Revealing the "Blood Wound" of the Spread of HIV AIDS in Henan Province --- Written on the eve of the first AIDS Day of the New Millennium By He Aifang November 28, 2000 (Posted on the http://bbscity.com/news/rdxw/forum.html Corruption forum among the postings of November 28. http://bbscity.com/cgi-bin/anyboardc.cgi/news/rdxw/?cmd=get&cG=63030373&zu=36303037&v=2&gV= [Translation follows] Ever since 1995 - 1996, the HIV/AIDS epidemic in Henan Province has alarmed Chinese health experts including the renowned Chinese AIDS expert Zeng Yi, an academician of the Chinese Academy of Sciences. These experts warn in different ways and in different places that the Henan AIDS epidemic is real and is serious and may well become a national disaster. However, Liu Quanxi, the director of the Henan Provincial Health Department said emphatically at the time, "There is no HIV/AIDS in Henan Province". Experts say "This is seeing the casket but shedding no tears".HIV/AIDS has a 5 - 10 year latency period so when the time comes can the deaths of many, many people be covered up? Liu Quanxi seems to think, "Well, when that time comes, it'll be time for me to retire."Liu seems to think that so long as others do not expose my secret it'll be all right. Although the experts predict misfortune and people really don't want it to come true, around the year 2000 it became clear: Henan Province has about 500,000 - 700,000 people infected with the HIV virus. There are many more still who have Hepatitis B or Hepatitis C.In the eastern and southern parts of Henan Province there are many counties and cities where this year where strangely enough many tombstones are being erected. Some villages are already seeing 30 youths and middle aged people dying each year. This people have something in common. They all sold blood. The good natured, simple people of China's central plain never imagined that HIV/AIDS had anything to do with them. HIV/AIDS, they thought, well that was a rich people's disease. And they see HIV/AIDS as a disease that rich people get when they behave in certain ways and don't take precautions. These people were poor, so when the "blood head" came to them and said with his sly words, "Lend me some of your blood and I'll give it right back to you. I'll give you money to boot!", the farmers extended their rough-hewn arms worn by years of hard work. What they were doing in fact was giving away their lives to the Devil. That needle and knife, that plastic tube for giving blood, that blood bag, that centrifuge, that blood that all sloshed together, and especially that process of transfusing blood back into you, that Yama, the King of Hell,has already dispatched those aggressive little devils into your body. The blood heads want whole blood and blood plasma, of course, so they can sell it to the biological products company and the hospitals in the city. Those clever Shanghai people with their talent for accounts and that Wuhan people, known far and wide for their craftiness, could not have guessed that ever since 1992, Henan Province blood heads have been selling large quantities of contaminated blood to biological products companies in Shanghai and Wuhan. Those companies used the blood to make albumin, globulin, interferon, blood [xiaoban??] factor and other drugs in a whole line of nourishing drugs that were sold throughout China. These nourishing drugs not only infected city people with HIV, hepatitis B, hepatitis C and other diseases but people never even realized what was happening. To this day, these kinds of blood collection activities are still going strong underground in Henan. In 1992, all of China from the top of society to the bottom was caught up in the "get rich" craze of that overheated economy.That year a new Henan Health Department head came into office, creating among other things a "reform office", a "development office", a "central blood collection station", a "Wanda Co.", a "development center", and a "biological pharmaceuticals company". He enunciated his new way of thinking: count on official seals for the interior, and count on selling blood plasma for the exterior. Counting on official seals for the interior meant making full use of the power of the official stamp of the Henan Provincial Department of Health.Many permits are issued in order to make a lot of money. Counting on blood plasma for the exterior meant taking only blood plasma from blood donors. The red blood cells are returned to the donors and the blood plasma is sold to pharmaceutical companies. This article will focus mainly on blood plasma collections to tell you an inside story that will make you want to make accusations against the perpetrators. A senior Henan Provincial Health Department official, now retired, said that Liu Quanxi at the beginning of 1993 in a closed internal meeting of the Henan health agencies said: We need to focus on developing the service sector so we'll set up many blood collection stations.Henan has a population of 90 million people, 80 % of whom are farmers. One to three percent of them would be willing to sell blood. They could do that once or twice a year.We can collect that blood and sell it to a biological products company [shengwu zhipin gongsi] . We can create products worth hundreds of millions of RMB, which at the same time could be considered to be helping the farmers escape from poverty. Why don't we put our heads together and think along this new line of