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CHINA’S
CENTENNIAL
CHALLENGES


THIS summer was dreadful in China. Hundreds of lives were lost and millions of people driven from their homes as torrential rain brought monstrous flash floods and landslides. The last thing the country needed was an earthquake or a series of typhoons. But what China needs is not what it gets in the natural — or unnatural — order of things. Soon the world’s most populous country was being very seriously shaken while still struggling with the flood season.

On 10 August in southern Yunnan province, an earthquake registering 5.6 on the Richter scale left four people dead, nearly 600 injured and 126,000 without a home. Another 50,000 were afraid of floods because 22 reservoir dams had been cracked and were now visibly leaking.

The Chinese Red Cross was stretched. The day before the earthquake, it had launched a nationwide appeal to extend flood relief operations already under way in 14 provinces. Yunnan had been one of the worst affected but now the Red Cross was obliged to divert assistance to cover the earthquake as well. It was the third to hit the same county in less than 12 months. As tents and medical supplies, and relief goods from fast-diminishing disaster preparedness stocks, reached the county, provincial operations chief Fan Lin commented, “You wonder what next this summer will bring.”

He did not wonder long. Heading out of the Pacific and across the East China Sea came typhoon Rananim, the worst in half a century. Yunnan escaped. Rananim was content with ravaging the coastal provinces but by the end of the week, the authorities in Zhejiang were reporting 164 people dead, 42,000 homes destroyed and almost 13 million people affected. Before August could end two more typhoons would follow, and elsewhere in China there was drought.

Year of the Disaster

Coming in its centenary year, the horrendous summer has only underlined that never in the history of the Chinese Red Cross have the humanitarian challenges been greater.

Disasters loomed large on the agenda last month as the Chinese Red Cross assessed the road ahead at its five-yearly National Convention. From a centennial vantage point, however, there are other serious challenges. Among them is the scaling up of response to the HIV/AIDS epidemic spreading rapidly through the country, a push for 100 per cent voluntary and non-remunerated blood donation, the need for half a million blood stem cell donors and the reduction of urban risks.

There is, too, an organizational challenge: galvanizing a National Society of 20 million members and 400,000 volunteers in an immense land following a gradual separation from the Ministry of Health, under whose umbrella it operated for half a century.

On World Red Cross Red Crescent Day, Madame Peng Peiyun, the society’s president, told an international gathering in Beijing’s Great Hall of the People that after a hard, century-long journey through the twists and turns of history, the Chinese Red Cross had arrived at a fresh starting point. Unprecedented new opportunity was accompanied by new requirements, she said. “We must work with ever-greater enthusiasm to push forward and contribute to the making of a well-to-do society.”

Born on a battlefield

The Chinese Red Cross, like the global Red Cross and Red Crescent Movement itself, was born out of conflict. War between Japan and Russia broke out in north-eastern China in 1904 as these powers pursued imperialist ambition, bringing enormous suffering to the Chinese population. Mirroring Red Cross founder Henry Dunant on a northern Italian battlefield half a century earlier, a man called Shen Dunhe founded the Shanghai branch of the International Red Cross to help the wounded and refugees.

A couple of name changes later, in 1911, it became the Red Cross Society of China. By then it had long been dealing with natural disaster as well as frequent conflict that would continue to plague the country.

Conflict may have faded but no one in China needs to be told that natural disasters are increasing, and have done so rapidly worldwide over the past decade. According to the country’s National Statistical Bureau and the National Meteorological Bureau, disasters in 2003 — floods, four serious earthquakes, typhoons and drought among them — impacted upon 490 million people out of a population of 1.3 billion. Seven million were displaced and 2,000 died. As elsewhere in Asia, floods are the most common disasters and between 1996 and 2003 they alone accounted for 660 million victims.

Steeling its disaster response has been a Chinese Red Cross priority. That was reflected this summer as from Jilin and Inner Mongolia in the north to Guangxi and Yunnan in the south, and from western Sichuan to eastern Shandong and Jiangsu, the Red Cross delivered food, clothing, tents and quilts, and mitigated health risks to stricken communities. But in its centenary year the National Society is pushing ahead with programmes to reduce the vulnerability of rural communities as well.

Despite its strong economic growth, China still has nearly 20 per cent of the world’s poor and 160 million predominantly rural people living below the international poverty threshold of one US dollar a day. The gap between rich and poor is growing and poverty and economic loss due to natural disaster is undermining the country’s otherwise rapid development.

Health is also suffering. Poor sanitation and unsafe and unprotected water supplies in rural areas present enormous hazards, particularly during flooding. Waterborne and sanitation-related illness accounts for more than 70 per cent of infectious disease in China and effluent from village latrines has contaminated surface and ground water again this year.

