Prologue: The Final Watch
On December 10, 2023—International Human Rights Day—ninety-five-year-old Gao Yaojie passed away in her sleep in a small apartment on Manhattan’s Upper West Side. She was just nine days short of her ninety-sixth birthday.
The frail old woman had been in exile in the United States for fourteen years. Her feet had been bound in childhood, leaving her with a lifelong limp. Three-quarters of her stomach had been removed after a suicide attempt during the Cultural Revolution. In her final years, she was largely bedridden, her laptop perpetually resting on her chest as her fingers tapped out words she believed more important than life itself. “I’m not afraid of death,” she once said. “What I fear is that the truth about China’s AIDS epidemic will be forgotten.”
Her desk was piled high with letters—more than ten thousand of them from rural Henan. Each one told the story of a family’s destruction: husbands dead, wives ill, children orphaned. Most of the letter writers had since passed away, but their voices had been preserved by this old woman, becoming indelible testimony to a man-made catastrophe.
Gao Yaojie could have lived a quiet retirement. In 1996, she was a sixty-nine-year-old retired gynecology professor with a respectable pension, a husband, and children. But on April 7 of that year, when she was invited to consult on a rural woman suffering from a “strange illness,” her life’s trajectory changed forever.
“I could have lived a quiet, peaceful private life after retirement,” she wrote in her memoir, “if I hadn’t gone to see that AIDS patient—she set me on a path of no return.”
She chose to walk that path because she could not look away from suffering. This was not a hero’s choice, she insisted—it was simply what a person should do. But the reality is that very few people did “what everyone should do.”
Chapter 1: The Plasma Economy — Birth of a Catastrophe
Blood Selling Born of Poverty
Henan Province in the early 1990s was one of China’s most populous, with approximately ninety million residents, eighty percent of whom were farmers living in extreme poverty. In many villages, annual per capita income was only around 500 yuan. A popular slogan of the time captured the farmers’ predicament: “Stretch out your arm, clench your fist, fifty yuan in hand”—the income from selling blood once was enough to buy fifty kilograms of rice.
Against this backdrop, the Henan provincial government vigorously promoted the “plasma economy” between 1991 and 1995. One government official publicly stated: “We want to develop blood stations as a ‘tertiary industry.’ Even if only one to three percent of seventy million farmers are willing to sell blood once or twice a year, we can collect that blood to sell to pharmaceutical companies and create millions in value.”
The Deadly Collection Process
This plasma economy campaign attracted approximately three million blood sellers, primarily impoverished rural residents. Between two hundred and three hundred government-operated blood collection centers were established across the province, alongside numerous illegal stations run by “blood heads” and “blood tyrants.” These operators were largely connected to health department officials—as AIDS activist Zhu Jinzhong noted: “They were all officials from the Provincial Health Bureau or disease control stations, along with their relatives and friends. Without these connections, you couldn’t possibly open a blood collection center.”
The true disaster stemmed from deadly practices in the collection process:
Blood drawn from multiple donors was pooled together in a single centrifuge to extract plasma. To prevent anemia and enable more frequent blood selling, collection stations reinfused the pooled blood cells back into donors’ veins after plasma extraction. Needles, blood bags, and collection equipment were reused without proper sterilization, and no HIV testing was conducted.
One foreign media report described the process: “Farmers’ blood was drawn, pumped through dirty equipment, and mixed with others’ blood in a large vat. After plasma extraction, the remaining blood was pumped back into the donors’ veins to prevent anemia.”
Scale of the Epidemic
Official figures and independent estimates diverge dramatically regarding infection numbers. In 2004, a Henan provincial government survey acknowledged more than 25,000 infections, but this figure was widely considered a gross underestimate. That same year, the Chinese government admitted that blood transmission alone had caused over 69,000 infections nationwide, representing 24 to 25 percent of all AIDS cases in China.
However, Gao Yaojie and other activists estimated that Henan Province alone had one to two million infections. Gao herself estimated that nationwide infections from blood selling might exceed ten million.
At the village level, the numbers were even more staggering. In Wenlou Village, Shangcai County—later the most famous “AIDS village”—of 3,170 residents, over 1,300 had sold blood, representing 41 percent of the population. Testing revealed 678 people infected with HIV, more than half of whom had died by 2016. In Donghu Village, Xincai County, the infection rate among 4,500 residents was estimated at 80 percent.