thought. An official should do something to help the people. I believe that setting up blood collection stations is the way to do it. We need to work hard along this line so that we produce results. We need to draw on both inner resources and make outside contacts as well. We can bring in foreign capital. China doesn't have HIV and so its blood is very clean so the foreigners will certainly want it.We need to assemble the capital and mobilize all of society to set up blood collection stations.We need to fully bring into play Henan Province's advantages and push for the reform of the Henan health care system! Kaifeng was the first to respond to the call by setting up a blood collection station. The Henan Provincial Department of Health praised it and even held a special meeting at that blood collection station.The whole province was energized. The epidemiological stations of the various counties and the woman and child health protection stations set up blood collection stations. Blood collection stations were also established in some townships and villages. Military units, distribution companies, coal mines, and factories set up blood collection stations as well. Some county People's Consultative Congresses and People's Congresses also get into the act and set up their own blood collection stations. At one point Henan Province had set up 200 "legal blood stations" and an unknown number of illegal blood stations. Some blood stations were composed of just a centrifuge, some plastic tubes reused many times and some needles carried on a tractor. They would go into the village to draw blood, bringing blood collection services right to the door and paying on the spot. Biological products companies from all over China came to Henan to buy blood plasma. They all shared a common goal -- to take the blood of the central plateau rural village country cousins in exchange for money. In order to find even bigger buyers, Li Quanxi lead blood selling delegations to the United States in 1993 and 1994.The second time that he went to the United States, he had negotiations with several U.S. blood products companies.Liu suggested to the U.S. companies that they set up plants to do processing in Henan Province to make blood products. This would be more convenient, would avoid problems with Chinese Customs, which doesn't allow blood to be exported, and would be more profitable. Liu Quanxi said to the U.S. companies, "Henan Province has abundant and concentrated blood supplies. The blood is clean. There isn't any HIV in Henan Province and the blood is cheap" .Considering that at that time Henan was China's second most populous province and that Liu was the first Chinese official who dared to sell blood, the U.S. companies arranged for a special plane to transport Liu Quanxi during his visit to the United States.Later Liu on many occasions told people in China about that special plane he used in America and how the Americans treated him like a VIP. The American companies visited Henan several times to study the situation. Later,the U.S. companies were thinking of making a very large investment that would result in the formation of a new unit at the provincial deputy department head level, and might have been handled by the Henan Provincial government or the Henan Province Planning Commission (as it was called at that time). This would have put the investment into an area, which Liu did not control, so he lost interest and let the matter slide. Recently, an important officials in the Luohe City Health Bureau had this to say: Liu Quanxi set aside 200,000 RMB (USD 25,000) in capital as well as equipment and then directed his younger sister to set up a blood station in his own hometown of Yancheng County, Henan.With the support of the then director of the Luohe Health Bureau Liu Xuezhou (now Vice Director of the Henan Provincial Health Department) six blood collection stations were established in Xiping, Shangcai, Xihua, Xuchang, Taikang and Weishi counties. This six blood collection stations belong to the Liu family. These stations followed no rules, they took blood any way they pleased and even beat and cursed some of the blood donors. For example, as one bloodhead said to a small paper that had reported on the bloodhead's activities, "You go tell the Department of Health. I'm not afraid!" There was a small time bloodhead in Zhongmu County who collected blood not far from the Liu family blood station in Weishi County. The bloodhead wasn't finding buyers so he went to the Henan central blood station to look for a buyer.Liu Quanxi took advantage of the bloodhead's credulity to out the situation and address of the blood station. Then the bloodhead trustingly lead a group of people to the blood station. Even when that bloodhead went into prison he perhaps still didn't know how he had been caught red-handed.This case became the basis for the political achievements of Liu Quanxi in the later period of suppressing the bloodheads.Liu Quanxi made himself a bloodhead. However the position he achieved as a blood lord is a position his flunkies created for him. Henan Province is not developed. It neither lies on the coast nor on the frontiers. It is the heartland of the central plain. In the early 1990s, Henan's economic and social environment was such that there wasn't much drug addiction or prostitution.The farmers of the central plain, like their fathers and ancestors before them, made a living from