Old Habit Has China in Its Grip

One boy’s sister was crushed by a train after she pumped heroin into her veins and passed out on the tracks. A young man became an addict in the city; his parents carried his body home to this village in a box. The father of two girls overdosed, and their mother is hooked.

Heroin-related tragedies are as common as the dried twigs that locals scavenge and burn to stay warm in this hardscrabble ethnic enclave in Sichuan province, along China’s new drug trail. Though remote by distance and developmental standards from the country’s booming coastal cities, Ergu and its 2,700 people are on the cutting edge of an emerging national health crisis.

“At one point, you could look out onto the field and you wouldn’t find a single young person working. Everybody is taking drugs: men, women, even 11- and 12-year-old kids,” Mahai Muji, 35, a former addict, said from his windowless mud hut.

The situation grew so desperate that village elders banded together a couple of years ago to form the country’s first known village-based anti-drug brigade. It’s part of a wave of alternative remedies springing up across China -- from acupuncture to herbal cures -- to combat soaring drug abuse and ineffective treatment by the central government.

The villagers had no experience and no outside aid. They asked hundreds of families, many making only about $60 a year, to chip in 25 cents each. They slaughtered a cow and drank a toast of fresh chicken blood -- an ancient declaration of war against a devastating modern plague.

“If we don’t do something about it now, there won’t be any children left to save,” said Ma Quzhe, 53, head of the brigade.

Opium has long been used here, since even before Europeans began importing the drug into China in the 19th century as a dubious way of offsetting a growing trade imbalance. The Qing Dynasty fought back unsuccessfully in the Opium Wars, losing Hong Kong and other enclaves to European rule in the process, and China became known for its dark and smoky opium dens populated by addicts.

Communist China’s founding fathers made it a priority to erase that humiliating past. Within a few years of taking power in 1949, they shut down the opium parlors, plugged the inflow of foreign drugs and swept pipe-smoking zombies into the pages of history books.

“It was one of the triumphs of communism,” said Chris Beyrer, an expert on the current Chinese drug epidemic with Johns Hopkins University’s Bloomberg School of Public Health. “To see it come back is extremely sensitive. The Communist Party does not want the world to know it’s come back on their watch. But it has, big-time.”

Blame it on the extraordinary social changes sweeping the world’s most populous country. Reforms starting in the 1980s turned the stagnant communist economy into one of the more dynamic in the world. The Chinese benefited from increases in personal freedom, social mobility and international trade. The greater openness also created an environment for the return of the drug scourge.

According to a government report, China counted about 148,000 registered drug users in 1991. By the end of 2001, that figure had soared to more than 900,000. Some independent reports estimate the number is about 7 million. The government is increasingly concerned about the epidemic’s potential to cause more economic damage and social instability.

Officials have every reason to be alarmed.

Most drug users are younger than 35 and are taking their heroin intravenously, which leaves them vulnerable to this opium derivative’s other great danger: the risk of acquired immune deficiency syndrome. China officially estimates it has 1 million people with the human immunodeficiency virus, which can lead to AIDS. Outside experts believe the infection pool could be twice that. The sharing of needles by drug users and the growing migrant population contribute to the disease’s spread.

A recent report by the U.S. government’s National Intelligence Council projects 10 million to 15 million HIV/AIDS cases in China by the end of the decade. That would mean China and Nigeria would be tied as the second worst-hit nations, behind India, in total numbers of cases.

“This is definitely a wake-up call,” said Tao Hong, a project manager for Save the Children, a British nonprofit organization running a program to fight the spread of HIV in Yunnan province.

Not that Beijing is ignoring the escalating problem. China boasts some of the toughest penalties for drug-related offenses; for example, it executed 64 people accused of drug crimes in June to mark the International Day Against Drug Abuse. The government has vowed to intensify its crackdowns and work more closely with other countries, including the United States, to fight drug use. But for now, the battle appears to be a losing one.

“In China, drug use is seen as a political issue, a national security issue, not so much a health issue,” Beyrer said. “You can execute drug dealers all you want. But you can’t stop the drug problem if you don’t have effective drug treatment.”

China has plenty of state-run rehabilitation centers. But they function more like prisons and treat drug users like criminals. Drug counseling is rare. Some addicts even find it easier to buy drugs from crooked guards inside the detox centers than on the streets. Not surprisingly, the failure rate at these facilities is alarmingly high: Relapses are estimated at between 70% and 90%.

“Locking up people doesn’t really work. It doesn’t address the reasons why they take drugs in the first place,” said Lucy Reynolds, a Western aid worker based in Yunnan.

That question of why, however, is much tougher to tackle.

