About the Trust
I am just back from a week in China – my 3rd visit this year, and perhaps my 300th over the last 30 years. It had rained in Beijing last Friday, and the famous pollution was washed away, and the sky was blue – and the moon was waxing towards its full, which occurred only yesterday. The full moon in September is the beginning of the mid-autumn festival, and moon-cakes are offered everywhere – and between now and China’s national day on 1st October there is a festive atmosphere. Flags are waving and banks of flowers decorate Tiananmen Square, where the students were crushed in 1989, and over which the portrait of Mao Tse Tung still presides.
It is one of the nicest seasons to be in China, and I was there to present the fourteenth annual Barry & Martin’s Prizes in the nearby city of Tianjin, and to meet at the hospitals in Beijing with newly-infected young HIV-positive men, and with groups of activists among them who are campaigning to persuade the government to implement anti-discrimination measures, and to treat Aids victims kindly – and at reasonable or no cost.
But first, I want to say how grateful I am to be asked by High Mistress Clarissa Farr to lecture to the sixth form of St. Paul’s Girls’ School about China, and about the work we have done there since I started my Aids charity Barry & Martin’s Trust in 1996. It is also kind of Barbara Woodward to have recommended me.
However before getting on to China, and the scourge of the Aids epidemic, I should begin in the City of London, in the shadow of St. Paul’s Cathedral. I had the good fortune on leaving Oxford in 1963 – fifty years ago – to be employed by Siegmund Warburg and his bank S.G. Warburg & Co – and remained there for forty years, until 2003.
During my first 19 years there, until his death in 1982, I worked frequently for Sir Siegmund, who was the most principled and creative banker of the post-war period, and who placed literature and philosophy above the money-making concerns of the bank. When I interviewed with him, he was more interested in the books I was reading than in my knowledge of finance – just as well because my knowledge of finance as that time was zero.
Siegmund took the greatest interest in people, especially young people; and his liberal and international viewpoint contrasted with the domestic ‘little England’ attitude of other City banks at that time. To a young starter in business, Siegmund gave a sense that the banking profession was useful and enjoyable – and that it offered a career in which a young person with ideals could find fulfilment. Quite a contrast with the image of banking today; and it is up to a new generation like yourselves to restore the moral foundation of this profression, which has a central role in a functioning society.
I have come to your School this morning with Sir Siegmund’s 92 year old secretary Doris Wasserman, to spend an hour in your Library with your Librarian Linda Kelley. As I am sure you all know, Siegmund Warburg’s library was bequeathed here to St Paul’s Girls’ School. His daughter Anna, who lives in Israel, is an old Paulina, and Siegmund was for many years a close friend of Clarissa’s predecessor Heather Brigstocke. St Paul’s Girls’ School has this precious collection of Sir Siegmund’s books, which any of you can take from the shelf, and tap into the culture of this wise and humane man.
And it was through my S.G. Warburg career that I became involved with China, as China gradually opened up after the Cultural Revolution ended in 1976. I had many family links with China: my mother was born there exactly 100 years ago, when her father was a doctor in Manchuria; my uncle served with the British Army in south China in the war; and my partner Barry was Chinese from Hong Kong. I was therefore keen as a banker to connect with China at the first opportunity, and this came to me after 1984, when I was stationed by the bank in Japan, and was asked to develop our China business by frequent visits from Japan.
It was exciting making the bank’s early contacts in Beijing 30 years ago. The city was a sea of bicycles, with hardly a car in sight, and not a single office building. Now the city is ringed with tall buildings, many with cutting-edge architecture and the ever-expanding roads are jammed with cars. The first transactions in China were treated with amazement – and our office switchboard got excited when the first telephone calls started coming from Beijing.
These early contacts were to be of great value to me when I started working in the charitable field in China. My great friend Barry died of Aids at the Chelsea & Westminster Hospital in 1996; and I immediately wrote to the head of this unit at the hospital, Dr Gazzard, to thank him for the kindness and care they had shown to Barry, and to propose a cooperation between his hospital and China – probably to take the form of exchanges of doctors and nurses between the UK and China. Dr Gazzard replied with enthusiasm. There were very few contacts between England and China in the field of HIV/Aids, and the hospital was willing to cooperate to the full.
Those were the circumstances in which I founded Barry & Martin’s Trust in 1996. For you sixth formers it must seem a long time ago. I expect many of you were born in 1996 (hands up – those of you born in 1996!). Up to 1996 the medical profession had very little idea of how to control Aids; and after 1996 the triple combination therapies were introduced which, at least in the West, did start to control Aids, but not so far to cure it. Patients who have the right treatment and drugs can now live long lives, but in many countries the disease is still raging – often from ignorance, incompetence, prejudice or poverty.
