Your browser does not support the audio element.

“Following categorical denial and the outbreak of the epidemic, the government is compelled to confess; large-scale forced evacuations; panic and stigmatization spreading faster than the disease itself; lack of a cohesive plan for citizens’ livelihood, medical staff pushed to the front line without any backup policies; mass fear and public anger.”

These are the words used by Shao-Hua Liu (劉紹華), Research Fellow and resident anthropologist at the Academia Sinica, to describe China’s past response to HIV and leprosy outbreaks. If one tries to write about the 2019 novel coronavirus (2019-nCoV) outbreak, one won’t have to change a word.

Liu has studied the prevention of infectious diseases in post-1949 China. She authored books such as “Passage to Manhood: Youth Migration, Heroin, and AIDS in Southwest China” (我的涼山兄弟：毒品、愛滋與流動青年) and “Leprosy Doctors in China’s Post-Imperial Experimentation: Metaphors of a Disease and Its Control” (麻風醫生與巨變中國). The former was banned after publication in China; the latter was never allowed to publish. Her prediction about the Wuhan coronavirus is pessimistic.

“The epidemic in Wuhan will eventually be quelled with panicky, violent, but largely effective preventative measures. After it has died down, the authorities will go back to their daily routine of issuing denials, forgetting history, and outright banning faithful portrayals of history…

The only thing that may be left is the stigmatization of the “others” living in the stricken areas. As with Henan and HIV/AIDS, or with Liangshan and narcotics, Wuhan will be the synonym of the coronavirus. As for how the people there got in and out of hell — no one cares.

People living outside of “ground zero” certainly can’t be expected to care. As for the “others” carrying the stigma, their attention may be more focused on diversion and denial—anything to avoid the labeling. Few are willing to take on the root cause of the stigma, or to take a critical look at the apathy and inaptitude of those in power.”

Liu believed that so long as China refuses to disclose information and face the full judgment of history, China, the world, and neighboring Taiwan will just have to get used to an unending stream of new epidemics and crises coming from China. Read the full interview below.

Q: As an anthropologist who has studied the prevention of infectious diseases in post-1949 China, why does the current development of the novel coronavirus infuriate you?

A: The truth is, during my long years of research, I have always been angry. I am angry because I can see too clearly that nothing will change. Due to political problems stemming from a sense of patriotism, China will not engage in self-criticism, nor will it let others criticize China.

The result of this negligence is a euphoria of wealth and prosperity in the best of times. But in the worst of times, catastrophes ensue. Veteran researchers like me can predict what will happen next. But we are powerless to do anything about it.

Q: As a scholar of infectious diseases, why do you feel so strongly about history?

A: Back when I was researching leprosy, the sense of helplessness I felt about history was at its height. Because the real history I witnessed and recorded firsthand will never be seen. Around the time I published my book about leprosy, an official account by the Chinese government was also published. Their recounting of history was entirely different from mine.

Leprosy, as a major infectious disease, continues to survive in China long after 1949. The leprosy crisis represents the systemic problem China has with disease prevention in general.

Q: Are there similarities in the Chinese government’s responses to the novel coronavirus outbreak and leprosy?

A: There are too many. Let me name just two of them.

First, the medical staff. Medical personnel were being pushed to the front line simply because they were already there. While huge numbers of patients were flooding into local hospitals, authorities provided them with no resources and no directions. How could they expect these local doctors to deal with this kind of outbreak?

We have seen despairing patients ripping surgical masks and protective gears from their doctors and question, “how come you get to protect yourself? I want you to feel how I feel.” Similar attacks also happened to leprosy doctors.

The question we should be asking is, who pushed these doctors to the front line to fend for themselves? They face hordes of patients alone, with no access to medicines, resources, or hope. Prevention cannot be an individual effort. It takes the coordination of the entire nation and society.

Taiwan has its share of mistakes. During the SARS outbreak in 2003, the city government locked down the Taipei Municipal Hoping Hospital. This resulted in unwilling doctors climbing out of windows trying to escape. This sort of thing still happens in China, it just doesn’t make the news. During the leprosy outbreak, the Chinese government also quarantined patients and forced doctors to go in there and take it. Could the doctors escape? They would have been beaten to death by the mob if they tried. My heart goes out to these medical staff in China.

The Quarantine Mindset: So Long as No One on the Outside Dies…

The second problem is quarantine. In the face of infectious diseases, many Chinese officials have a go-to solution: quarantine. They imagine that the problem will solve itself once everyone in the quarantine zone has died. In the case of leprosy, even for some patients when quarantine was unnecessary, they were still quarantined. The same happened with HIV patients. The authorities in Henan thought, HIV would stop spreading as soon as all the patients were dead. I saw the same in Liangshan. The local bureaucrats felt the situation was under control so long as no one on the outside died.

