商洛地区艾滋病调查报告 2001.03.15南方周末 □赵世龙　商光武 　　瞿诗权一家五口中，已经有两个被检出“怪病” 赵世龙　摄 　　从２０００年年初开始，来自陕西省商洛地区商洛山的多名农民患上一种“ 怪病”， 地方医院无法确诊。其中４名患者被第四军医大学确诊为艾滋病。当年６月，患者之一赵 日爱（女，２５岁。商南县湘河乡红鱼口村人）在医院中死亡。 　　这是一个危险的信号。据专家对艾滋病的研究表明，当一个地区出现艾滋病人死亡时， 艾滋病在该地区的流行率已经非常高了。此事已经引起了陕西省卫生、防疫部门的高度重 视与警觉。 　　记者近日前往该地区，对商洛山的艾滋病现象进行调查。 　　“我当然没病！” 　　３月１日，商洛地区山阳县高坝店镇黄土凸村，村民张新来在家门口有气没力地劈柴。 在他体内ＨＩＶ病毒正在肆虐着。 　　张是去年６月份后出现的病症：四肢无力、感冒、咳嗽、头疼，老治不好，要反复打 针吃药才行。他自得上这病后体重已减少了１５斤。 　　５年前的那次卖血害了他。１９９５年，山阳县血头姜华朝、赵鹏学以“招工”的名 义把村民骗到山西省稷山县。张也兴冲冲地去了。 　　在那里村民５天要抽３次血，每次抽８００ｃｃ的量，只给６０元钱。张新来先后卖 了２０多次，除去吃喝费用，只剩余了８００元卖血钱。　　 　　张回忆说，当时抽出来的血液被送入一个离心机里，血头把分离出来的血清吸出来， 把血浆加上５０％的盐水调和后，重新注回村民的身体，整个过程约需半个小时。可怕的 是那个吸血清的管子是重复使用的。 　　他从山西回来后，和妻子过着毫无安全措施的性生活。结果是妻子也染上了 "怪病”。 　　张新来到现在还不知道他的病有多严重。在采访中这夫妻俩一脸麻木，不大相信地看 着记者，反问：“我的病有那么严重吗？”他们根本就不知道什么是艾滋病，也不知道这病 是要死人的。 　　他老婆余桂荣也不知道丈夫得的是啥病，更不相信自己被检验出“劳什子病毒”，她加 重语气说：“我当然是‘没病！’” 　　在当地，不少村民被检验出艾滋病毒后仍然心存侥幸，认为这病“会好的” 。 　　“我的日子不多了” 　　据张新来说，在小峪沟村还有多人卖血，其中就有他的姑父刘新民。他愿意带记者去 找。 　　半路上张新来突然停下，指着一个男子说：“瞿诗权也是个卖血汉哩。” 　　顺他所指，记者看到一个身高１·８０米的汉子，瘦得不成人形，面色蜡黄，破烂的 裤子拖到了地上。 　　瞿是１９９５年的１０月份被熟人骗去山西稷山卖血的。他夫妻是村里第二批去的， 共有３０多人。他们在那里两天被采一次血，以４００ｃｃ为一单位，检验合格的血给１ ００元，不合格的也要，给６０元。他在那里呆了两个月，连卖了２５次。 　　１９９６年４月的一天，他在种包谷时突然昏倒，被乡亲送到镇医院。经过检验后， 他现在已经知道自己得了艾滋病。越来越严重的症状已经由不得他不信了。 　　他说自己每天都在做恶梦，走路都打晃。而村里人说，在没卖血以前，瞿诗权是一个 很健壮的小伙，能挑几百斤粮食哩。 　　记者见到张新来的姑夫刘新民时，他正靠在墙边晒太阳，脸色铁青，不停流着鼻涕， 咳嗽。 　　１９９５年１０月，他被侄儿劝到山西卖血，在那呆了４０多天，总共赚得１０００ 元钱。 　　回来他就为这１０００元钱付出代价了：１９９７年４月胃病；１９９８年７月左肋 奇痛；１９９９年开始肚子剧痛，每天发作；２０００年６月，眼睛火烧火燎地痛，视力 急剧下降，现在几十米外就视物不清。 　　他指着家对面一所小学的旗杆，对记者说：“以前那旗杆我一口气就能爬上去，卖血回 来后我再也没力气爬了。” 　　他的手脚指甲都出现了病变，指甲表面变厚，像鼓起的包，一抠指甲就像粉一样往下 掉，指甲缝里还长起了水泡，手背上长起了癣一样的东西，特别痒。现在后半夜咳出来的 痰中带血，足有一大碗。 　　“我的日子不多了。”他摇摇头叹气。 　　赵志军一家三口 　　３月２日，记者前往山阳县银花乡梅子沟村，３２岁的村民赵志军已于２０多天前因 艾滋病死亡。 　　“他死的时候毛发基本脱落光了，人瘦得只有这么一小把了”，村支书用手作了个比划。 　　赵的丧事没几个人参加。由于不了解艾滋病，村里人不敢在赵家坐。走到他家门口都 要绕个弯。 　　和赵志军一起去卖血的村民殷狗娃身高回忆说，当年他们被血头骗去后就没了自由， 好多人被关在一个大院子里，有黑道上的打手把守，五天中要抽血三次，一次抽两袋（最 少４００ＣＣ），只给６０元钱。幸亏因为血头嫌他的血质不好，放松了控制，他才得以翻 墙逃回了村。 　　赵志军不得不去山西卖血，因为当时赵的妻子石春芳正怀着孕，他想卖血赚点钱养孩 子。 　　失去丈夫的石春芳单身去了西安打工，乡亲们谁也说不清她在西安哪里。一个ＨＩＶ 携带者就这样消失在茫茫人海中。谁也不知道她会不会瞒着自己的病况和别人结婚。 　　他们的孩子今年３岁多了，谁也不打算收养他。甚至连外婆家也不想收留他，“艾滋病” 在这个村子里是一个吓死人的字眼。 　　赵志军的族人一直说要去山西砍死那些“狗日”的血头。 　　“重型丙肝”大普查 　　从２０００年１０月开始，有关部门在商洛地区所辖７县（市）进行了摸底调查，各 地报上来的数字相加后是个惊人的：约有１２７００多人有过卖血史。 　　２００１年春节，趁外出打工者返家过年、人口相对集中之际，有关部门在这７个县 （市）秘密、全面进行了一场名为“重型丙肝”的大普查。实际上要查的是ＨＩＶ病毒（艾 滋病毒）。 　　普查的目标是：凡有过卖血史、全年注射过１２次以上的人以及他们的家属。其中包 括１２岁以下的卖血者子女。 　　２００１年元月，商洛地区得到陕西省卫生厅拨的专款，购买了用于艾滋病防治检测 的酶标仪等专用仪器。据商洛地区卫生防疫部门人士证实，此次发现的感染者（ＨＩＶ呈 阳性者）居多，艾滋病发病者相对要少一些。 　　记者获悉，已经有７０００余人被紧急抽检。