How the Yi made me reconsider HIV

You are standing by a raging river rushing towards a waterfall You see a little boat out of control being rapidly swept towards certain death With horror you realise that your childhood friend is alone on the boat He is crying out for help What would you dordquoA hand went up ldquoIrsquod jump inrdquo said the petite girl with large shining earrings and rosered cheeksldquoBut yoursquod never reach himrdquo I said ldquoThe torrent would kill you firstrdquoAnother hand ldquoBut hersquos my friend I cannot watch him dierdquoldquoEven if you dierdquoAnother hand ldquoWe cannot just stand there We must jump into the riverrdquoFinally each of the 40 Yi people in the room had delivered identical answersmdashjump into the river and die trying to save a doomed friendI had a problem I was supposed to teach the Yi how to protect themselves from acquiring HIV infection from others It was clear that they would rather drown with a drowning Yi than save themselvesI was in Xichang the main township of Chinarsquos Liagshan Yi autonomous prefecture in the Sichuan province up at 5000 feet in the Zhuhe region My brief from the Nike Foundation who were funding this project had been patronising and blunt if a little crass ldquoGet them under a showerrdquo The Yi I was supposed to infer were not strong on hygieneBut the Yi had two additional problems Chronic unemployment among young Yi women had been driving them in search of work as far north as Beijing where many would drift into sex work Theyrsquod return home with some money some HIV and a heroin addictionThe second problem was that injectable heroin was easily available in the Zhuhe region which has been growing opium for a century Where another family might have served tea and biscuits the Yi would be expected to bring out syringes and some fine white powder Everyone would share the needle which would not have been washed or sterilised because you know the above mentioned poor hygieneTopping all this was a tolerant and permissive attitude towards sex creating a lethal cocktail of behaviours HIV spread easily through unprotected sex and unwashed needles Unemployment and desperation drove the epidemicThe first case of HIV was detected in 1995 When I got there in 2007 people were living with HIV in seven districts and 25 townships about half the total in the prefectureThe western worldrsquos prescription for the Yi I was told was better hygiene clean syringes and condoms just like everywhere elseBy the end of day one I knew that I found the Yi adorable They smiled all the time hugged each other a lot laughed easily and were affectionate As for their supposed lack of hygiene that was because they simply didnrsquot receive much water supply from the municipalityThe Yi had a strong culture of being there for each other If a Yi fell ill no matter how lethal the illness fellow Yi would come together to careThe thought that they themselves could get infected would never cross their mind The Yi have a strong system of traditional medicine passed on through generations Living near bat caves that harbour the SARS virus they are known to have been repeatedly exposed to the coronavirus and over generations acquired some immunity to it Would HIV do them inFor the first time in 15 years of HIVrelated communication I was forced to consider how profoundly selfcentred our HIV messages have beenmdashwatch out for yourself because you never know who is infected Itrsquos each one for themselvesWhat if we returned in five years to find that our cynical messages of suspicion had destroyed a once trusting and loving Yi communityThat evening I told the donors that we would effectively destroy a charming community by sowing the seeds of mistrust stigma and discrimination among them with our selfcentred selfserving HIV messagesmdashprotect yourself with a condom every time you have sex and never inject drugs using shared needlesBut these prescriptions come from a western social order that celebrates the power of the individual a central tenet of any capitalistic society You take care of yourself because no one else will What would such a selfpreserving message do to a society built on caring community and collaborationmdasha combination common in many socialist and nonwestern societiesFor two days I found it impossible to resume the workshop while the donors grew progressively irritatedOn third day I sat with the Yi and told them that the best way to avoid unintentionally condemning a fellow Yi to certain death from HIV and AIDS was to sterilise needles before and never ever have sex without condomsThey understood instantlyHere viewed from there C Y Gopinath in Bangkok throws unique light and shadows on Mumbai the city that raised him You can reach him at cygopigmailcomSend your feedback to mailbagmiddaycomThe views expressed in this column are the individualrsquos and donrsquot represent those of the paper