The majority of China’s heroin supply comes from Southeast Asia. Like retailers all over the world, the traffickers have zeroed in on this nation’s potential market of 1.3 billion people. Among their first targets have been disenfranchised ethnic minorities, who tend to live in poverty in remote border regions near the transit points where drugs are plentiful and cheap.

In pockets of Yunnan and Xinjiang, regions bordering such drug-producing nations as Myanmar and Afghanistan, HIV prevalence among drug users runs as high as 50% and 85%, respectively, according to the United Nations.

Tucked deep within the mountains of Liangshan Yi Autonomous Prefecture in Sichuan province, Ergu is fast on its way to becoming a similar disaster zone. The area is historically part of China’s opium-growing territory and straddles an ancient trade route known as the Southern Silk Road.

Since the 1980s, the ethnic Yi of southern China have been leaving home in droves, joining an avalanche of unemployed workers and idle farmers crisscrossing the land searching for a piece of the new economic miracle. Many journey to the nearby cities of Chengdu and Kunming, gateways for illegal drugs arriving from Southeast Asia. As many as 90% of these low-skilled workers can’t find jobs, according to Fang Guangxing, the Liangshan prefecture’s deputy Communist Party secretary.

So, many turn to drug trafficking. A dealer can make more money in a day than a farmer makes in a year. Some of their best customers are other migrants from their villages.

“They hooked us by giving it to us for free in the beginning,” said Mahai Zhizhen, who took his first hit of heroin when he was 14. Like most young migrants from Ergu, he has never spent a day in school and speaks only the language of the Yi people. Soon after arriving in Chengdu, Sichuan province’s capital, he was recruited into a gang of thieves. Together, they picked pockets to support their habits and shared needles as well.

Now 18, Mahai Zhizhen has returned to the village and is in recovery under the watchful eyes of the brigade. He doesn’t know if he has AIDS or HIV. But he did test positive for tuberculosis, and that scared him enough to want to quit.

“I saw too many people die. Seventeen are from my hometown,” said the teen, coughing thick puddles of spit onto the red earth.

Unlike state detox centers, the village brigade in Ergu gets to know teens and offers them tough love emphasizing community and family support.

“We don’t run a prison, so they don’t have to be afraid of us,” said Mahai Muji, the former addict, who is now a brigade captain. He is not related to the teenager, though they share a last name that is common here.

“We try to be more like parents. We teach them the importance of helping themselves to avoid bringing shame to the family,” he said.

About 300 people take turns patrolling the dozen or so small villages in this hilly region, home to about 15,000 residents. There’s no money to hire transportation, so they walk -- usually at night, guided by donated flashlights and the moon.

“It takes at least six hours to survey the entire area. Sometimes we don’t finish until sunrise,” Mahai Muji said.

When they find suspected junkies, the volunteers work with family members to persuade the users to quit. When that doesn’t work, brigade members lock them in their homes until they are clean.

On the surface, the system appears to be working. The rate of relapse is reportedly about 40%, far better than at government facilities. Few people dare to do drugs openly in the villages these days. Those who quit say they are grateful.

“I stopped because they told me I could die and leave my children behind,” said Qumo Aqu, 30, a mother of three. Her husband was traveling for work when she bought her first taste of heroin from returning villagers. She smoked away $2,500, an unthinkable sum that left the family deep in debt.

Mahai Muji knows firsthand how hard it is to stay clean: “I tried to quit 50 times. When I finally made it to the end, it was like I had been dead for five days.

“I joined the anti-drug brigade because I pity my people,” he said. “Lots of us used to share needles. We had no idea we could get AIDS that way.”

Brigade members use their limited resources to spread their message, borrowing the old-fashioned tactics of communist guerrillas. They draw skulls and poppy flowers on blackboards and add a warning: “A beautiful killer.” They blast disco music from boomboxes in the middle of a village. When a crowd gathers, they sing songs and stage skits about the harms of xidu -- literally, “inhaling poison.”

But all their efforts cannot bring back the parents of three children also named Mahai: Layi, 13, Chuni, 11, and Zuni, 8.

About four years ago, their father overdosed on heroin and their mother died of an undetermined disease, leaving the girls on their own. Relatives take turns giving them food but can’t afford to send them to school or buy them warm clothes.

“There are at least 20 other orphans like them just in this pocket of Ergu,” said Mahai Muji as he pointed out knots of youngsters in ragged clothes with dirt-caked faces.

He hopes they will grow up and say no to drugs. But many more villagers are out in the cities seeking their fortunes. It seems only a matter of time before they will sneak back and poison the waters some more.

“Our work never ends,” Mahai Muji said.