仅第一天发现的ＨＩＶ检测呈阳性者就 达２６人，目前总共发现有３００余人ＨＩＶ检测呈阳性…… 　　ＨＩＶ携带者比例之高（２３比１）已经远远超乎了有关部门的的想象。 　　当地卫生防疫部门随后接到上级通知，“调整了调查检测方案”，立即停止了对余下的 ５０００多人的血检工作。 　　此后，政府部门也没有对这一数量庞大的高危人群进行监控，也没有对已查明是ＨＩ Ｖ感染者人群进行严密监控。 　　对于这一切，来自卫生部门的一位知情人说，“１２７００人”这个数字被层层“缩水” 过，实际卖过血的人肯定不止这个数，保守估计也在２００００人以上，实际上的感染者 还会更多。 　　艾滋病爆发的前兆 　　其实早在１９９７年，商洛地区就出现过艾滋病流行的征兆，但似乎并没有引起当地 有关部门的足够重视。 　　１９９７年１月１８日，商南县城关工商局接报，说在县中心市场边有一民房内正在 生产假葡萄糖。工商执法人员前往查封，却发现现场全是劣质血浆。 　　现场令人不寒而栗：脏乱不堪的房间里，大量人血就盛在敞开的大塑料盆里，腥气逼 人，几个工人正拿缸子往里兑葡萄糖，搅拌，然后往袋子里装，装好的封口准备运走。　　　 　　工商人员在现场查封了血液成品１９６袋，和两大桶已经分离出来的血浆。当地有名 的大血头陈邦福的老婆说查扣的不是血，而是油，是她老公搞的。 　　带队的工商执法人员牛凤雅在检察院工作过，马上意识到这是个大案，决定将在场所 有人暂时扣留，并当即要求县公安局协助调查此案。 　　可惜当时主管刑侦的县公安局副局长方某（后因贪污受贿被判刑除名）一直不予协助。 工商部门只有扣物权，没有抓人权。牛凤雅只能把陈邦福带到工商局询问。 　　原来陈在当地租了十几间房子大干非法抽血贩血的勾当。工商部门从中查出了七八个 大蛇皮袋子，共有５０００多个带残血的小血袋。 　　几天以后，地区行署组成工作组进驻商南。陈邦福一直不肯承认那加工的东西是人血， 说那是“油”。 　　此案工作组从查扣的那堆血袋中随意抽取了５袋，送到上面去检测，竟然在那５袋血 里都检出了艾滋病毒！血里还混有丙肝、梅毒病毒。此事在当地引起了极大震动。 　　但对此事的处理却出乎人们意料。直到１９９７年１月２６日，商南县领导直接建议 把陈邦福抓捕归案时，县公安局才想起去抓人，当晚陈却跑了。 　　后来总算在山西省洪洞县抓到了陈邦福，他也才被判了两年徒刑，目前已经出狱。　 　　最后县上有关部门为了应付上面对艾滋毒血一事的查问，推诿说“那事发生在河南， 不在本县。”（商南县毗邻河南）一次应该引起足够重视的艾滋病爆发征兆就这样被忽视掉 了。　　　　　　　　 　　血站管理的背后 　　商洛地区血站管理的弊端在事发后才浮出水面。 　　据当地卫生防疫部门两位领导透露：每当他们对商州血站、商南血站所采血样进行监 测时，就会有各级领导打招呼，叫他们以后别再去查了。 　　而商洛地区艾滋病监测中心一直处于“无米下锅”的尴尬处境。鉴于１９９７年商南 出现艾滋毒血事件，他们多次要求上级拨给经费购买检测设备与测试试剂，以加强监控， 但直到２０００年底出现多例艾滋病患者死亡事件前，此事迟迟得不到解决。 　　商南县卫生系统一个领导透露，该县西关血站是被某军医大除名的几个人打着西安某 公司名义搞起来的。他们神通广大，每当防疫部门对其血样进行监测时，总能搬来上级领 导出面说情，查不下去。 　　血站成了凌驾于本地卫生行政管理部门的“太上皇”，地方部门对之无能为力。直到去 年山阳县出现艾滋病患者后，该血站才被暂时关闭。 　　记者找到了该血站管理者雷付全，假称是从广东来的大买家，两名当地记者充当中介。 　　雷说自己是在此行搞了１４年的的老血头，认识很多本地、山西和河南的血头，因为 手头有稳定的供血者，而被西安来的王恩德、胡涛等人请来当管理。 　　他拍胸脯保证说他手里有一两千供血者，“跟县上、镇里的医院也熟得很” ，过检测 关没问题；河南那边还有几千名供血者，那边随时有人会组织送人过来采血，只是价钱方 面要高一些，采４００ｃｃ要１５０元。 　　据雷说，商南血站过不几天就又要开业了，据说是神通广大的那几个人活动的结果。 　　而据商洛地区卫生防疫部门的人证实：因为血站管理混乱，现在一些受血者（使用的 是血站提供的血液）也出现了问题。在商州大荆镇，查了９０多例受血者，竟查出３０多 个所谓“重型丙肝”患者。 　　令人不安的是，这些含有病毒的血液在防疫部门毫不知情的情况下流向哪里？还会有 多少人因输血、用药而感染ＨＩＶ病毒？这都是一个待解之谜。 http://www.nanfangdaily.com.cn/today/gb/zm/zmbb1501.htm According to a March 15 Southern Weekend report (see the URL above), there are probably one thousand cases of HIV among a group of over 7000 paid blood donors tested in the Shaanxi Province district of Shangluo. Some of these people gave blood many times in 1995. One person gave blood five times in three days, each time 800 cc. The blood was taken for plasma and the blood was returned after filtering along with a saline solution. The tubing was reused. Each time 60 RMB were paid to the blood seller. Now