PARIS (AFP) - Syphilis, virtually eradicated in China under Mao Zedong, has become a viciously-growing epidemic there, driven by prostitution, internal migration and poor health controls, a new study warns.

In 1993, the reported rate of syphilis in China was a mere 0.2 cases per 100,000.

In 2005, it had surged to 5.7 cases per 100,000, a figure that may well be a serious under-estimate, according to the paper by Chinese epidemiologists.

In addition, the number of babies born with syphilis has shot up. Congenital syphilis occurred among just 0.01 per 100,000 live births in 1991; in 2005 it was 19.68 — an annual rise of nearly 72 percent over that time.

“Surveillance data and focussed reports from throughout China provide compelling evidence of a substantial and worsening syphilis epidemic in individuals at high risk and in the general population,” the research says.

“The spread of syphilis in China has been insidious and has only recently attracted the attention it deserves.”

The paper, written by experts from China’s National Centre for STD (Sexually Transmitted Diseases) Control, appears in Saturday’s issue of the British health journal The Lancet.

Syphilis is a sexually transmitted disease caused by a bacterium, Treponema pallidum, that can be treated by antibiotics. If untreated, it can cause genital ulcers, damage the cardiovascular and nervous systems and brain, affect fertility and foetal health.

By the time the Communist Party took power in 1949, China had one of the biggest syphilis epidemics in history: one person in 20 in some large cities had the disease, and the rate was two to three percent among dwellers in the countryside.

In 1952, the Communists launched an unprecedented campaign, instituting mass screening for the T. pallidum germ, providing free treatment to infected individuals and closing brothels. By the 1960s, the initiative, while contested for its authoritarianism, virtually eradicated syphilis in China.

The Lancet paper says that this success ironically worsened the danger for the Chinese population when the country opened up its economy in the 1990s, unleashing the social earthquake that continues to this day.

As syphilis had been virtually absent for 20 years, the general population of young, sexually active individuals had become “completely susceptible” to infection, it says.

The driver for the epidemic has mainly been sex work, which has flourished with the expansion of China’s vast, shifting population of migrant workers.

There have also been changes in sexual habits, including a move towards sexual intercourse at an earlier age, with more partners and before marriage but also with poor use of condoms.

Syphilis prevalence is highest in the big-growth regions of coastal China, led by Shanghai (55.3 cases per 100,000), Zhejiang (35.9) and Fujian (26.8).

This was followed by Beijing (24.9 cases per 100,000) and the Zhujiang river delta, comprising Guangxi, Guangdong and Hainan provinces, with rates of 14-21 per 100,000 individuals.

Other countries have likewise reported a resurgence of syphilis in high-risk groups recent years, although China’s official rate is substantially higher than that of most developed nations. It is double that of the United States, where the infection rate was 2.7 percent in 2004.

The paper, lead-authored by Chen Xiang-Sheng, admits that the picture could be even worse, as the data is based on 26 nationwide “sentinel sites” which receive details of patient admissions from government STD clinics.

Many people, though, may get treated at family planning centres, gynaecological clinics and other facilities or by pharmacists or private practitioners, and these cases go largely unreported.

In addition, the increasing privatisation of health care in China has left many people without the resources to get screened or treated for syphilis.

By Robert Marquand | Staff writer of The Christian Science Monitor
- from the November 29, 2006 edition

BEIJING – “I never meant to stay in China…. I never even meant to go to China.”

The contradiction defines Sidney Rittenberg’s life and world. Mr. Rittenberg knows China’s epic Communist revolution intimately, not as a witness, but a participant - often on the wrong side of history.

Not many people can still close their eyes and recall playing cards and folk dancing with Mao Zedong, Zhou Enlai, and the young rebels in the bean-oil lit caves of Yanan. But Rittenberg can. The idealistic Jewish boy from Charleston, S.C., stayed behind when the US Army left China, dreaming of a new social order where skin color and ethnicity wouldn’t matter.

Madame Sun Yat-Sen, wife of China’s founder, got him a UN relief job. He later joined the Communist Party, became a top cadre, translated Mao, rose in the broadcast department, married twice, played politics on the far left. Twice he was thrown in prison, once by Stalin and once by Mao - getting out only when those men died.

