On December 19, 2003, four AIDS orphans from Shaodian Village in central China's Henan Province arrived at Chongqing Municipality, in the nation's southwest. They expected to attend school there, funded by the Tumor Testing and Early Treatment Center of the Chongqing Municipal Red Cross Association. However, they recently had to return to Henan because the city's schools would not admit them.

Huang Wei, director of the center, thought there would be no problem when he began planning to bring the four children out from Henan, as long as he could provide care and support and get permission from their guardians. As it turned out, he was too optimistic. Putting the plan into practice involved numerous detailed arrangements, but even more difficult to overcome were social pressure and imperfections in the charity system.

CCTV's Time Online recently ran an in-depth story on the case.

Unintended media sabotage?

He Chengyin, vice director of Chongqing's Jiangbei District Education Committee, argues that extensive media coverage put all parents and schools in the city on notice that the children would be arriving. Many local parents called the education committee, declaring that if the four AIDS orphans were placed in the same school with their children, they would transfer their own kids to another school.

"I have been in education for a long time and I know that environment is key to the upbringing of children. They need good health as well as good scores. Even more important is psychological health. If the education committee had arranged for these orphans to attend any school in Chongqing, their identities would have been exposed. There is no doubt the other students would discriminate against them. That is not good for their psychological health," He claims.

But requiring the children to return to Henan also sent a strong signal that they were not welcome. Any psychological damage that might result from that, says He, is not the responsibility of the district education committee.

However, the vice director says the committee had the best intentions. "I feel that the media created this situation. If they had not made such frequent reports on the four AIDS orphans, we could have made arrangements secretly. The problem now is that it is very difficult for other children and their parents to accept them."

Huang Wei, the orphans' sponsor, disagrees. He believes that media coverage can help to assuage people's fears about AIDS. Moreover, it enhances awareness and encourages the public to assist AIDS orphans.

Right to privacy vs. right to information

While hiding the identity of the AIDS orphans might have avoided the current dilemma, secrecy would create its own problems.

Researcher Yang Tuan of the Chinese Academy of Social Sciences formerly served as the general secretary of the China Charity Foundation. She believes that hiding the facts about AIDS and AIDS orphans will keep the public ignorant of the disease and its potential impact. Without facts concerning what the disease is, how it spreads, reliability of testing and whether the orphans might have spread the disease, people are inclined to speculate and panic. Yang believes the parents calling in to oppose the acceptance of the AIDS orphans must have been a minority.

He Chengyin argues that the public's acceptance -- or non-acceptance -- of AIDS and the orphans is simply a social reality.

Were fears well-founded?

The crux of the issue is whether there is a possibility that the AIDS orphans might be a source of contagion.

Huang Wei says that none of his family or friends feared being infected with the disease. "All my neighbors know that these children are AIDS orphans. They patted their heads and washed their clothes and even bought food for them. The four children slept with my kid, and no one was afraid."

Nevertheless, before going forward with his plan, Huang made sure the children were healthy. "This is really a question that concerned us all. I took them to the most authoritative epidemic prevention clinic and watched their examinations in person. I didn't bring them home until I made sure that they had no health problems. Later, they were checked again at Xinqiao Hospital in Chongqing. Those tests again showed no problems. In light of this, we finally asked local education committee to allow them to attend school in Chongqing."

He Chengyin says the committee informed concerned parents of the results of the children's health checks, but the response was always a question: Who would take responsibility if something happened to their children?

According to researcher Yang Tuan, this means that AIDS education is still far from adequate. Armed with the knowledge that those who are not infected cannot spread the disease, Yang believes that every member of society can take responsibility. With adequate awareness of the facts about AIDS, any school, child, parent or teacher would have welcomed the four orphans. Yang Tuan feels that the fears He attributes to the parents are a reflection of his own bias.

Why leave Henan?

Huang Wei is not sure what the future holds for the orphans. "The four children have been sent back to Henan. It is hard to say whether interested parties there will sue our center. We mainly want to support them to study in Chongqing, but schools here haven't made a final decision. We are caught in a dilemma and don't know what to do next."

Before the AIDS orphans went to Chongqing, the local civil affairs department signed an agreement with Huang Wei's center concerning the children's stay in the city. Since they were required to return to the village, the department may have grounds for legal action. But Ren Qinghua, head of the Shaodian Village Civil Affairs Department, says they have not even considered filing a case.

Ren Qinghua personally signed an agreement with Huang Wei concerning the orphans. Huang Wei sent a number of letters to Ren, saying that his center wanted to take the orphans in and provide their support and schooling until they graduated from middle school. The center was also willing to continue supporting the kids through high school and university if they passed the entrance examinations. Huang believed that providing support without a change in guardianship would benefit both the children and their relatives.

Ren concurred with Huang's plan. The grandparents of the children are all very old, and two of them are disabled. Their ability to care for the children is very limited. Ren also believed that a large city like Chongqing offered greater educational benefits. Moreover, he was convinced that Huang had the children's best interests at heart.

Some might feel that the trouble involved with placing the children in the care of an organization outside the area outweighs the potential benefits. But Ren said that it does not matter whether the kids are raised by their relatives, by the government or by public donations, as long as they are cared for properly.