the soil. Whoever would have thought that the dreams of wealth of a high official of the Henan Provincial Department of Health would push so many people to these people towards death. Some people say that Shangqiu Department of Health Director Zheng Bingyin assigned important tasks to Hu Wanlin was because Zheng didn't understand medicine and other people got him all confused.That argument would perhaps convince people who have knowledge of the situation. If one were to say that Liu Quanxi started out with the intention of spreading HIV to the people of the central plains, perhaps that would not be believed. Liu Quanxi's problem was initially that he was in a rush to make money. A shot at big bucks weakened his judgment. His ambitions knew no limits. He believed that there could not possibly be HIV in Henan.Later, when the collection of blood had gotten seriously out of control, he began to fear for his own personal responsibility and that the Liu family blood stations would be exposed.So he decided on a cover up, lying to those above and suppressing those below, telling lies, and striking in revenge against whistleblowers. LIu's story is one in which differences in degree gradually became became fundamental differences. In 1995 and 1996, grassroots medical workers discovered some people who were HIV positive. In order to confirm their finding, they sent samples to Shanghai, Beijing, Nanjing and Wuhan.The test results astounded some Chinese experts.HIV/AIDS was already very serious in Henan Province. When these experts want to go to Henan Province to investigate, nobody dared take them out to the rural villages. Recently, a physician said:In 1995, he took blood samples near a blood collection station sponsored by a transportation company and the local health bureau near a certain city in eastern Henan.Three out of the ten samples contained HIV antibodies -- positives. He sent the samples to another city. Results confirmed. When he reported the results to the local health bureau, criticized him, saying. "You are an idiot. When the Health Department gave permission to set up a blood collection station they thought of everything.It is impossible that there is HIV. You careless talk will influence the income of our blood station." The physician said: At this time, the three people who had tested positive said that they regularly sold blood plasma at blood stations in theKaifeng, Lankao, Shicheng, and Shangqiu region. Usually this blood was sold to a big company in Shanghai. Liu Quanxi was astonished to hear that outside experts wanted to come to Henan to investigate HIV/AIDS.It was then that he realized the bankruptcy of his policy: During his time as an official, he was going to produce benefits for people. For internal matters, rely on the power of official seals; in external matters, rely on selling blood plasma. Liu arranged for fine food and drink when the Academician Zeng Yi visited Henan. No problem with visiting the office, just don't let him go down to the countryside. The Ministry of Health can collect documents but rumors can be strenuously denied; the Provincial government can collect reports but the guesses of individuals should not be given credit lest they affect the economic development of our province. A physician at the Zhoukou epidemiological station did not obey this call. The physician bravely gave information and help to experts from outside the province. The physician lost both job and income. The latency period of HIV gave Liu Quanxi a hand. High officials in the provincial government who didn't understand medicine gave him the opportunity. Because nobody was dying just then, so it looked like there was no problem. Moreover, provincial officials just didn't want to look into the matter. Recently, two Henan Province epidemiological station experts said: In 1996, under pressure from society and experts, the Henan Provincial Department of Health mobilized "its own" forces to carry out a study of HIV that focused on blood sellers in thirteen counties.People who went out to the countryside to do the study were divided into six groups.They tested 100,000 people in all. In order to ensure secrecy, Liu Quanxi ordered that the people who participated in the survey may not exchange data and may not reveal their results to outsiders. Each group made its own independent report.A participant in the study of the Shangqiu blood station said that the data there showed that 84% were HIV positive. Weishi, Xiping, Shangcai, and Taikang were also very serious. The lowest survey among those counties found 67 percent HIV positive.Since the figures for each study were never released, experts estimate that at that time in Henan Province there were at least 100,000 people infected with HIV.But Henan at that time had one million people who were selling blood. Moreover, the two experts said, those people who helped Liu Quanxi with the coverup all got promoted into good positions. A reliable source said: The Party organization in the Henan Department of Health held a stormy debate about the results of this survey.Liu Quanxi insisted that the results of the survey could not be published nor could they be reported to higher authorities. A vice director of the Health Department who insisted that the results be reported was criticized. Things often happen that way these days. In a situation in which the ordinary people can?t fight those in power, when someone in power says