Occupational health and social estrangement in China 9781526113634

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New Ethnographies

New Ethnographies

Occupational health and social estrangement in China

This book examines the experiences of individuals suffering from occupational diseases in contemporary China. It illustrates how the experience of most Chinese sick workers can be understood as examples of Agamben’s notion of homo sacer – the ultimate biopolitical subject whose life is located at the domain of “double ambivalence” in which they are constantly and disturbingly caught in between the public and private, the productive and unproductive, and the culturally normative and the culturally deviant. The study regards two of the most common occupational diseases in China – pneumoconiosis and heavy metal poisoning. Through a corpus of qualitative, ethnographic data solicited from one hundred individuals, the book details the experiences of four different groups of employees – battery workers, gemstone and jewellery workers, Japanese mat workers, and coalminers – as well as their family members, non-governmental organization workers, and healthcare and legal professionals in Guangdong, Sichuan, Chongqing, Hunan, Beijing, and Hong Kong.

HO

Covering a wide range of issues related to occupational disease in China, this book possesses a gaze which focuses on the lived experiences of occupationally sick workers at the actor-power interface. Through their stories as well as the descriptions of their life-worlds and power relations they are living with, this book aims to shed light on how the socially marginalized encounter and understand domination in their everyday life in China, now and in the foreseeable future. Wing-Chung Ho is Associate Professor at Department of Applied Social Sciences, City University of Hong Kong

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ISBN 978-1-5261-1361-0

9 781526 113610 www.manchesteruniversitypress.co.uk

Occupational health and social estrangement in China WING-CHUNG HO

Occupational health and social estrangement in China

New

Ethnographies Series editor Alexander Thomas T. Smith Already published The British in rural France: Lifestyle migration and the ongoing quest for a better way of life Michaela Benson

Literature and agency in English fiction reading: A study of the Henry Williamson Society Adam Reed

Ageing selves and everyday life in the North of England: Years in the making Catherine Degnen

International seafarers and transnationalism in the twentyfirst century Helen Sampson

Salvage ethnography in the financial sector: The path to economic crisis in Scotland Jonathan Hearn Chagos islanders in Mauritius and the UK: Forced displacement and onward migration Laura Jeffery South Korean civil movement organisations: Hope, crisis and pragmatism in democratic transition Amy Levine Integration in Ireland: The everyday lives of African migrants Fiona Murphy and Mark Maguire Environment, labour and capitalism at sea: ‘Working the ground’ in Scotland Penny McCall Howard An ethnography of English football fans: Cans, cops and carnivals Geoff Pearson Iraqi women in Denmark: Ritual performance and belonging in everyday life Marianne Holm Pedersen Loud and proud: Passion and politics in the English Defence League Hilary Pilkington

Tragic encounters and ordinary ethics: The Palestine-Israel Conflict in British universities Ruth Sheldon Devolution and the Scottish Conservatives: Banal activism, electioneering and the politics of irrelevance Alexander Smith Exoticisation undressed: Ethnographic nostalgia and authenticity in Emberá clothes Dimitrios Theodossopoulos

Immersion: Marathon swimming, embodiment and identity Karen Throsby Enduring violence: Everyday life and conflict in eastern Sri Lanka Rebecca Walker

Performing Englishness: Identity and politics in a contemporary folk resurgence

Trish Winter and Simon Keegan-Phipps

Occupational health and social estrangement in China Wing-Chung Ho

Manchester University Press

Copyright © Wing-Chung Ho 2017 The right of Wing-Chung Ho to be identified as the author of this work has been asserted by him in accordance with the Copyright, Designs and Patents Act 1988. Published by Manchester University Press Altrincham Street, Manchester M1 7JA www.manchesteruniversitypress.co.uk British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library

ISBN  978 1 5261 1361 0  hardback First published 2017 The publisher has no responsibility for the persistence or accuracy of URLs for any external or third-party internet websites referred to in this book, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

Typeset by Servis Filmsetting Ltd, Stockport, Cheshire

Contents

List of figures List of tables Preface Acknowledgments List of abbreviations Series editor’s foreword Maps  Part I  Life in perspective 1 Facts, theoretical gaze, and journeys 2 Sick workers as homines sacri 

vi viii ix xxviii xxx xxxi xxxii 1 3 43

Part II  Responses to marginality 3 Cadmium-poisoned women: contesting for sick role status 4 Pneumoconiosis-afflicted workers: toward rightful resistance 5 Sick coal miners: the compromising citizenry

57 59 87 112

Part III  Sick life governed  6 Law as a technique of Chinese governmentality 7 Conclusion: the future of Chinese marginality

131 133 153

Appendix References Index

165 169 189

Figures

1.1 Occupational disease trends in China, 1993–2014. 9 1.2 Accumulative cases of occupational diseases. 9 1.3 The proportion of CWP in pneumoconiosis, 1949–2013 (incomplete). 14 3.1 Shiwai’s paper strip, indicating name and the level of blood cadmium. (Source: author) 63 3.2 Results of Shiwai’s blood cadmium test without an official chop. (Source: author) 64 3.3 Shiwai’s blood cadmium test result with an official chop. (Source: author) 64 3.4 Sick workers reminiscing about the past over a lunch in rural Luzhou. (Source: author) 65 3.5 Shiwai’s urine cadmium test result, indicating a level of 47.2 µmol/L. (Source: author)  67 3.6 Shiwai’s urine cadmium test result, indicating 28.0 µmol/L. (Source: author)67 3.7 Shiwai’s urine cadmium test result, indicating a level of 17.3 µmol/L. (Source: author) 68 3.8 Workers rally outside the court building in Huizhou. (Source: GM)  73 3.9 Protesting outside Gold Peak Battery International Ltd, Hong Kong after its violent suppression. (Source: GM) 74 3.10 and 3.11 Sick workers’ living arrangements in the hospital. (Source: informants) 78 3.12 and 3.13 The residence rented by hospitalized sick workers. (Source: author) 79 3.14 Cooking together at Shiwai’s home in rural Luzhou. (Source: author) 81 4.1 Juhong in his home in rural Lianyuan. (Source: author) 91 4.2 Qinsheng in his home in rural Lianyuan. A plastic container containing his phlegm is on the table. (Source: author) 93 4.3 The store where Wenwai and his wife did business and lived. (Source: author) 95 4.4 The grocery store owned by Qifa. The LED torches shown were the bestselling items at the time of the fieldwork. (Source: author)  96

List of figures 4.5 Yaoyuan’s backyard business producing noodles in rural Liangping. (Source: author) 4.6 The dilapidated house of Yaoyuan’s younger brother in rural Luangping. (Source: author) 4.7 Two workers protesting in front of the company in Hong Kong. The employer, however, kept the door shut and refused to meet the protestors. Police were monitoring the action. (Source: author) 4.8 Pingkwan (fourth from left) holding a work meeting with pneumoconiosis-afflicted workers at LAC’s office in Shenzhen. (Source: author) 4.9 LAC’s sick workers’ self-help center in Liangping. (Source: author) 5.1 Used clothes given away to CWP sufferers and their families at the self-help center at Liangping. (Source: author) 5.2 and 5.3 Loudi Municipal Coal and Charcoal Hospital specializes in the prevention and treatment of CWP. (Source: author) 7.1 Guoshou’s wife holding the photo of her dead son. (Source: author) 

vii

99 99 103 109 110 117 121 160

Tables

1a–1d  Official statistics of occupational diseases (MoH) 1993–2014

8

Preface

Preface

Knowing the problem from afar This book is about the lived experience of occupationally sick workers in China, but has its origins in Hong Kong. Located in southeastern China, Hong Kong is a city of 1,104 square kilometers, 8,941 times smaller than China proper, 8,712 times smaller than the United States, and 230 times smaller than the United Kingdom in terms of land area (Map 1). The city had been under British colonial rule since 1842, was handed over to the People’s Republic of China in 1997, and then became its Special Administrative Region (SAR).1 I was first introduced to the problem of occupational disease in 2004 in Hong Kong by a personal acquaintance, Shek Pingkwan (“Pingkwan” hereafter). A child of 1970s’ colonial Hong Kong, I had never heard of any sizable local occupational disease outbreaks. It was Pingkwan who alerted me to the plight of ­pneumoconiosis-stricken workers in the lapidary factories of the Pearl River Delta (PRD) region of Guangdong province (Map 2). I came to realize the numerous predicaments that Chinese sick workers face in their process of gaining diagnosis, undergoing treatment, and pursuing compensation. Thus, it is Hong Kong, Pingkwan, and the year 2004 that constitute the context of this book. These factors – Hong Kong, Pingkwan, and the year 2004 – deserve further attention as a reflexive approach to anthropology upholds that how the researcher is positioned in relation to his/her informants, and how the two parties perceive each other are determinants to the way the resulting ethnography is represented (Robertson 2002). In my case, it is essential to let readers, as suggested by King and King (2011), glimpse how the personal interactions to be presented in subsequent chapters may be culturally choreographed by me, the author, as someone who was born in colonial Hong Kong, and like the majority of post-handover Hongkongers, has come to self-identify as both Hongkonger and Chinese.2 The contextualization of the vantage point of this book is thus a prerequisite for readers to question “the relative status of interviewer and participant, and social norms about what is appropriate or inappropriate” in various ethnographic situations which involved a Hong Kong male researcher probing into the subjectivities of peasant workers in China, and how these factors may have interacted and influenced the empirical data collected (King and King 2011: 1478).

