Ma Zhengzhou: An AIDS Relief Practitioner on the Frontline

China Development Brief, No. 53 (Spring 2012)

中文 English

Editor’s Note: This article originally appeared online in 2012 and we are re-publishing it to mark 2014 World AIDS Day.

As part of her series on NGOs in Anhui, Guo Ting tells the bittersweet story of an AIDS relief practitioner’s ultimately successful efforts to set up a Chi Heng Foundation office in Anhui province, register it as a NGO and deliver financial assistance to HIV-infected families in the area. Ma Zhengzhou’s story reveals the difficulties faced by NGO practitioners in China yet also illustrates how they can overcome those difficulties by persisting through adversity and rejection, and building good relations with local GONGOs.

At the end of 2011, I received an anonymous reader’s letter.  The letter in fact consisted of only a single line, “please pay attention to the tragic fate of rural HIV-infected people,” while the body was completely empty, without a name or contact details.  Curious, I wrote back to seek an understanding of the writer: He was Xiao Dai, a young man from rural northern Anhui, whose parents contracted HIV through blood transfusions in the 1990’s, bringing further hardship to this already poor family.  He had to study hard to secure a place at a university, and yet he arrived  carrying his bedroll, unable to pay his tuition, and prepared to be rejected and head south to do manual work.  He avoided this fate thanks to the generosity of the Chi Heng Foundation (智行基金会), an organization that provides financial aid to children affected by AIDS and which, having learned of his situation, provided tuition fees and living expenses.  Today Xiao Dai has graduated and is married with children.

Of course, behind any inspiring story is a more complicated struggle. Xiao Dai’s story deviated from the standard script.  After graduating from university, rather than seeking a highly-paid job, he chose to join Chi Heng’s AIDS relief work.  He is currently working in their Anhui office, the Fuyang Women and Children Development Association (阜阳妇女儿童发展协会) where he is the assistant director. In order to help children with backgrounds similar to his own, he plans to work with Chi Heng for at least a decade. But, his meager salary, coupled with his father’s death and mother’s illness, not to mention the financial strains of raising a child have left Xiao Dai feeling troubled. He found China Development Brief’s (中国发展简报) contact details on its website and wrote a letter of appeal, imploring CDB to bring attention to rural impoverished areas affected by HIV and the relief work being carried out.

Having received Xiao Dai’s introduction, before the new Lunar year, I traveled to the Fuyang Women and Child Development Association, to visit its director, Ma Zhengzhou.

AIDS Relief Work in Poverty-Stricken Areas

In early 2003, Ma, now in his early thirties, graduated from university and threw himself into public interest work.  Initially, he joined the well-known Fuyang AIDS Orphans Salvation Association (AOS, 阜阳市艾滋病贫困儿童救助协会). Three years later he accepted an offer to set up a Chi Heng Foundation office in Anhui. Recalling the work of the past few years, he felt the first year he buried himself in work matters, while his second year was committed to rooting out false claims for aid. Then in the third and fourth years, his work finally began to enter a routine.

In the 1990s, farmers living in impoverished areas in Henan and Anhui provinces sold their blood to blood banks.  The blood banks’ lack of standards led to a high number of HIV infections, including in the Fuyang region.  In order to help infected persons, a number of NGOs were set up in the Fuyang area to provide aid and carry out relief work.

The blood banks’ errors produced tragic consequences on a massive scale, and government subsidies so far have not met the needs of those affected.  NGOs providing relief also tend to have a variety of constraints, and have to balance political concerns with provision of aid to the infected, which adds even more difficulties to the situation.

In the first year of Ma’s work with Chi Heng, he investigated villages affected by HIV going from family to family, recording things such as family income, number of children in the family and educational level, and provided grants and subsidies based on his assessment.  However, during the second year problems began to surface, most notably, finding several residence permits (hukou) at a given home, some real and some fake, which showed discrepancies in the number of children.  When the family planning authorities came around the family would present its one-child permit. When Chi Heng came, the family might present a five or six-child permit—in one case a family claimed twelve children, borrowing them from neighbors and schooling them in how to answer the case worker’s questions.1

Due to the lack of government capacity, those infected with HIV and living in poverty are doubly marginalized in status.  Ma is very clear that moral accusations against vulnerable groups are another type of oppression.  In truth, moralistic teachings are beautiful but not practical, and individuals face hard realities. Nevertheless, NGOs owe a duty to their donors. To screen and examine people living on the margins is hard work but has to be done.

