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Translated from report by CHRD, published: March 8, 2016 and updated on March 9
(China Change exclusive: Guo Feixiong attending a citizen meeting in Beijing on July 28, 2012, with Dr. Xu Zhiyong, who has been serving a four-year sentence since July 2013 for leading the New Citizens Movement, in the audience. Video recorded by Xiao Guozhen, subtitle by @ and @.)
On Friday March 4 we received news that Guo Feixiong, the renowned human rights leader who was wrongfully sentenced to six years last November, had on February 22 been sent to the remote the Yangchun Prison in Guangdong (广东阳春监狱) to serve his sentence. On February 29 his older sister, Yang Maoping (杨茂平), went to see him in prison, and found that his physical condition had deteriorated substantially. He looked emaciated and had lost nearly half of his weight.
Yang Maoping said: “I saw Maodong [Guo Feixiong’s legal name] on the afternoon of February 29, bringing a letter from his daughter Xixi, and news of his son Jinbao having recently won an award. Because we only had half an hour, we were very rushed. He said that he’d arrived at the jail on February 21. If they didn’t let him read books he would go on a hunger strike. He said his case is an injustice, and if he wasn’t granted access to a lawyer he would also protest.”
Guo Feixiong told his sister that “there are over a dozen people in the cell, there are no surveillance cameras, and it’s extremely noisy. The people cooking food in the morning shuffle back and forth outside the cell, and I can only sleep three hours a night.”
She added that he looked much worse than he did during a previous period of captivity, in the Tianhe Detention Center. “His face was pallid, he body thin, and his eyelids drooping. He said that there is something seriously wrong with his health, and that on February 22 he was unable to get up after sitting down, on three occasions.”
His sister pleaded that he cease the hunger strike for the sake of his health. “I thought he looked about three-fifths of his regular weight, and I’m not exaggerating. When I arrived this time he was already sitting. Earlier, in the courtroom, when I saw him walking it didn’t look normal. So I suspect that he’s suffered a spinal injury. As we spoke, a commissar in the political division of the prison was there, watching us the whole time.”
“Yang Maodong’s protesting by hunger strike is really dangerous,” she said. “The person from the political division of the jail said that he has to do labor during his sentence. I responded: ‘Yang Maodong’s health is already ruined. He can’t work. If you don’t believe it, go and perform an MRI on his back. I can pay for it.’”
The other concern is that there’s no surveillance camera in his cell. Guo Feixiong was beaten in Meizhou Prison in Guangdong when serving a five-year sentence from 2006-2011, and the continued absence of any monitoring means he could again be subject to violence, perpetrated by other prisoners, at the order of guards. “I might lose my life here,” he told his sister, “I won’t be a suicide.”
Guo Feixiong has been imprisoned and tortured by the authorities on numerous occasions. On August 8, 2013 he was locked in the Tianhe detention center in Guangzhou and not allowed a day of fresh air for over two and a half years. Many of his supporters were infuriated by this treatment, but multiple attempts by lawyers to lodge complaints about this abuse were rejected. Lawyers believe that this is the most severe, vile, and blatant attack on human rights during a time of peace. Article 25 of China’s own “Regulations on Detention Centers” clearly stipulated: “Criminals should be given between 1-2 hours of activity time outdoors per day.”
In December 2007, when Guo Feixiong was sent to the Meizhou Prison, he was also subject to cruel torture. When the prison guards forced him to crouch on the ground with his hands behind his head, and he refused, they called another detainee over and directed him to beat Guo. This inmate kicked Guo down a flight of stairs, then kept beating him as Guo rolled around on the ground trying to dodge the blows. This continued until the rest of the roughly 200 other detainees began making a hissing sound in disapproval, upon which time one of the jail administrators appeared and told the assailant to cease, lest Guo be killed.
Zhang Lei, Guo Feixiong’s defense lawyer, said in a statement to the Chinese Human Rights Lawyers Concern Group on March 9: “After Yang Maoping (Guo Feixiong’s older sister) saw Guo in prison, she explained to me his situation. Guo told her that there’s no surveillance camera in his cell, so he is extremely anxious about his personal safety and feels highly insecure. Prisons in China are an extremely complex place, in a way that’s difficult for outsiders to imagine. Normally there is always a camera set up in every cell, monitoring it 24 hours a day. Then, if anything happens, the recording can be checked. If every other cell is being monitored, and his isn’t, then he’s worried that he’s exposed to assault and attack, and that if anything were to happen, there would be no way to know. Firstly, the jailers wouldn’t know, and secondly, in his words ‘if I died, no one would even know how it happened.'”
