Stuck: Black, Unwell, and in Need of Care

Imagine you’re in a foreign country and you have a medical emergency. You have lived long enough in this foreign country to not only understand its cultural nuances but also how to work its medical system, thanks in part to your being able to speak the local language. On top of that, as a foreigner, you are armed with fabulous medical insurance that will see some of the best international medical institutions roll out the welcome mat and treat you to 5-star service. You would think that you would be spared from the harsh realities that most healthcare systems in the world subject unsuspecting, often helpless patients to.

But, there’s a catch. You’re a Black man in a country that is not all too welcoming when it comes to your kind. That alone is enough to see you turned away from certain facilities out of pure racism. There is an added complication. For those who are willing to even let you through the door, few are willing to treat you, because, in a country steeped in stigma and discrimination, you happen to be an HIV-positive Black foreigner seeking medical treatment. The only way around this is forking out a massive amount the hospital label’s as “insurance” just in case the doctor who’s brave enough to take on your case “catches” what you have. What would you do then?

This is the fate that has befallen a friend I met a little over two years ago in Beijing’s drunk-like-a-skunk nightlife when he put yet another one of my friends in his place for aggressively flirting with him. Don* and I became fast friends, chatting fairly regularly, and meeting for a drink every once in a while. On one of our nights out drinking, he confided his status to me. The entire weight of his experience hit me all at once. Not to say that I knew what it means to be an HIV-positive Black man living in China, but as a Black African man myself, I knew all too well what he might have possibly been subjected to. There is still an enduring fear in China, especially among gay men, that Black men are the vectors of the virus, and on dating apps, along with the question of endowment, Black men are often pressured to reveal their HIV status. This fear of Black people being vectors of disease has only expanded to COVID-19 where Black people have faced new sorts of overt and subtle discrimination as a result of their perceived virulence.

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Don*, a single gay man himself, then revealed that he was undetectable; a term used to mean that someone’s viral load is in such small quantities that it can no longer be detected by standard blood tests thanks to antiretroviral treatment (ART). Undetectable people cannot pass the virus onto a partner during sex, though being undetectable doesn’t mean that one is cured of HIV. But as much of a relief as that might be to a single dater, it gives little succor in an environment where ignorance prevails.

To prove this, he tells me of a surgery he needs to be performed, it has been put off long enough he says. But no surgeon was willing to touch him and no hospital was willing to admit him. Medical professionals that one would expect to have a better understanding of how HIV and its transmissibility work, refused to treat him for this very reason. His only choice would be to travel back to his home country where surgery and aftercare would be all but free. But an extended stay away from China would effectively erase the financial freedom he had created for himself by virtually guaranteeing that he would lose his job – the same fate that’s befallen so many foreigners once in China, now stuck in their respective home countries thanks to the global pandemic.

This was late 2019 when he revealed this medical diagnosis to me, right before the COVID-19 outbreak which would soon see the world shut down almost indefinitely. It is during the period when China indefinitely shut its borders that Don* had hoped to return home to get the surgery done after filing for leave of absence. But he was effectively stuck. Having shut its borders down, China was yet to issue a protocol for return for foreigners stuck abroad. And for those in the country who chose to leave, it was a big gamble whether they would be allowed to return, and if so, how long it would ultimately take. Don* had to decide to either go back home and get the surgery done but ultimately lose his job in China if he wasn’t allowed back in due to lockdowns, or stay in China and roll the die hoping someone would ultimately take on his case and give him the surgery he needs, or his medical condition would continue to get worse. He chose the latter.

Recently he expressed his frustration at the situation. “I just don’t feel I’m given truly the best medical services and feel like a Disease and not as a human. Like my healthcare doesn’t actually matter and I don’t matter,” Don* told me. He found a surgeon willing to operate on him at a 40,000 yuan contingency fee, or an equivalent of approximately $6,000 above the expected cost of the actual surgery. “It has made me very depressed, even question my existence. For medical professionals to say they are doctors but refuse to be a part of the solution and have no issue having someone escorted out like a criminal, still having to pay. For no service,” expressed of the situation.

Already hobbled by being a Black foreigner in China, Don’s* quality of life continues to decline due to being denied medical care which would be offered to anyone in his place outside of China. He is left to start the search for a new hospital or healthcare provider willing to take his case on, explaining, “Hospitals don’t even talk to each other. So I have to explain everything over again and getting nowhere further.” He is left without recourse, stuck in a country whose borders aren’t likely to open any time soon, and whose people’s mindsets aren’t likely to shift soon.    

_{Photos: Unsplash}