Ma’s main approach to uncovering fraud involves soliciting information from anonymous informants, though sometimes the deception is obvious from the start. For example, regarding the family claiming they had 12 children, Ma initially felt some uncertainty, and a glance at the hukou confirmed his suspicions:  the counterfeit hukou was so shoddily made that several children’s dates of birth were written in different months within the same year.

Ma made a joke to the man of the house, saying: “You seem pretty well-off and influential, so why are you looking for a handout?”

The man naturally surprised said: “Director Ma, what are you talking about?  I’m extremely poor.  How could I be influential?”

Ma pointed to the hukou and said: “You must have several wives, otherwise how can several children be born in the same year, one every few months?”

Ma took the dumbstruck man aside and explained that, although money is tight, public interest organizations are just well-meaning people donating money to help others, and people should not fake poverty to take advantage of others’ kind hearts.  According to regulations, the aid eligibility of the person making the fraudulent claims should have been rescinded.  But after a verification of the family’s actual situation and cancellation of their false claim, Ma connected the family with some other aid organizations to provide support.

The man was chastened and voluntarily took on the role of informant, ferreting out other fraudulent claims in the community and smoothing out many of the obstacles that Ma would have otherwise faced.

Working in the countryside for so many years, Ma has a host of stories, but the one that he remembers most is the time he drove into a river. It all started with Chi Heng’s accounting system, which is very strict, and requires an official receipt before reimbursing any expenses.  On many trips to the countryside, unable to procure any sort of receipt, Ma ended up paying his bus fare out of pocket. To avoid this problem, he bought a motorbike. Not only was it convenient, but he could always get an official, reimbursable receipt from a filling station.  Ma, however, was unsteady on his new bike and before long, on the way to Funan County, he had an accident and fell into a river.  Fortunately, he was uninjured and able to extricate himself without any trauma, hurrying home to rest.  To his surprise, the next day many people called him to express their sympathies. He thought no one had seen the accident, but it seems that someone had witnessed it from a distance, and word quickly spread. A few days later, the entire Funan HIV circle knew and had expressed their sympathies, which touched him very deeply.

When You Stumble, Get Back Up and Try Again

Ma’s first job was assisting in the filming of the Oscar-winning documentary “The Blood of Yingzhou District” and working with the renowned AOS2. When he was young he thought about, but ultimately left AOS due to a clash of personalities and principles.  Afterwards, he found work doing marketing and promotion for a milk company. His sheer drive and willingness to work through the hottest summer days saw him promoted to sales manager after just three months. He made 2400 RMB per month which, in Fuyang in 2006, was a considerable income.

After seeing the job vacancy at the Chi Heng Foundation, Ma sought to rekindle his original dream. During the interview, the interviewer said they could only give him a wage of 600 RMB. When asked if that was ok, Ma stated that even no money would be ok. Upon hearing this, another interviewer asked if 400 RMB was acceptable, and Ma gladly accepted.  He thus joined Chi Heng on a salary that was 2000 RMB/month less than his previous job.  Recalling his decision, Ma says that he was not really motivated by compassion, but more by a desire to prove his own character and mettle.

At first, the entire Chi Heng Anhui office consisted of just him, in one room, with a desk and a telephone.  Not knowing what to do and having no one to provide guidance, Ma went to Xu Zhenjun, the director of the Chi Heng Foundation in Greater China.  Xu said, “We hired you to figure the job out yourself,” and added jovially “if you are truly at a loss you might as well go home.”

Ma had to figure things out on his own and set about implementing canvassing and relief efforts in accordance with Chi Heng’s policies aimed at AIDS-affected youth. Today, the Fuyang Women and Child Development Association has employed a total of five full-time staff, with the addition of two information specialists and two interviewers, and has provided relief to a total of 1150 children.  During busy times, the five head to the countryside to deliver goods and materials and provide subsidies.  Due to Chi Heng’s regulations, the provision of grants and subsidies must all be witnessed, for fear of unexpected irregularities that could be hard to deal with.