The human rights community is concerned with Guo Feixiong’s condition, and will continue following the news and make his case known to the outside world.
Chinese Rights Advocate Known as Guo Feixiong Convicted of Unexpected New Charge, November 27, 2015.
Activist Guo Feixiong Held 743 Days Without Yard Time, August 21, 2015.
To Obama: Why China Does Not Have a Nelson Mandela, September 23, 2015.
Dream of Ding Village by Yan Lianke is the Man Asian Literary Prize nominated story of a small village in Henan as it is ravaged by the AIDS epidemic that spread through central China nearly a decade ago (and continues to devastate communities to this day). Even though it is a work of fiction, the author is a respected anthropologist who did a large amount of field work prior to writing this book. It is a tale of the gov’t’s failure to prevent/control the spread of the disease and inability to provide basic assistance to those afflicted. It is also an interesting view of how village life is portrayed in Chinese literature and the ways in which extended families operate in rural life.
The story focuses on the Ding Family, which at this point as been reduced to just a few members- Grandpa, one of the few likable characters, who struggles to right the wrongs of his blood-selling eldest son, Ding Hui; Ding Hui, a detestable man who sees nothing but opportunity in the midst of tragedy; and Ding Hui’s brother, who is infected with AIDS, but still wants to enjoy the life he has left. (you can read more about the story itself in these other reviews, but I think they include far too many spoilers).
Over the past five years I’ve had the opportunity to visit AIDS villages in Henan, Guangxi, and Hunan and felt a personal connection to this tale. In each place the story is roughly the same: the disease begins to spread, the local gov’t denies it, and then when a large number of villagers are on the verge of death, the old leader is tossed out and a new one is brought in. Aid to the families is minimal, and those infected are ostracized from the community. Furthermore, the disease destroys the family structures that make village life work, and will take generations to repair.
In a small town near Ningming, Guangxi I met a man whose family had forced him to live in a tent outside of their home out of fear of his disease. In Henan, I met grandparents struggling to raise orphaned grandchildren in their crumbling houses, the generation responsible for income had died a few years earlier. The gov’t officials wouldn’t let us eat in that village, out of some irrational concern that we would get AIDS from the interaction. In Hunan, I met with activists trying to educate the public about the disease, but found themselves limited in what could or couldn’t be said due to China being a “traditional” country. For me, the story of AIDS in China is a sad tale of denial, misinformation and needless suffering; Yan Lianke captures it very well in this novel.
As critical as Dream of Ding Village is of the gov’t’s initial indifference to the disease, it is also a strong reminder of another crucial factor in the epidemic – poverty and the desire to get rich quick. In the novel villagers are disgusted when the local cadres come encouraging them to sell their blood, but they change their minds when they hear that they can earn an extra 80RMB (~$10 at the time) each month. Other scams to cheat villagers are often over amounts that will seem trivial to western readers and readers in China’s urban areas (my co-workers were), but to the characters in the story they seem like small fortunes. There has been a sixty year pattern in China of officials jumping from scheme to scheme to transform their village/county/province from a poor backwater, to a moderately wealthy place in just a few years. This has had disastrous consequences time and again for the villagers, but rarely effect those who initiated the policies.
At times the writing suffers from being overly descriptive and heavy handed with imagery, but from my experience, this seems to be a cultural difference in story telling as poetic Chinese is often far more adjective heavy than English. Some of the villagers in the story are also treated as simple-minded bumpkins, which is an unfortunately common trope in Chinese stories and movies. These flaws however did not keep me from enjoying (if that word can be used) this book.
If you have an interest in China’s AIDS epidemic or rural life, then I would recommend reading Dream of Ding Village. If you have an aversion to foul language though, this book may be grating for you. The F-word in English is much harsher than it is in Chinese, and in translation creates a rather coarse cast of characters.
Any foreigner who has spent more than a few hours in China might have noticed that smokers are everywhere. Many notice it before they even leave the airport. In Shanghai’s Pudong airport, it’s not uncommon to see a man place a cigarette between his lips or behind his ear before he’s even off the plane. Most of them will duck into the first bathroom they can find to light up, despite the ban on smoking in airports (this might not be the first impression they were hoping for when they built PVG). But what does the ubiquitous smoking tell us about China?