that person has full blown AIDS. Pains began in 1998. Some people reported being kidnapped, forced into a yard, and being beaten into submission so that they would give blood. In some cases people who passed a medical exam were paid 100 RMB (USD 12) for 400 ccs of blood. People who didn't pass the exam were paid only 60 RMB. According to the Southern Weekend report, the "departments concerned" made a study beginning last October in the seven counties and cities in the Shangluo District. By combining results from counts in various localities, they concluded that a total of 12,700 people had sold blood at some time. The authorities, under the pretext of testing for "serious cases of hepatitis B" but actually tested for HIV. The study included people who had sold blood, had had 12 or more injections in a full year, or were the 12 years or age or younger children of blood sellers. According to Shaanxi Province Shanluo District epidemiology station workers, the study revealed not very many full blown AIDS cases but many HIV infections. In the first 2000 samples tested, over 300 people were found to have HIV. The one in 26 HIV positive ratio found was much higher than expected. After that testing stopped and the remaining 5000 people were not tested. The government did no follow up or monitoring of people found to be infected with HIV. This result makes entirely unbelievable, writes Southern Weekend, the official report of 12,700 people in China with HIV. There must be more people than that with HIV among blood sellers alone. On January 18, 1997, the technical standards bureau of Shangluo found that a factory was ostensibly making sugar was actually processing low quality blood plasma under very unsanitary conditions. The standards bureau wanted to arrest the factory workers but the local police chief (later removed for corruption) would not help. Since the technical standards bureau doesn't have the authority to arrest people, it could do little on its own. Large quantities of illegal blood were stored in ten rooms. Five thousand bags were found. Several days later, a group sent by the top administrators of the district came. The top bloodhead, named Chen Bangfu, said it wasn't blood it was oil. One of the special group members took five bags of blood at random and had it tested. All five bags contained the HIV virus. Moreover they also contained hepatitis and syphilis. When two weeks later the