Gao Yaojie has placed six AIDS orphans with different families. "I have been engaged in AIDS work for almost eight years; three years ago I started to focus on AIDS orphans. I discovered that much of the money and goods donated to AIDS orphans was not really used on the children. I donated 1,100 yuan (US$133) for two AIDS orphans in 2001, but only 300 yuan (US$36) of it was spent on them. Their uncle took rest of the money for gambling. I paid three semesters of tuition for another child, but he didn't go to school for a single day. So I suggested dispersed foster care. Having parents and a normal family life is good for their studies. The six orphans I brought back to my hometown, Caoxian County in Shandong Province, have all gotten along well with local children."

Dispersed foster care considered best option

Yang Tuan says that foster care of orphans can be divided into two categories: collective and dispersed. Orphanages, welfare institutes and private residential centers are examples of collective foster care. Yang believes that in general, dispersed care -- where a child is placed with a family -- is better for the children.

Dispersed foster care helps the children to get involved in normal life and form intimate relationships with the families. They can experience not only family love, but also the frustrations and difficulties of life in a household, just like other ordinary children. This, says Yang, is conducive to the development of a healthy personality. She believes the four orphans in Shaodian Village have two dispersed foster care options: they may be placed with their grandparents or uncles locally; or an intermediary like Gao Yaojie may find suitable families with which the children can be placed.

Originally, Gao had believed that it was best for such orphans to remain with members of their own families, with financial aid that she provided. However, she found that when extended family members failed to care properly for the children, the local authorities hesitated to interfere. Gao now makes sure that any family she places a child with will provide a good home. She personally visits foster families in order to monitor the situation.

Yang Tuan feels that these issues indicate that government regulation is key to the success of dispersed foster care. Laws, guidelines and methods need to be established and implemented.

Discrimination may have long-range impact

Gao Yaojie says many AIDS orphans suffer from emotional problems as a result of their experiences. "I have a letter written by a 13-year-old girl. She wrote that she wanted to beat other children. Once I went to a rural area, and met an AIDS orphan who actually said he wanted to kill people. If these children cannot be well educated, they may become a destabilizing factor in our society. On the evening of December 18, 2003, Vice Premier Wu Yi talked with me. I suggested to her that dispersed foster care could alleviate the burden of the nation. Vice Premier Wu Yi was in favor of my suggestion."

Gao says that about 60 percent of the people who are willing to adopt AIDS orphans are sincere and good-hearted. Families that have adopted AIDS orphans raise the children at their own expense. She visits the six children she placed twice a year.

Home assessment & monitoring crucial

Ren Qinghua, head of the Shaodian Village Civil Affairs Department, says that even when children are placed in foster care outside the province, he keeps tabs on them. "I called the four in Chongqing every 10 days. We were very concerned about their living conditions there. We planned to visit them once a year."

Ren also says that his office will check any home offering to adopt AIDS orphans. "We will visit and review their places in person before sending the child there."

Yang Tuan suggests that local civil affairs departments conduct such work because the government should share the responsibility of protecting and caring for children.

Gao Yaojie says that her ability to place AIDS orphans in foster homes -- only six in the past three years -- has been hampered by lack of cooperation from local governments. "Some don't allow the children to go for fear they will say something bad about them."

Ren Qinghua says no such thing will happen in his township. Their top priority is to provide schooling and normal, healthy lives for the orphans.

Integration & organization

Gao Yaojie says that at present, funds donated to assist AIDS orphans are not monitored. Thus, there are no guarantees that the money will actually be used for the kids.

Yang Tuan says that despite the excellence of volunteers like Gao, far more is needed. "We need to find new ways to solve the problem. I think the most important thing is to integrate various social resources. The work and volunteers should be organized. Warm-hearted people who want to donate money should not send it directly to the families. Instead, an intermediate organization should be responsible for this. It can be the charity association or some foundation. Volunteers organized by the charity association or foundation can monitor to ensure that the money has reached the designated place and is used on the children. There should be many excellent volunteers like Gao Yaojie. We need to determine how to organize such social resources, train volunteers and make them more professional."

Future uncertain for the four AIDS orphans

Shaodian Village and the Shangcai County government scrambled to make arrangements for the four children who returned from Chongqing.

"We have reported this to higher authorities and arranged for them to stay in a home for the aged. So they have a place to live. The school they will attend is near the home, so it will be convenient for them to go to school. Since there are many orphans there, they may feel better to be with them," says Ren Qinghua. Huang Wei has indicated that although the children were sent back, he still plans to provide them with financial aid for their education.

Yang Tuan approves of these arrangements, but she still asserts that it is important for them and others like them to be placed in more homelike surroundings. Indifference or even aversion to society's disadvantaged will only create more problems, she says, and the public should be enthusiastic in its care and support.

Yang places great hope in Chongqing Municipality and the Chongqing education committee to solve this problem fairly. If they can quell prejudice and eliminate discrimination by increasing AIDS awareness, they will succeed.

(China.org.cn, translated by Wang Qian, February 24, 2004)