First, it gives us a very interesting glimpse into how many Chinese view freedom. In the west we might define freedom as the ability to participate or not participate in any act, so long as it doesn’t affect others. This version of freedom is very visible in our anti-smoking campaigns in the States; you can’t smoke here, because other people’s health would be effected. In China however, freedom means that you should be able to do whatever you want (several of my Chinese friends have made this argument). If I want to light up in a crowded restaurant, I should be able to, because that is what I would most like to do. Laws and placards be damned.
This Chinese notion of freedom fits within one conception of freedom, just one that becomes somewhat untenable in a country of well over a billion people. It’s the same notion that leads to 6 a.m. construction projects in neighboring apartments, driving in reverse down sidewalks full of students, and a good amount of the other unusual behavior that drives expats crazy. One thing that you might not realize by simply watching what happens, is that most of my Chinese friends would describe these same behaviors as uncivilized and rude, but they wouldn’t want to impose on someone else’s freedom.
While this seems to contradict the idea that Chinese society focuses more on collective benefits than individual ones, this notion of freedom ignores the individuals who don’t want to breathe second-hand smoke and is limited only by acts that interfere with collective issues like stability (so clearly rumor-mongering is beyond the pale).
The second thing that we can learn from smoking in China, is that the line between “can’t” and “won’t” is often poorly defined. Virtually every doctor I have spoken with in the last two years at the hospital has mentioned that smoking is causing massive health problems, with roughly 12% of male deaths being linked to the practice. The Chinese gov’t has also released a flurry of articles and proclamations in an effort to reduce smoking with virtually no effect (even a state report said that they were among the least effective in the world).
So which is it? Is it that the Central gov’t simply can’t reign in local gov’t agencies to enforce these no smoking laws that are on the books, or is it that they won’t enforce these laws because it would effect tax collection efforts (this is overly simplified, but the gist of the arguments are there)? The answer is that there is an inextricable mix of both “can’t” and “won’t”.
Similar questions could be posed about prostitution, corruption, black jails and a whole host of other social ills. An angry opinion piece from PD last year, the kind that has since disappeared from the paper, argued that
…because of low salaries of law enforcement officers, offering bribes is relatively easy. As a result, law enforcement officers in the chain have become corrupt. With the protection of law enforcement officials, counterfeiters will be more reckless. When the industry becomes open to “hidden rules,” the role of law enforcement officers becomes numb or powerless.
So even though the Central gov’t may desperately want to curb these scandals, they may actually be powerless to stop them.
It’s always interesting to see how something as meaningless as smoking in the airport (and everywhere else) can reflect both gov’t policies and ideas about freedom.
After reading an article about the myriad problems facing China’s health system, I asked the doctors in my medical English class to briefly reflect on the system based on their own ideas and opinions. Of the 17, 15 doctors wrote that China’s system faced serious challenges. The following are excerpts from their papers that I think accurately reflect the challenges currently facing China’s health. I have not fact checked them, and in some cases I’m fairly certain they aren’t accurate, but that the doctors believe these statistics is revealing.
This one echoed many of the main points of the other doctors.
“For patients, medical services are too expensive. It is said that the average cost is about 500 yuan for a common cold in a mid-level hospital (the average income per day is about 80RMB in Beijing). About 70% of people living in the city get social insurance, which could cover 60% of the cost. For chronic diseases, the cost is even more. So people with diabetes or cerebral vascular disease, do not go to see the doctor and do not take the medicine regularly because they cannot afford the cost. What is worse, some people living in rural areas do not go to the village hospital when they are ill because they have to sell their house and go into debt to treat the disease. In order to raise China’s health level, the cost of medicine should be lowered.
For doctors, this job is no longer a good choice. 90% of doctors said that they are extremely tired. Most doctors have to work 60 hours per week (the average work week is 48). Additionally, being a doctor is a high pressure job which means that they have to focus almost every minute. 30% of doctors admit that they are depressed. In these years even the doctor’s personal safety is threatened. Several doctors were killed by their patients or their family members because of the unexpected therapeutic effects. However, the income for the doctor is low, which is not enough to raise a family. In this situation, some doctors choose to quit for an easier life and fewer students want to go to medical school.”
Red Envelopes and unnecessary prescriptions appeared in more than half of the papers –
“Although most doctors do their best to help patients, there are a few doctors who did some ugly behaviors such as accepting red envelopes, lacking responsibility, and so on.”
“The government does not pay enough money for the health-care system, so the hospital and doctors want patients to buy more drugs to get more money. Even some drugs are unnecessary. 75% of hospital’s income is from drug sales. World bank’s report on China’s health system found that less than 1% of drug prescriptions were reasonable in 2005.”
