Clinic on frontier of AIDS care

A member of the medical staff calculates the amount of methadone the clinic has dispensed.[Photo by Jiang Dong / China Daily]

Advanced equipment

Huang Fangyan, the doctor at the Better Clinic, said HIV knows no borders, particularly given the low levels of awareness among local people.

Ruili boasts advanced medical equipment and has the capacity to treat large numbers of patients, factors that have resulted in many Myanmar nationals who live close to the border choosing to travel to the city for medical treatment, Huang said. More than 40,000 people from Myanmar enter and leave the city via the checkpoint every day, official statistics show.

According to Li, since 2009, the two countries have collaborated to curb contagious diseases such as HIV/AIDS, dengue fever, and plague (which still exists in small pockets around the world, but in a far less virulent form than the one that devastated Europe in medieval times), Li said. The increased level of cooperation has seen vulnerable groups including long-haul truck drivers, IDUs and prostitutes covered by anti-HIV/AIDS programs that include regular screening, prevention, lectures, and referrals for treatment. "Information is regularly shared between the two sides", according to Li, who added, "Preventive measures need to be undertaken, too."

Guan Yong, an AIDS patient and drug user, has been on medication for more than 12 months at the Better Clinic. The 36-year-old lives in Muse, about 500 meters from the clinic, and was diagnosed two years ago in Myanmar but had difficulty accessing treatment.

Every morning, Guan visits a methadone outlet on the ground floor of the Better Clinic to pick up the pink liquid that helps keep him away from heroin and syringes.

About 35 Myanmar nationals collect methadone from the outlet, paying the same price as Chinese, 3 yuan per day, because the treatment is subsidized by the Chinese government.

After his daily "treat", Guan heads to a studio next door. It's called the 19th Layer Club, and is run by the clinic. Ren Guoliang, who came up with the club's name, said he was inspired by Chinese legend in which Hell has 18 layers, and the deeper one goes, the more suffering there is: "The suffering of drug users is even greater than in the deepest hell, so I named the place after that."

The visitors are mainly vagabonds and drug users, according to Guan, who is fluent in Myanmarese and Chinese and works as a volunteer helping with outreach work and patient referral for Myanmar people in Ruili.

"For a variety of reasons, some of them, especially the drug users and HIV sufferers, can't go home, but they need help," he said, adding that some stay in China for better-paid work, while others are dodging the military draft.

Patients usually visit the club after getting their methadone. "They come for a chat and to rest," Guan said, adding that patients can watch TV, take a shower, or take their pick of footwear and clothing donated by local people. Although the donated items are secondhand, they're clean and serviceable.

Several blocks away at the border checkpoint, a 20-something long-haul truck driver from Myanmar appeared shocked that the result of his HIV test was positive - his face was as white as a sheet of paper.

"Can we talk later? My mom is outside and I don't want her to know," he told A Fang, the interpreter at the Better Clinic, who provides information and counseling for those who test positive at the checkpoint's clinic, run by the local Entry-Exit Inspection and Quarantine Authority.

All long-haul truck drivers entering China from Myanmar are required to undergo HIV screening under the partnership between the two countries. "Follow-up services, including treatment referral, are provided for those diagnosed with HIV," Fang said.

Deemed one of the most vulnerable groups for HIV/AIDS, the drivers "contract the virus mainly through paying for sex", she said. About 30 Myanmar-based drivers are diagnosed with HIV every month at the checkpoint. The figure, accounting for 3 percent of all truck drivers passing through the checkpoint from Myanmar, is high by international standards.

To encourage greater awareness, the drivers are provided with lectures on safe sex, HIV/AIDS preventive measures and treatment, according to Fang.