Cover-up and Silence
By 1993, the Henan Provincial Health Department had already discovered HIV transmission among blood sellers. In 1995, another whistleblower, Dr. Wang Shuping, tested over 400 blood samples and found 13 percent positive. But when she reported this to Liu Quanxi, then director of the Henan Provincial Health Department, she was told: “Other provinces haven’t reported this problem. Please don’t report it again.”
Wang’s laboratory equipment was subsequently destroyed, she was beaten, and she was eventually forced from her position. She fled to the United States in 2001 and died in Utah in 2019.
Local governments implemented systematic cover-up measures: invoking “state secrets laws” to classify epidemic information; detaining, interrogating, and expelling Chinese and foreign journalists attempting to enter Henan; and surveilling, harassing, and even placing under house arrest activists who publicly criticized official responses.
Human Rights Watch noted in a 2005 report: “To date, no officials involved in this disaster have been held accountable. In fact, some senior officials with significant responsibility for the catastrophe have even been promoted.”
Chapter 2: Before the Storm — Gao Yaojie’s Early Years
Daughter of a Landlord Family
On December 19, 1927, Gao Yaojie was born into a wealthy landlord family in Cao County, Shandong Province. She wrote in her memoir: “I was born in Cao County, Shandong Province. My family was wealthy, living in a large mansion. We had over seventy mu of land and were quite well-known in southwestern Shandong.”
Following tradition, her feet were bound for six years, leaving her with a permanent limp. But she also received a traditional Confucian education—able to recite from the Four Books and Five Classics—and these teachings planted in her heart the idea of “taking responsibility for all under heaven.”
In March 1939, twelve-year-old Gao Yaojie experienced a disaster that changed her family’s fate. An Eighth Route Army unit kidnapped her father and uncle, and the family was forced to pay 300,000 silver dollars in ransom to secure their release. Afterward, the entire family fled Shandong and relocated to Kaifeng, Henan.
The Path to Medicine
In Kaifeng, Gao Yaojie entered Henan University to study medicine. Her studies were interrupted by the Japanese invasion, and she didn’t graduate from Henan University Medical School until 1953, specializing in obstetrics and gynecology. That same year, she married fellow physician Guo Mingjiu, and they had two daughters and one son.
Over the following decades, she became one of Henan Province’s most distinguished gynecologists, working at the First Affiliated Hospital of Henan College of Traditional Chinese Medicine, specializing in ovarian diseases and gynecological tumors. In 1986, she was appointed professor. In 1990, at sixty-two, she retired.
Ordeal and Tempering
Gao Yaojie’s life was far from smooth. During the Cultural Revolution, she suffered brutal persecution due to her landlord family background.
In 1967, Red Guards stormed the hospital where she worked. She was beaten multiple times, one blow so severe that three-quarters of her stomach had to be removed. To evade capture, she hid in the hospital morgue for eight months, with a kind kitchen worker secretly bringing her small amounts of food each night.
In despair, Gao Yaojie attempted suicide by poisoning. She was discovered and survived, but was left with drug-induced liver cirrhosis and other lasting effects. Even more painful, because she refused to submit to the Red Guards’ persecution, her thirteen-year-old youngest son Guo Chufei was accused of being a “counter-revolutionary” and imprisoned for three years, becoming the youngest political prisoner in Henan Province.
In 1968, Red Guards also desecrated her family’s ancestral graves in Shandong, looting gold, silver, and jade burial objects before burning her ancestors’ remains.
These sufferings didn’t break Gao Yaojie—instead, they forged her character. She later said: “I have experienced too much suffering, so I help others. I sympathize with them.”
Retirement and the Turning Point of Fate
After retiring in 1990, Gao Yaojie didn’t choose to enjoy her twilight years in peace. She gave thirty to seventy public health lectures annually on topics including personal health, STD prevention, and women’s healthcare. She was dedicated to advocating for women’s and children’s rights and protecting vulnerable groups.
On April 7, 1996, the turning point came. Sixty-nine-year-old Gao Yaojie was invited to a Zhengzhou hospital to consult on a forty-year-old rural woman suffering from a “strange illness.” The woman, surnamed Ba, had been hospitalized for two weeks, and doctors remained unable to diagnose her condition.
