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Chung To, founder and director of the nonprofit Chi Heng Foundation in Hong Kong, is one of the few outsiders who has penetrated the state-imposed isolation of the so-called AIDS villages in central China. He is all too familiar with the plight of small children orphaned by the disease. On a recent visit to a village in Henan, he watched an 8-year-old boy taking his father out for a walk. The boy was pushing his father along in a creaky wooden cart. The man was dying of AIDS and had been confined to his bed for weeks, too weak to walk. His son suggested the cart, hoping that a little fresh air would energize his ailing parent. A few weeks later, the father was dead.
"It was an unforgettable scene," says To. Using his own funds and donations, To has been helping these children continue their schooling, giving them a chance to free themselves from the taint of having a parent--or both parents, in some cases--die of AIDS.
In heavily affected provinces like Henan, Hebei and Shaanxi, an entire generation is vanishing in the shadow of AIDS. In family after family, mothers and fathers are dying, leaving as many as 200,000 children in Henan alone either parentless or in the care of aging grandparents. Ho and his colleagues were the first foreign group officially allowed to visit one of its villages, Wenlou. At the local hospital, only two doctors care for more than 1,000 HIV-positive patients, and they were trained not by the Chinese health system but by one of Ho's colleagues based in China.
Here, unlike in Yunnan, HIV spread not through illegal behavior but through blood donation. In the early 1990s, the Chinese leadership launched a blood drive and paid donors for their plasma. It was a program intended to benefit all Chinese--the poor by giving them a way to supplement their income, and the rest of China by replenishing the national blood banks' dangerously low stocks. "It was like a poverty-relief program," says a Henan resident who gave plasma in 1993 and became infected. Through campaigns in the villages and schools, the government encouraged rural farmers and factory workers to sell their plasma for 40 yuan ($5). The good intentions backfired when "bloodheads," as some of the unofficial blood collectors came to be known, found a way to extract more plasma from fewer donors. Those running some stations pooled and processed the blood. Then they sent the plasma, containing useful proteins, to the blood banks and reinjected red and white blood cells, which can house HIV, into the donors. This enabled people to give several times a day, and nobody seemed to realize how dangerous the practice was. Infected blood now flowed through hundreds of thousands of residents in the central provinces, shifting the epicenter of AIDS cases, many experts believe, from Yunnan to the heart of China.
Henan and its neighbors, Ho has decided, cannot wait for his program to become established in Yunnan. In his proposal to the Ministry of Health, Ho has modified his plan to include testing, treatment and prevention projects for Henan and Yunnan. "They desperately want help," he says of the doctors he met in Wenlou. "They obviously have the data on AIDS patients but are afraid to show us."