Wall Street Journal - December 19, 2001
Leslie Chang, Staff Reporter of The Wall Street Journal

LUOYUGOU VILLAGE, China -- Chen Sufang, a farmer and the mother of three teenagers, fell ill last year with headaches, cough and fever that wouldn't go away. Local health authorities visited her twice, but didn't say what the problem was.

In June, Ms. Chen, 36 years old, died of what villagers in this southeast corner of Shaanxi province are calling the "strange sickness." "It is connected with giving blood," says her husband, Qu Shiquan, sitting in his unfurnished mud-brick house. "Who is there to blame? I can only blame myself for selling blood in the first place."

The Qu family's personal tragedy is a stark warning for Chinese authorities. World attention has focused on extraordinarily high rates of HIV, the virus that causes AIDS, in some villages of central Henan province, where poor farmers contracted the virus while selling blood to unlicensed operators. But the Qu family lives in Luoyugou Village, 250 miles from those Henan hamlets, in a swath of countryside believed to be free of the disease.

The beginning of an AIDS outbreak here -- where the farmers who sold blood over the years number in the hundreds or more, based on conversations with villagers -- is chilling proof that Henan's crisis is spreading to other parts of China.

According to health experts, the blood-buying companies used unclean methods that spread the disease: They pooled all the donated blood, spun it through a centrifuge to separate out the plasma, then pumped the residue back into the villagers' bodies in the belief that the practice was good for one's health. The outfits preyed on rural villagers -- the people in this country most desperate to supplement their paltry incomes and least likely to complain when things go wrong.

Thus, China could be facing an epidemic of unknown scope, since most outbreaks occur in remote areas but nevertheless may involve large populations. China faces "not a generalized epidemic, but a bunch of smaller epidemics," says Joan Kaufman, an expert in reproductive issues affiliated with Radcliffe College, who says half a dozen Chinese provinces, including Shaanxi, are believed to have seen blood-selling operations similar to Henan's. Chinese and international AIDS experts estimate that one million or more Chinese may be infected with HIV.

In Beijing, officials have begun to acknowledge the AIDS threat, hosting China's first national AIDS conference last month and running educational segments on state TV. But in places like Shaanxi, local governments continue to suppress the truth, thus denying patients the treatment and education they need. The strange sickness is so common in Luoyugou and neighboring villages that locals can point to a house where a sick person lives. Yet in the county seat of Shangluo, officials dismiss such talk as exaggeration and rumor.

"Epidemic situations must be announced by the government," says the director of the Shangluo health department, who gave his surname as Han. Reports that people have fallen ill through selling blood, he adds, "are pure hearsay."

As in many places in rural China, villagers in Luoyugou farm small plots of millet and corn but keep their eyes open for better opportunities. That seemed to materialize in 1995, when strangers appeared with job offers in a place called Jishan in neighboring Shanxi province to the east, a two-day bus ride away on mountain roads. Mr. Qu, the widower with three children, went, along with about 20 people from the area, each paying about $12 in bus fare. His wife went with a later group of villagers.

They arrived in an enclosed yard, marked with a sign reading "Jishan County Blood Station," recalls Mr. Qu. There, he and others say, villagers were told to give blood for a period of days, weeks or even months. One after another, they were hooked up to a device that collected their blood with shared tubes and needles for all the donors. They were paid $12 a bag.

"I stayed two months and gave blood more than 50 times," says Mr. Qu, 45, who so far shows no symptoms of the disease. He says he knew he had been cheated but that he had no choice. "We had already paid the bus fare. If we didn't give blood, we had no way of getting home."

The penchant of the "blood heads," or the unlicensed operators of blood banks, for pooling blood and reusing medical equipment meant one sick person could infect others. And the long period after infection during which the virus shows no symptoms -- sometimes more than 10 years -- meant the successive waves of villagers, who presumably knew about the blood donations but went for the money, had no inkling of the hazards involved.

But last year, the disease began to show its face. Zhang Xinlai, a farmer who lives in nearby Huangtutu Village, was one of the local residents who travelled to Jishan in 1995 on the promise of a job. Instead, he gave blood twice a day over five days and received $8 each time. Last August, he began to experience headaches, fever and cough and was subsequently diagnosed with HIV. "Many of the others who sold blood have this, but the disease has not yet developed in some of them," he says.

Early this year, health officials from Shangluo collected blood samples from villagers who had sold blood. They told at least some of the villagers that they had tested positive for HIV and gave them medicine for colds and headaches. Other villagers say they were told nothing. The Shangluo health department has not released any findings. Mr. Han, the health department director, confirms that HIV cases have been found but would not say how many people have been tested or infected. "I don't have the right to publicize the number," he said in a phone interview, pointing out that the problem is really in neighboring Shanxi, where the blood collectors operated.

The question of blame does not seem to concern villagers much. In his home, Mr. Zhang splits long strands of bamboo with a sharp cane knife, barely looking up as he speaks about his illness. He says his 11-year-old son, who hovers in the doorway, has not been teased at school, and that some of his neighbors have been kind to him. He is not afraid because there would be no point. But he looks up long enough to ask, "This disease, how long can I stay alive with it?"

Write to Leslie Chang at leslie.chang@wsj.com.

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