Gao Yaojie ordered blood tests. The results were shocking: the woman was infected with HIV. Tracing her medical history, Gao discovered that Mrs. Ba had received a blood transfusion during uterine tumor surgery years earlier—that was how the virus had entered her body.
Ten days later, Mrs. Ba died.
What struck Gao Yaojie was that Mrs. Ba’s husband and children were not infected with HIV, despite living with her for years. This proved the virus wasn’t sexually transmitted—the official narrative that AIDS spread primarily through sex and drug use didn’t hold up.
“I first encountered an AIDS patient in 1996 at a Henan hospital,” she later recalled in international speeches. “She was a forty-year-old rural woman who wasn’t diagnosed with HIV until days before her death. This made me realize that in China, most people, including most doctors, knew nothing about this deadly disease.”
Chapter 3: The Awakening — Discovery and Early Investigation (1996-2000)
A One-Person Investigation
After Mrs. Ba’s death, Gao Yaojie didn’t choose to return to quiet retirement. She began visiting rural areas to determine whether this was an isolated case or the tip of an iceberg.
The reality was far worse than she had imagined. In Wenlou Village, she found that 65 percent of villagers were infected with HIV. Villagers told her: “Everyone here sells blood.” In Donghu Village, the infection rate was estimated at 80 percent. Across southern Henan, countless villages were shrouded in “unexplained fevers” and “strange illnesses”—the symptoms of AIDS.
Gao Yaojie’s investigative methods were simple but solid: she documented each patient’s medical history, photographed them for records, went door-to-door asking villagers about their blood-selling experiences, and tracked infection patterns. Over the following years, she visited more than one hundred villages, contacted over one thousand affected families, and covered sixteen provinces including Henan, Hebei, Shandong, and Shanxi.
Nearly all funding came from her retirement pension and personal savings. Each print run of educational pamphlets cost 3,000 to 5,000 yuan—a huge expense for a retiree. By 2000, she had spent so much on patients and advocacy that her husband had to take over family finances, forbidding her from using their savings.
Uncovering the Truth
Through extensive fieldwork, Gao Yaojie gradually pieced together the complete picture: the epidemic’s root cause was not official claims of sexual transmission or drug use, but cross-contamination in the plasma economy.
She stated bluntly in interviews: “I’ve visited many provinces, cities, and counties and seen thousands of AIDS patients. But I’ve never seen drug users, and I’ve found that sexual transmission cases are less than ten percent. The likelihood of infection through blood transmission is 100 percent.”
She cited a study showing that among 500 couples where one partner was infected with AIDS, the infection rate for the other partner was less than 9 percent—proving that sexual transmission was not the primary route. Village-wide infections—including children, the elderly, and married couples—could only be explained by blood transmission.
Early Cries of Warning
On December 1, 1996—World AIDS Day—Gao Yaojie launched the AIDS Prevention Knowledge newsletter. The first issue was funded by the Henan Provincial Bureau of Cultural Relics and the Soong Ching Ling Foundation. All subsequent issues were self-funded.
Her distribution method was ingenious: she handed out newsletters to passengers at Zhengzhou Railway Station, asking them to carry the materials to rural areas. She also distributed through the Henan Provincial Disease Control Center, family planning centers, buses, and trains. Ultimately, the newsletter ran for fifteen issues with 530,000 copies distributed.
She gave thirty to seventy public lectures annually, incorporating AIDS prevention knowledge. Her apartment became a “command center” where she printed pamphlets and responded to letters and phone calls from patients and doctors across the country.
In August 2000, Gao Yaojie was interviewed by China Newsweek, and the story was reprinted by multiple media outlets. This exposure brought broader attention but also trouble—local government immediately ordered her to stop accepting any journalist interviews.
Resistance and Risk
Seventy-year-old Gao Yaojie, dragging feet crippled by childhood binding, bearing injuries from Cultural Revolution beatings, traveled through rural areas for days at a time. Her mail was intercepted, her phone monitored, her movements surveilled, her photographs confiscated.
In November 2000, a scheduled student lecture was cancelled hours before it was to begin, because she had acknowledged she would discuss AIDS.
Public reaction was not always friendly. She was chased out of clinics, factories, and bars—simply for distributing AIDS awareness materials. The disease’s stigma was so severe that even raising awareness was considered dangerous.