they want things done a certain way, even when that it is wrong we just carry out the order anyways. Gao Yaojie Gao Yaojie is a gynecologist at the Henan Chinese School of Traditional Medicine Hospital.After she retired, she began doing research on sexually transmitted diseases.At first she just looked into the STD advertisements on the street and criticized them. As she got deeper into her research, she found that the strongest opposition to her work came not from quack doctors who were cheating people out of their money.Her biggest opponents turned out to be an organization that she thought originally thought would support her efforts -- the Henan Provincial Department of Health.That strong little old lady didn't realize just who that opponent she was going to conquer was.She frequently wrote letters to central governmentand provincial leaders. She shared her views with the news media. She used her small pension to print educational materials and to go to see AIDS patients in the countryside, especially women and small children. She won the praise of society and the media.She won the honorary title of "The Number One Citizen Worker for HIV Prevention". Many newspapers, television stations and websites in both China and foreign countries reported on her activities. Gao Yaojie's personal campaign upset Liu Quanxi's plans. As pressure from society to clean up the blood market increased, he realized that in choosing between money and power it is better to hold on to power. He imagined that he could take advantage of the latent period of HIV, bring the blood market under control, and hide the seeds of Henan's disaster that had been planted some years before. Then, when HIV had appeared throughout the country, Henan's problem would not look so exceptional. The strenuous calls of Gao Yaojie and the reports of some journalists that appeared in the Great River News (Dahe Bao), the Zhengzhou Evening News (Zhengzhou Wanbao) and other newspapers became a background noise blocking Liu Quanxi's further political advancement.Liu secretly put pressure and harassment of Gao and her family.Liu used personal connections to engineer the transfer of Wang Jiheng, the top health reporter of the Great River News. In late 1998, Liu Quanxi heard that the Great River News was going to print an article about HIV in Henan Province.Liu at once ordered a person named Han who had a close connection to the newspaper company to take 80,000 RMB to the newspaper company and offer to replace the HIV article with a big advertisement. Liu also used his influence to get the health reporters of several influential Henan newspapers transferred. These reporters hadn't been writing about HIV in just the way that Liu Quanxi wanted. Late one night in July 1999, Zhengzhou police seized a van carrying blood plasma to Kaifeng.When journalists got to the scene, a policeman said that the people in the van had all run away.Did they really run away? Later, a journalist made an undercover visit and was told in a whisper by a policeman: "We got a phone call from a "VIP" in the provincial government who ordered us to secretly let them go. "There were four blood sellers involved, two men and two women. One was the younger sister of Liu Quanxi. A journalist went to the site of the old blood station, but it was already empty.Such a rapid move was not something that an ordinary crook could manage. The journalist went back to the police station and was told but a policeman, "We didn't get a chance to interrogate them. They all ran away. Without a trace." There is more and more HIV/AIDS in Henan. HIV is being passed along to children.Some Beijing hospitals discovered:these days most of the people diagnosed with HIV come from Henan Province.Although some patients don't want to reveal their identity, they are identifiable from their Henan accent. Their clothing shows them to be country people.Professor Zeng Yi of the Chinese Academy of Sciences and Beijing experts have said many times to Henan Health Department officials: Pay close attention to the HIV/AIDS situation and set up HIV/AIDS prevention stations.If necessary, the central government will provide assistance. Liu Quanxi response has been negative. A director responsible for disease control at the Chinese Ministry of Health in an informal meeting said: Liu Quanxi of Henan Province speaks empty, false words. No truth comes out of his mouth. Just as Gao Yaojie and some journalists were giving Liu Quanxi a hard time, Gui Xien like a cat slunk into the heart of the central plains.He went to Henan to see patients at the request of his student in Shangcai County. During a simple and unannounced visit to Henan, this expert discovered that the rate of HIV infection in Henan villages had already exceeded 60 percent.His report astonished people at high levels in Beijing and scared the Henan Health Department as well. Academician Zeng Yi began to watch the HIV situation in Henan from 1995 onwards. However the social situation at that time did not allow that scholar to get the support that would have been needed from all quarters to stop the spread of HIV in time. He could only sigh, "Henan see the casket but doesn't shed tears!" Gui Xien's 1999 report confirmed Zeng Yi's deductions.Gao Yaojie, fearlessly went several times to the countryside to see sick people and to draw attention to the problem. The media began to pay attention to the problem. Some of the journalists at