Rural doctors cut HIV/AIDS infection in China(2)

DOOR-TO-DOOR, HEART-TO-HEART

Li Chunhua, 38, openly admits she is a sex worker. A native of the central China province of Hunan and mother of a school age boy, she thinks the job is less demanding but better paid than most other jobs available to migrants like her.

One of some 200 sex workers in Guangxi's Lingshan county, Li works with 10 other women, aged from 18 to 60, at an out-of-the-way video room where porn movies flicker all night long.

She serves at least five customers a day and earns 20 yuan each time. "In the busiest days, I can make more than 200 yuan a night," said Li.

Her workday starts at 5 p.m., when she gets up, powders her face and puts on skin-tight pants and fake jewels.

Most of her customers are local farmers, largely men that remain unmarried after 40.

Li's husband and parents know vaguely what she does. "Several young women from my home village have followed me into the job."

Li and her co-workers know the risks. They opened up to Li Weichang, a doctor with the county's disease prevention and control center, and now a regular visitor to their video room.

Wei, in his late 30s, is now able to speak openly with the women, who were hostile to him in the beginning. "They felt I was a government spy and refused to talk to me."

Initially, he carefully avoided the topic of AIDS, and talked about family life, parents and children. As the barriers came down, he began distributing condoms and AIDS-prevention brochures, and reminded the women to stay healthy.

Within a year, he befriended more than 100 sex workers in the county.

Thanks to rural doctors who are preventing HIV/AIDS infection from the very root, Guangxi's total number of newly reported HIV-infected cases and confirmed AIDS patients dropped by 18.6 percent year-on-year in the first ten months of the year.

AIDS-triggered deaths were cut by 7 percent, according to the regional health administration.

POVERTY

Poverty remains a major challenge in HIV/AIDS prevention in China's underdeveloped regions. It has forced women into prostitution and men to sell blood to illegal dealers, in both cases infection risks are high.

As the only doctor for more than 2,000 villagers, Qin Jiang is overburdened with general practice and AIDS prevention. He never has time for farming, which should be the bulk of his family income.

"I get 300 yuan a month in subsidy for AIDS prevention and about 1,000 yuan from general practice," he said. "I can make as much money by harvesting sugar cane for just a week."

To increase his family income, Qin moonlights by keeping watch at a local factory, a night job that pays another 1,000 yuan a month.

Hard work and low pay make a rural doctor's job unappealing for new graduates.

"Most village doctors are aged over 40 and we haven't recruited any new graduates for more than 10 years," said Zhang Yi, deputy chief of Longzhou county's disease prevention and control center.

To strengthen AIDS prevention at grassroots levels, he said more government spending is essential to improve village hospital facilities, increase doctors' income and provide better training.