Gao Yaojie, Chinese doctor and Aids activist, 1927-2023

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The life of Gao Yaojie, a Chinese whistleblower who exposed official connivance behind an Aids epidemic, revealed the personal costs that public-spirited heroism can incur in the People’s Republic of China. The campaigner died in exile in New York this week, aged 95.

The Aids outbreak she helped bring to light from 1996 onwards grew out of the “blood economy” in dozens of villages in the impoverished province of Henan, northern China. This grizzly trade involved farmers seeking to supplement their meagre incomes by selling blood — sometimes as often as twice a day — at counters run either by local health authorities or by illegal “bloodmongers” eager to cash in on China’s surging demand for plasma.

As a cost-cutting measure, the blood collected was often pooled at a central collection point, mixing several bloods into the same centrifuge. After the plasma had been extracted, the remaining blood was then transfused back into donors so that they could recover and donate more. Once the centrifuges, syringes and needles became contaminated with HIV, the disease spread rapidly through local populations.

Local governments in Henan supported the trade, not only by licensing collection points but also through publicity efforts. Posters with slogans such as “Honour Blood Donors: Heal the Wounded and Rescue the Dying” were plastered on to the walls of hospitals in Henan, Gao said in testimony to a US Congressional commission in 2009. “Bloodmongers told blood sellers: ‘Blood is like water in the well. It remains at the same amount no matter how much you have donated. Blood donation is like substituting old blood with new blood. It is good for the metabolism,’” she added in her testimony.

Estimates on the size of Henan’s epidemic vary widely. Official data in 2004 put the number of people living with HIV in China at 840,000 but Wan Yanhai, a former health ministry official and Aids activist, estimated in 2002 that in Henan province alone some 3mn were HIV-positive.

Gao, a doctor who graduated in gynaecology from the School of Medicine at Henan University in 1953, was nearly 70 when she embarked on her mission as an Aids activist. She was motivated by the human tragedies she witnessed in Henan’s villages and by a deep mistrust of officialdom born of the hardships she herself had suffered.

During the Cultural Revolution (1966-76) she was beaten up and paraded through the streets with a “with a papier-mâché hat on my head, my shoes taken off and hung around my neck and . . . forced to walk barefoot”. This ritual humiliation was to punish her for being the daughter of a former landowner — a class then vilified by Chairman Mao Zedong as “capitalist roaders”. She attempted suicide after that ordeal by swallowing 30 tablets of chlorpromazine, an anaesthetic. “I’ll never forget that day, August 26, 1966,” she wrote in her book, The Soul of Gao Yaojie. 

“It was my children’s cries of pain that woke me up. I first vaguely heard the cries, struggled to open my eyes, and saw my three children gathered around the bed, each in tears, this one calling ‘mom’, that one calling ‘mom’,” she wrote in the Chinese version of her book, which is translated by David Cowhig, an independent scholar.

Such lacerating experiences inspired a vow to live and help others. She delivered food, clothes and medicine to patients in the “Aids villages” and personally financed the printing of some 670,000 public information leaflets which she then helped to distribute. However, her outspoken criticism of local government officials in Henan for promoting the “blood economy” and covering up the scale of the epidemic made her increasingly unpopular with Beijing. In Henan, she was regularly chased out of villages by authorities denying the existence of any problem.

In 2001, the government refused to issue her a passport to go to the US to accept an award from a UN group. In 2007, 50 policemen surrounded her house in Henan for about 20 days to prevent her travelling to Beijing to get a visa to receive another award from then US senator Hillary Clinton. They later relented and Gao made the trip. In 2019, Clinton called Gao “simply one of the bravest people I know”.

Following her eventual exile to the US in 2009, Gao lived in New York. She never returned to China, growing somewhat estranged from her three children. But in an “end of life statement” she made in 2016, she said she wanted to be cremated and her ashes “scattered in the Yellow River as soon as possible after my death, with no ceremony of any kind”. The Yellow River runs, for several miles, through Henan.