Family relationships also began to strain. Her eldest daughter later said her mother “saved others but destroyed our family.” Gao herself admitted: “I am a good doctor, but not a good mother.”
But she couldn’t stop. “I worried about how the situation would develop, but I had no power, no money,” she said. “So I started writing; I printed some materials about AIDS. I went to train stations, public squares, busy streets, and distributed them to people.”
Chapter 4: The Struggle — Confronting Power (2000-2009)
Surveillance and Harassment
After 2000, as Gao Yaojie’s profile rose, so did official pressure.
Her mail was intercepted and phone monitored for years. She was banned from accepting journalist interviews. Her blog became a “battlefield” between supporters and critics—in February 2007, she revealed on her blog that people were being paid 50 yuan per comment to leave negative posts.
In 2001, Gao Yaojie was awarded the Jonathan Mann Award for Health and Human Rights, but she was barred from leaving the country to accept it. In 2003, she received the Ramon Magsaysay Award for Public Service—often called the “Asian Nobel Prize”—but again could not travel to Manila to receive it.
Her books couldn’t find publishers in China. “No Chinese publisher would publish Ten Years Fighting AIDS or AIDS Orphans,” she said. “Editors who accepted my manuscripts lost their jobs.” She could only self-publish, using the $20,000 from her awards and a $10,000 grant from the Ford Foundation to print 150,000 copies of AIDS/STD Prevention.
2007: The House Arrest That Changed Everything
In February 2007, Gao Yaojie was awarded the Vital Voices Global Leadership Award, with the ceremony scheduled for March 14 at the Kennedy Center in Washington, D.C.
However, just before her planned February 4 trip to Beijing to apply for a U.S. visa, Henan provincial officials placed her under house arrest. Approximately fifty police officers surrounded her Zhengzhou apartment. Officials tried to force her to sign a statement saying she was “too ill to travel.” The Chinese ambassador to the United States told Senator Hillary Clinton that Dr. Gao was “too frail to travel.”
Gao Yaojie angrily demanded: “I think they believe I’m interfering with their political achievements and careers. Otherwise, why put me under house arrest? What law have I broken that requires mobilizing so many police?”
Hillary Clinton immediately took action, writing directly to Chinese President Hu Jintao and China’s top health officials. International pressure mounted rapidly, with widespread media coverage.
On February 16, under international pressure, the Chinese government finally allowed Gao Yaojie to travel. Senior officials including Henan’s deputy governor and deputy party secretary personally visited her home with flowers to inform her she could go to the United States to receive her award.
On February 26, 2007, eighty-year-old Gao Yaojie checked in at Beijing Capital Airport and flew to America.
A Voice on the World Stage
In Washington, Gao Yaojie delivered her most powerful message: “The primary route of AIDS transmission in China is blood trading. China’s epidemic is different from the rest of the world, because I’ve communicated with American AIDS groups, and they say it’s mainly spread through sex and intravenous drug use.”
She publicly thanked President Hu Jintao for approving her travel. “I thank you for your help,” she told supporters. “I thank you for everything you’ve done.”
This victory brought her even greater trouble. After returning to China, authorities intensified surveillance and even pressured her family to silence her.
The Escape
In May 2009, Gao Yaojie’s phone was cut off by police—she recognized this as a signal that arrest was imminent.
What finally prompted her decision was the arrest of AIDS activist Tan Zuoren. Tan was prosecuted for “subversion of state power” after investigating child deaths in the Sichuan earthquake. Gao Yaojie feared the same fate awaited her.
“I don’t care if I can return to China,” she told the BBC. “I want to publish my three books and leave the truth about China’s AIDS epidemic for the world.”
With help from Texas-based ChinaAid, eighty-two-year-old Gao Yaojie secretly left from Guangzhou and flew to New York. She never revealed the details of her escape, only saying with a “sly smile” that she wanted to “protect those who helped her get out.”
“I left so that those AIDS patients would not have died in vain,” she wrote.
Chapter 5: The Rescuer — AIDS Orphans and Direct Aid
The Orphan Crisis
The plasma economy left behind not only hundreds of thousands of dead but countless orphans. Gao Yaojie estimated that each AIDS death left behind one, two, or more orphans. In Henan Province alone, the number of AIDS orphans could reach hundreds of thousands.