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Pingkwan (born 1949) has been concerned about labor rights since November 1979 when his brother, a worker on a construction site, was killed in an occupational accident in Hong Kong. In total, the accident killed two workers and seriously injured five others. Pingkwan, who was an ordinary factory worker, was actively involved in negotiating with the employer about compensation for the families of the victims. The yearlong process of pursuit, however, only resulted in the meager compensation of tens of thousands of Hong Kong dollars. During the process, Pingkwan was assisted by the Hong Kong Christian Industrial Committee (CIC), which was then the key labor NGO in Hong Kong. After his brother’s accident, Pingkwan became a volunteer for the Association for the Rights of Industrial Accident Victims (ARIAV), which was established in 1981. Being a sub-unit of the CIC, ARIAV focuses on helping workers afflicted by occupational injury to fight for their rights. From being a volunteer in 1981 to a full-time worker of CIC in 1994, Pingkwan witnessed fundamental changes in the structure of Hong Kong-based labor NGOs, which extended their work from Hong Kong to China, especially the PRD area. When China initiated its economic reform in 1978, the PRD started attracting immense industrial capital from Hong Kong. Statistics show that from 1983 to 2000, Hong Kong occupied almost fifty percent of foreign direct investment in mainland China (National Bureau of Statistics 2000). Capital from Hong Kong and Taiwan established tens of thousands of factories, which had created numerous job opportunities for peasant workers, who were often labeled “cheap labor.” According to former CIC worker Choi Yukyuk, since the CIC’s strategy was to “follow the capitalists,” it began to turn its focus from Hong Kong to factories in China, which were established by Hong Kong-based capital. She recalled that “the workers of CIC were deeply shocked, even though they were well-experienced labor organizers [in Hong Kong] when they saw the [extremely poor] working environment in Chinese factories.”3 However, there were two tragic fires in PRD factories in the early 1990s that sharpened the mission of Hong Kong-based labor NGOs in China. In 1991, a fire broke out in Qingye Factory (which produced raincoats) in Silong (now called Dongguan) and killed seventy workers. At that time, Pingkwan was also a garment factory worker in Dongguan. A couple of years before, he had followed his employer when the latter moved his factory from Hong Kong to China. Since Qingye was geographically located near to his own factory, Pingkwan became for the first time involved in helping Chinese peasant workers obtain compensation. He said that unlike Hong Kong, there were no labor-related regulations in China at that time, and the amount of compensation for dead or injured workers merely relied on the conscience of the employer. Eventually, the employer only offered a small amount of compensation to the injured and the dead, ranging from 7,000 yuan to 25,000 yuan.4 Two years later, another fire broke out in Shenzhen at the Zhili factory. The fire, commonly known as the “Zhili fire,” took the lives of eighty-seven workers and seriously injured forty-seven others. Both factories were established through Hong Kong capital.

Prefacexi Pingkwan reached the scene the day after the Zhili fire. He visited the hospitals in Shenzhen, met the victims, organized them, and fought for compensation. Feeling that the CIC needed a full-time worker to do liaison work for the victims of the Zhili fire, Pingkwan quit his original job and took up a full-time post at the CIC in 1994. Since the Zhili Toy Factory was a supplier of the well-known Italian brand “Chicco,” the Zhili fire turned out to be the first time that Hong Kong NGOs had worked with Western trade unions and consumer groups, and pressured “Chicco” to provide compensation for the victims (Chan 2013: 9; see also Tsui 2013). Pingkwan said that “Chicco” eventually yielded to the pressure and compensated the workers by an amount of 300 million lira (around US$ 180,000) distributed to about 130 victims. However, in order not to acknowledge direct responsibility for the Zhili fire, “Chicco” simply called the compensation “humanitarian aid.” The aftermath of the Zhili fire marked the invention and consolidation of different strategies on the part of Hong Kong-based NGOs to protect the rights of Chinese workers.5 Consequently, Hong Kong-based labor NGOs have been playing an active and vital role in supporting and strengthening the labor activism in China, by engaging in direct organizing, campaigning, and advocacy for the rights of migrant workers and regulating the violations of foreign investors, particularly those Asian, exporting capital from Hong Kong and Taiwan (Chung 2010). The CIC, in particular, changed its strategy from factory-based to community-based so that workers were contacted, educated, and organized outside the workplace. CIC workers would visit workers’ dormitories, or conduct simple body checks on the street in order to meet factory workers. Local centers were set up to raise the workers’ awareness of their legal rights in the workplace. It was due to this community-based strategy that occupationally sick workers were brought to the attention of the Hong Kong-based NGOs in the late 1990s. In 2005, the CIC was split into two NGOs: Worker Empowerment (WE) and Labor Action China (LAC). While WE emphasizes the educational approach to help equip workers with knowledge related to labor law and occupational safety, LAC adopts a case intervention approach to help occupationally sick workers pursue compensation. Since 2005, Pingkwan has been working under LAC, and specifically on intervening in protecting the rights of occupationally sick workers. The spinning-off of LAC from CIC in 2005 was also prompted by the surge of pneumoconiosis cases among gemstone/jewelry workers in Guangdong province being diagnosed in 2004. With the help of a Chinese lawyer called Zhou Litai, Pingkwan obtained a list of around 350 workers who were suspected of suffering from pneumoconiosis. All these workers had been working in a factory called Lucky Gems & Jewelry Factory Ltd. (“Lucky Gems” hereafter) in Shenzhen. Zhou Litai was a well-known lawyer handling occupational injury cases in Guangdong province, but was relatively inexperienced in occupational disease cases. Zhou and his group of lawyers then decided to pass the cases on to Pingkwan. It was 2004 which marked the beginning of the intervention of Hong Kong-based NGOs in protecting the rights of Chinese occupationally sick workers. This also marked

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the year when I began to focus my attention on the problem of occupational disease in China. In fact, sizable occupational disease incidents identified in Guangdong province in 2004, e.g., the pneumoconiosis outbreak at Lucky Gems in Shenzhen, and the cadmium poisoning outbreaks at two battery factories in Huizhou and one battery factory in Shenzhen (cadmium poisoning will be discussed in Chapter Three) can be attributed to the legal developments pertinent to occupational health and safety (OHS) since the early 2000s. On October 27, 2001, the National People’s Congress (NPC) passed the Law of the Prevention and Treatments of Occupational Diseases. This law together with the regulations which stipulate the detailed standardized procedures of diagnosing occupational disease and assessing its severity, Management Regulations for Diagnosis and Assessment of Occupational Diseases (issued by the Ministry of Health (MoH) on March 28, 2002), were both effective as of May 1, 2002. Two more regulatory documents were later approved to revise and specify the classification of occupational diseases and the calculation of compensation benefits. These two laws were Work-Related Injury Insurance Regulations (issued on April 27, 2003 by the State Council); and Regulations on the Classification of Work-Related Injuries (issued on September 23, 2003 by the Ministry of Labor and Social Security (MoLSS)). Both regulations were effective as of January 1, 2004. The progress referred to above in the legal framework pertinent to the OHS system could be considered a belated one in China: there had been more than a decade of a legal vacuum for the employer to provide a safe environment for workers since the famous southern tour of Deng Xiaoping in 1992, which brought about rapid marketization of the Chinese economy. But in any event, by the beginning of 2004, the legal framework for occupational disease workers was in place for those affected to fight for compensation via the legal route. A local factor which made 2004 a tipping point for occupational disease cases in Guangdong province was the outbreak of the epidemic of severe acute respiratory syndrome (SARS) in south China. Commonly called “atypical pneumonia,” SARS was a viral respiratory disease of zoonotic origin caused by the SARS coronavirus. In a report to WHO on February 11, 2003, the MoH stated that the SARS virus was found in Guangdong province and had killed five and infected three hundred others (Lo 2013). On February 21, 2003, a Chinese doctor who had treated SARS patients in Guangdong booked into the Metropole Hotel in Hong Kong to attend a wedding. Suffering from respiratory failure, the doctor was admitted to a Hong Kong hospital the next day. The SARS virus then spread to other guests at the hotel and the local Hong Kong community (Voigt 2013). Infected guests, who did not know they had the virus, continued their journeys around the world, spreading the SARS virus and causing 8,096 infections and 774 deaths in thirty nations. In Hong Kong, a city of seven million, SARS infected 1,755 people and killed 299.6 Since one of the major symptoms of work-related pneumoconiosis and cadmium poisoning is infection of the respiratory system, which is similar to SARS, almost half the sick workers I met in the field admitted that they had had their first medical checkup during 2003, which was in one way

Prefacexiii or another related to the disturbing news of SARS that they had heard about from Hong Kong. All of the above provides the background against which Pingkwan obtained the list of hundreds of gemstone workers suspected of suffering from pneumoconiosis in 2004. Starting from this point, he began his work of giving legal advice to sick workers and boosting solidarity among them. In my own case, I first met Pingkwan in 1999 when both of us served as volunteers and executive committee members of another NGO concerning social security issues in Hong Kong. Moved by his stories about how the sick Chinese workers struggled for survival and compensation, I began to toy with the idea of conducting a study on occupational disease in China at the close of 2004. However, it remained merely an idea for some years. During that time, I was immersed in another “life-and-death” struggle myself – my PhD (1998–2005), which was followed by yet another painful struggle, that of obtaining a tenured academic position at my university (2006–12). In fact, with the promulgation of important laws and regulations in protecting the rights of occupationally sick workers, I thought at one point that my study on occupational disease might not be needed. I thought that the situation of the sick workers and their families would be improved with the better legal protection and growing civil society that was developing in China. However, very soon, as I embarked on to my fieldwork from 2010 onward, I realized that I was totally wrong and my optimism was merely grounded in naivety.