the Great River News, the Zhengzhou Evening News and the City Morning News (Chengshi Zaobao) were angry.They anonymously printed articles about HIV. While reporting on Gao Yaojie's visits to people in the countryside, they wrote veiled criticism of the Henan Provincial Department of Health.Liu Quanxi, through the Provincial Propaganda Department, put pressure on the newspapers and put a stop to that kind of reporting. The journalists then began "surrounding Henan from the exterior" [Note: by placing articles about Henan in papers in other provinces. end note]. Intense attention from the outside forced the Henan Health Department to send people to the countryside during 1999 and 2000 to determine what the actual situation was. According to an official at the Henan Province Epidemiological Station official who asked to remain anonymous, he did a sampling survey at Shangcai County in the Zhumadian region and discovered that the situation was even more serious than had been reported in the newspapers.Luo Gang and Zhaodiangxiang, both to the south of the county seat, were the most serious. Three people had died in one household. The situation in Wenlou Village in Luogangxiang was reported several times in the media.He said that Zhaodianxiang is more serious that Wenlou Village. He mentioned a woman in Lipu Village who developed an unbearable fever and so hung herself. She had been infected with HIV when she sold blood in 1993 and 1994. She left behind two children aged two and five. Both the two children and their father have HIV. He also mentioned that a Shangcai County health official opened a restaurant but when it turned out that one of the waiters had HIV, nobody ever dared to go to that restaurant again. The official lost a large sum of money as a result.People in the area say that HIV came from Ronan County since a blood station was set up there before Shangcai. The official strongly insisted that I should never say whom I got the information from. According to an expert at the Henan Health Department Epidemiological Station, HIV in Henan is concentrated in regions south of the Yellow River such as Zhoukou, Zhumadian, Xinyang, Luohe, Kaifeng, Shanqiu, Nanyang, Xuchang and Pingdingshan.The farmers there are relatively poor, the population is dense and there are relatively few natural resources.Some farmers eager to escape poverty along with some lazy people fall for the economic enticements of the bloodheads. They don't know what they are doing and lose their lives to the blood disaster. The expert estimates that now over 500,000 people are infected with HIV in Henan Province, but it is difficult to get a more precise idea than that. That area with very serious HIV is situated around Luohe where the Liu family set up its blood stations. Is there a connection? He gave the journalist a mysterious wink of an eye and said, "No, that couldn't be." Nevertheless, the every reckless operation of the many blood stations in southern Henan is the main reason for the spread of HIV there. When you consider that HIV is not as common in northern Henan, you understand. Recently, Gao Yaojie has noticed that why controls on her remain, some officials are taking a more friendly interest in her family life.Her daughter who has continually harassed at a newspaper but some officials took the initiative to arrange a job for her at the hospital of the Henan School of Traditional Chinese Medicine.Professor Gui Xien of Hubei University has also been informed that he is welcome in Hunan and will be supported in his investigations. The condition for the support is that Gui not reveal his result to outsiders. The Henan Province health departments want to buy his tongue. While it is true that some families are happy and others have worries. Some officials of the Henan Provincial Department of Health who have spent a good chunk of youth and later life rising in officialdom together with Liu Quanxi are coming down with hepatitis B and hepatitis C and ending up in the hospital.Perhaps they don't even know themselves how they got their illnesses. Could it have been from blood products?Even if they know that blood products harmed them, do they dare say so? Is there anyone who dares to tell them to speak up?A sickroom nurse in the Henan Provincial People's Hospital for senior cadres said: This year, Liu Quanxi often came to the hospital. Sometimes it was high blood pressure. Other times it was high blood sugar. He often had a cold and felt weak. One hospital director flattered him saying, "Department head, your resistance is getting a bit weak, we should transfuse some blood proteins into you."Liu Quanxi turned pale, waved his hands and shouted, "Don't transfuse me with blood proteins! Don't transfuse me with blood proteins! "Really, it is as if God is playing a joke on them. The beginning of the deaths of those honest farmers is a sign. The end of the HIV latent period has come.The media reports reveal the news. Liu Quanxi's "blood wound" can no longer be hidden. This child of a farmer harmed many farmers and at the same time put the lives of many city people in danger as well. Just how many people were affected by this blood disaster is still an unsettled issue.Perhaps it will come to pass that a high official gets HIV. Maybe it will be from nourishment products made from blood plasma or from a prostitute. It will be hard to say.That such an idiot has sole responsibility for the public health of the people of China's most populous province, it is strange to think about just what it means to say that the health of the rural and city people is being protected. Strange, strange indeed.