These children’s circumstances were desperate: after losing their parents, they had no food, shelter, or money for school. Many lived in mud huts with family incomes of only about $300 per year. Some children ate raw wheat grains from the fields, causing diarrhea.
Even crueler was social discrimination. In rural areas, people superstitiously believed these orphans were “criminals” or “jinxes” who had “cursed” their own parents to death. Relatives would tell children: “You bring bad luck wherever you go.” Even the twenty-two government-built “Sunshine Homes” boarding schools remained largely empty, because entering one meant publicly acknowledging that parents had died of AIDS.
A One-Person Rescue Mission
Beginning in 2000, Gao Yaojie shifted her focus to AIDS orphans—a term she coined.
Her methods were direct and practical: she personally visited villages to find orphans; she paid for their school fees and living expenses from her own retirement pension; she helped find adoptive families; and she publicly held AIDS-infected children in villages to dispel misconceptions about viral transmission.
From 2000 to 2004, she spent over 80,000 yuan directly supporting 164 AIDS orphans. Her total expenditures—including educational materials, patient assistance, and orphan support—exceeded one million yuan.
Her funding sources included: her personal pension, the $20,000 from the 2001 Jonathan Mann Award, the $50,000 from the 2003 Magsaysay Award, a $10,000 Ford Foundation grant, and all royalties from her more than twenty books. She converted all book income into books that she distributed free to those in need.
Scenes She Could Never Forget
In her public speeches and writings, Gao Yaojie repeatedly recounted scenes that haunted her for life.
The most famous occurred in 2000: “I walked into a village, through a narrow alley, and heard a child calling: ‘Mama, come down; Mama, come down.’ Going inside, I saw the child’s mother had hanged herself. The little child didn’t know his mother was dead—he was pulling at her feet, calling for her to come down.”
The mother had just tested positive for HIV. Her husband had already died of AIDS, and the family’s savings had been swindled by quack doctors. “Stories like this are everywhere in all the AIDS villages in Henan,” Gao Yaojie said.
Another time, she and a journalist entered a village and heard loud weeping from a house: “Going inside, I saw a child clutching his mother’s legs. The mother had hanged herself because she couldn’t afford treatment for AIDS.”
“As I walked out of that village, I couldn’t stop crying.”
The Cost
This work took a heavy psychological toll on Gao Yaojie. In her later conversations with biographer Lin Shiyu, “every time she mentioned those victims, she would become emotional and couldn’t help but cry.”
Friends recalled that when discussing AIDS-infected farmers and orphans, “she often cried uncontrollably.”
“These people died so miserably, so unjustly,” she said. “I must speak for them.”
Chapter 6: The Witness — Her Writings and Voice
Ten Thousand Letters
One of Gao Yaojie’s most important contributions was collecting and preserving letters from AIDS victims and their families.
After diagnosing her first patient in 1996, desperate victims began writing to her from across the country—from Henan, Hainan, Hubei, Guangdong, Yunnan, Xinjiang… Letters arrived by the thousands. Her apartment became a “command center” for receiving and responding to these letters.
The letters told of family destructions: the infection process, the suffering of illness, social discrimination, the despair of having nowhere to turn. When the 10,001st letter arrived, she decided to compile them for publication.
In 2004, Ten Thousand Letters: The Living Conditions of AIDS and STD Patients I Have Witnessed was published by China Social Sciences Press. However, all sharp criticism of the government was deleted—the editor wept over this. Because authorities banned promotion and bookstore display, only 3,000 copies sold. Gao Yaojie had to distribute the remaining copies herself.
After fleeing to America in 2009, she finally published the unabridged version in Hong Kong as Blood Disaster: 10,000 Letters—A True Record of AIDS in China. “All my books about AIDS suffered the same fate in China,” she said. “Now I can express myself freely, so I changed the original title to China’s AIDS Catastrophe.”