Rittenberg left China after 35 years, in 1980, battered and bruised, sadder and wiser, but with his spirit intact - still delighting in the language and people of China.

Today, the man who urged on Page 1 of the People’s Daily to fight “until the international workers revolution proceeds to its conclusion!” is a business consultant in Seattle and Beijing.

China today is no longer the same country, of course, Rittenberg says. The days of no hot water or stoves, and of community baths are over. Chinese are proud that their rising position and voice is gaining its due respect.

But China’s spectacular rise carries hidden dangers, mainly for itself, he says. The nation is “at a crossroads, a life-and-death juncture, 70 years after the Long March.” The top problem is a lack of imparted moral and spiritual values, one reason for leader Hu Jintao’s “harmonious society” program.

“There are a lot of unhappy intellectuals, old party members, young people with high ideals, peasants, and farmers…. They hate the new corruption and the vice … making money as No. 1.,” he says. “They don’t have power, are docile and patient - but beware the anger of the patient man. I have to ask about China, ‘What does it mean to build a strong economy, but to lose your soul?’ ” he asks, paraphrasing the New Testament.

Rittenberg’s own soul has been extensively searched since leaving China. He admits to mistakes, naivete, and blindness - particularly his zeal in backing the Cultural Revolution, the terror and fear between 1965 and 1975. It was a time of “insane ideology” when people “hardened their hearts and blocked out all human feeling in the name of doing good.”

“I didn’t see what Mao was doing,” he says. “Mao betrayed his own promises. He unleashed the students to destroy his enemies, all in the name of democracy…. I didn’t see it then, what ‘class struggle’ really meant.”

Rittenberg’s story is that of a man who “loved not wisely, but too well,” he suggests. He is no longer a party member.

Rittenberg grew up a lawyer’s son at a time when, he says, “No white man in South Carolina had ever been convicted of rape or murder of a black person - they weren’t considered human. I felt the world as it was, was not acceptable. When I came to China, I thought they had the answer…. During the Cultural Revolution, I thought, ‘Wow, this is the real real new world!’

“If you asked me [then] about Libya, say, I could … tick off every answer in terms of class analysis. But now I’ve lost all those answers. I just have questions.”

China will develop a democracy, Rittenberg says, but probably in its own time and way. The party’s failure in delivering on its promises after 1949 - land for peasants, democracy, and fairness - was inherent in the ideology of Chinese communism.

“I feel it wasn’t just Mao, or good or bad people in charge … but in using dictatorship to achieve democracy, you turn out not to get democracy, just more dictatorship.”

Today, he has come to feel that the American revolution was uniquely successful.”When you read Washington and Jefferson, it’s clear America came much closer to achieving its ideals than France, Russia, or China.”

Rittenberg’s recent memoirs, “The Man Who Stayed Behind,” is serialized in the Shanghai Evening News under his Chinese name, Li Dunbai. Well past 80 years old, Rittenberg remains indefatigable, an adroit speaker, and funny (he quipped to a packed house in Beijing that the audience must have mistaken him for New York Times columnist Tom Friedman, the next speaker.) Rittenberg “figures in a long line of ‘China helpers,’ ” says Roderick MacFarquhar, an authority on China at Harvard University. “He is enormously experienced in the ways of the Chinese people.”

China experts describe Rittenberg’s endless energy. “So many people who took part in the story of China simply went down,” says a friend. “Either they were killed or died indirectly, or went into solitude. Rittenberg … never took an obstacle for the end of the road.”

Rittenberg turned down a scholarship to Princeton University to study philosophy at the University of North Carolina. The Army had him study Japanese for the US occupation after World War II. But, he says, he did not want to spend years in Japan. So he switched to Chinese, thinking he would come home early, and went to Stanford University. He knew French, Latin, and German. But he fell in love with Chinese. “It was magical…. I still get excited about learning a new character.”

Once in China with the Army, Rittenberg’s interest in the Communist Party thrust him into a cloak-and-dagger-world in Shanghai. He met Zhou Enlai after hearing him speak. China’s eventual No. 2 leader politely told Rittenberg he had been clapping too loudly, that Nationalist spies would see this, and it would cause harm. Rittenberg was stunned that Zhou would even have noticed.

