http://www.washingtonpost.com/wp-dyn/articles/A41140-2002Aug3.html
Poisoned Back
Into Poverty
As China Embraces Capitalism, Hazards to Workers Rise
By Philip P. Pan
Washington Post Foreign Service
Sunday, August 4, 2002; Page A01
DONGGUAN, China --
Wang Xiao had been working in the sneaker
factory for only a few months when she noticed a strange tingling
in her feet. Over time, the sensation spread to her ankles,
then her shins. Her fingertips went numb next, and her appetite
disappeared. Soon, the mother of two was so weak she could
barely climb the stairs to her factory dorm room.
At first, Wang, 33,
thought it was just exhaustion from work,
or maybe a stomach flu. After all, she recalled, she had been
putting in 17 hours a day, gluing together sneakers that would
be shipped from this industrial city in southern China to shops
across Europe and the United States. Morning after morning, she
joined 2,000 other workers on the assembly lines at the
Taiwanese-owned Anjia Footwear Factory, determined not to
quit until she saved enough to build a new house back in her
home village.
She never suspected
that toxins in the glue were slowly
destroying her nervous system.
So the numbness continued
to spread. It moved past her
wrists and up her forearms. It crept along her legs and
seized her knees. Just standing became a challenge.
Finally, too sick to work, Wang quit and went home.
Weeks later, she woke up paralyzed, unable even to
wiggle a finger.
Now, despite a year-long
search for treatment, Wang
remains confined to a hospital bed, barely able to
walk. Her misfortune has been compounded by medical
bills that have wiped out years of savings and knocked
her family, once on the verge of escaping poverty, back
into debt and destitution.
Caught in China's wrenching
transition from socialism to
capitalism, huge numbers of industrial workers such as
Wang are falling ill or suffering injuries on the job,
then fending for themselves with little or no health insurance.
Unrestrained by labor
unions or a strong legal system,
businesses seeking to maximize profit have allowed job
hazards to proliferate. China has adopted work safety
rules, but enforcement is lax because local officials
often can be bribed, and they are worried about chasing
away factories that pay taxes important to their budgets.
Most vulnerable are
about 150 million to 200 million migrant
workers from China's impoverished countryside, many so desperate
for work they will take any job, no questions asked. Managers
often fire them if they get sick, sending them back to their
villages, where they may never realize the cause of their
illnesses and where access to medical care is least certain.
By the government's
own count, 25 million workers in China
are in regular contact with hazards such as toxic chemicals
and coal dust, and 13,000 new cases of job-related illnesses
are reported every year. Tens of thousands of other workers
are injured or killed in industrial accidents.
At the same time, market
reforms have undermined the socialist
health care system that once covered 90 percent of China's
population. In its place has emerged a jungle of a medical
system in which many workers are receiving inferior care,
at higher costs, with little or no insurance.
The wealthy have access
to better health care than before,
but increasingly the poor must take their chances with bad
doctors and bogus medicine -- and pay for it in cash.
Researchers say illness has become the leading reason
why Chinese families fall below the poverty line.
"I never imagined
this would happen when I went out to work,"
Wang said, wiping away tears. "My husband worked so hard,
and
my two kids -- one is in the first grade, the other is in
second grade -- we need money for both of them. . . . Now,
all the money is gone."
Pursuing a
Dream
The Wangs are natives
of Tiegang, a dirt-poor hamlet in the
mountains north of the central Chinese city of Wuhan and
about 400 miles west of Shanghai. There, children play
barefoot on rock-strewn paths, using discarded syringes
as water guns, while grandparents toil in fields of peanuts
and sesame, straining to bring in a harvest large enough to
feed their families and pay their taxes.
Most houses in the
village are rickety structures made of
stones and logs. But in recent years, some families have
saved enough to build brick homes. That was Wang's dream.
She and her husband pursued it by joining the millions who
have left the countryside for work in the cities.
She landed a job as
a seamstress in Wuhan. He found work
as a carpenter. Year after year, they saved. Then, in 1997,
Wang gave birth to a boy, her second child. Local officials
who enforce China's one-child policy fined the couple
nearly $1,000, draining their savings, they said.
Last March, they entrusted
the children to relatives and
left home again. Wang's husband returned to Wuhan. She
ventured farther, all the way to the Pearl River Delta,
a manufacturing area just north of Hong Kong.
She said a relative
helped her get a job at the Anjia
Footwear Factory in Dongguan, one of hundreds of plants
in the region that together produce a large share of the
sneakers sold in the United States. Factory officials said
Anjia alone churns out 5 million to 6 million pairs every
year. They declined to identify their customers, but the
North American retail chain Payless ShoeSource confirmed
it was one of them.
"I started at
7:30 a.m. and took an hour break for lunch
at noon. At 6, we had another hour for dinner, and after
that there were the night shifts," Wang recalled. "It
was
such an exhausting job. I worked until 2 or 3 in the morning.
