Since 2002, Taiwanese anthropologist Liu Shaohua has been studying a rural community in southwestern China’s Sichuan province that has been harmed by the consequences of rapid urbanization.

The community is made up of the Nuosu people, an ethnic group from the region who are classified by the government as belonging to the Yi people — one of the country’s 55 officially recognized ethnic minorities.

In the 1990s, Nuosu communities across the Sichuan’s Liangshan Yi Autonomous Prefecture were shaken by a drugs epidemic, when locals who had migrated to nearby urban centers returned with habits picked up in the cities and “goods” to sell.

The Nuosu people, who had been previously detached from mainstream culture, offered an unsuspecting, virgin market for the sale of heroin. Drug use among Nuosu youth subsequently skyrocketed, and was often practiced without sterilized needles. A report in 2000 found that 9.6 percent of the prefecture’s residents had HIV.

Liu’s time living with young Nuosu people was recounted in her 2010 book “Passage to Manhood: Youth Migration, Heroin, and AIDS in Southwest China” — the Chinese version of which was published last year.

Liu talked to Sixth Tone about how the community has changed over the years, how inadequate health care provisions are for those living with HIV or AIDS, and how social stigma in China about the Nuosu people is worsening their plight. The interview has been edited for brevity and clarity.

Sixth Tone: When was the last time you went back to Liangshan? What has changed since 2002?

Liu Shaohua: I went back last year and a lot has changed. Many young people have left and a lot of the elders have passed away. All of the people I knew who had AIDS when I first visited the village have died. 

Those who have chosen to remain are living tough lives. Those who have left have settled down in towns and cities across the country. You can tell there isn’t much of a future left in the village. People try to leave whenever they have the chance.

Sixth Tone: What progress has been made on the region’s drug problem?

Liu Shaohua: The number of people who use drugs has declined.

The region’s severe drug and AIDS problem began when the region started experiencing rapid economic development. It was a painful process of tremendous change. In my book I use the phrase “passage to manhood” to describe how the older generation was becoming increasingly exposed to the modern world. But the current generation is heading down a different path, similar to other migrant workers in China.

Education levels are improving, and more children are going to school. As more students learn to speak Mandarin, the barriers to mainstream society are lowered.

All of these factors have contributed — and will continue to contribute — to the decline in drug users. However, problems still exist.

Sixth Tone: What kinds of problems persist?

Liu Shaohua: Poverty. I still see many young Yi girls of school age working in restaurants in Chengdu — Sichuan’s capital. Parents must pay fines if they do not send their children to school, but the adults don’t care as long as their children can earn more than the fines amount to.

Villagers living in the mountains do not have enough land to support themselves, and so steady income is becoming an increasingly urgent issue. They have no resources in the cities, so what can they do except trade their labor for cash?

This is a fundamental problem and if the government cannot work it out with social welfare, then nothing else can be solved.

Sixth Tone: What changes in attitudes toward HIV or AIDS have you found among the Nuosu people?

Liu Shaohua: When I first went to Liangshan in 2002, no one looked on AIDS with revulsion. However, with the launching of an anti-AIDS campaign and other anti-AIDS efforts, people living with AIDS became increasingly alienated by the population.

The situation hasn’t changed. Discrimination against AIDS patients, reinforced by mainstream society and the education they receive at school, is rife among the young generation.

Sixth Tone: In your book you say Nuosu youths have struggled to live alongside the Han people in mainstream society. Is this still a problem?

Liu Shaohua: They have more common ground now, but discrimination still exists. One problem is that the closer they come to mainstream society, the more marginal they feel. Han Chinese continue to have a negative impression of the Yi people, and even if the drug problem was resolved, the stigma of disease and poverty attached to this group would not fade in a short amount of time.

As the Nuosu people strive to make it into mainstream society, their sense of being excluded becomes stronger. They are in a tricky position.

Sixth Tone: You say that traditional notions of kinship used to act as a force that held the community together. To what degree are the Nuosu people in touch with their traditional roots?

Liu Shaohua: In rural regions, you still hear people speaking their traditional dialect, because it is the daily language in the village. But those who left the village when they were children or those who grew up in towns can speak very little of the language now.

This is the path of modernization that many rural communities have gone through — the Nuosu people are among the last communities in China to travel this road.

Sixth Tone: What issues in health care provision do the Nuosu people currently face?

Liu Shaohua: They face the same problems as other migrant workers. The current health care system does not work well for them. For example, under the New Rural Cooperative Medical System, migrant workers can only claim their health insurance in their own provinces, but many migrant workers move from place to place.

Sixth Tone: Have you felt that your book has inspired any change in this community?

Liu Shaohua: Since my book came out, many Yi youths, especially those who have received a good education and are more a part of mainstream society than villagers, have spoken with me. They know there are stigmas attached to their ethnic group, but they do not understand why.

In a way, my book has inspired them to think about their identity, and has helped them to understand that this is not their fault. Some of them have begun retracing their ethnic roots. I think this is a good thing.

(Header image: A man of the Yi people stands on a hillside in Butuo County, Sichuan province, May 13, 2012. Butuo County is home to a great number of Nuosu people. VCG)