I think you all know that HIV is a virus which causes the body’s immune system to break down. The body’s natural mechanisms to resist infection give us immunity from many illnesses. When this breaks down, we cannot resist infections – and we can be invaded by all sorts of different illnesses – of the lungs, the stomach, the brain etc, and the patient cannot survive. The strong drug combinations introduced in 1996, and further developed since then, enable the body to fight back, but not so far to get rid of the virus. The virus is mainly spread by sexual contact or drug abuse with infected syringes. In Western Europe and North America, contact among gay men has been the prime sexual source of infection; whereas in Africa it has more generally spread through heterosexual contact.
In China in 1996, when I started this work and met the principal doctors and government officials concerned with disease control, they were all of the view that Aids was likely to be a problem in China; there had not been many cases but they could not expect to escape, and they needed to do something about it. When I asked them about the situation among the gay community, they told me that although they knew that gay people existed, they had no contact with them whatsoever.
One of the earliest suggestions I made to them was that I should bring a group of doctors and nurses from the Chelsea & Westminster Hospital to China, to conduct with them a seminar on Aids education, prevention and treatment. My new friends at the Chinese Ministry of Health, and the Chinese Academy of Preventive Medicine, were delighted with the idea and agreed to contribute to the costs – this was a breakthrough at a time when China was still quite poor.
Accordingly I brought 16 doctors and nurses from the Chelsea & Westminster to Beijing in May 1997, and we had a 3-day symposium with some 120 of their experts, among whom we met the leading people involved around China – contacts which have continued to feed our work there ever since. We also arranged for the first set of Chinese doctors to come to the UK for training at Chelsea & Westminster Hospital.
In the aftermath of these early contacts, which resulted in further exchanges of doctors and nurses between our countries, there were 2 developments which had important effects on our subsequent work in China.
The first of these developments concerned the town of Dali, in Yunnan in south west China, a lovely old town with the Changsan mountains behind it and the beautiful Lake Erhai before it. As the snows melted at the end of winter, wild camellias and rhododendra would bloom on the mountainside. It is the site of the ancient kingdom of the Bai people, who twice defeated the armies of the Tang emperors of China, and who ruled as far as Chengdu in the North West and Hanoi in the south east.
Our wonderful English charity VSO – Voluntary Service Overseas – had stationed an English nurse, Peggy Barnes, in Dali, and she was struck in her early contacts that there were many Aids cases, and no one was doing anything about it. She asked her field office in Beijing whether it would be possible to send an English doctor and nurse to Dali to lecture to the local doctors about Aids. My niece Nathalie, one of the founding Trustees of Barry & Martin’s Trust and herself a former VSO volunteer in China and then working at VSO’s head office, picked up this request and suggested that Barry & Martin’s Trust handle this.
Accordingly we sent a doctor and a nurse, Penny Neild and Fiona Gracie, to Dali – and the work was taken up by an excellent local doctor Zhang Jianbo, ably abetted by Nurse Peggy. There still existed in Dali an old hospital building, built by missionary doctors of the China Inland Mission, but no longer in use. It sat next to a Christian chapel, which was and is still in use. This chapel had been built in 1900 to commemorate an American missionary lady who had been murdered in the Boxer Rebellion. We met there an old Chinese doctor and nurse, Timothy and Faith, who had worked in the missionary hospital before the Revolution of 1949 – after which all foreign missionaries had been turned out of China.
Timothy and Faith were able to put us in touch with a missionary couple for whom they had worked, Billy and Dorothy Toop, who at the age of 90 were still living in retirement in Scotland – and on whom we called – Elizabeth Shields and I. We learnt from the Toops some of the history of the mission in Dali, going back to 1886, and the colourful period of the mission’s survival through the Second World War up to the Revolution and their expulsion.
Then, some 11 or 12 years ago, the old hospital burned down, as a result of squatters cooking their meal in the old wooden building; and it was the idea of an instant that we should rebuild it, in cooperation with the local municipality, and make it an Aids centre.
The local authorities took more than a year to consider it, but once the decision was made the implementation was rapid, and the local town gladly contributed 50% of the cost – and the new hospital building, in the architectural style of the Bai people, was opened in October 2004.
This project has gone from success to success – one could almost call it divine intervention. We called it the Peggy Health Centre, and the local doctor Zhang Jianbo has run it so well with such excellent outreach to the sick, that it has become a model for the whole of China – and Doctor Zhang was summoned to Beijing 2 years ago and invested with the sash of a National Model Worker. I do recommend you young ladies to visit Dali and its mountains and lake and while there, do drop into the Peggy Health Centre.
The second development of that early period was a list that the Ministry of Health gave me, giving projects which we might like to finance in the field of Aids in China. At the end of this list, almost as a footnote, was a reference to a doctor in the seaside town of Qingdao, who was working on the subject of homosexuality. So I got on an aeroplane to Qingdao – made famous in the last century by the production of Tsingtao beer; and more recently as the site of the Olympic yachting events in 2008.
In Qingdao I met the doctor in question, Professor Zhang Beichuan, who had been facing many obstacles in bringing the subject to the attention of the authorities, and who maintained a confidential correspondence with 5000 gay men around China – many in high positions in government and the military. We each became each other’s friend and ally, in reaching out to the gay community all over China – and tactfully involving the authorities.