Concerns for safety came up in nearly half of the papers, this was partially because of the murder of a doctor in Harbin around the time of the assignment.
“…Under these circumstances doctors are worried about troublesome patients and their families. They only dare to make secure diagnosis and operations that insure success. If the risk of the operation reaches a certain degree, some doctors may avoid it. Therefore many patients who have difficult or rare diseases can’t get treatment.”
Government waste was also a major concern, and it surprised me that they were so forward with their discontent.
“The rich and officials waste medical resources. VIPs are very common in many large hospitals. They always do many unnecessary tests and waste the expert’s time.”
“Currently, China is an extremely unfair society. The possession of medical resources is extremely unfair too. It seems the Chinese government only serve themselves. It is reported that about 80% of the health care costs were consumed by 8.5 million governmental officers of the Chinese Communist Party. Despite a loud voice demanding an increase in spending on public health care, the government never wants to spend too much on medical care. It is not difficult to understand. The Chinese Government has a huge budget for spending on cars, banquets, travel, and economic development, but it cannot afford the health care of the large population.
Chinese health is a big problem, and I do not believe that the Chinese gov’t will change its policy on public health care in the near future.”
“Huge gaps in medical resources make many people prefer to seek treatment at prestigious hospitals, instead of at local health centers, for even minor complaints such as headaches and colds. In many large- and medium-scale cities of China, doctors see at least 50 patients a day. Emergency services are so overcrowded that the staff has set up beds in the corridor. People start lining up early in the morning to obtain appointments the following day.”
“Production and circulation of drugs in China is in full accordance with the operation of the market – to pursue profit maximization. This is a serious departure from the public welfare and health services. As of the end of 2005, China has more than 4,000 certified pharmaceutical manufacturing enterprises, as well as 120,000 of the pharmaceutical retail enterprises. In 2005, China’s State Food and Drug Administration approved 1,113 new drugs, while the U.S. FDA approved less than 100.” (This author later wondered whether the oversight was really sufficient).
The other week I had a chance to discuss nutrition with the doctors at my hospital. As we looked at beverages and snacks, many of them were surprised to see that the healthy choices they thought they had been making, weren’t so great. For example, every single one of the 30 doctors was shocked to learn that a bowl of instant noodles had twice as much sodium and much more fat than a grilled chicken sandwich from KFC.
The general agreement was that if they were misinformed about nutrition, than the public would probably be even less informed. A large part of the problem was that nutritional information was either absent or not in a standard, easy to understand format.
China’s urban areas are now facing nutritional problems similar to those seen in developed countries. Hypertension is one of the biggest killers in China, which isn’t surprising given smoking rates, but is also greatly influenced by the Chinese diet. Recent studies have showed that sodium consumption in China is nearly 3x higher than the recommended maximum of the WHO, and 50% beyond what the average American consumes.
Diabetes has also become a major concern in urban areas, rates of those affected are now similar to what we are seeing in the US. Childhood type 2 diabetes, something that was “unimaginable” in the US 30 years ago, is now appearing in both countries. One local doctor told me that she was currently working with two women under the age of twenty who had been diagnosed with type 2 diabetes. They reported that they had switched to drinking only iced tea and soft drinks, completely unaware of the repercussions it may have on their health.
Meanwhile children of poorer families in China, who are largely in rural areas, suffer from a variety of problems related to malnutrition. China has the second largest number of underweight children world wide (this is due partially to China’s massive population, and the fact that ~125 million Chinese still live on about $1/day). Additionally, 20% of rural children are anemic. Malnutrition has been linked to a number of physical and mental development problems, and as the author of the China study points out, it could easily be treated for a few cents per child per day.
When I worked in the countryside, college students were rarely taller than me, even though I’m not tall myself (about 5’7″), and you could tell just by looking which students came from rural areas. In Nanjing however, middle school students are regularly taller than me. The same was true even just visiting the cities of Guangxi, where people were both taller and fatter than in the countryside.
I believe this physical difference is a combination of proper/over nutrition in urban areas, and the steady flow of growth hormones that comes with eating more meat in China (there have been several scandals in connection with illegal growth hormones being fed to animals in China. This had caused several foreign athletes to bring their own food to China out of fear that they would test positive for steroids if they ate locally).
This visible gap between these two groups of people is a reminder of just how big the economic gap is in China. As China continues to develop, it will struggle with these preventable diseases. In urban areas it will lead to increasing health costs, and premature deaths. In the countryside though, poor nutrition will shape children’s futures and limit their potential.
