VI.  POSITIVE PRACTICES IN MAINLAND CHINA

Credible reports from Chinese policymakers indicate that serious consideration is now being given to the review and reform of national and local laws and policies on HIV/AIDS.  This development is welcome and should be actively encouraged by international donors and NGOs working on AIDS in China.  International experts and donors should offer technical assistance to facilitate the enactment of laws that will help to combat human rights violations against people with HIV/AIDS and persons at high risk of being infected. 

China has the capacity to improve its approach to education about HIV/AIDS and to improving the lives of people living with HIV/AIDS.  This has already been demonstrated by a number of pilot projects in localities around the country (described below), and by the relatively successful example of Hong Kong.  The following projects could be studied and evaluated for national implementation in China.

Education and prevention

Over the past five years, a number of Chinese associations, local authorities, NGOs, international donors, and multilateral agencies have developed education and prevention programs aimed at informing persons at high risk of HIV/AIDS about the epidemic and how it can be prevented.    

Several cities and provinces have launched education and prevention projects and have begun distributing condoms.  In 2002 the state family planning commission began distributing free condoms in four pilot areas, including Sichuan, Shandong, Henan and Gongzhuling.[461]  In 2001, Anhui province announced a decade-long campaign for prevention and control of HIV/AIDS including publicity campaigns and increased medical services.[462]  Shenzhen, a special economic development zone near Hong Kong that attracts large numbers of domestic migrants, launched a five-year publicity campaign on HIV/AIDS.[463]  The city of Shanghai launched a fifteen-year project to prevent and control AIDS by stressing the importance of safe sex.[464]

Some NGOs and associations have established small-scale pilot AIDS education projects that target women, ethnic minorities, injection drug users, sex workers, and men who have sex with men.  Many of these pilot projects have been concentrated in Yunnan province, both because it is an area of high HIV prevalence and because its provincial government is described by some international NGO workers as more tolerant than others.  For instance, the Yunnan Reproductive Health Research Association is a professional association that brings together scholars, government officials, and NGO workers for research and pilot training projects in rural communities.  It also runs a number of training workshops targeting women and girls on reproductive health issues, including HIV/AIDS.  The workshops also address women's empowerment, men's responsibility and participation in reproductive health, traditional cultures, drug abuse issues, and provide services to migrating populations.[465] Save the Children-UK also runs two centers in minority prefectures of Yunnan that do training workshops targeting women, including sex workers.[466]

Some U.N. agencies and NGOs have supported innovative education and prevention projects in ethnic minority languages that aim to draw on traditional educational practices to transmit HIV/AIDS information around the borderlands.  UNICEF has conducted training workshops for Tai minority Buddhist monks in Yunnan who teach younger novices in Buddhist seminaries, and has funded the printing of posters and educational materials in the traditional Tai alphabet, an alphabet the state does not officially encourage Tais to use.[467]  UNESCO has supported the production of a radio soap opera about HIV/AIDS in the Tai language which is broadcast in northern Thailand and reportedly can be heard in nearby regions of Burma, Laos, Thailand and Yunnan.[468]  Health Unlimited also does transborder HIV/AIDS education projects in the Tai and Kachin minority languages, working in border areas of Yunnan and Burma.[469]

The Sino-American Daytop Center, a non-profit voluntary facility staffed by Chinese workers and founded by the U.S.-based Daytop Center, offers an alternative treatment approach to the forced detoxification centers described above.  The Daytop Center, a small residential facility based in Kunming, incorporates methadone, psychological counseling services, and the "therapeutic community" model in which patients talk about their experiences and give each other emotional support.  Services at the Daytop Center include small, informal women's and men's support groups.  The Daytop Center also houses an Injection Drug Users' HIV/AIDS Prevention Peer Education Project, which offers individual counseling and a telephone hotline.[470]  Several pilot projects in Kunming run by the Australian Red Cross and others train former drug users to run HIV/AIDS workshops with other injection drug users housed in forced detoxification centers.[471] 

Fewer projects have targeted men who have sex with men.  One is run by the Hong Kong-based Chi Heng Foundation.  Chi Heng works with saunas and brothel owners to hold HIV/AIDS education projects and to distribute AIDS information, as well as doing one-on-one counseling and education with sex workers.[472]

All these projects could be evaluated for possible expansion to a larger scale.  Moreover, the Chinese government should use public education to promote HIV/AIDS awareness in ways that would reduce stigma and increase tolerance.