Black humor My fieldwork involved about twenty visits ranging from days to weeks to different places in three provinces (Guangdong, Hunan, and Sichuan), and one special municipality (Chongqing) of China (Map 1). My fieldwork visits – both to rural and urban areas – were interspersed unevenly over five years (February 2010– November 2015). Mainly ethnographic in nature, my fieldwork was designed to explore the lived experience of occupationally sick workers in a context where the legal framework which is supposed to protect their rights has been operating for over a decade. Before proceeding to the chapters which contain the stories of these sick workers, I would like to preface this book by saying something about these sick workers, and at the same time, allowing readers an earlier glimpse into certain key features of their post-illness lives. It was not an easy task, however, as the subject matter I deal with is by nature distressing. In revisiting my field notes and re-listening to the audio records, I found it still possible to share with readers three fieldwork anecdotes that will have bearing on the theoretical discussions of this book. On June 8, 2011, I remember that it was a hot day in Huizhou. I was surrounded by five former battery-factory women workers diagnosed as having excessive cadmium. We were virtually crammed in a room which was a residence of one of the sick workers. One by one, the tearful women shared with me their stories of physical suffering and struggles for compensation. In the process, I was

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deeply moved, and on the verge of shedding tears myself. Then one informant said that years of suffering and struggles had resulted in successfully pressing the court to rule in favor of the workers in 2007. Based on the court’s adjudication, the employer was required to give each worker with excessive cadmium no less than 300 yuan per month in order to strengthen the worker’s health. But in reality, the employer only offered calcium tablets and milk powder every month, which were said to be worth 300 yuan. However, the sick workers quickly found that the calcium tablets were of low quality and simply unpalatable. But the worst was yet to come. More than a year of drinking the milk from the milk powder gave them kidney stones. This milk powder was associated with the melamine scandal of September 2008. At that time, several famous national brands of milk powder produced by the Sanlu Group, one of the world’s biggest dairy producers, were accused of using dairy products contaminated with melamine – a toxic substance which increases the level of protein only during laboratory testing but itself carries no nutrient value. The WHO had already warned consumers that melamine easily forms crystals in the human body that could give rise to kidney stones.7 The melamine scandal directly caused the death of six children, the Sanlu Group was forced into bankruptcy, and the court sentenced two men to be executed and nineteen others to long jail terms. Over 300,000 children in China were made ill from milk powder contaminated with melamine.8 So I realized that after years of struggle the women who had excessive cadmium levels after suffering from body pain, severe body discomfort, miscarriage, social discrimination, and various forms of suppression had ended up with nothing but more symptoms: pain on urinating and urinary incontinence. The next anecdote I want to share also involved the case of cadmium poisoning. On August 28, 2012, I met Fengping (born 1963) in Hong Kong. Diagnosed as suffering from excessive cadmium levels, Fengping was well-known among Hong Kong-based NGOs as she had come to Hong Kong several times to protest against her former Hong Kong employer. Fengping had been working in a battery factory in Huizhou for sixteen years before being fired at the close of 2009. When I met her, she came to Hong Kong both to attend a conference organized by a Hong Kong-based NGO and for a body checkup. Fengping told me yet another angle of the story. Unlike all other workers suffering from cadmium poisoning and excessive cadmium levels I had met, Fengping was an engineer rather than a frontline worker at the battery factory. She told me that she did not pay much attention to the workers’ struggles at the outbreak of the cadmium poisoning episode in 2004 as she thought that the disease would never affect her. Two years later, she was totally shocked when doctors told her that she was suffering from chronic kidney failure (renal atrophy). Fengping believed that her kidney failure was caused by the exposure to cadmium in her working environment. She then told me how she was fired by the factory, and how her financial situation had been deteriorating since she had fallen ill. Showing sympathy on account of her poor health, I asked her what medication she had been taking. To my surprise, she said that she had not taken any specialized medication for years; she said, “I feel very pleased not to have taken the medicine

Prefacexv prescribed by the doctors.” Bewildered by what she said, I asked her the reasons behind this. She then could not contain her delight in telling me that if she had taken the medicine all these years she would have died from cancer caused by the drug whose capsules were tainted with chromium – a carcinogenic substance – in the poison capsule scandal of April 2012. The scandal resulted in the shutting down of eighty illegal production lines in Zhejiang, Hebei, and Jiangxi provinces, detaining forty-five people, arresting nine, and seizing more than seventy-seven million capsules tainted with chromium (Reuters 2012). Apart from the fact that the medication would have caused more health problems instead of solving them, Fengping also told me that her finances would have been even worse if she had listened to the doctors’ advice; she said, “The employer refused to offer any compensation, and the medication was very expensive. You know, should I have taken the medicine, my financial situation would have been a lot worse than now.” I still remember how “funny” that scene appeared. All along, for more than one hour of the interview, Fengping looked depressed, but when she spoke of her “smartness” in not taking the medicine, she smiled and her eyes sparkled. The final fieldwork anecdote I would like to detail came from a home visit I paid to Juhong, a sick worker suffering from final-stage pneumoconiosis in rural Hunan. On July 5, 2011, I – accompanied by my fieldwork assistant Mengguo – walked through many mountainous paths and arrived at the dilapidated cottage where Juhong and his family lived. Mengguo was excited about the visit as both of them had worked as gemstone workers at Lucky Gems. However, it had been more than seven years since they had last seen each other. When we met, Juhong had been bedridden for four months. His life depended on the use of oxygen tanks twenty-four hours a day and talking was difficult for him due to his breathing difficulties, so the forty minute interview could not have been completed without the help of his wife. After the interview, I talked to his children, and two neighbors who were curious about the new faces in the village. Thinking of talking to another sick worker living in the same village, I uttered some encouraging words to Juhong and his wife. I took out two one-hundred banknotes and put them into the palm of Juhong’s wife’s hand. And then, supposedly, we were to leave. At that moment, I  just got completely stuck and could not find the right words to say to end the visit. I found that to say “goodbye” (zaijian, 再見), or “take care” (baozhong, 保重) meant that “we would see each other again,” or that Juhong “would get well soon.” But everyone in the cottage at that time clearly knew that this was not going to happen. Years of illness had already cost Juhong all his household savings, including the small amount of compensation he received from his employer. The family was in serious debt. The social security system in the rural area only offered him a minimum livelihood protection (MLP, dibao 低保) of 80 yuan per month, which was only equivalent to the cost of oxygen tanks that were enough to support his life for four days. When we met Juhong, his illness had reached the terminal stage and, apparently, every heavy breath was a countdown signaling the remainder of his days. So, I just kept asking myself: “What is the most appropriate way to finish off such an interview?” I could not find the right words out of my more

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than a decade’s long fieldwork experience in China. My hesitancy led to a couple of minutes of silence. Sensing the awkwardness, Mengguo broke the impasse by saying: “Well, we have to leave now.” Patting Juhong’s shoulder, Mengguo said to him loudly: “Just let everything go naturally (yiqie dou shenqi ziran le, 一切都順 其自然啦)!” Taking this as a cue to leave, I made my exit. I had mixed feelings as I left their home. On the one hand, I felt it was strange that Mengguo’s final words were “Let everything go naturally.” This might mean that things would go as they would be meant to go, but, in that particular context, it was understood as a euphemism for saying: “My dear friend, whatever happens, including death, take it easy.” I felt huge sadness for Juhong, his wife, and children for obvious reasons that I think I do not need to elaborate here. The above episodes might be able to prompt the question: why the passing of laws to protect the rights of occupationally sick workers since the early 2000s has been seemingly unable to help the socially marginalized obtain a better quality of life? As we have just seen, wider problems in society, such as the problematic quality of food and medicine, and the lack of social protection in rural areas would simply add further difficulties to existing problems.

