There was no furniture in the room and they had to go to their neighbors' houses to do their homework.

When winter came and it was snowing outside, the children were still wearing single layer coats and worn-out shoes.

"When it gets too cold, we run in the yard to warm ourselves," says the girl, Yiguayi.

When asked if they miss their mom, Yiguayi cries. "In those moments, I sing the song 'Girl without Mom' and weep in a corner," she says.

However, measures have been taken to help those affected by the deadly disease in Liangshan.

Ten hospitals offer methadone replacement therapy to addicts and 64 such outlets were set up. Also, impoverished people were exempted from the costs. To date, 4,839 people have received medical treatment for drug rehabilitation.

Further, local doctors were trained to be "supervisors" for hose infected with the disease. A total of 6,366 doctors were involved in the training.

Cooperating with some non-governmental organizations such as UNICEF, the prefecture launched training for affected people, including AIDS orphans.

"They could learn some skills so as to live a better life on their own," Xu Wenqing says.

In Butuo County the infection rate, at 7 percent, is among the highest in China, says Li Xu, an official with the Health Bureau of Liangshan Prefecture. To date, 23 girls have been trained and are now working.

Low-income subsidies were given to these orphans. A total of 1,771 orphans in Butuo received 126,000 yuan (US$18,906).

However, Xu notes that more orphans were not eligible to enjoy the subsidy, as they were not registered after birth. "In the past, some people in Liangshan attached little importance to education and didn't think a hukou, or household registration, was necessary," she says.

A prime example was 15-year-old Ayijizha (not his real name) from Bingdi Village of Jinyang County, whose parents both died of AIDS. UNICEF gave him two sheep and he now lives on money made selling wool.

He grew vegetables and chopped firewood, but didn't go to school. The house left by his parents was almost empty. The only thing eye-catching was a wooden frame with photos of the boy with his parents on the wall, when the family was still complete.

Another problem was lack of funds.

Xu says that the civil affairs bureau of Jinyang County had only some 3,000 yuan a year for AIDS prevention and control.

"Local officials had wanted to go door-to-door in villages to get some detailed information, but as the roads were rugged, the sum of money was not even for fuel fees," she says.

The UNICEF program officer who had been to Liangshan several times became sad when talking about the situation in the prefecture.

"This disease is still spreading and the situation of the infected people is worse than you can imagine."

While she was calling for more concern for the people in the mountains in Liangshan, Qubisuobu was worried about his family.

When the writers visited him, a funeral in his village had just ended and several men dressed in black went out of a shanty.

Qubisuobu says it was another person who had died from AIDS.

"I know my days are numbered," he says. "But who will take care of my wife and children after I die?"


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