32 Years Ago: China’s First AIDS Death
On our third morning in China, Oscar Messina, a 34-year old Argentinean resident of Los Angeles who was traveling alone on my tour, told me he had caught a cold and would sit-out the day’s sightseeing. Since this was a common occurrence on tour groups, I didn’t think much of it. The last thing I expected was that I would soon face a crisis that would make headlines around the world.
It was the end of May 1985, and we were in the provincial capital of Nanjing. As a newly-minted graduate with two degrees in Chinese language and East Asian studies, I had landed my first job as an international tour guide. I was now leading my second tour: a 28-day round-the-world trip beginning in China, and then crossing the Soviet Union by train to Scandinavia. My group consisted mostly of retirees, with a few middle-aged couples, and a couple of young, professional singles.
The next morning, Oscar told me he was feeling worse, and confessed that he was suffering from leukemia. He said that he had a round of chemotherapy just before leaving the States, and felt that he was now starting to suffer from his compromised immune system. I offered to have him seen by Chinese doctors, but he declined. Rather, he wanted to rest, continue on the tour for our remaining few days in China, and then return to the States from Beijing, our last stop before heading to the Soviet Union. I assured him that I would make the necessary arrangements to get him home.
During our flight the next day to the city of Xian, Oscar was visibly distressed. His situation appeared to be progressing rapidly downhill, and I realized I would have to devote myself full-time to his needs. I therefore fully relinquished my guiding responsibilities to the national Chinese guide traveling with our group, and our local Chinese host guide in Xian. By this point, Oscar was walking slowly and with difficulty due to his increasingly labored breathing. However, he once again adamantly refused to let me hospitalize him, although he did allow me to bring doctors to our hotel to make him comfortable. For the next day and a half, I spent all my time alternating between helping Oscar in his room, interpreting during the doctor visits, and working the hotel phones and telex machines to keep my company apprised of the situation, and finalize the arrangements to get Oscar back to the USA. At the same time, Oscar told me he was in contact with his family and doctor in California.
Our final flight in China from Xian to Beijing seemed interminable. It was already very difficult for Oscar to sit upright comfortably, but since the flight was completely booked, there was no place for him to fully recline. So, I sat next to him, holding his arm, giving him water, and adjusting blankets and pillows to help him rest and keep him warm. In an effort to distract him from his discomfort, I told him about the history and sights of the cities where we had been, and the great attractions that awaited us in Beijing. I assured him that once he recuperated, he could retrace our itinerary to experience all that he had missed in the last few days.
We arrived mid-evening to Beijing, and I offered to take Oscar directly to Peking Union Medical College Hospital — the leading facility that was authorized to treat foreigners. But with his return reservation to Los Angeles already booked, and the trip now just a day away, he refused yet again. At our hotel, it took some time to settle him into his room as he was experiencing tremendous difficulty walking. I sat with him until he appeared to be resting, and then headed to the lobby to meet with the Beijing representative of my tour company who had organized Oscar’s travel arrangements. My colleague told me that the flights to Los Angeles from Beijing had all been full, but that one airline had allocated a reservation due to the medical situation. However, precisely for that reason, the airline insisted that we present signed documentation from Oscar’s doctor in the US to attest that Oscar could endure a 13-hour flight. So, we sent word that night to his doctor to immediately expedite the necessary medical authorization.
By the next morning, however, the documentation had not arrived, and I had to tell Oscar that we lost his reservation. He was panicked, and I tried to calm him by telling him that I would immediately visit the offices of several other airlines to see if there was any other possible way to get him out that night or the next day. When I got up to leave his room, I asked him if I could get anything for him — a drink? some food? He just whispered, “oxygen.”
For me, this was the turning point, and I knew that I could no longer respect Oscar’s wishes to avoid hospitalization. He started to cry as I turned away from the door to sit down again. I explained that if he couldn’t lie in a hotel room without oxygen, he would never survive a long flight home. I would take him to the hospital, speak to the doctors, and he would be well cared for. I would also alert the US and Argentinean embassies to his situation, and he could speak with his family and his doctor in the States. Once he had regained his strength, our company would make all the arrangements to get him home. This time, Oscar didn’t refuse, and I called for an ambulance to come to the hotel.
Although Oscar’s condition seemed dire, his intake at the hospital went smoothly, with several doctors interviewing him as I interpreted. I explained what he had told me about his leukemia, and the progression of his condition during our tour. The hospital staff took blood, checked all his vital signs, and gave him oxygen. I spent several hours with him that afternoon, and I left feeling that he would finally be cared for in a proper way.
He died sometime in the early morning hours of the following day.
Of course, Oscar didn’t have leukemia, he had AIDS. The doctors in Beijing were puzzled as to why such a young man — even one suffering from leukemia — had deteriorated so quickly. Only after speaking directly to his family in the States after his death did they learn of his true illness. The following month, the Chinese Ministry of Health formally announced Oscar’s death as the first reported AIDS death in China, news that immediately flashed around the world.
Over the years, my thoughts have constantly returned to Oscar. Initially, I was just confused — how could he possibly have embarked on such a long and arduous international journey knowing that he not only had HIV, but full-blown AIDS? Even the healthiest of tourists succumbs to colds and infections during such travels, and such minor conditions can spell disaster for AIDS patients. And, why had he concealed his true condition from me to the very end? Had I understood his real situation, I might have been able to do more for him, both practically and emotionally. Of course, I was very naïve about the disease in 1985. In hindsight, I do understand the legitimate fear that AIDS patients harbored in the 1980’s (and even still today) when revealing their condition to strangers. I can also fully appreciate that Oscar’s decision to keep his illness a secret during our tour was further amplified by his fear of how the Chinese might specifically react. To a great extent, that fear was validated following his death, when the health authorities in China immediately cremated his body and burned his personal effects, announced an “emergency quarantine” to stop the disease from spreading, sealed off the hotels we had stayed in, and subjected our Chinese guides and all others who had interacted with Oscar to blood tests.
Oscar’s death in Beijing was pivotal. It was an unspeakable, sudden tragedy for his family, friends, and colleagues. In the global history of the AIDS epidemic, it was a milestone event. To China, itself, it was the jolt that fostered the initial, official recognition of, and attention to, the disease. This led to concrete response: the immediate screening of blood sources, the implementation of health declarations for foreign tourist arrivals, the mandatory health examinations administered to foreign applicants for Chinese residence permits, and, more gradually, the awakening recognition that AIDS would be as much a domestic problem as it was a foreign one.
This was Oscar’s accidental, yet far-reaching legacy.