Chi Heng has particularly strict financial requirements, and on one occasion when Ma attempted to claim for travel costs, due to a discrepancy of one RMB, he was refused travel reimbursements for a whole month. As it turns out, on his return trip to Fuyang the bus ticket vendor had errantly torn off the one RMB of travel insurance from Ma’s ticket. He ultimately procured a testimonial from the chairman of the Funan County Women’s Federation, explaining the local practices of bus operators and corroborating Ma’s account. Ma ultimately was reimbursed.

Although the Chi Heng’s financial system is particularly strict and at times a little harsh, the operating expenses of this institution have not been a problem for many years.  But, in order to expand and apply for more projects, or receive local contributions, they needed to register in order to obtain legal status.  The two-year process saw Ma jumping through an endless series of hoops, once again demonstrating his unyielding character.

In the past two years, all over the country, many of the requirements for registering a NGO have been relaxed.  But while several major cities have implemented direct registration, in a prefecture-level city like Fuyang, NGOs must still find an official sponsor3. Because of the nature of Chi Heng’s work, Ma thought the Fuyang City Women’s Federation would be an appropriate sponsor, and began the application process in 20084.  At first his applications were all rejected without explanation, so Ma got in touch with a seemingly affable department head from the Women’s Federation and cultivated a relationship, seeking this insider’s advice.  Even after the improvements, again and again Ma submitted the applications only to be refused.  After a year of this, Du Cong, founder and director of the Chi Heng Foundation, heard that they had still not been accepted, and proposed that he personally meet with the Women’s Federation chairman.  However, after the meeting, he felt the situation was hopeless and advised Ma to give up.

But Ma refused to give up and continued to apply over and over again.  In November 2010, over half a year later, the Chairperson of the Fuyang City Women’s Federation made a telephone call to say they would be the NGO’s sponsor.  But Ma’s troubles were not over.  The Bureau of Civil Affairs was poised to deny approval because of Chi Heng’s programs aimed at homosexuals. Ma went back to the Women’s Federation to seek their explicit, written support as a guarantor—a trusted organization to vouch for Chi Heng’s activities. After a month of limbo, the application was finally approved and the Fuyang Women and Child Development Association became the first of Chi Heng’s ten nationwide offices to secure official recognition on the local level.

After hearing the news, and after six years of its own rejections, another Fuyang volunteer organization came to Ma to ask him if he had a strong network of relationships to help him succeed.  Ma said he really did not, and the secret to success is an unyielding character.

Ma Zhengzhou’s New Year Wishes

In early January 2012, when the Chi Heng Foundation held their national annual meeting, Du Cong asked Ma if he had any wishes, Ma said he was hoping for a raise—not for himself, but for the other employees.

Despite Chi Heng being a Hong Kong foundation, it is still difficult for them to raise money needed to cover administrative costs.  There was a two-year period when administrative costs came out of Du Cong’s own pocket. Even when there is money, it is limited.  As a result the office staff salaries all over the country are quite low.  Chi Heng’s employees, all university graduates, enter on a salary of just 800 RMB, later raised to just 900 RMB. After deducting various insurance premiums, employees are left with a net salary of just over 500 RMB.

Staff who wish to develop their careers and live with dignity have no choice but to find alternative jobs, and a high staff turnover means low efficiency. The loss of key employees makes Ma very sad. Many people stay on for a year, only to leave because of the low salary, and the re-recruitment cost for small institutions like this is too great.

In addition to increasing salaries, Ma hopes to increase the Association’s ability to fundraise. Although his office receives regular funding as a branch of Chi Heng, the whole purpose of procuring local registration was to increase the number of local funding channels and develop new projects. Grant proposals have proven challenging but improving their capacity to fundraise and develop sustainably is one of Ma Zhengzhou’s New Year wishes.

Postscript: This interview took place on the 19th January 2012, and was distributed to the press in early March 2012.  I mentioned at the beginning of the article a chat with Xiao Dai who has in the last few days told me some surprising news.  The new was that Ma Zhengzhou had decided to change careers due to financial pressures.  Ma did not want to be interviewed further and Xiao Dai did not want to elaborate.  We therefore have no way of knowing the details, but this outcome perhaps illustrates the predicament faced by grassroots NGO practitioners in central China.