A Complete Bibliography
Gao Yaojie published more than twenty books in her lifetime:
- Ten Thousand Letters (2004) — Recording patient letters, won Best Chinese Book Award 2005
- Blood Disaster: 10,000 Letters (2009) — Unabridged edition, published in Hong Kong
- The Soul of Gao Yaojie (2008/2017) — Autobiographical memoir
- An Investigation of AIDS in China (2005) — Field investigation report
- China’s AIDS Catastrophe (2008) — Latest testimony
- My AIDS Prevention Journey (2011) — A decade of activism
- Truth Through the Lens (2013) — Photographic documentation of AIDS villages
- Gao Yaojie: Memories and Reflections (2015) — Reflections from exile
Additionally, she self-funded printing and distribution of over 1.2 million pamphlets and nearly 500,000 books.
Her Voice
Gao Yaojie’s public statements were frank and pointed, never shying from sensitive topics:
On her mission: “My driving thought is: how can I save more people from dying of this disease? Each of us lives only once.”
On the cover-up: “The government has a good weapon—saying AIDS is a dirty disease brought by drug use and sex. So everyone thinks AIDS patients are bad people with moral defects.”
On the truth: “If mishandled, China’s AIDS crisis will be as catastrophic as civil war or famine.”
On accountability: “This was a man-made disaster. Yet those responsible have never been held accountable, nor have they said a single word of apology.”
On herself: “I am not a hero. I am just an ordinary person. I am a person in the original sense. I cannot look away from others’ suffering.”
Chapter 7: The World Takes Notice — International Recognition
Honors and Their Price
Beginning in 2001, Gao Yaojie began receiving international recognition:
- 2001: Global Health Council Jonathan Mann Award for Health and Human Rights — Barred from leaving to accept
- 2002: TIME magazine “Asian Hero”
- 2003: Ramon Magsaysay Award for Public Service — Barred from leaving to accept; also named CCTV “Person Who Moved China”
- 2004: Southern People Weekly “50 Public Intellectuals Influencing China”
- 2007: Vital Voices Global Leadership Award (allowed to attend after international intervention); Heinz R. Pagels Human Rights of Scientists Award from the New York Academy of Sciences; International Astronomical Union named asteroid 38980 “Gaoyaojie”
- 2015: Liu Binyan Conscience Award
However, international honors were both protection and a source of trouble. Each instance of international attention made her a bigger target for authorities. For the two major international awards in 2001 and 2003, she was unable to leave China. The 2007 house arrest showed that only international pressure could temporarily protect her—but such victories invited harsher retaliation.
The Friendship with Hillary Clinton
Among Gao Yaojie’s international supporters, Hillary Clinton was the most important.
In 2007, it was Clinton who wrote directly to President Hu Jintao, enabling Gao to leave the country. The two met multiple times afterward. In 2019, Clinton visited Gao in New York, calling her “one of the bravest people I know.”
After Gao Yaojie’s death in December 2023, Clinton posted on Twitter: “I am very sad to hear of my friend Dr. Gao Yaojie’s passing. She endured house arrest and exile for exposing the blood transfusion program that spread AIDS. She was one of the bravest people I’ve ever known.”
Chapter 8: Exile — The Final Chapter (2009-2023)
Surviving in a Foreign Land
In August 2009, eighty-two-year-old Gao Yaojie arrived in New York and moved into a one-bedroom apartment in West Harlem near Columbia University. The $2,000 monthly rent was raised with help from Columbia professor Andrew Nathan.
She never learned English and never truly adapted to American life. “It has been more than ten years since I left my motherland in 2009!” she wrote. “My family members have either passed away or are separated from me. Living in a foreign land, I cannot settle down or learn the language… Through the long nights, I am like a heartbroken traveler!”
She described her existence in America as “living on in degradation.” When American friends suggested she move to a nursing home, she refused, considering it even more humiliating.
Her health deteriorated steadily: having lost most of her stomach from the Cultural Revolution suicide attempt, she could only eat noodles and steamed bread; blood clots spreading made walking difficult; her hearing and vision worsened. In 2016, she was hospitalized with pneumonia. In her final years, she was largely bedridden, “able to get out of bed for only a few minutes each day.”
Yet even so, she continued to write. Her laptop rested perpetually on her chest, her fingers tapping at the keys. “After writing for four hours yesterday, all my fingers turned black,” she once described.
The Final Work
During exile, Gao Yaojie continued publishing: Truth Through the Lens in 2013, Gao Yaojie: Memories and Reflections in 2015, and an updated The Soul of Gao Yaojie in 2017.