Can the law help? Bearing this in mind, I asked the above question of Wang Keqin in Beijing on March 19, 2015. Wang Keqin was the founder of a Chinese NGO “Love Saves Pneumoconiosis” (LSP, 大愛清塵). Set up in 2010, LSP is by far the biggest and most influential NGO in China concerning pneumoconiosis-stricken peasant workers. LSP has helped thousands of sick workers in terms of subsidizing their medical treatment and offering bursaries for their children’s education. Wang Keqin said that LSP currently had over 6,000 volunteers all over the country. Wang Keqin pinpointed three conditions that sick workers must fulfill before they could seek confirmation that they had an occupational disease. The first prerequisite was that the sick worker must have signed a labor contract with the employer. Second, the sick worker must present evidence which indicated that he or she had been working in a high-dust or highly polluted environment. Third, the employer must apply for occupational disease confirmation procedures on behalf of the sick worker. However, Wang Keqin said that less than five percent of the peasant workers had signed a labor contract with their employer, based on a report conducted by the Chinese Social Academy of Social Sciences in 2008. To the best of his knowledge, he had not heard of even one employer taking the lead in initiating occupational disease confirmation procedures. He described these prerequisites as moronic as it would be unlikely that any employer would be proactive in confirming the harm he or she brought about to the worker. Consequently, cases where the sick worker had finally won a lawsuit or reached a settlement with the employer with a compensation equivalent to what was stipulated by law, according to Wang Keqin, were only “less than five percent.” The next day, I met Huang Leping, who is the Director of Beijing Yilian Legal Aid and Study Center of Labor (“Yilian” hereafter). Huang Leping is a

Prefacexvii well-known human rights lawyer in China. He established Beijing Yilian in 2007 to provide legal aid to occupationally injured and sick workers experiencing financial hardship. Huang Leping said that Yilian was an NGO which had the mission to advance labor rights in China by improving the legal framework. I then asked him the very same question I asked Wang Keqin and shared with him Wang’s answer. In response, Huang Leping showed no surprise at Wang Keqin’s suggestion of “less than five percent.” Huang Leping pointed out that the key problem of the existing OHS system was the non-existence of a centrally financed fund at the provincial level that was dedicated to helping occupationally injured or sick workers before they obtained compensation from the enterprise. Without such a fund, it was the responsibility of the worker to negotiate with the employer and go around various state departments in order to prove his or her illness. Each encounter with an institution would mean that the sick worker faced an institutional hurdle, and it would mean one more layer of difficulty in obtaining the legally stipulated compensation. During the interview, Huang Leping revealed to me that the establishment of the provincial fund for occupationally injured and sick was “almost approved” (chayidian jiu tongguo, 差一點就通過) by the Standing Committee members of the NPC in December 2011 when they discussed the revisions of the Law of the Prevention and Treatments of Occupational Diseases. Huang Leping was one of the legal experts who helped formulate the proposal, and observed the whole process at the NPC meeting. Since the proposal fund was supposedly financed by the central government without affecting the budgets of provincial-level governments, many members who represented different provinces did not show disagreement of the proposal. A few members, including the former vice-chairman of the National Federation of Trade Unions, even spoke in support of setting up the provincial fund. However, the approval of the proposal would have big financial implications for the Ministry of Finance. Huang believed that this was the main reason that the member representing the Ministry of Human Resources and Social Security – the key policy stakeholder in formulating laws and regulations protecting workers’ rights – had remained silent about the proposal. The representative of the Ministry of Civil Affairs then suggested that civil affairs departments at the provincial level could offer financial support to the sick workers if their labor relationship with the employer could not be confirmed. This alternative proposal was then passed, which contributed to Article 62 of the Law of the Prevention and Treatments of Occupational Diseases (revised in 2011) which states that “Where the employer of an occupational disease patient no longer exists or the employment relationship of an occupational disease cannot be confirmed, the patient may apply to the civil affairs department of the local people’s government for medical assistance, subsistence support, and so on.” Huang Leping was disappointed about the decision as he knew that the ­provincial-level civil affairs departments would not have adequate funding to support the medical needs of occupationally sick workers. He was pessimistic that his proposal would be reconsidered in the future, as he said: “The political environment has changed. At the time our proposal was considered, Wen Jiabao was

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the Premier. Wen Jiabao really wanted to do something to help marginal groups in society. But, now, it is completely different.” Back in Hong Kong, I posed the question to Pingkwan, and shared with him the views of Wang Keqin and Huang Leping. Pingkwan had been working with gemstone and jewelry factory workers in Guangdong province where the contract system was more formal than in small private enterprises in the inland rural area. Thus, most of the sick workers that were seen by Pingkwan had signed a labor contract with the employer. However, Pingkwan said that the dispute with the employer over the occupational disease diagnosis usually dragged the victims into a marathon of bureaucratic and legal procedures which might last for years. When I asked for his opinion on the “less than five percent” claim, he agreed with it. He said: “Just take the list of the 350-odd gemstone workers I obtained in 2004 as an example, only […] five workers did follow the whole of the legal procedures and obtain law-stipulated compensations at the end. […] So, they are right, the ‘success rate’ was less than five percent.” Knowing that different NGO experts in the field unanimously agreed that only “less than five percent” of sick workers are protected under the current legal framework, I am, however, not satisfied with the way these experts seem to imply the rights of the sick workers would be protected if the labor contract as a prerequisite were removed, a centrally financed provincial fund were set up, or if the regulatory procedures were simplified. However, I believe that from the lived experience of the sick workers, from a bottom-up perspective, there are other reasons that explain the ineffectiveness of the current legal framework. Bearing this doubt in mind, I thus formulate the first objective of this book as follows: Why do the passing of laws and improvements in law seem unable to bring about adequate protection for the rights of occupationally sick workers? Based on the lived experience of these workers, what extra light can I shed on understanding the reasons apart from those provided by different NGO experts?

Responses to marginality What can occupationally sick workers do if few receive legally stipulated compensation? One should note that occupationally sick workers are usually poorly educated and come from poverty-stricken peasant families. In my fieldwork, I did meet a small number of sick workers whose disease was less severe and whose education level relatively higher. These workers could change occupation through smart use of their compensation. They set up lucrative businesses or found other jobs, such as sales assistants and security guards, which were less physically demanding than working in factories. A few even became staff of NGOs who helped other sick workers fight for compensation. But, for the vast majority, it was impossible for them to “return” to normalcy, not only in terms of physical health but also economically, socially, or culturally. For example, big factories in the coastal area now require all newly recruited workers to pass a health check which helps the employer to screen out those already suffering from occupational disease. Sick workers were able to circumvent

Prefacexix the medical screening by working in small factories with less rigorous recruiting procedures; however, their health conditions usually hindered them from performing well and doing overtime. For the pneumoconiosis-stricken coal miners in the inland regions, their disease even prevented them from playing their gender roles as “men.” For example, they could no longer, or at least, not as much as before, work in the coal mines, which offered a stable and substantial income to their families. At home, many men could no longer shoulder physically demanding agricultural tasks as they could before. In short, occupational disease inevitably marginalizes sick workers, and their efforts to resume their pre-illness levels of economic, social, and cultural competency are usually in vain. So, what could they do? Existing scholarly and non-scholarly discussions on the way occupationally sick Chinese workers deal with their social marginalization usually portray relatively exclusive and extreme illustrations of the actors’ responses. Either they emphasize the agentive nature of the workers who tend to enact collective actions and rightful resistance of “no choice but to fight” (Leung and Pun 2009; GM 2009); or they lay stress only on the institutional hurdles faced by victims who feel helpless on “the hard road” to fight (CLB 2005, 2010, 2013). Based on s­ ingle-disease, single-location studies these discussions bar observers from gaining a panoramic view of the spectrum of heterogeneous responses towards marginality, ranging from being bedridden and critically ill, to passive retreat from society, to petition to higher administrative levels, to legal action, and to rightful resistance. The present book, however, covers the two most common occupational diseases in China – pneumoconiosis and heavy-metal poisoning, which led me to contact four types of workers – battery-factory workers (female), lapidary-factory workers (male), Japanese-mat workers (male and female), and coal miners (male) – as well as some of their family members, relevant NGO workers, healthcare workers, legal professionals, and volunteers in three provinces (Guangdong, Hunan, and Sichuan) and two special municipalities (Chongqing and Beijing), as well as Hong Kong. My fieldwork also covered sites both in the urban and rural areas. This book thus is able to provide – from a bottom-up perspective – a spectrum of responses to marginality and how these responses have been associated with underlying social, economic, and cultural factors. It is against this background that the second question of this book is formulated: What are the responses enacted by different groups of occupationally sick workers? What are the factors leading to these heterogeneous responses and under what circumstances? Which response to marginality is considered by each sick worker group as the preferred, and most desired, and why?