  1. Editor’s Note: Chi Heng gives subsidies to children whose parents are HIV-positive, so families have an incentive to falsify the number of children in order to receive a larger amount of money. 

  2. Editor’s Note: “The Blood of Yingzhou District” was a documentary directed by Ruby Yang about AIDS orphans in Anhui’s Yingzhou District” 

  3. Editor’s Note: The author is referring here to experiments being carried out in several cities such as Shenzhen which are allowing NGOs to register directly with the Civil Affairs office without having to find a government sponsor, also known as the “professional supervising unit.” The main reason why many NGOs in China cannot register is because of the difficulty of finding such as sponsor. 

  4. Editor’s Note: The NGO’s sponsor or professional supervising unit should be working in the same sector as the NGO.  Since Ma’s NGO was working on women’s and children’s health, a logical sponsor would be either the Women’s Federation or the local Health department. 

正洲:不服的艾滋救助工作者
郭婷
中国发展简报2012年春季刊
2011年底,笔者收到一封匿名读者来信,说是信,其实只有一行“请关注命运悲惨的农村艾滋感染者”的标题,正文空空如也,也无落款与其他联系方式。好奇 之下,笔者回信追问,这才了解来信者小代的故事:他曾是一个普通的皖北农村少年,20世纪90年代,父母因血液传播双双感染艾滋,原本贫困的家境更加艰 难;他发奋读书考取大学,却因贫困无法交起高昂的学费,带着铺盖卷到学校报到的时候,已经做好被拒绝便南下打工的准备。当然,同所有成长励志故事一样,峰回路转,专门资助受艾滋影响孩子的智行基金会得知他的情况后,资助了学费和生活费,如今小代已顺利毕业,并成家生子。
寥寥数语概括的励志故事背后往往是主角经历的无数艰辛和始终不懈的奋斗,而这个故事的结尾与大多数故事略有不同的是,小代大学毕业后,并没有选择创业或高薪工作,而是投身智行基金会的艾滋救助工作,目前任智行基金会安徽办事处——阜阳妇女儿童发展协会的副会长。为了救助像曾经的他一样命运的那些艾滋孩子, 他说要在智行至少坚持干十年。但是,走村串户的走访工作和微薄薪水支撑下的理想,在父亲因艾滋去世多年、母亲免疫力低下且多种并发症到了晚期、幼子成长需要沉重养育费用的现实面前,是如此的苍白无力。年关临近,小代一时忧心,在中国发展简报网站上找到笔者联系方式,试探性地写来求助信,期盼简报能对农村贫困地区的艾滋感染者及相关工作给予更多关注。
由此,借着小代的介绍,农历新年之前,笔者辗转来到阜阳妇女儿童发展协会 ,并拜访了负责人马正洲。
困地区的艾滋救助工作
同复新学校的田楠一样,今年30出头的马正洲也是2003年大学毕业,并在当年投身公益事业。最初,他进入小有名气的阜阳市艾滋病贫困儿童救助协会(以下 简称“阜爱协会”)工作,3年后应聘到筹办中的智行基金会安徽办事处,并一手创立安徽办。回顾这几年的工作,他觉得第一年是埋头做事,第二年致力打假,厘清救助对象造假骗取资助的行为,三四年之后工作才开始做顺。