She collaborated with journalist Lin Shiyu on the oral autobiography Through Rain and Mist, with Lin visiting her apartment “dozens of times” for in-depth interviews. She also worked with BBC journalists and documentary filmmakers to record her story.
She maintained contact with AIDS patients in China through intermediaries. Many Chinese visitors regarded her as a hero and made special trips to see her. Professor Nathan said: “Many Chinese people consider her a hero. When they come to New York and don’t know how to contact her, they ask me… As far as I know, she always wrote back to them and welcomed their visits.”
Her Final Wishes
In November 2016, Gao Yaojie issued a solemn declaration:
“My name is Gao Yaojie. I hereby solemnly declare that when I die, I want my body to be cremated, not buried. I want my ashes scattered into the Yellow River as soon as possible after my death, with no ceremony.”
“I don’t want a grave, because I worry that liars will try to profit from it. I cannot stay in America. I want to drift eastward along the Yellow River and basically disappear from this world.”
In her will, she expressed hope that her son would bring her ashes back to China and scatter them in the Yellow River. “Every time she saw me, she would mention this,” Lin Shiyu said. “She was always worried about it.”
The Passing
On December 10, 2023—International Human Rights Day—Gao Yaojie died at her home in Manhattan, just nine days before her ninety-sixth birthday.
Professor Nathan was at her home that morning, waiting for the medical examiner. “She had been weak for years, only able to get out of bed for a few minutes each day, but her health had been stable, and her death was sudden and unexpected.”
Chinese social media was flooded with tributes. Weibo comments read: “It can be said that Gao Yaojie devoted everything to AIDS patients. People with conscience will remember her forever.” “She was a great person, but unfortunately died in a foreign land due to political reasons.” “She said ‘A person cannot live only for themselves’—won’t some officials feel ashamed?”
In Wenlou Village, Henan, a villager named Liu said: “She did so much for HIV-infected people in Henan. Everyone is very sad that she has passed away.”
Chinese official media did not report her death. When Caixin magazine included her alongside Li Keqiang and others in its “Farewell 2023” feature, the article was deleted.
Chapter 9: The Inner World — What Sustained Her
Sources of Strength
The forces that sustained Gao Yaojie through decades of struggle came first from her childhood education. Even in her later years, she could still recite from the Book of Songs and Mencius. Mencius’s teachings were deeply impressed in her heart: “Wealth and honor cannot corrupt him, poverty and lowliness cannot move him, force and power cannot bend him.”
The life philosophy of “taking responsibility for all under heaven” was formed in her childhood.
Second was her early suffering. As Zhang Jicheng observed: “Many people don’t understand why she did this, but she had already experienced so much that she wasn’t afraid.” The Cultural Revolution persecution, the suicide attempt, her son’s imprisonment, the desecration of ancestral graves—these sufferings forged her resilience.
She herself said: “I have experienced too much suffering, so I help others. I sympathize with them.”
Fears and Doubts
Gao Yaojie was not without fear. In her memoir, she wrote: “As a doctor, I could not look away; I had a responsibility to do everything I could to stop this epidemic from spreading. However, at the time I did not know the unfathomable forces causing AIDS to spread so widely. If I had known, I might not have been able to muster the courage.“
During her exile years, she experienced moments of despair. Friend Wu Wei recalled: “Sometimes she would say she was tired of living, that she didn’t want to live anymore.”
But she also had a strong sense of urgency—”like she was really anxious” to finish writing and recording everything. When her writing tablet broke, “she was very frustrated because she couldn’t do anything.” Lin Shiyu reflected: “Writing may have been her only reason to keep living.”
What She Truly Feared
“I’m not afraid of death,” Gao Yaojie said. “What I fear is that the truth about China’s AIDS epidemic will be forgotten.“
“Everyone eventually faces death. I’m not afraid of death—what I fear is that the truth about China’s AIDS epidemic will be buried. I left so that those AIDS patients would not have died in vain.”
The Human Choice
Reflecting on Gao Yaojie’s life, Lin Shiyu concluded: “When faced with the choice between speaking the truth or remaining silent, Gao Yaojie always chose the humane way… Between humanity and the authoritarian system, she chose humanity, thereby placing herself in opposition to the system.”
