How the Yi made me reconsider HIV

A Yi man performing in the local market in Yunnan Nationalities Village, Kunming, Yunnan, China. I found the Yi people adorable, they smiled a lot, hugged each other a lot, laughed easily and were affectionate and kind. Pic/istock

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 do?"

A hand went up. "I'd jump in," said the petite girl with large shining earrings and rose-red cheeks.

"But you'd never reach him," I said. "The torrent would kill you first."

Another hand. "But he's my friend. I cannot watch him die."

"Even if you die?"

Another hand. "We cannot just stand there. We must jump into the river."

Finally each of the 40 Yi people in the room had delivered identical answers - jump into the river and die trying to save a doomed friend.

I 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 themselves.

I was in Xichang, the main township of China's Liagshan Yi autonomous prefecture in the Sichuan province, up at 5,000 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: "Get them under a shower!" The Yi, I was supposed to infer, were not strong on hygiene.

But 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. They'd return home with some money, some HIV and a heroin addiction.

The 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 hygiene.

Topping 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 epidemic.

The 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 prefecture.

The western world's prescription for the Yi, I was told, was better hygiene, clean syringes and condoms, just like everywhere else.

By 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 didn't receive much water supply from the municipality.

The 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 care.

The 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 in?

For the first time in 15 years of HIV-related communication, I was forced to consider how profoundly self-centred our HIV messages have been - watch out for yourself because you never know who is infected. It's each one for themselves.

What if we returned in five years to find that our cynical messages of suspicion had destroyed a once trusting and loving Yi community?

That 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 self-centred, self-serving HIV messages - protect yourself with a condom every time you have sex; and never inject drugs using shared needles.

But 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 self-preserving message do to a society built on caring, community and collaboration - a combination common in many socialist and non-western societies?

For two days, I found it impossible to resume the workshop, while the donors grew progressively irritated.

On 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 condoms.

They understood instantly.

Here, 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 cygopi@gmail.com

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The views expressed in this column are the individual's and don't represent those of the paper.