The actor–power interface By identifying different responses to marginality, this book does not stop at the descriptive level to merely concentrate on examining the conscious, ­practical-evaluative, and projective (re-)actions in response to social marginalization. Rather, this book is committed to go beyond the conscious, discursive level of analysis; it explores the fabric of the taken-for-granted, unspoken assumptions

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of the everyday life which shapes the attitudes and the structures of preference of individuals. However, one should be reminded in the context of contemporary China that any response to marginalization on the part of sick workers due to the inadequacy of legal protection will immediately place them as objects and targets of the established authorities, and more especially, of the power of the state. Since the communist party gained supreme power over China in 1949, different generations of leaders have refused to follow a tripartite separation of power considering legislative, juridical, and administrative authorities as independently distinct power entities countervailing each other. For example, Mao Zedong emphasized that China was led by the working class – under the leadership of the Communist Party – in the form of a people’s democratic dictatorship based on the worker–peasant alliance (Mao 1986: 687). To Deng Xiaoping, China’s socialist democracy was never guided by the tripartition of powers as in democratic Western countries (1987). Both Jiang Zemin and Hu Jintao stated explicitly that China should stick to its socialist democracy, and to imitate the political system of Western countries was not beneficial to maintaining national governance, ethnic solidarity, and social stability (Jiang 1997; Hu 2004). Xi Jinping, the current leader, even suggested a “collaboration of the three powers” (sanquan xiezuo, 三權協作) such that “legislative, juridical, and administrative authorities should support each other” (Apple Daily 2013). With such a strong and consistent political ideology to place the legislature under single party rule, it is logical that all the laws in communist China are formulated, implemented, and understood explicitly or implicitly by all stakeholders as having the ultimate goal of keeping state power unchallenged. In contemporary China, one should note that only a small proportion of judges receive formal legal training, and half do not even have a university degree. Wu (2013) makes this point succinctly: China has a lot of judges – most estimates say about 200,000, or roughly twice the number of lawyers. Until recently, relatively few Chinese judges had significant legal training: reports in mid-2005 stated that, for the first time more than fifty percent of judges were university graduates. A decade earlier the figure was just 12 percent. In the past, many judges were retired military officials or government cadres. (2013: 517)

The 2015 Zhou Yongkang corruption scandal marks further how far the legislature is enmeshed with state power in China. Zhou Yongkang was one of the most powerful figures in the country, one of the nine Standing Committee members of the Politburo while Hu Jintao (2002–12) was leader. In charge of the country’s legislation, litigation, and public security, Zhou was arrested in December 2014. He was convicted on a number of corruption charges, including bribery, abuse of power, and revealing state secrets. In June 2015, he was sentenced to life in prison. Official reports indicated that Zhou accepted 731,000 yuan in bribes while his family members received bribes valued at 129 million yuan (Forsythe 2015). However, experienced China observers unanimously believe these official figures

Prefacexxi for the bribery were seriously underestimated. Various sources suggest that the assets seized from Zhou’s family members and associates were worth at least 90 billion yuan (approx. US$14.5 billion or £8.7 billion) (The Telegraph 2014; Wu 2015; Sieren 2015). All the above factors encourage a legal environment that favors powerful bureaucrats and wealthy businessmen who are able to use power and money to determine adjudication outcomes. Under these circumstances, one should be able to understand that when an individual expresses dissatisfaction towards the enforcement of a particular law, or a particular court judgment, he or she will be seen in one way or another as politically unfriendly to the power of the state. In the case of occupationally sick workers, since the current system is likely to produce aggrieved sick workers who feel that the legal system is not able to protect them, they are prone to respond to the system by expressing dissatisfaction. Once this happens, the sick workers are likely to be placed in a position vis-à-vis the existing power structure in their post-illness lives. Therefore, while the present book covers a wide range of issues related to occupational disease in China, it possesses a specific empirical focus on the lived experiences of occupationally sick workers at the actor–power interface. Thus, by observing the reasoning and calculations behind how the sick workers enact a wide spectrum of responses to marginality in contexts where the anti-­ government sentiment is routinely suppressed, this book endeavors to examine how the exercise of power over the workers features a particular governmental rationality and how it reflects their everyday experience of marginality. This leads to the third and final question which this book poses: How does the empirically rich, experience-near account of the responses to marginality at the actor–power interface reflect the current mode of governance in China? How does this mode of governance impact on the future of the marginalized situation of the sick workers?

My approach As the objectives of this book suggest, my approach to explore the post-illness experiences of occupationally sick workers will go beyond the boundaries of conventional labor studies which lay stress on OHS policies, industrial regulations, workplace measures, and the institutional hurdles faced by sick workers in pursuing compensation. More precisely, this book’s perspective is to consider these occupational sick workers as a form of estranged life located within a specific context of power relations. In the literature, studies of occupational disease and its connection with distributions of power have been mainly examined from three approaches. A historical approach to occupational disease, which is usually supplemented by ethnographic methods, emphasizes the emergence and growth of particular occupational diseases, including black lung disease, silicosis, asbestosis, and lead, radium, and beryllium poisoning, as a consequence of a historical process (Dembe 1996: 4). This approach’s central concerns are how specific economic, political, and social factors at particular times exerted critical effects on the scientific and medical understanding of occupational disease. In Deadly Dust by David

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Rosner and Gerald Markowitz (2006), the authors argue that occupational disease is a “condition of modern industrial society” (2006: 11), and the history of silicosis reflects the “dramatic growth and decline of America’s industrial might” (2006: 230). The perception of the nature of silicosis, and its responsibility as a cause of industrial disease thus have been changing across time. In Miners’ Lung, Arthur McIvor and Ronald Johnston (2007) explore the experience of coal miners’ lung diseases and the attempts at voluntary and legal control of dusty conditions in British mining from the late nineteenth century to the present. The workers’ oral testimonies help elucidate a characteristic “machismo” work culture and socialization inherent in their work, and explain why their ideas about the disease have changed over time. A contestability approach is premised on the fact that, unlike other diseases, occupational disease in modern society brings with it a liability problem, that is, “who is responsible?” Therefore, the “underlying cause” of an occupational disease is usually controversial and becomes an issue of contestation among different stakeholders (Morello-Frosch et al. 2012: 7). Steve Fox’s book Toxic Work (1991) published in the early 1990s unveiled the contestability of a case of occupational poisoning outbreak which had afflicted 250 high-tech workers (mostly Hispanic women). The book captured six years of legal and medical investigation into the post-illness lives of these workers, and revealed how the testimonies of expert medical witnesses for both sides could shape the plaintiffs’ stories in particular ways. The issue of contestability in occupational disease has been closely connected with a series of institutional changes in OHS policies during the 1970s in the United States, including the establishment of the American Industrial Health Council, an advocacy group created by several major chemical companies in 1977 (Patterson 1987; Jasanoff 1990; Proctor 1995). Officially, this council’s aim was to study occupational exposure and draw up a list of proposals for the Occupational Safety and Health Administration (OSHA) in the United States, and to improve federal policy on the identification and regulation of carcinogens (Boudia 2014: 103). In developed countries, the contestability of occupational disease has developed from a sectoral debate in the workplace, to specific controversies in domestic and global contexts “related to medical and environmental health science, the politics of public health prevention, and regulatory decision making” (MorelloFrosch et al., 2012: 7). The final approach to occupational disease, also the least researched one, is the medical anthropological approach. Focusing heavily on the lived experiences of the sick, medical anthropology underscores an emic (insider) perspective of understanding disease that recognizes how cultural beliefs define sickness, health, and recovery (Kleinman 1980). Emerging as a sub-discipline of medical anthropology, critical medical anthropology focuses on how social, political, and economic factors are interwoven into the cultural fabric of understanding of health and illness (Singer and Baer 1995; Sargent and Johnson 1996). Previous queries along this line included the analysis of the “body politic,” which features how power is exercised through embodiment and corporeality in specific contexts (Scheper-Hughes

Prefacexxiii 1994), and the extended meaning of the concept of “having a disability” from an individual, physical fact, to understanding it at the social and political levels (Oliver 2009). Quintessential to this approach is King and King’s (2011) study of male workers in Northeast Thailand who had experienced a severe spinal cord injury at a time when they were both breadwinners of their family and active participants of a modernizing state. The study illustrates the complex ways the informants make sense of their illness when different social and cultural factors interact with the opportunities, challenges, and constraints of a country’s transition to modernity. With less emphasis on an historical approach, my approach in this book is led essentially by contestability and critical medical anthropological approaches, in such a way that the lived experiences of sick workers are placed under a particular domination–subordination analytical conceptual focus. Rather than considering power exercised on the sick workers as a form of governance emanating from a center, this book adopts a bottom-up perspective in understanding the sick workers’ experience of power, and how their responses to established authorities may improvise or maintain the existing power relation from the bottom up. As will be argued in detail in subsequent chapters, the bottom-up approach to understanding the experience of power has been informed and inspired by a relatively new strain in anthropology known as anthropological studies of governmentality. This corpus of studies lays emphasis on the politics which is involved in the formation of individuals’ “desires, aspirations, interests and beliefs” in accordance with a governmental rationality (Dean 1999: 11); hence, the formulation of programs and interventions which are supposedly humanitarian and therapeutic in nature to improve the quality of the population. Seemingly precarious, these programs and interventions have significantly informed governance, and the ways of living that people adopt vis-à-vis ailing public institutions have been based on previous anthropology studies of governmentality (e.g., Abélès 2009; Anand 2011; Biehl 2007; Biehl and Locke 2010; Fassin and Pandolfi 2010; Feldman and Ticktin 2010; McKay 2012; Nguyen 2010). Attention to the soft power that shapes attitudes and structures of preference has presented new ethnographic quandaries which, as pointed out by Biehl and McKay (2012: 1211), engage us to “think through the ambiguous political subjectivities that crystallize amidst the blurring of distinctions between populations, market segments, target audiences, and collective objects of intervention or disregard.” The emphasis on the bottom-up perspective of this book has further been reflected in my first proposed title of this book. Sick Life Governed – rather than Governing Sick Life – confers a focus that scrutinizes the art of government from the perspective of the sick workers rather than that of the powerholders.