20世纪90年代,河南、安徽多地农民因贫困卖血,由于血站操作不规范导致大量艾滋病感染事件,其中阜阳地区的多个县市都受到影响,为了救助不幸的感染者,多家NGO在阜阳地区设点创办,开展相关工作。
因血站的错误感染艾滋无疑是巨大的人生悲剧,如何要求赔偿都不为过,然而由于种种现实,政府补助远远不能满足需求,NGO开展工作也往往有各种掣肘,只能在政府和感染者之间平衡行走,于是更添了很多棘手之处。
马正洲第一年在智行工作的时候,挨个乡镇调查,摸底艾滋感染者的家庭情况,家庭收入如何,有几个孩子,是否在念书,之后根据情况发放补助。然而到了第二 年,许多问题就浮出水面,比如有些感染者,家里有几个户口本,有真有假,上面的孩子数量各不相同。查计划生育的去了,拿出的户口本就只有一个孩子,发艾滋救助款的来了,拿出的户口本会有五六个小孩,最多的一家有12个小孩,而且入户调查时还能看到这些孩子,问起父母家庭情况都说得丝毫不差——这些孩子都是从亲戚邻居家借来,事先早教好了会被问什么问题,应当如何回答。
由于政府职能的缺位,艾滋感染者身处贫困与疾病交织的双重弱势地位,马正洲也很清楚对弱势群体的道德指责是另一种压迫。事实上,对真正底层的人们,空洞的大道理讲得再漂亮也没有用,生活在那摆着呢,然而做NGO项目就得对捐款人负责,甄别工作难做也不得不去做。
马正洲的主要方法是鼓励私下举报,有时候他也能当面甄别出来。比如一家有12个小孩子的感染者,他一看到报表上这么多孩子心里就有些打鼓,等拿到户口本一看就乐了:造假水平太差了,好几个小孩的出生日期都写成了一年之内、不同月份出生。
马正洲就对男主人开玩笑的说:“你行啊,这么有势力,还要找救助啊?”
对方自然很诧异:“马干事,你说什么呢?我穷着呢,哪有什么势力?”
他就指着户口本说:“你肯定有好几个老婆,不然怎么能一年生好几个孩子?俩三月就一个?”
男主人自然张口结舌面红耳赤,马正洲就拉着他私下去沟通,说知道你缺钱,但弄钱不是这样弄的,人家公益组织也都是好心人主动捐钱救助我们,不能这样做假寒了人家的心。本来按规定应当取消作假者的受捐助资格,但在核实孩子的真实数字后,取消了虚报的资格,后来马正洲还帮这家人联系了一些别的帮扶资源。
男主人心服口服,反而为马正洲当起了“线人”,主动告知他别的造假的家庭,就这样一点点梳理打磨,慢慢的,工作就顺多了。
常年下乡工作,要说的事情一箩筐,但马正洲这些年印象最深,也是他心中最糗的事,是曾经掉进河里的经历。由于乡镇交通票证制度的不完善,马正洲下乡到一些地方坐的车经常没有可以报销的车票,但智行的财务管理制度非常严格,见到车票才给予报销,这样那些没车票的车费,马正洲就每次都得自己掏腰包,久而久之, 心里也觉得不舒服。后来他想了个法子,买了个摩托下乡,拿加油票报销,摩托车骑着方便快捷也有利于工作。然而好景不长,由于骑车技术不精,有回到阜南县下乡,骑着骑着就掉进了河里,所幸人及时爬了出来,没什么大碍,匆匆回家休息。但令他诧异的是,第二天很多受救助的感染者都打来电话慰问,他很奇怪,当时觉 得没人看到啊,但听慰问的人们说远远的有人看到,随后一传十十传百,没过几天,整个阜南的艾滋圈全知道了,这让他觉得糗又深为感动。
从哪里跌倒,就从哪里爬起
马正洲的第一份工作在因协助拍摄奥斯卡最佳纪录片《颍州的孩子》而闻名国内外的阜爱协会,那时候年轻气盛,想着要做一番事业,但由于性格和理念上的冲突, 最终以比较激烈的方式告别了阜爱协会。之后他一度干起了光明牛奶的销售,由于肯吃苦,不管多么酷热夏日的中午都出去跑推销,3个月就升到销售部经理,工资 拿到2 400元/月,这在2006年的阜阳是相当可观的收入。
然而在看到智行基金会的招聘启事后,马正洲重新燃起当初的梦想。应聘面试时,智行的面试官说我们这里工资只给600,行不行?他说,不给钱也行,我来这里的目的就是要从哪里跌倒,就从哪里爬起。听到这话,另一个面试官说,那就给你400吧,他也欣然接受,最终以比上一个工作低了2 000元的薪水入职智行。回想起当初这个决定,马正洲说,其实那时候驱使他来智行的动因,真说不上什么爱心,就是那种要证明给自己和别人看的不服输性格。