Background That hundreds of thousands of paid blood donors in Henan Province have HIV has been a dark secret for at least the past five years. The article below now circulates among Chinese experts in Henan Province and Chinese patriots elsewhere who can see clearly the disaster that now threatens their country. Just as the line goes in the wartime anthem, the "Song of the Volunteers", the Chinese people are at the most dangerous moment [Zhonghua minzu dao zui weixiande shike]. Some Chinese experts who have known this story for years but have had to keep quiet are pleased that this story is out. They agree that this story is accurate but it is not the complete story. Just as the press reports on HIV among blood donors first focused on the widespread HIV infections among blood donors in Shangcai County in central Henan, and have now widened to report that no, Shangcai is unfortunately not an isolated case but all too typical. Yet the problem is not confined to Henan. The problem of paid blood donors and underground blood collection centers, as the Chinese press occasionally reports, is serious in Shanxi, Hubei, Hebei and other provinces. Paid blood donations and bloodheads also work in Beijing and Shanghai even if the problem seems to be worse in the interior provinces. Southern Weekend in October 2000 for example discussed the legion of 4000 paid blood donors in the impoverished Dingxi region of Gansu Province. Some of this blood from donors with high rates of hepatitis and other blood borne diseases was sold to a blood products company in Lanzhou.There the blood is made into various blood protein products sold in China as well as to developing countries (the US FDA does not permit the importation of Chinese blood products into the USA). The spread of HIV among blood donors and especially blood plasma donors seems to be driven by the high prices that biological products companies (some connected with the Chinese military) pay for blood plasma and their willingness to procure it illegally if need be. On one level this article can be seen as a poison pen attack on the director of the Henan Province Health Department. The anger the author feels for the Health Department and its leaders role in the spread of HIV and the subsequent cover-up is apparent. Yet poison pen letters can be true, and some Henan activists familiar with the situation vouch for the authenticity of this article. Restrictions on the speech of some of these activists such as Zhengzhou physician and HIV campaigner Gao Yaojie remain although she is now praised in the official press for drawing attention to HIV in Henan. Dr. Gao came to Beijing for a public conference on HIV on January 8th and 9th but the authorities do not permit her to speak. The problem is bigger than one province and bigger than the alleged misdeeds of any one official. The Chinese government has a well-thought out HIV strategy but getting it implemented in the provinces is very difficult. The Ministry of Health has excellent dedicated people working on the problem but the Ministry has only several hundred people and just a few people working on contagious disease policy.One theme of the article is that officials in Beijing knew about the problem in Henan Province, very much wanted to stop it but were unable to do so. Why? China sometimes to be not so much a country of Big Brother but of many little brothers (some well meaning, others not) who don?t pay much attention to each other. China's HIV problem breaks down into management components that can be addressed by the government such as blood collection and donation irregularities and the spread of disease due to substandard medical practice (also called iaotrogenic disease). Both are very serious in China. In fact dirty needles (the rule rather than the exception in much of rural China, especially in the interior provinces) spread hepatitis to ten percent of China?s people but are even higher -- near 20 percent in the interior. Indeed, now that China seems to be on the verge of admitting to the big problem in Henan Province, perhaps the first place to start with strict management of medical practice to ensure safe medical practice and no medical transmission of disease would be those AIDS villages in Henan. So many people have HIV there, the chances of it spreading further must be quite high. Now the chance of getting HIV from a dirty needle is small each time but not if you are getting regular frequent dirty needle injections. Both the problems of blood donation and collection and the spread of disease by substandard medical care can be addressed by government.Other cause of HIV spread related to behaviors such as intravenous drug injection and prostitution can be addressed through behavioral interventions which would take much longer. The Chinese government in December announced a crackdown on illegal blood collections and sales in violation of December 1996 Ministry of Health regulations on blood collection procedures and the October 1998 law that outlawed paid blood donations.An early January press report discussed a crackdown in Chongqing where five blood plasma collection stations were closed and the biological products company that bought the blood plasma is under investigation.