Plan of this book This book is composed of seven chapters. Entitled “Facts, theoretical gaze, and journeys,” Chapter One begins with the story of Zhang Haichao (1980–), who is indisputably the most well-known occupationally sick worker in China. His drastic move to undergo a thoracotomy to prove his occupational illness in 2009

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constituted a painful accusation against the loopholes of the existing OHS system in protecting the rights of occupationally sick workers. Next, certain key fundamental facts about occupational disease in China will be introduced, including official statistics, the problem of underreporting, the features of the major occupational diseases, and the current legal and regulatory frameworks of the OHS system. How these frameworks have developed over the past decade will also be highlighted. The theoretical framework which guides my analysis of the lived experiences of occupationally sick workers in subsequent chapters will be detailed under five concept-discussion sections. Finally, my fieldwork journeys, my methodology as well as the sampling bias that my fieldwork has incurred will be outlined. Chapter Two is called “Sick workers as homines sacri.” This chapter argues that the social estrangement of Chinese sick workers can be understood as an instantiation of Agamben’s notion of homo sacer – the ultimate biopolitical subject whose life is located outside “normal” political, economic, and cultural practices. The major argument is that sick Chinese workers as homines sacri exist in a “zone of indistinction” in which they are constantly and disturbingly caught in between the public and private, the productive and unproductive, and the culturally normative and culturally deviant. One consequence is that the problem of occupational disease is rendered largely silent and unintelligible in the public realm insofar as the specific set of social regulations and power relations have created such a “double ambivalence” among the sick workers. The chapter further suggests that such experience of “double ambivalence” on the part of the sick workers is closely connected with the common use of “stability maintenance” measures on the part of the state to suppress the resistance of aggrieved sick workers by illegal and violent means. Chapter Three – “Cadmium-poisoned women: contesting for sick role status” – marks the first of three consecutive chapters focusing on the content-rich stories solicited from occupationally sick workers. The chapter will begin with a description of the outbreak of occupational poisoning in 2004 in two battery factories in Huizhou which led to hundreds of female workers becoming afflicted with excessive cadmium levels, or cadmium poisoning. Illustrated here are the sick workers’ experiences of social estrangement which was mainly due to a lack of understanding from their significant others, and also their experience of violence in the process of the uphill struggle for compensation. Owing to the contested nature of cadmium poisoning, the workers’ stories shed light not only on the contemporary state power that emphasizes the silencing of victims rather than adherence to the rule of law but also on the workers’ desire to be granted the sick role status so as to be protected by the legal system which has failed to protect the rights of many. Chapter Four is entitled “Pneumoconiosis-afflicted workers: toward rightful resistance.” Suffering from workplace-induced pneumoconiosis, the sick workers concerned were mainly originally peasants, and later employed as factory workers at gemstone or jewelry or Japanese-mat factories in the wealthy coastal regions. By unraveling different trajectories in their post-illness lives this

Prefacexxv chapter explores their experiences of social marginalization. It reveals that only a small proportion of victims managed to re-adapt to society; only a handful were able to transcend their marginality and became activists protecting the rights of other sick workers. Most of the time, the impact of the disease on the body and the family household was so severe that the affected individual needed to struggle against a sense of social estrangement, if not helplessness, in everyday life. However, in comparison with workers suffering from excessive cadmium level or cadmium-poisoning, or coal miners who are afflicted with pneumoconiosis in inland regions, sick workers in the lapidary industry in the coastal regions have been fortunate. Relatively more of them have been successful in pursuing compensation via the legal route. But, none of those whom I talked to during my fieldwork could obtain legally stipulated compensation without enacting certain forms of rightful resistance. Chapter Five – “Coal miners: the compromising citizenry” – focuses on dozens of inland provincial peasant workers who worked as coal miners in small privately owned mines and subsequently developed pneumoconiosis. Their stories prompt me to take a brief detour to a corpus of studies known as “rightful resistance” which emphasize peasants’ use of existing legal and political resources to right the wrongs done to them and the law as a narrative frame to assert their claims in protests. Next, the chapter shows that the image of a “restive citizenry” by which peasants – as rightful resisters – struggle valiantly to defend their own rights has been increasingly questioned by scholars who find either that the wronged peasants do not get angrier or that their rightful resistance is eventually muted. The stories solicited from the sick peasant coal miners showed an unwillingness to pursue their rights through the courts or enact rightful resistance if the courts or other formal institutions fell short in delivering the promised rights. In examining how sufferers consider what is the “best way” to obtain compensation, the chapter sheds light on one response pattern observed at the actor–power interface, which is what I shall call the “compromising citizenry” response pattern through which the sick workers recognize the legal and formal procedures as somehow legitimate, but at the same time consider bribing state officials as a prerequisite to protecting their legal rights. Summarizing what has been observed in the previous three chapters, Chapter Six pioneers the idea of law as a technique of governmentality operating to marginalize millions of Chinese sick workers through shaping their attitudes and structure of preference. Based on the empirical findings identified, I argue that while the occupationally sick workers genuinely do not trust the law and bureaucracies to protect their rights, they understand that being subject to legal protection is the only hope that their demands can be heard. Thus, they need to engage in myriad struggles, ranging from quarrels with officials, to protests against state authorities, to petitions to higher authorities (shangfang, 上訪), to appeals to the media, to the bribing of judges, officials and/or professionals, and even to obtaining faked diagnoses indicating more severe illness. The three major types of preferred ways of seeking compensation solicited from different groups of occupationally sick workers, namely, the craving for sick role status, rightful resistance,

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and compromising citizenry, can be considered as struggles for obtaining “legality.” These accounts of struggle reflect not only how the sick workers make sense of the existing legal system but also how law as a governmentality technique is used to shape the victims’ desires, aspirations, interests, and beliefs, through which they are governed and also govern themselves. The chapter concludes that the government mechanism and victims’ quotidian experience are inextricably interconnected and have been contributing more to proliferate than oppose constituted power. The concluding chapter, Chapter Seven, begins with a schematic summary of how far the three objectives outlined above have been addressed. Entitled “The future of Chinese marginality,” the chapter points to my observations that the  sick workers’ struggles in everyday life have been operating in a way that effectively entails the existing governmentality and masked social contradictions.  This is to  argue that to frame law as a governmentality technique provides a useful  means in which to understand the operation of contemporary Chinese state power, in particular the ways in which modern biopolitical power is enmeshed with and embedded in traditional power models based on sovereignty. In this way, it is possible to give consideration to important questions that underlie the domination–subordination analyses in contemporary China which have not been given sufficient attention: What are the characteristics of governance of the self which constitute the basis of governmentality in contemporary China? What is the significance of acting at a distance in relation to governmentality and to the fabric of everyday life? What roles does personal reflexiveness play in maintaining governmental mentality, hence reproducing existing power relations?

Notes 1 By the terms of the Nanking Treaty signed in 1842 between the Chinese Qing rulers (1644–1912) and the British governments, Hong Kong Island was ceded to Britain after the First Opium War (1839–42). After the Second Opium War (1856–60), the Qing government signed the Treaty of Peking in 1860, and the Kowloon Peninsula was ceded to Britain. In 1898, the British government leased the New Territories for ninety-nine years based on the Convention for the Extension of Hong Kong Territory. According to the Sino-British Declaration signed in 1984, both the Chinese communist and British governments agreed that the Chinese government would resume sovereignty over Hong Kong, including Hong Kong Island, Kowloon Peninsula, and the New Territories, from July 1, 1997 onward. 2 In 2012, I collaborated with two colleagues and conducted a comprehensive study on national identity among secondary students in Hong Kong. The study was commissioned by the Central Policy Unit of the Hong Kong Special Administrative Region Government. Based on a sample of 1,445 students, 75.1 percent self-identified as having both a Hongkonger and a Chinese identity. Such a normative pattern of dual identities applied to Hong Kong-born (72.6 percent) and especially China-born respondents (Ng et al. 2012). 3 Interview with Choi Yukyuk, March 7, 2012, Hong Kong.

