This article is part of the following series: From the Somatosphere archives
Stanford University Press, 2010. 248 pp., US$ 22.95 (paperback).
Reviewed by Nicholas Bartlett, University of California-San Francisco
Shao-hua Liu’s Passage to Manhood: Youth Migration, Heroin and AIDS in Southwest China chronicles the tragic consequences of the efforts of Nuosu youth to improve their lives during the turbulent economic reforms of the post-Mao period. Her project explores how this group’s twenty-year involvement with the heroin trade is deeply shaped both by the unique history of the Nuosu and broader political and economic shifts in China. The book moves between compelling depictions of social suffering caused by heroin use and AIDS and a sobering critique of the programs mobilized to alleviate these epidemics.
Liu starts by making a strong case for understanding the Nuosu entanglement with heroin within a complex legacy of interactions between this rural minority community and the Han-dominated cities. Limu, the township located in a highland basin in Liangshan, Sichuan where Liu conducted her fieldwork, is home to a poor farming community that had limited contact with Han Chinese for much of the first half of the 20th century. The post-Liberation Communist government officially categorized the nearly two million Nuosu in Liangshan prefecture, along with several other groups scattered throughout Southwest China, as the “Yi” minority group after conducting surveys of non-Han populations. Since the late 1980s, young Nuosu men have engaged in a circular migratory pattern, generally spending between two and four months at a time in Chinese cities attempting to make money before returning home (66). Often lacking fluency in Mandarin, educational opportunities and social networks in the urban centers, many young migrant Nuosu workers supplement unsteady day labor jobs with participation in theft and other illicit activities. The Nuosu’s early presence in urban areas coincided with an increase in heroin flowing into the country from Southeast Asia. The Nuosu’s name for heroin, “yeyi”, is also their word for opium, a drug that helped fuel Liangshan’s economy in the first part of the 20th century (63). Before long, not only the young men who travelled to the cities, but also their families at home became involved in the consumption and distribution of heroin. It is hard to overestimate the impact of the heroin on this community: According to Liu, by the mid-1990s, 200 of the 1,200 residents in one Limu town had used the drug (65), and nearly every household had some connection to the heroin trade.
Much of Liu’s ethnography focuses on the various responses of local community leaders, state agents and international donors to the “dual epidemics” of heroin and HIV/AIDS. In the “Multivocal drug control” chapter, the author documents the history of a “grassroots” anti-drugs campaign implemented through Nuosu kinship structures rather than local police. Reliant on Nuosu rituals and the often brutal use of force by local leaders and family members to treat addicted heroin users and clamp down on villagers involved in the heroin trade, this campaign briefly succeeded in greatly reducing the drug trade in one Limu village. However, subsequent Chinese state party officials’ attempts to promote this “local” model of drug control to surrounding areas failed to replicate early successes as disparate interests overpowered attempts to marshal collective action (101).
HIV/AIDS prevention and care programs also struggled to take hold in Limu. Liu shows how the top-down management style at the China-UK Project, a bilateral partnership funded by the British government and managed from the provincial capital, neglected to adequately engage local stakeholders before implementing needle exchange, income generation, and anti-retroviral treatment programs. Each of these programs subsequently failed to meet their targets. Most devastatingly, she discusses how a public awareness campaigns attempting to “transplant the global anti-stigma agenda”(167) into the township actually served to produce new forms of discrimination in a community that had initially been highly accepting of HIV_ villagers due to the strong bonds of the lineage kinship system and a local ritual healing system that had absorbed AIDS symptoms into existing disease etiologies (171,173). Whether demonstrating the continued relevance of Cultural Revolution-era relations between Han and Nuosu, examining the ongoing effects of the state’s decision to promote privileged local enterprises in the 1980s, or describing the resiliency of local medical practices despite the introduction of socialist medicine by Han barefoot doctors and the more recent privatization of healthcare, Liu’s account does a commendable job of documenting the ways in which the past shapes (and in one case, literally haunts (4-8)) current efforts to attend to pressing social ills.
Liu also offers a powerful account of the social suffering she witnesses. Gathering the stories of several cousins from one large Nuosu family, she explores the ways in which the intersection of heroin use, incarceration and disease continues to take a heavy toll on a community that lacks the resources to effectively deal with these problems. Even a task as straightforward as bringing home the remains of those who die while working in far-away cities presents great difficulties for family members who, unable to afford the services of urban funeral homes, are arrested when attempting to perform their own cremation ceremonies (77). The gap between the optimistic youthful search for “fun and adventure” (72) that fuels migration and the pain and suffering that often result from this travel is a stark reminder of how the Nuosu continue to struggle to find sustainable ways of participating in China’s booming market economy (20, 190).
Following Victor Turner, Liu suggests that we understand the migratory patterns of Nuosu youth as a rite of passage, with the risk-taking and consumptive behaviors associated with travel to cities constituting a liminal stage on the path to a “glorified manhood” fueled by the yearnings for a better life (53). The personal trajectory of heroin use related by her informants appears to symbolize the broader fate of the Nuosu’s engagement with Reform era economic opportunity as early euphoria gives way to increasing dependency and misery. Liu grimly concludes that “no definite end to (the dual epidemics of heroin and HIV) seem within reach” (186).
This reader believes that alternative understandings of the relationship between heroin and this “rite of passage” are worth considering. Firstly, Liu’s account hints at, without explicitly exploring, how the Nuosu’s relationship to heroin may be shifting. The total number of active heroin users in Limu in 2005, due at least in part to the high rates of morality in preceding years, is already a fraction of what it was just a decade before (66, 75). In many other parts of the country, the dramatic increase in the price of heroin and the broad national scale-up of methadone maintenance treatment in the last seven years have contributed to what many believe is a significant decrease in overall heroin consumption. Additionally, as stories of the dependency, misery and suffering of heroin users circulate, the drug has increasingly become associated with the aging “1970s generation” and eschewed by younger users who prefer “new-style” (xinxing) drugs such as ecstasy and methamphetamines. It is quite possible that Nuosu youth could continue to be drawn to cities (80) without having their lives become entangled with the particular complications associated with heroin use in China.
A second point that could have been further explored is the alternate narratives that drop out of Liu’s account in her emphasis on the suffering of long-time heroin users and AIDS patients. With local elders and party officials caught up in the rush to sell heroin in the 1990s and well-constructed homes belonging to individuals with known connection to the industry (66), the heroin trade appears to have been one of the few sectors of the new economy that measurably improved the material quality of life in Limu during the Reform era. The reviewer wonders if, given the degree to which heroin in the past was a highly lucrative business for variously-situated members of the Limu community, some Nuosu might hold different understandings of heroin’s position in the local economy. Could certain roles in the heroin trade come to be tolerated over others, and what, if any, sense of regret do those who secured conspicuous wealth during the booming heroin trade in the 1990s feel today? If we understand heroin productive not merely of suffering, but also of new forms of sociality and re-configured relationships between the Nuosu and China’s developmental trajectory, the decision by the “most talented” (75) to become involved in the heroin economy may not need to be interpreted exclusively as a detour from the “drive to become modern” (12), but also a sign of a world in which the community’s moral compass of right and wrong, as well as the status of modernity itself, are far from clear.
Nicholas (Nick) Bartlett is a PhD candidate in the Joint Medical Anthropology program at the University of California, San Francisco and Berkeley. His dissertation research explores the intersection of history, memory, and recovery among a community of longtime Chinese heroin users. He previously worked in the public health field on drug-related issues, also primarily in China.
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