入职之后,整个智行安徽办只有他一个人,一间屋子,一个办公桌,一部电话,他不知道要做什么,也没人提供指导,跑去问主管领导——智行基金会大中华区主管徐振军,后者说,要你来就是要你自己想怎么工作的,想不清就回家呗。
他只得自己想怎么开展项目,根据智行救助受艾滋影响的孩子的政策,下乡调研,设计如何开展救助。到如今,注册成阜阳妇女儿童发展协会之后的专职人员已有5个,除他之外还有2名资料员、2名家访员,一共救助1 150名孩子。忙的时候,5个人都下乡发物资、补助,因为智行规定,发放财物都要互相有见证,怕有意外难以处理。
智行的财务规定特别严,有一次马正洲去阜南县下乡,回来要报销的交通费差了1块钱,结果整整一个月的账都被财务拒绝报销,其原因是他去的时候买的车票有保险,回来的时候坐车售票员随便撕票没给保险,这样往返费用就对不上了。后来他请出阜南县的妇联主席写证明说乡镇的交通票据的确是这种情况,之后才给予补报。
 虽然智行的财务制度严格到有些苛刻,但背靠这棵大树,机构多年的运营经费都不成问题,但要想扩展申请更多项目,或者接收本地捐款,就要正式注册获得一个合法身份。在奔波了两年的注册历程中,马正洲再次展现了他不服输的性格。
这两年来,各地相继出台规定放宽民间组织注册以后,几个省会城市已逐渐落实直接注册,但在阜阳这样地级城市,还必须要找一个挂靠单位。因为工作方向,马正洲选择阜阳市妇联作为挂靠对象,自2008年就开始写注册申请,最开始连解释都没有,直接就被回绝。后来马正洲联系上一个看起来脾气甚好的妇联部长,与他打好关系,请他指出需要改进的地方,又一遍遍重新递交申请。这样过了一年多,智行基金会的老总杜聪听说还没结果,就提出自己亲自去和妇联主席打招呼,然而一番交谈下来,留下的话是:“小马啊,要不你就放弃吧,我看这个主席很难沟通。”
然而马正洲还是不肯放弃,他继续一遍遍地跑,过了大半年,2010年11月,阜阳市妇联主席打来电话,批准让他们挂靠注册。但到了民政局这关,又出现了反复,因为智行基金会的同性恋项目,让民政局心存疑虑,马正洲只好再回头请求妇联出面做保证人,多出具一份保证书,这样又过了一个月,才大功告成,阜阳妇女儿童发展协会由此成为智行在全国十家办事处中第一家成功本地注册的机构。
听说这个消息后,一家6年都没注册成功的阜阳义工组织,来问马正洲是不是有很强的关系网,他说,这个真没有,要说成功秘诀,就是不服输的性格吧。
马正洲的新年愿望
2012年1月初,智行基金会召开全国年会时,杜聪问马正洲有什么愿望,马正洲说希望能加薪,但不是给自己,而是给员工。
 智行虽然是香港的基金会,也很难筹到行政费用的款项,曾经有两年的行政费用都由杜聪自己掏腰包,后来虽然筹到资金但额度有限,所以各地办事处的员工们薪水都相当低。比如现在协会的员工,都是大学毕业,入职第一年薪水只有800块,转正之后涨到900,还要扣除各种保险,到手只有500多。
员工要发展、要有尊严地生活,只得跳槽,而高流动意味着低效率。经历过多个骨干员工流失的马正洲对此十分感慨,很多人花了一年时间才带出来,却因为低薪而流失,再重新招聘,对这样只有几个人的小机构影响太大了。
除了加薪之外,协会作为智行基金会的安徽办事处,一直按照智行的模式走,虽然总体上资金不愁,但时间长了,想拓展别的资助渠道,却发现连项目申请书写起来 都有些困难,而协会注册的目的就是为了拓展新的本地资源、开展新的项目。因此,提高募款能力、寻求新的资助,从根本上实现协会的可持续发展,这也是马正洲 的新年愿望之一。
后记:本文访谈时间为2012年1月19日,就在发稿前,2012年3月初,笔者与本文开始提及的小代聊天,他说马正洲在前几天因为家中出现经 济压力,决定改行,这一消息令笔者大为震惊。由于马正洲暂时不愿再受访谈,小代也不愿详述,无从得知个中细节,但这一结局也许更加印证了中部草根NGO从业者的生存窘境。

CDB Senior Staff Writer

Translated by Sophie Chadd

Reviewed by Michael Schmale

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