Prefacexxvii 4 At today’s rates (December 15, 2015), one British pound is equivalent to 9.79 yuan, and one US dollar to 6.45 yuan. The value of the yuan, or renminbi, against these two major currencies was about twenty percent lower twenty-four years ago. 5 For example, a factory-based strategy was developed to educate workers about occupational health and safety (OHS) issues and their legal rights. Another strategy was called the “name and shame” strategy and emphasized campaigns aimed at consumers. Since many international brands outsourced their production to Chinese factories, Hong Kong-based NGOs first conducted extensive investigations into the loopholes of OHS precautionary measures in different types of factories, such as toy, shoe, and textile factories, and disseminated the information to consumers through protests, publishing reports, public media, and collaborations with international consumer movements.    The “name and shame” strategy was effective as new NGOs were subsequently established in response to the need of international brands to have a partner to conduct the “social audit” or workers’ training so that they could meet the corporate social responsibility expectation of consumers. These NGOs include The Chinese Working Women’s Network, Dagongzhe Centre, China Labor Support Network, and Labor Education and Service Network. These NGOs also set up their own centers in China aiming to provide a place for workers to gain awareness of their rights. 6 A summary of probable SARS cases in different places with onset of illness from November 1, 2002 to July 31, 2003 can be found on the WHO website: www.who.int/ csr/sars/country/table2004_04_21/en/. 7 See the WHO website: “Questions and answers on melamine,” www.who.int/csr/media/ faq/QAmelamine/en/; last visited on March 17, 2016. 8 In January 2009, the Chinese government revealed that a total of 296,000 children had fallen ill from consuming milk products tainted with melamine (BBC 2010). Western media generally believe that the actual number of children affected was over 300,000. Eventually, the government ordered twenty-two dairy firms which were implicated in the melamine scandal to compensate hundreds of thousands of families to the tune of 1.1 billion yuan (BBC 2009). However, more than two hundred families petitioned the Supreme Court demanding higher levels of compensation.

Acknowledgments

There were many people who helped to make this book possible. My thanks first goes to Chung Mingli, Shek Pingkwan, May Wong, Li Hangtung, Nana Lau, Chen Juying, Wang Keqin, She Yinhu, and Li Bianfeng. Without them my fieldwork in Guangdong, Hunan, Sichuan, Chongqing, Beijing, and Hong Kong would not have been possible. I would also like to express my gratitude to Professor Pun Ngai, Apo Leung, Choi Yukyuk, Monina Wong, Francine Chan, Alan Sze, Huang Leping, Ye Mingxin, Wang Shengli, and Li Guoguang for their invaluable information and insights. Throughout this project, many have offered critical comments which have helped form this book. For such help, I wish to thank Chan Kingchi, Cheung Chaukiu, Wu Keungfai, Fung Saifu, Chen Fenling, and Professor Chui Winghong. My sincere thanks go to Ho Kitho for his outstanding research assistance, and Jennifer Eagleton for her excellent proof-editing work which has turned my prose into a more readable text. I have dedicated this book to my wife Christine, and my children Ronald and Nicole who have tolerated my absence at home during fieldwork and the final stage of writing up the manuscript. I feel deep regret that in order to protect the anonymity of the sick workers I talked to and lived with, and that of my fieldwork assistants who also became sick, I cannot mention them by name. I am particularly grateful for their hospitality in welcoming me into their homes in villages in Hunan, Sichuan, and Chongqing. Being sufferers of an incurable disease and victims of the current system, they have helped me not only to understand their own experiences but they have also enabled me to connect with others in similar situations. Last but not least, I am grateful to the New Ethnographies series editor  Alex  Smith for his unswerving confidence in this book project, to Manchester University Press for its efficient review process, and two anonymous reviewers for their constructive, and sometimes sympathetic, comments on the manuscript. Although I would not have arrived at my final draft without the help of those already mentioned, I bear sole responsibility for any errors, omissions, and inaccuracies in the text.

Acknowledgmentsxxix Data from the early stage of my fieldwork have appeared in The China Quarterly, China Review: An Interdisciplinary Journal on Greater China, and China: An International Journal. I would like to take this opportunity to extend my gratitude to the editors and blind reviewers of these journals whose inputs and comments have greatly improved the book. At different stages, my study was supported by three grants. They are Marginality, Suffering, and (Dis-)empowerment: A Study of the “Multiple Exits” for Victims of Work-induced Pneumoconiosis in China (granted by the College of Liberal Studies and Social Sciences, City University of Hong Kong; ref# 9610250); Occupational Poisoning and Body Politics in Post-Deng China: Female Peasantworkers’ Testimonies both at and away from Home (granted by the College of Liberal Studies and Social Sciences, City University of Hong Kong; ref# 9610202); and Exploring “Localism” vis-à-vis Central Strategy: A Study of Cultural Schema Pertinent to the 2010 “Save-Cantonese” Protests (granted by the UGC-General Research Fund (GRF); ref# 144012).

A note on anonymity When I began fieldwork, I promised anonymity to the people whom I interviewed. Therefore, all personal names in this book, save those of widely recognized public figures, are pseudonyms. However, special consent has been given for photographs in which individuals can be identified.

A note on verbatim quotation In this book, “…” connotes a natural pause in the utterance of the actor; “[…]” means that one or several sentences are skipped to avoid the verbatim quotes from being too long and superfluous.

Abbreviations

CIC CPPCC CWP GM ICESCR ILO LAC LDAC LSP MLP MoH MoLSS NHFPC NPC OHS OSHA PRD SAR SARS SAWS SEZs WE Yilian

Christian Industrial Committee Chinese People’s Political Consultative Conference Coal workers’ pneumoconiosis Globalization Monitor International Covenant on Economic, Social, and Cultural Rights International Labour Organization Labour Action China Labor Dispute Arbitration Committee Love Saves Pneumoconiosis Minimum Livelihood Protection Ministry of Health Ministry of Labour and Social Security National Health and Family Planning Commission National People’s Congress Occupational Health and Safety Occupational Safety and Health Administration Pearl River Delta Special Administrative Region Severe Acute Respiratory Syndrome State Administration Work Safety Special Economic Zones Worker Empowerment Yilian Legal Aid and Study Center of Labor

Series editor’s foreword

When the New Ethnographies series was launched in 2011, its aim was to publish the best new ethnographic monographs that promoted interdisciplinary debate and methodological innovation in the qualitative social sciences. Manchester University Press was the logical home for such a series, given the historical role it played in securing the ethnographic legacy of the famous ‘Manchester School’ of anthropological and interdisciplinary ethnographic research, pioneered by Max Gluckman in the years following the Second World War. New Ethnographies has now established an enviable critical and commercial reputation. We have published titles on a wide variety of ethnographic subjects, including English football fans, Scottish Conservatives, Chagos islanders, international seafarers, African migrants in Ireland, post-civil war Sri Lanka, Iraqi women in Denmark and the British in rural France, among others. Our list of forthcoming titles, which continues to grow, reflects some of the best scholarship based on fresh ethnographic research carried out all around the world. Our authors are both established and emerging scholars, including some of the most exciting and innovative up-and-coming ethnographers of the next generation. New Ethnographies continues to provide a platform for social scientists and others engaging with ethnographic methods in new and imaginative ways. We also publish the work of those grappling with the ‘new’ ethnographic objects to which globalisation, geopolitical instability, transnational migration and the growth of neoliberal markets have given rise in the twenty-first century. We will continue to promote interdisciplinary debate about ethnographic methods as the series grows. Most importantly, we will continue to champion ethnography as a valuable tool for apprehending a world in flux. Alexander Thomas T. Smith Department of Sociology, University of Warwick

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Map 3 Hunan Province / MUP/ DD / DS / 15.05.2017

Map 3  Hunan province, showing Changsha (provincial capital), Lianyuan, and Loudi

Mapsxxxv

S

I

C H U A N Chengdu

P

R O

V

I N C

E Luzhou

0

km

200

Map 4 Sichuan Province / MUP/ DD / DS / 15.05.2017

Map 4  Sichuan Province, showing Chengdu (provincial capital) and Luzhou

xxxvi

0

Maps

km

100

Kaixian

Liangping

Wanzhou

Zhongxian

C H O N G Q I N G M U N I C I P A L I T Y

Map 5 Chongqing special municipality / MUP/ DD / DS / 16.05.2017

Map 5  Chongqing special municipality, showing Liangping, Zhongxian, Kaixian (where Kaijiang is located), and Wanzhou

Part I

Life in perspective

1

Facts, theoretical gaze, and journeys

In China, pneumoconiosis makes up more than 80% of all [occupational disease] cases; in recent years, between 10,000 and 23,000 new cases have been registered annually. (ILO 2013: 6) By the end of 2010, official data show that there were over 600,000 who suffered from workplace pneumoconiosis. This figure equals the total number of pneumoconiosis cases in the world. (Liu 2010: 9) From the 1950s, the number of deaths due to pneumoconiosis amounted to 580,000, which is about the total of pneumoconiosis deaths in all other places. (Beijing Youth Post 2005)

How many occupationally sick workers are there in China? No one really knows. What is certain, however, is that the official data publicly announced by the MoH every year represents the absolute minimum number of cases as these are only based on formally diagnosed cases. Observers have pointed out that the official data represents only 10 to 20 percent of the actual number of cases (Fung and Chan 2012; Zhongguo Xinwen Net 2013; Wang 2015). What makes it so difficult for sick workers to obtain a formal diagnosis? The story of Zhang Haichao is a case in point.