If the next day was a holiday, like Labor Day, we would
work until 4 a.m."
Making a sneaker was
a three-step process. First, one
team of workers cut out the pieces of rubber, foam and
fabric. Another division sewed and glued the pieces together.
Finally, a third group glued the sole to the rest of the sneaker.
Wang was a member of
the second team. She and about 700 others,
almost all of them young migrant women, toiled in a vast workshop,
hunched over long rows of sewing and gluing machines. All day,
she glued together foam sneaker pieces.
"The windows were
small and there was hardly any ventilation,"
Wang said of the factory. "Before work, we were allowed to
turn
on the fans. But as soon as the machines were on, we had to
turn the fans off. . . . If we used a fan, the glue would
dry up and it wouldn't spread very well anymore.
"It smelled horrible,"
she continued. "There was an oven,
and the heat swept over us. After we brushed glue on each
pair of shoes, we sent them to the oven and got another pair
to work on. . . . They scolded us whenever we slowed down."
James Zhou, the general
manager, acknowledged ventilation
problems in the plant, but he said he ordered new equipment
installed as soon as he learned from local officials last
month that his workers were getting sick.
He also acknowledged
workers were sometimes required to work
extra hours, when power blackouts put the factory behind
schedule, but he denied they ever worked more than 52 hours
a week. He said labor and health officials inspect the factory
at least once a year, and it has always passed.
Timothy Reid, a spokesman
for Payless ShoeSource, said the
company sent inspectors to the plant and began canceling orders
as soon as the factory informed them of the problem. He said
Payless sets "strict standards" for its many suppliers
and would
resume the orders only after the factory finished carrying out
changes Payless demanded and ensured workers were safe.
Zhou said the factory
has switched to a safer glue. The
original was imported from Taiwan and had been approved
by the Chinese government. He said managers had no idea
it contained n-hexane, a hazardous solvent also found in
spray paint and cleaners.
Long-term overexposure
to n-hexane damages the peripheral
nervous system, causing numbness, muscle weakness and eventually
paralysis. Doctors first diagnosed the problem among shoemakers
in Italy in the 1950s; similar cases have been reported in many
countries, including the United States.
But n-hexane appeared
in China only in the 1990s, after the
country opened up to foreign trade and investment. Regulators
have struggled to keep up with the growing number of dangerous
foreign products now used in Chinese factories.
Market reforms have
also weakened the government's ability
to enforce safety rules. State-owned mines and factories have
cut safety and health budgets to avoid bankruptcy, according
to a senior occupational health official, who asked not to be
identified. And the government has trouble imposing order on
the new private sector, especially small enterprises that have
proliferated across the countryside.
Here in Guangdong province,
for example, a recent study
conducted by a provincial task force found that 96 percent
of businesses contained dangerous levels of hazardous chemicals
and dust in the air or were otherwise in violation of health
standards, according to an unusually candid story published
last month in the Yangcheng Evening News, an official provincial
newspaper. Sources said government censors ordered a clampdown
on coverage of the subject soon afterward.
The number of workers
getting sick in Guangdong each year is
rising at an annual rate of 70 percent, and at least 2,500 people
have died of occupational illnesses since 1989, the report said.
The Chinese government
acknowledges the problem and is trying
to solve it, saying the annual cost of work-related accidents
and diseases exceeds $1.2 billion. In May, it put into effect
a new law setting stricter safety standards.
But based on experience,
enforcing the law is likely to be
difficult. One problem is a severe shortage of trained health
inspectors. Even in Guangdong province, among the nation's
wealthiest, the ratio of health officials to workers is
1 to 10,000, compared with 1 to 300 or 500 workers in other
nations, the Yangcheng Evening News said. Only seven of
21 counties have offices assigned to preventing occupational
diseases, the newspaper said.
But the most serious
challenge may be to find a way to compel
local officials to impose safety rules on businesses that are
often run by their friends or relatives.
In many places in the
Pearl River Delta, well-connected
factory managers simply refuse to let health inspectors in,
the Yangcheng Evening News reported. Some local leaders
"tacitly consent to and support" businesses when they
block
health officials from examining workers; others help them
pay off workers and cover up problems.
High Cost of
Health Care
It was after the Dragon
Boat Festival in late May that
Wang's hands and feet went numb. By July, she was having
trouble walking and needed to stop and rest every few steps.
Finally, a friend took
her to the Dongguan Qingxi Hospital,
where a doctor examined her and told her she needed to be admitted.
"I asked how much
it would cost," Wang recalled. "The doctor
said, 'You're worried about money when you're in this condition?'
"
Wang said she had saved
only $125 after nearly five months at
the factory, and she was worried about what would happen when
she ran out of cash. So she left, quit her job and boarded a
train for home, where at least she would be near her family.
She was so weak, she said, she could not even pack.