authorities told public security to arrest Chen, he had long before fled. Later, whenever asked about the case, the officials of the district would say, "That didn't happen here. That happened in Henan Province!" The Shaanxi Province where it happened borders on Henan. Two leaders of the local epidemiological station said that whenever when to do testing for surveillance of the Shangluo and the Shangnan blood collection stations, they would be told be various leaders to leave and not come back. The epidemiological stations asked several times for support to buy testing equipment and reagents but were only funded at the end of 2000 when more people were dying of AIDS. The blood collection stations are run by people with a military background who have good connections with a certain company in Xi'an. Whenever the epidemiological station tested samples, they blood stations would get a leader involved to have the testing stopped. The blood collection stations became like an emperor lording it over the epidemiological stations and other local offices. The local blood collection station was temporarily closed at the end of last year when AIDS cases appeared in Shanyang County. Two reporters pretended to be big blood buyers from Guangdong Province. The director Lei Fujin said that he has been a bloodhead for 14 years and knows many local, Shanxi and Henan province bloodheads. Pounding on his chest, Lei claimed to have at his disposal 2000 blood sellers and to be well known by the local hospitals. Lei said that there were still several thousand blood sellers in Henan and that people could organize them to come to Shaanxi to sell blood. The price would be a bit high though --- 150 RMB (USD 20) for 400 cc of blood. Lei said that the Nanshang blood collection station would be reopened in just a few days. The Shangluo district epidemiological station checked people who had received blood from the local blood collection stations. Problems have already arisen because of poor management there. Thirty of the ninety blood recipients checked had problems. Thirty of them had the so-called "severe hepatitis B". What is frightening, concludes Southern Weekend, is that with the epidemiological agencies completely in the dark, just where is this virus ridden blood going? Just how many people are getting HIV from blood transfusions or from medicines made from HIV infected blood? That is a mystery that must be solved one day.