*China numbers did not fully account for those who have not been diagnosed due to lack of access to health care, but US numbers do estimate for such cases. This partially explains the rural/urban gap in diabetes rates. US numbers are based on pop. over 20 years old. Total US average is 8.3%
The other day I was discussing infectious diseases with a group of doctors. The question was relatively simple, “How do diseases spread?” They quickly offered: through coughing, sharing chopsticks, touching, mother to infant, and even mosquitoes. I continued, “those are all correct, but how about viruses like HIV or hepatitis?” A few perked up with “Blood transfusions!” I waited another minute before giving in, and adding, “and sexual intercourse.” When I said those two words, everyone’s eyes dropped to the floor (keep in mind these are doctors in their 30’s and 40’s). I had mentioned a taboo topic.
The problem, as in most cultures, is that even though the topic is off limits, it doesn’t mean that Chinese youth are celibate. Chinese youth have a poor understanding of contraceptives and reproductive health. Attitudes in China’s younger generation towards sex seem to have shifted rapidly from the more puritanical morals of their parent’s generation, and no one seems willing to fill this knowledge gap.
When I worked in rural Guangxi, I was encouraged by former volunteers from VSO to teach a lesson on AIDS in connection with World AIDS Day. In the days leading up to the class, I was terrified of having to say words like “sexual intercourse” in front of 30+ mostly female students, but if I didn’t talk with them about HIV, nobody else was going to. I planned to spend the first 40 minutes of class explaining how HIV is transmitted and how to prevent transmission. The second half of class would be opened up for anonymous questions written on a slip of paper. It was one of the more surprising days of my life as a teacher.
I explained to them that a decade earlier I would have been able to focus on the danger of intravenous drug use and blood transfusions, but for a woman in Guangxi, the highest risk for transmission is through sexual activity (as of 2007). This is due to the fact that AIDS has spread beyond drug users, and has moved into the more general public. An AIDS activist in Nanning told me AIDS was most prevalent in the cities along the freeways between Vietnam and Guangdong. AIDS infected long-distance truckers were having unprotected sex with prostitutes in towns along their route. These prostitutes than spread the disease to local men, who communicated it to their wives.
At this time AIDS had become a growing problem in China, and since little action had been taken in the first years of infection, a strong stigma against AIDS infected patients was almost encouraged. At first the official attitude was that it was a foreign problem. An OB/GYN nurse told a foreign guest at the hospital that she didn’t need to be careful about fluids in the delivery room because “Chinese women don’t have as many STD’s as foreigners”. Then it was acknowledged as a problem for those living at the margins of society. Finally it was admitted that there were a large number of people infected through tainted blood, poor hospital sanitation, and marital relationships (~2003, when Wen Jiabao became the first Chinese premier to shake hands with an AIDS patient). But the damage had already been done. In 2009 I visited a small town in Guangxi that had a large number of AIDS patients. Many of them had been forced to live in tents outside of their family homes due to an irrational fear of the disease.
After I carefully explained the planned material in class, I started answering questions. At least one person in every class asked if AIDS could be spread by mosquitoes or handshakes, which made it clear how limited their knowledge of AIDS really was. What surprised me most though was that the most common question in every class was, “My boyfriend wants to have sex, how do I say no?” The second most common was, “How do I tell my boyfriend to use a condom?”
Even in the countryside, where traditional culture still supposedly reigned, it appeared that many of the ~20 year old students were already engaging in sexual activity. In urban areas the age for beginning sexual activity is even younger, as I was informed by teachers and students at a middle school in Chengdu.
While China is making progress in the diagnosis and treatment of AIDS patients and the stigma is gradually fading (the recent increase in AIDS patients could actually signify a greater number of people being diagnosed who in the past would have suffered silently due to social pressure and lack of treatment options), health education for prevention is still lacking. Until medical professionals are willing to discuss this disease with their patients, it is doubtful that teachers or even parents will.
Note: When I asked a roomful of doctors what the most common means of transmission for AIDS in China was they said: #1 Intravenous drugs #2 Tainted blood transfusions #3 Sexual intercourse #4 Mother to infant. This outdated knowledge leads people to create programs that do not effectively address the problem at the source. In actuality it is #1 Sexual intercourse (Heterosexual sex 42% of new cases, Homosexual sex 32% of new cases, totally 74%) #2 Intravenous drugs #3 mother to infant and tainted blood (both have improved dramatically in the past few years) Source: UNAIDS