With support from the European Commission’s Humanitarian Aid Office (ECHO), the International Federation and the Australian and Danish Red Cross, the National Society is working to redress the balance. By providing health education, good sanitation and improved water supplies, and fostering community disaster preparedness, integrated programmes in the south-central province of Hunan and the southern Guangxi Autonomous Region are leading the way.

Alarm over AIDS

The spread of HIV/AIDS, though, is the premier health concern in China. No one knows how many people are living with the disease and official statistics are grossly wanting. The most useful figure available is an indicative one from UNAIDS which says the number of infected people could rise to 10 million by 2010 unless much greater action is taken.

China’s central government is making enormous efforts to mobilize the country, hindered in some provinces by authorities who continue to turn a blind eye, harass activists and suppress information for fear that it will reflect badly on them. The bottom line is contained in a Ministry of Health/United Nations report, which warns of the need “to seize the fast-disappearing window of opportunity in both prevention and care, to keep the economic and personal losses caused by HIV/AIDS as low as possible”.

All 31 provinces have reported HIV infection and transmission has been mainly through intravenous drug use and the sale of blood and plasma that has not only infected recipients but donors exposed to unsafe practice. Now the proportion of sexually transmitted infections is growing.

General ignorance and misunderstanding of what is popularly perceived to be a self-inflicted disease bring stigma and discrimination, and accelerate the epidemic’s spread. A report released this past summer says surveys show only 8.7 per cent of the Chinese population is well informed about HIV/AIDS.

Breaking down the ignorance requires massive investment. Present budgets are far short of requirements in both prevention and care. The Chinese Red Cross has been working on prevention, and care and support for people living with HIV/AIDS (PLWHA), since 1994. Much Red Cross focus is on peer education, particularly youth peer education. In Yunnan and the western autonomous region of Xinjiang, the Red Cross is developing peer education by and for PLWHA.

Safer blood

Already the Chinese Red Cross has scored great success in the process of securing the nation’s blood supply. Transfusion-transmitted infections such as HIV and hepatitis can be eliminated or substantially reduced through a safety strategy based on collecting unpaid blood from volunteers in low-risk sections of the population. With a government mandate to recruit and retain reliable donors, the Red Cross has long championed the cause.

The number of Chinese blood donors who are voluntary and unpaid has risen dramatically over the past few years. The National Society is campaigning to reach 100 per cent and, given its commitment, it was appropriate in its centenary year that it hosted the 9th International Colloquium on the Recruitment of Voluntary, Non-Remunerated Blood Donors. Experts from around the world gathered in Beijing to discuss how to increase and effectively manage a sustainable global supply.

There is another type of donor the Chinese Red Cross is pursuing, the blood stem cell donor. Some 4 million people in China are waiting for stem cell transplantation to overcome leukaemia and other blood disease. A Red Cross Data Bank of Chinese Hematopoietic Stem Cell Donors or the Chinese Marrow Donors Programme (CMDP), which opened in 2002, has already recruited 170,000 donors and by 2009 wants to reach between 500,000 and 700,000. A blood marrow programme had been in operation in the 1990s but due to lack of funds and technical difficulties had not flourished. Now, with state lottery funding to secure it, it operates in 27 provinces with an administration centre in Beijing.

What the programme does is to provide Human Leukocyte Antigens (HLA), proteins found on the surface of white blood cells among other places, which are immunologically compatible with those of patients in need of transplant treatment. “The chance of a match can range from one in 400 to one in 10,000 among people who are not blood relatives,” explains programme director Junling Hong. “For some rare HLA types the chance may be one in hundreds of thousands.”

That was the case this summer when a student from Chongqing University of Medical Sciences became the first stem cell donor in China to donate desperately needed cells to a blood cancer patient in a foreign country, the United States. The recipient was an American Chinese doctor.

The student, Wu Yu, became a donor last year when the Red Cross made an appeal for donors on her campus. Her possible saving of the American’s life brought enormous media attention. In its centenary year, the Red Cross was again good news in China.

John Sparrow
John Sparrow is International Federation
regional information delegate in Beijing.


A Chinese family saves what they can of their belongings from their
flooded home in Wuhan, near the Yangtze River.

©Reuters / STR / Courtesy www.alertnet.org


Volunteers sterilizing their arms before entering a Red Cross
mobile laboratory to donate their blood.

©Reuters / Andriw Wong, Courtesy www.alertnet.org


A woman walks in front of an illuminated poster calling on people to prevent
the spread of HIV/AIDS in Shanghai.

©Liu Jun / AFP Photo


At a Red Cross AIDS seminar in Kunming, hotel attendants learn how
to apply condoms using a wooden model.
©Fritz Hoffman / Network


A Chinese farmer receives food aid from the Red Cross after
his home was flooded in Chuhe, which lies between
China’s Anhui and Jiangsu province.
©AFP Photo


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