A year or two later, Rittenberg walked 500 dusty miles to the caves of Yenan, headquarters of the revolution. His job was to put Mao’s message into readable English, and translate world news picked up by Morse code into Chinese (including dispatches from this newspaper). He felt he was helping liberate China from imperial cruelty. Yet in 1949, outside Beijing and on the eve of victory, Stalin sent a special cable that got Rittenberg jailed.

After Stalin died, Rittenberg was exonerated. He was told he never had to work again, that he could have a villa, and was offered funds for leisure travel. “The smartest thing I ever did was go right back to the work I was doing” at state media, he says. “And I met my [second] wife, Yulin, a few weeks later.”

It is a life of contradictions: He sat in prison for six years, yet decided he must forgive his jailers. His views on family changed: He used to feel personal life mattered little. But after his second jail term, he felt that if he could only make his wife happy, his life would not be wasted. Again, in the 1960s, he backed a wing of the party more extreme than the infamous “Gang of Four” - yet now is a businessman who feels “radical student movements are not the way to bring change.”

“People like Rittenberg were described by Arthur Koestler in ‘Darkness at Noon,’ ” says Jasper Becker, author of “Hungry Ghosts,” about China’s famine. “They remained heroically loyal even in jail, even falsely accused and about to be executed. Their commitment to a cause, without a wish for comfort or riches, is extraordinary. But they harbor illusions that made what they did justifiable….”

Rittenberg’s views on Mao remain complex: Mao “genuinely believed he was doing good.” Mao was “definitely a genius and a brilliant writer,” he says. Mao’s essay “On Protracted War,” for example, tells exactly how Japan’s military would crumble.

Yet Mao was despotic, “a peasant boy who grew up in a remote village, with a narrow education [who] never lost the capacity for the envy and revenge of his childhood.”

“Those who endorsed the party or Mao … are still reluctant to tell the truth,” Mr. Becker argues. “Mao was a tragedy for the Chinese people; you can’t really get around that.”

Realizing one’s mistakes is liberating, says Rittenberg. China may be in a spiritual crisis, but its history is a cycle of brokenness and renewal. “I’ve been impressed by the ingenuity and goodness of the Chinese people. No other nation has lived so long in one place, 2,000 years, with the same language, in the same territory, without destroying itself and others. In 20 or 30 years, China will work out and develop its own new moral code, find a new way, repair its civilization.”

An American in China: Rittenberg recalls prison

“The time I did was all solitary. Solitary time is different. The first year, with no light, I stopped worrying about whether I would be shot. That was not the issue; my sanity was the issue. You ask the most basic questions: Has your life mattered? What is happiness, opposed to mere animal pleasures?

“To survive you need a clear purpose. If your life is aimless, you won’t survive solitary darkness. You have to train yourself. There are a whole series of little battles to fight and win. At one point something unusual happened which I can’t stop thinking about even 30 years later.

“Getting out seemed like a less than 50-50 chance. I wasn’t allowed to speak. I started to feel that if I ever did get out I would never be normal. I felt despair, betrayal by … the communists I had given so much to. But … a little voice startled me. It asked me when I began to feel such fear? Finally I realized there was no one point when the fear began. I felt it but could not say precisely why or when,. The minute I saw this the fear went away. I began to wonder, where does this voice come from?

“I have begun to feel there is some moral nature in man, and that at some deep level this moral element performs a kind of Google function - to find more resources inside us.

“For example, I remembered clearly a poem by Edwin Markham that my aunt and sister had me read when I was sick back in South Carolina, and that helped me:

He drew a circle that shut me out-
Heretic, rebel, a thing to flout.
But Love and I had the wit to win:
We drew a circle that took him in!

“One morning across the prison courtyard, I heard the dulcet tones of Jiang Qing [Mao’s wife, Gang of Four leader, and main perpetuator of the Cultural Revolution]. I heard her voice and I was very happy. I knew that if she is coming in - then I am soon going out.”

KIEV, Ukraine - A Chinese journalist serving a 10-year jail sentence for allegedly leaking state secrets has been awarded a press freedom prize, the World Association of Newspapers said Tuesday.

The association awarded its annual Golden Pen of Freedom honor to Shi Tao, a former writer for the financial publication Contemporary Business News, who was sentenced under state secrecy laws to 10 years in prison in 2005 for allegedly providing state secrets to foreigners.