Why does China still resort to this primitive response in the face of an epidemic despite being vastly richer and technologically more advanced? Because they don’t learn from history on how to correctly deal with disease outbreaks, they are always at a loss.

The purpose of quarantine is not to isolate the afflicted and let them fend for themselves. If the Chinese quarantine was for the benefit of the patients, why aren’t there officials coordinating the effort? Where are the supplies? I think for a long time, the mentality of the Chinese government is not to care for their sick citizens, but to protect the healthy half.

What’s worse, I don’t think this mindset is limited to the powers that be. A society that doesn’t know the history of disease prevention, that doesn’t look back on the stigma and harm caused by pandemics—how could people in such a society come to the realization that they are part of the problem?

When people in such a society look at themselves, unless they were one of the afflicted, how could they think they did anything wrong? As long as the society continues to be ignorant of history, it will never learn any lessons from it.

Nationalism and Face-Saving

The reluctance of the Chinese authorities to confront the problem stems from a sense of nationalism and the notion of “saving face”. In political parlance, it is the question of Chinese “subjectivity” in the face of “imperial” or “foreign” encroachment.

Whether the Chinese succeed or fail at combating the disease; whether they censor the bad news or selectively glorify the accomplishments—all is driven by China’s anti-imperialist and anti-American sentiment. Individuals play along voluntarily or involuntarily to help the country save face. They bury scandals, push back at outside criticism, reject opinions on account of the speaker, and sacrifice their individualism to protect the collective image.

Q: Your research is about leprosy. How did you arrive at a conclusion that involves Chinese nationalism and patriotism?

A: Nationalism is an essential part of China study. Many political scholars are convinced that the common thread running through any research involving China is the legitimacy of the regime. However, the current regime would not have survived had it not fed on the undercurrent of wounded dignity and Chinese nationalism.

Q: Is Chinese patriotism simply the product of individual thought and public opinion control by the government?

A: It is more complicated than a question of politics. The Chinese notion of saving face is rooted in familialism and regionalism. This enduring belief has become part of Chinese culture, and now it serves as an important tool in politics and governance.

Deep in their mind, the Chinese still think of all foreigners as imperialists. Applying “foreign thinking” to a problem equals taking the side of the imperialists. That makes them angry.

The Chinese notion of face-saving is compounded by their history of strife, poverty, and humiliation at the hands of foreign powers. These forces gave birth to Chinese Communist Party, and it is now using them to manufacture a sense of foreign encroachment to facilitate their own internal socialist experiments.

Q: Speaking of patriotism: while the city of Wuhan was placed on lockdown, the people of Wuhan opened their windows and sang the Chinese national anthem, “March of the Volunteers”. The government’s official channel discouraged them from doing so. This seems incredible to an outside observer.

A: I feel nothing but pain when I see this. For people unfamiliar with the historical context of China, this may seem absurd. However, absurdity is too simplistic a word to describe what’s happening.

In Taiwan and other places with freedom of religion, one could speak to gods when one feels helpless. A deity is a common symbol for people to coalesce behind. But the Chinese don’t have even this. When religion is non-existant, the only thing left to turn to is a nationalistic spiritual placebo such as what motivated the Boxers toward the end of the Qing dynasty.

There Will Always be Contagious Diseases from China; the Key is to Learn from History

However, China is a large country full of people. There will always be infectious diseases. The key is to learn from each epidemic. Otherwise, not only will China suffer, its neighbors will also suffer.

This is what pains me the most. Epidemics will continue to break out in China, simply a different disease in a different place every time. The official response, the people’s reaction, the pain and plight of the patients, the stigmatization of the ground zero, all of that will be the same.

Pestilence in Europe reached a fever pitch during the era of rapid urbanization, therefore it is unrealistic to expect China to become free of epidemics. The task ahead is to improve preventative measures, and to learn from history. China needs the whole world’s help to build its prevention system.

Q: Is change possible? Is the Chinese willing to “lose face”?

A: If the Chinese government allows the disclosure of information, and if it is willing to study its own history with a critical eye, then the whole society may change. But I cannot say when it will come to this realization. All I know is history repeats itself. There is no society that can avoid repeating past mistakes without full transparency and an honest review of its history. That is the one unchangeable rule in history.

Have you read?

♦ Desperation in Wuhan

♦ University of Hong Kong: Coronavirus Epidemic to Spread Until May

♦ Behind WHO’s Controversy: Epidemic Politics and the Black Hole Effect

Translated by Jack C.