Somewhere in the midst of the campaigns to raise awareness about the dangers of drug abuse and how to prevent HIV infection, the children of those who have died from AIDS got lost. Few laws and policies protect their interests, but there are people fighting on their behalf.

Qian Liwei stands apart, a solitary figure in the courtyard he now calls home. The quiet 15-year-old seems to prefer the company of his foster family's dog. They've been looking after him since his mother passed away last year, four years after his father died of AIDS.

"We took him in because he didn't want to live with relatives," says Xie Dajin, the neighbour-turned-father whose two grown children work away from home in Xincheng Township in western Yunnan's Yingjiang County.

The county is near the China-Myanmar border in southwestern Yunnan Province, part of the notorious "Golden Triangle", where drugs are widely and readily available.

Qian's natural father, once regarded as honest and well-behaved by his fellow villagers, ended up roaming the streets and consoling himself with heroin when his relationship with his wife began to deteriorate at the end of the 1980s. After his death, she remarried. But her second husband also died of AIDS and infected her with the disease as well.

Qian's six-year-old stepbrother stays with his 80-something grandmother now, but the teenager refused to move in with them. He quit school three years ago and is now largely idle. His foster father worries about him.

"We provide him with meals and accommodation, and occasionally allow him to help with some chores, but nothing heavy. We can't beat him (as we did with our own children). That's not acceptable to outsiders. But we are at our wits' end because he won't listen to us. Looking after him is more difficult than rearing my own two kids combined," he says.

It's hard to tell what Qian is thinking. But one thing is certain. "I won't abuse drugs when I grow up," he says firmly.

Most children orphaned by drug-addicted parents harbour a deep hatred of heroin. "My younger brother often swears that all drug traffickers deserve the death penalty," says Bai Lili, 13, from the same village. She's been living with her 76-year-old grandmother since she was 18 months old.

"Her mother ran away from home three years after her father's death. We have no idea where she is," says the frail grandmother. She takes care of Bai and her brother with the help of her eldest bachelor son, who would not consider marriage at the cost of abandoning the two children.

While her grandmother saves every penny she earns from raising chickens, ducks and pigs, growing vegetables and tending a couple of fruit trees, Bai Lili helps with the housework after school, sweeping the floor, feeding the poultry and cooking for herself.

Young as she is, she is sensitive to the discrimination around her. "People look down on me. Sometimes they say nasty things about my family," says the strong-willed girl. She befriends other children with similar backgrounds and seeks pleasure from books in the school's reading room.

Children orphaned by parents with AIDS are not uncommon in Yingjiang, where Yunnan's first case of HIV was reported. Since then, more than 200 people have died of AIDS there, well over half of the provincial total.

"Most of the drug-addicted villagers were infected with HIV/AIDS through intravenous injections in the late 1980s or early 1990s, at the height of drug use, when they knew nothing about the killer virus," says Li Yuchun, director of the Xincheng Township Public Health Clinic.

Tang Quanyu, vice-chairperson of the Yingjiang County Women's Federation, who has visited 26 families in six townships, reveals that 40 per cent of the 50 children orphaned by parents with AIDS have dropped out of school due to the financial problems of their foster families.

Although most of the orphans are not infected with the HIV virus, they are not without psychological trauma, Tang says. "They won't talk about their families. You can see in their eyes the shadow cast by the deaths of their parents," she adds.

Life's early blows have given them a sudden maturity and a sensitivity absent in their peers, setting them apart with an invisible label of which only they themselves are consciously aware.

Lin Shuqin, whose father died of AIDS when she was three, still feels the difference, even though she lives with an affectionate aunt. "It's not the same. I cannot enjoy parental love, cannot have an intimate connection with them," says the 15-year-old who is now a high-school student.

As one of the 20 or so students in her school who cannot afford a school uniform, which she feels keenly on special occasions, Lin keeps telling herself to study hard so that "I can buy anything I want when I grow up".

Potential Social Problems

"These orphans are plunged into such difficulties that boys enter easily into child labour while girls are vulnerable to sexual abuse. They are ripe for exploitation and need assistance," says Gao Yaojie. The retired doctor in north China's Henan Province has been promoting AIDS awareness through education out of her pocket since 1996.

"Without due care, some of them develop twisted personalities and hold grudges against everyone. If they are not placed in safe hands and given a normal education, they might end up as a threat to society," warns the gynecologist, who won the Jonathan Mann Award for Global Health and Human Rights in 2001 for her involvement in AIDS work in China.

In Henan Province, where the selling of blood was rampant from the late 1980s to the mid-1990s as an income-generating business for cash-strapped farmers, there are a considerable number of AIDS orphans.

Professor Gui Xi'en from central China's Wuhan University conducted a survey in late 1999 of 155 villagers who sold blood collected at unsanitary blood stations. According to the results, 96 of them were HIV-positive, with an infection rate of 60 per cent.

Surveys on HIV/AIDS conducted in 2002 by the Beijing Aizhixing Institute of Health Education, a non-governmental organization (NGO), indicate that in Wenlou and Houyang villages of Shangcai County, Henan's epicentre for the spread of HIV, there are already 20 to 30 orphans each, while more than 100 children have lost one parent to the deadly disease.

The Aizhixing survey of 225 families in two counties having members infected with HIV or who engaged in blood selling found that each family had on average two children, most of them under 16. More than 26 per cent of the children polled had dropped out of school, and 3.1 per cent were found to be HIV-positive.

An official from the Ministry of Health estimates that AIDS orphans in China now number at least 100,000. The National Centre for AIDS Prevention and Control predicts that by 2010, the figure could reach between 138,000 and 260,000. And Henan is not the only province affected by the illegal blood trade.

Despite increasing the budget for AIDS research and the ongoing prevention campaign initiated by the central government in recent years, children orphaned by parents who died of AIDS have been largely neglected in existing policies and laws.

Reaching Out to Help

In 2001, Henan Province issued a series of relief policies for AIDS patients, including tuition exemption for their children for the nine years of compulsory education mandated by the government. The provincial civil affairs department also offered social security to orphans.

However, according to the Aizhixing survey, only 1.8 per cent of the children polled received subsidies from the government, which might actually be NGO funding distributed through the government. And some children simply refuse to apply for free tuition for fear of the discrimination they may incur.

But action is being taken to help AIDS orphans. In Yunnan, the Red Cross Society, the United Nations Children's Fund (UNICEF) and Save the Children, Britain's largest international charity, have been co-operating with local women's federations and other government departments to provide financial aid for orphans so that they may continue their compulsory education or negotiate tuition exemption with local schools.

Small as the sum may be, it's greatly appreciated by the victims' families. "Now I may die in peace," says Bai Lili's grandmother after receiving a monthly allowance from the local government along with some pocket money for the girl.

Dr Gao Yaojie in Henan has helped countless children return to school or find foster families in neighbouring Shandong Province in a bid to lift them out of their distressing surroundings.

"What we are doing is setting up a foster care centre where orphans will feel more at home and receive an education, while providing them with regular psychological counselling and medical care," says Li Dan, the 25-year-old head of the Dongzhen Project for assistance to needy AIDS orphans.

He calls for enforced campaigns to fight discrimination against AIDS sufferers and their children. In addition, he suggests that government policies be revised so that NGOs may be allowed to establish orphanages to shoulder the burden along with the government.

"Government-run orphanages are overloaded. If we (NGOs) are not entitled to open orphanages, we won't have a legal identity to receive funding for orphans. Then our work to help orphans will be squeezed into an obscure 'grey zone'."

(China Daily September 26, 2003)