Chapter 10: The Legacy — Lessons for the Good-Hearted
What She Changed
Gao Yaojie’s work brought tangible results:
Her revelations contributed to the Chinese government’s acknowledgment of the AIDS epidemic in 2003 and the introduction of the “Four Frees and One Care” policy—providing free antiretroviral drugs for rural patients, free testing, free treatment and schooling for infected children, and living subsidies for affected families.
By 2004, over 400 blood stations had been established nationwide to control blood transmission. The government invested more than two billion yuan in AIDS prevention and treatment.
She personally supported 164 AIDS orphans, distributed over 1.2 million pamphlets and 500,000 books. The more than 10,000 letters she preserved became an indelible historical archive of this man-made catastrophe.
Unfinished Business
Yet Gao Yaojie’s efforts could not change the system. As her biographer observed: “Gao Yaojie’s efforts could not change the system—the Chinese government’s cover-up of the initial SARS and COVID outbreaks mirrored its official attitude toward the AIDS epidemic almost exactly.”
She never saw a single official responsible for the blood catastrophe held accountable. Her family was fractured by her work. She died alone in a foreign land.
How She Is Remembered
In official narratives, Gao Yaojie’s name remains a sensitive term. But among the people, she is called “the nation’s conscience,” “China’s Mother Teresa,” and “Grandma Gao.”
The AIDS Healthcare Foundation declared after her death: “History will place her among the heroes of the global fight against AIDS.”
In 2007, the International Astronomical Union named asteroid 38980 “Gaoyaojie.” Someone commented: “Her kindness and persistence are like that asteroid. Even if you cannot see its light in the darkness, it will forever illuminate future generations.“
Lessons for the Good-Hearted
Gao Yaojie’s life offers valuable insights for those who may face similar choices.
First, do not underestimate individual power. Lin Shiyu said: “Think about it—in 1996 she was sixty-nine, already retired. She never thought she would save so many people, nor did she think she would get into so much trouble because of it. But not doing so would have violated her conscience, so she did it.”
Second, start from your professional expertise. Gao Yaojie used medical knowledge as her weapon, beginning with diagnosing one patient and gradually uncovering the truth about the entire epidemic.
Third, document everything, write everything down. Gao Yaojie published more than twenty books and preserved over 10,000 letters, leaving irreplaceable testimony for future generations.
Fourth, find allies. Her work was supported by journalists, international organizations, and foreign dignitaries. Even just a few loyal friends can sustain years of resistance.
Fifth, be prepared to pay the price. Surveillance, house arrest, phone monitoring, mail interception, family breakdown—these are all consequences whistleblowers may face.
Finally, and most importantly, choose to speak the truth, even when the cost is high.
“You don’t have to speak, but don’t tell lies,” Gao Yaojie summarized her principle.
Epilogue: Eastward on the Yellow River
On December 10, 2023, Gao Yaojie passed away peacefully in her Manhattan apartment. Her final wish was to have her ashes scattered in the Yellow River—that ancient river flowing through her native Shandong, through Henan where she worked half her life, through countless AIDS villages.
She hoped her ashes would drift eastward along the Yellow River, “basically disappearing from this world,” leaving no grave, no ceremony, no opportunity for anyone to profit from her reputation.
Yet what she left behind was far more than ashes.
More than 10,000 letters documenting countless families’ suffering and loss. More than twenty books bearing witness to a covered-up catastrophe. Millions of educational materials that once circulated through railway stations, rural roads, clinics, and classrooms. One hundred sixty-four orphans who received schooling through her support, some of whom went on to university.
“I could have lived a quiet, peaceful private life after retirement,” she wrote in her memoir, “if I hadn’t gone to see that AIDS patient—she set me on a path of no return.”
That path of no return was long and lonely, filled with suffering and sacrifice. But it was this path that transformed an ordinary retired doctor into the conscience of an era.
Gao Yaojie often said: “I am not a hero. I am just an ordinary person. I am a person in the original sense. I cannot look away from others’ suffering.”
Perhaps this is the most important legacy she left us: in an era when silence is safer, someone still chose to speak the truth; in a society where systems crush individuals, someone still chose to stand with the victims; in the confrontation between humanity and power, someone unhesitatingly chose humanity.
The asteroid named after her will orbit eternally in the cosmos, reminding future generations: even in the darkest moments, the light of conscience never goes out.
Gao Yaojie (December 19, 1927 — December 10, 2023) This article is available in Chinese.