Freedom of assembly

The restrictions on freedom of assembly and association that have significantly constrained the work of AIDS NGOs in Henan and elsewhere have been loosened in Yunnan without, apparently, causing social unrest.  In late 2002 NGOs and GONGOS in Yunnan were permitted to organize a spirited rally to promote understanding and support for persons living with HIV/AIDS, organized around the U.N.-promoted slogan, "Live and Let Live."  On a rainy afternoon the week before World AIDS Day, a few hundred students, NGO workers and volunteers rallied in Kunming's Jinbi Square, including dozens of volunteers who participated in a city-wide bicycle ride to raise awareness of HIV/AIDS.  Volunteers took to the stage to act out a skit about stigma and discrimination, while families of people living with HIV/AIDS, including small children, joined in writing messages and drawing pictures on a long banner on the ground that illustrated the principles of love and tolerance. 

They were watched by a few dozen passersby, including rural migrants dressed in ragged clothes, some carrying infants on their backs in embroidered baby carriers, who stared in amazement at colorful signs and banners on the taboo topics of AIDS and sex.  At one of a number of NGO information booths set up around the square, university students dressed in bright yellow t-shirts handed out free condoms and AIDS information brochures to passersby.  While some responded with shock and embarrassment at the suggestion, others simply blushed, smiled, pocketed the condoms, and continued on their way.

"Mostly, we just get together and talk" [473]

Ma is a Hong Kong resident in his mid-fifties, thin but energetic. As the conversation unfolds, he warms up, becoming enthusiastic and talkative.  Though he speaks good Mandarin he prefers to speak his native Cantonese through a translator.

I found out I was HIV-positive in July 1997, the month when Hong Kong was handed back to China. During that time I had persistent diarrhea, and had been to private doctors a couple of times, but they couldn't stop it.  One day I learned about HIV/AIDS in a newspaper.  The piece in the paper described similar symptoms [to what I had], and diarrhea was one of them.  I decided to take the blood tests.  I got the test results and learned I was HIV-positive, and it was a big surprise.  I couldn't take it at that moment.  I found out that not only was I HIV-positive but my health situation was critical, and I was admitted to the hospital immediately. 

I went to Queen Elizabeth hospital, and was sent into an isolated room.  I felt discriminated against, but because I was sick I had no choice.  I needed to be hospitalized.  I was very satisfied with the care provided by the specialty AIDS clinic, but once I left the care of the specialists, in other departments I felt discriminated against in different ways.  I was hospitalized about two months, and then discharged.  After I was discharged I was in touch with welfare services, NGOs, and those who provide services are nice, very good at providing care, and I felt no discrimination.

I have no health insurance.  I paid for my surgery out of my own pocket.  But health care in Hong Kong is cheap, usually only HK$50-60 [U.S.$6.40-7.70] a day.  People with AIDS in Hong Kong are the luckiest in an unlucky population.

In 1998 there was a PHA[474] conference in Warsaw, and Loretta [Wong, of AIDS Concern] organized a group of people to go.  I went to that conference.  After that I gained confidence, and began helping my own life.  Before that I had always thought I only had a few years of my life [left], I may as well just mess around.  But in Warsaw, I saw many kinds of people all gathered together.  Some had been fighting AIDS for ten to fifteen years, and had contributed a lot to their own countries.  When I came back, I set up a support group for people with HIV/AIDS. 

In the last three years, AIDS Concern has been guiding the group to grow.  We started to plan our own activities.  Most of the things we do now, we do by ourselves.  We have open membership, and anyone is welcome as long as they are HIV positive.  When it was first established, we had thirty to forty members, but people come and go.  We don't keep records of who comes.  Our last two activities were mostly trips outdoors in the Hong Kong area, and we visited Guangzhou and met some people with AIDS there.  Mostly we just get together and talk.

This has been the period for me to grow up.  I have a more confirmed life goal, and a better direction for the future, and… [Ma smiles] … that's all.