Before market reforms,
nearly all workers had government
health insurance. Now, those employed by troubled state
industries often have only limited coverage, and those
who have been laid off can lose it completely.
Migrant workers like
Wang have the least protection.
City governments consider them outsiders and rarely
require companies to cover them. And in the countryside,
the rural communes that used to pay basic medical expenses
have been dismantled.
Wang said she tried
getting help at two state hospitals
near her village, but was quickly overwhelmed by the cost.
She said a hospital in the nearby city of Xiaogan billed
her almost $150 for a week of tests, equal to more than a
month's pay at the sneaker factory. Then, she spent a week
at Xiehe Hospital, Wuhan's largest, and was charged about
$500 more.
She said doctors at
Xiehe diagnosed a neurological disease,
possibly caused by poisoning, and gave her shots that seemed
to help. But the medicine cost $20 a day. After eight days,
she asked the doctor to recommend cheaper medicine and left
the hospital.
Medical bills have
risen largely because Beijing has been
withdrawing subsidies to hospitals, part of an effort to
pass costs and responsibilities to local authorities. But
the localities have not stepped in, and hospitals are trying
to survive by passing more costs to patients.
"We are going
through a lot of reform now. . . . Government
funding has always been small, and now it is even less,"
complained one doctor at Xiaogan Central Hospital, who asked
not to be identified. "Sometimes the government even asks
us to make money."
Another important change
occurred in the early 1980s,
when China closed down its communes and allowed peasants
to lease individual plots of land. The policy boosted rural
income, but it cut off funding for the acclaimed "barefoot
doctors" -- peasants with minimal training who mounted
public health campaigns and provided free, basic care
across the countryside.
Now, rural residents
turn to slightly better trained
"village doctors" who usually run private clinics. Patients
receive similar low-quality care, but they must pay for it.
Like the hospitals, these doctors routinely overprescribe
medicine and sometimes sell fake drugs to make more money.
Wang visited two such
clinics near her village, one opened
by a cousin who passed his doctor's exam after three years
of self-study, the other by a man she heard possessed secret
cures handed down by his ancestors.
Wang spent 2 1/2 months
at her cousin's clinic, a one-room
storefront in Xiaogan equipped only with a bed during a
recent visit. Wang Yunchu, her cousin, said he diagnosed a
type of neuromuscular disease and prescribed several drugs
to treat it.
"I gave her a
discount on the services," he said, "but not
the medicine."
Wang Xiao spent another
two months at Ren Dingli's 15-bed
clinic in nearby Dawu county. Ren said he diagnosed rheumatoid
arthritis and treated her with acupuncture and a therapy
that involved sending electricity through needles attached
to her arms, legs and shoulders.
Wang said she was not
much healthier when she left the
clinics, but she was definitely poorer. The two doctors
billed her almost $700.
"I'll never forget
it," said Wang Kunming, her husband.
"When we came back from Dawu, I only had three yuan
[37 cents] left in my pocket."
'Rescue Mission'
Launched
When they were almost
out of money, the Wangs returned to Tiegang.
Day after day, Wang
Xiao lay inside the shack-like house
she had dreamed of replacing. Barely able to move, she
relied on her husband for everything. He fed her. He scratched
her when she itched. He gave her massages, hoping to restore
feeling to her limbs.
He said he borrowed
more money and purchased more medicine.
He gave her shots, sticking the needle where a doctor had
marked a spot with a pen. He experimented with medicinal
herbs, boiling so many he ruined their cooking pots.
Altogether, the family spent nearly $2,500, equal to more
than two years' pay at the factory.
Then, after about six
months, a local official showed up
at their home and told them authorities in Guangdong were
looking for women who had been poisoned at a sneaker factory.
For the first time,
Wang realized she was not alone.
The husband of another
worker had written letters
to 20 officials, pleading for help because he believed
his wife had been poisoned at the factory, sources
said. All the letters apparently were ignored except
one that went to the party-controlled All-China Women's
Federation. A legal aid worker there contacted health
officials and mobilized a "rescue mission" to find the
workers, according to state media.
The factory immediately
accepted responsibility and
fully cooperated, state media said. Zhou ordered physical
exams for all workers exposed to the glue and sent eight
with possible poisoning symptoms to the hospital.
He said managers also
compiled a list of all former workers
who may have been exposed in the past decade. To date,
the women's federation has located 34 former workers with
symptoms and brought them to Guangdong for treatment, he said.
Zhou has promised the
factory will pay their medical expenses.
But he said some customers, afraid of bad publicity, have
canceled sneaker orders. He said the factory might shut down
if others follow suit.
Thirteen workers remain
in the hospital, including Wang Xiao.
Doctors say they hope she will recover fully, perhaps in a
few months or a few years. But in some cases, the effects
of the poisoning are permanent.
© 2002 The Washington
Post Company