Through Dr Zhang we supported gay groups in more than two thirds of the provinces of China and, as Aids has proliferated among the gay community, a structure has existed to reach out to them, and the government and other national and international institutions have plugged in to these gay groups in order to tackle the disease.
In the eyes of the Chinese government, our 2 main contributions to Aids relief in China have been our work for the gay community, and our annual Barry & Martin’s Prizes. I mentioned at the beginning that I was in Tianjin on Friday awarding our fourteenth annual Barry & Martin’s Prizes – and since we started awarding them in the year 2000, the government and the medical community and the patients themselves have regarded the prizes as invaluable. The ‘People’s Daily’ – the organ of the state – describes them as “Prizes of National Importance”.
We give our prizes in recognition of excellent work in Aids prevention, treatment and care – and we give them all over China, in differing aspects of Aids care. We have given them to doctors and nurses, and to patients who have tried to help others cope with the virus which they themselves carry.
We also believe that the prize has greatest value if it is given in the place where it is earned. We are the opposite of the Nobel Committee which summons its prizewinners to Stockholm or Oslo. Thus we have been to remote parts of China to award our prizes – to Yunnan and Sichuan, to Canton and Qingdao, to Wuhan and Beijing and to the far away cities of Xinjiang – Urumqi, Yining and Kashgar – among the depressed Muslim communities on the borders of Kazakhstan, Kyrgyzstan and Afghanistan. We believe that rewarding good practice has more value than criticising bad practice – and our awards to those doing selfless and excellent work set a good example, and encourage others to do the same.
In the West, deaths from Aids have become rarer – unlike the period up to 1996 when Aids was an almost inevitable death sentence. Why then are so many people in China still dying, and why are infections in China increasing? China is sophisticated and wealthy – it should be able to tackle Aids more definitively. There was a young gay HIV-positive doctor from Chongqing at one of my meetings in Beijing over the weekend – he told me 30 people were dying every month in Chongqing from Aids – and in July 40 people had died – mostly young gay men.
At another meeting over the weekend, at the Beijing You’an Hospital, I attended a gathering of 30 newly-infected young HIV-positive men – one of them as young as 17. The hospital was getting the patients together for an afternoon of advice and games – so that they all made friends together – and I joined them for a mid-autumn festival dinner.
The situation whereby so many people are suffering does not mean the authorities are indifferent; and the Chinese government is far from poor – but a great many of the people are poor. There is little free medicine, and hospital stays are expensive, and hospitals sometimes keep patients inside unnecessarily. Nor are leading doctors ignorant – those involved with HIV know quite well how people are to be treated. There are bad practices in China, as in many countries, but there are also wonderful doctors and nurses making tremendous efforts for the sick: and it is among this latter category that we try to do our work.
But Aids patients have to put up with a lot of bureaucracy and prejudice and even fear. Free Aids drugs (the antiretrovirals) have been available to patients for nine years now – but how to get them? Under the Chinese ‘hukou’ system of household registration, you are meant only to apply for medicine in the town of your birth – so if you have moved to a different city you may not be able to get it. If you are HIV-positive and you need an operation, most hospitals will refuse to operate, because doctors fear that they will catch the infection. Aids patients need confidentiality and sympathy – and the law requires confidentiality – but this law is all too often breached. If you are a government employee – and a large percentage of Chinese are employed in government – you are automatically dismissed if you have HIV.
All these obstructions are being worked on – and I attended one meeting over the weekend of a group of young HIV-positive university graduates, who recounted many of the obstacles and the steps they were taking to combat them. And they had obtained many little victories in the discussions with the authorities – but it is hard going and slow. I told them to keep up the pressure; that we had had petty obstructions in the early days of Aids in England; and that they would certainly prevail in their logical arguments in due course.
The officials with whom we spoke in recent days are fully aware of these points – and acknowledge that China’s medical structure is cumbersome, and that it is difficult for best practice to trickle down to all corners of this vast country. But they do expect to succeed – and to solve the Aids problem within the next 5 years, as the President of You’an Hospital told us.
I would like to end more with a question than with a conclusion. I talked earlier about the missionaries in Dali – and I have friends among the missionary community, especially some wonderful catholic nuns in Ireland. 100 or 150 years ago, there were so few career opportunities for women, and perhaps this was one of the reasons why so many young women became missionaries. I believe that the chapel of Somerville College Oxford was built to commemorate graduates who had been murdered by the Boxers.
Today there are fortunately more opportunities for women, and we live in a much more free-thinking society. You girls are the spiritual heirs of St Paul, the first missionary of all. Today people with a sense of mission do not need to shut themselves up in a distant country for years on end, nor to adhere to a particular religion. They have to get to understand the people they are trying to help, and their point of view. This is a special challenge in the ancient culture of China.
I hope in my conversations with you today to hear how many of you feel about these things.
Lecture by Martin Gordon OBE,
Founder & Chairman of Barry & Martin’s Trust to
St. Paul’s Girls’ School
20 September 2013