Zhang Haichao Zhang Haichao is arguably the most famous occupationally sick worker in the history of China.1 In 2007, the twenty-seven-year-old from Hunan province began to suffer from a cough and tightness in his chest after working at an abrasive materials factory for more than three years. In the factory located at Xinmi, near Zhengzhou of Hunan province (Map 3), Zhang needed to operate stone-­ crushing and -pressing machines which generated clouds of dust. Several local and national hospitals confirmed Zhang was suffering from pneumoconiosis which was suspected to be work-related. In order to confirm the employer’s liability for his disease, according to law, he needed to obtain a formal diagnosis from the Disease Control and Treatment Center (“CDC center” hereafter) in Xinmi. The CDC center initially declined to examine him because his employer refused to provide the necessary documentation and proof of employment as the law

4

Life in perspective

required. Upon Zhang’s urging, his employer yielded. The report released from the CDC center on May 25, 2009 confirmed that Zhang was suffering from tuberculosis, not pneumoconiosis. Suspecting corruption and collusion between his employer and the CDC center, Zhang was deeply upset by the result which was completely different from several diagnoses he had obtained from other healthcare institutes. Tuberculosis, which is caused by a bacterial infection, is quite different from pneumoconiosis, which is caused by dust inhalation. A diagnosis of TB would impact on the terms of who had liability for his contracting of the disease. Refusing to accept the (mis)diagnosis, Zhang took the drastic action of undergoing a thoracotomy, literally open-chest surgery, at a hospital in Zhengzhou. The purpose of the operation was to check his lungs through direct observation to prove that they were clogged with dust which could not be caused by bacteria. On June 22, 2009, this was confirmed, proving that the diagnosis of pneumoconiosis was the correct one. The furor created by Zhang quickly made him a household name and he took part in hundreds of media interviews in the weeks following his surgery. That year, he acquired 1.2 million yuan with over half being the result of a mediated settlement for compensation with his employer.2 Zhang’s four other co-workers who also suffered from pneumoconiosis also obtained compensation. Zhang’s dramatic open-chest surgery shows the difficulty that occupationally sick workers in China have in obtaining a formal diagnosis of their condition. However, his story did not end happily. Right after his highly publicized surgery in 2009, Zhang estimated that he would live for about six more years. He then decided to devote the rest of his life to being an activist offering legal advice to other sick workers to pursue compensation. Unfortunately, deteriorating health almost made him give up the idea of helping other sick workers. In mid-2011, Zhang suffered another blow. Both of his parents were diagnosed with serious chronic disease. One year later, all his four former co-workers who were compensated in 2009 died from pneumoconiosis. In that year, the MLP benefits to which his family was entitled were unexpectedly stopped by the village cadres. Without MLP, according to the current regulations, one needs to pay social insurance in order to continue enjoying subsidized healthcare services. Zhang was not informed about the cancelation of the benefits, nor told that he had to pay social insurance. Zhang and his family had failed to use the inexpensive healthcare service. Zhang believed that this move was the local government’s revenge for his high profile in the media. The worst blow to Zhang was perhaps was when his wife divorced him. Despite his best efforts to portray a happy family of three: his wife, his daughter, and himself in front of the media, he revealed later in an open letter dated December 5, 2012 that his relationship with his wife “was never the same as before” once he had become sick. In October 2011, his wife left the family home. In June the following year, the two formally divorced. Zhang obtained custody of his daughter who was then six years old. In late 2012, he posted an open letter on his miniblog, entitled “My ‘happy’ family” (wo de ‘xingfu’ yijia, 我的「幸福」一家). In it he sought a foster family for his daughter after his death:

Facts, theoretical gaze, and journeys

5

Our relationship had been never the same as it was before I was ill. Last October [2011], my wife packed up and took away all her valuable belongings while there was no one at home. She has not returned. We got officially divorced this June [2012], and I was granted custody of our daughter according to our divorce agreement. This means that no matter whether I am alive or dead, my wife does not have the legal or financial responsibility for supporting our daughter. Last May, my father lost the sight of one eye because of anger at my illness and the misfortune that struck the family. The medical treatment of his eye cost us almost 30,000 yuan, and we now need to spend 500 to 600 yuan every month for post-illness treatments. This August, my mother, who was used to running every errand for the family, was diagnosed as suffering from gallstones. She had cholecystectomy surgery in September, but she still cannot totally take care of herself. Meanwhile, my health has been deteriorating day by day. The result of my body check last year indicated that my pulmonary function had suffered serious damage. Three years have passed. The first batch of five sick workers, including myself, who were working at the Zhengzhou Zhendong Material Co. Ltd. managed to get compensation in 2009. Up to June this year, Gao Shuiwu, Wang Youcai, and Shang Wenge passed away one after another due to pneumoconiosis. Now, I am the only one left. More than twenty other co-workers have already died. Since I received my compensation on September 6, 2009, no leader at the village, county, or city level governments had shown any interest in my health or living conditions. Recently, my father was informed by the bank that the MLP benefits in 2012 had been canceled. The New Rural Cooperative Medical Insurance Scheme (NRCMIS) is connected with MLP in a particular way. Once you are a MLP recipient, you do not need to pay the monthly payment for NRCMIS. But, if you do not receive MLP benefits and do not pay NRCMIS, you are not eligible for the subsidized health care services. Only at this point do I realize that the local government had canceled our MLP without informing us that we must pay for NRCMIS. Accordingly, we lost our protection under NRCMIS as well. My parents are already approaching seventy and my health condition is getting worse, but my daughter is only six years old. Every time I contemplate the future for my family, I have a strong feeling that my parents and I will not be around to raise my daughter to adulthood … My wish is to find my daughter a nice family who could bring her up. My wish does not come out of impulse. Rather, it is also the wish of my parents. If our wish cannot be fulfilled, we will not die peacefully. Therefore, I now beg with utmost sincerity for everyone’s kindness, and I shall bear your generosity to our family in mind forever. Thank you sincerely again for your help.3

Zhang’s open letter was well publicized. Over one hundred people, including a few from abroad, expressed their willingness to be his daughter’s foster parent. Zhang said he felt grateful to everyone who responded positively to his public request, and wrote a reply himself to each of them. Zhang did not agree to any of these offers because of yet another critical event he needed to face. In March 2013, Zhang was lying on the bed of Henan Provincial Chest Hospital with tubes in his chest due to a pneumothorax (collapsed lung). The doctor told him that his open-chest surgery in 2009 had led to the development

6

Life in perspective

of lung adhesions, which had in turn hindered other possible treatments for his pneumoconiosis. Zhang was told that he was left but only one option for ­survival – a lung transplant. In mid-2013, Zhang underwent expensive lung transplant surgery in a hospital in Wuxi, Jiangsu province. The 600,000 yuan surgery, however, did not mark the end of his huge medical expenses; instead, it was only the beginning. In an interview published in May 2015, he revealed that he needed to take seven to eight kinds of medicine every day including anti-rejection drugs which he needed to take for the rest of his life (Guangzhou Ribao 2015). In the interview, Zhang said: Before the lung transplant surgery, my doctor told me that my future quality of life could only be ensured by strong financial backup. Since if I do not take [anti-resistance] medicine for a couple of days, symptoms of rejection will emerge which can be fatal. I knew a friend whose health condition was quite stable after the lung transplant. However, during the Spring Festival, he felt that taking medicine in the first few days of the year was inauspicious. He then stopped the medicine for three days. This resulted in an acute rejection, and soon after, his death.

Zhang told the journalist in early 2015 that the medicine cost him 3,000 yuan per  month, and the annual medical expenses ranged from 80,000 to 100,000  yuan.4 He admitted that the amount of compensation he received in 2009 would be just enough for him to live for another few years. The bright side of having new lungs was that there would be a possibility he could live for decades and gave up the idea of looking for a foster family for his daughter. However, to maintain what he called as the “too expensive life” (tai anggui de sheng ming, 太昂貴的生命), money became an even bigger problem than before. He said that he wanted to find a job, but knowing his activist background, no employer was willing to hire him. Another hurdle in finding a job, as he remarked in the same interview, was that there was no way that he could pass the pre-recruitment medical check. At the time of writing, Zhang is still alive. The story of Zhang is still not yet over. But, his story so far – as I intentionally described it at length above – not only reflects the difficulty of occupationally sick workers in getting a formal diagnosis, which in turn explains why official statistics only represent a minimum number of occupational disease cases in China. It also reflects the myriad problems faced by such workers, including physical suffering, marital problems, financial problems, and lack of support (or even harassment) from state cadres, as well as a feeling of hopelessness about the future, which I considered “typical” of those I met during my fieldwork. But, before we go into further detail about occupational health and disease in China, it would be better to return to the question posed at the beginning of this chapter: How many occupationally sick workers are there in China?

Facts, theoretical gaze, and journeys

7

Official statistics To my best knowledge, it was not until 1993 that the MoH began to publicly announce the number of different types of occupational diseases newly detected each year. Based on the information by the MoH, I managed to construct Tables 1.1a to 1.1d, and Figure 1.1, which indicate the magnitude and trends of different occupational diseases over the past two decades; Figure 1.2 indicates the cumulative occupational disease cases in China from 2008 to 2014. Before examining the official statistics, I find it necessary to register two caveats. First is underreporting. The story of Zhang Haichao has already  unveiled two major reasons for underreporting: the refusal of the employer to acknowledge the diagnosis and the suspected collusion between the employer and the  local CDC center, which results in misdiagnoses. Fung and  Chan (2012: 38) added two further reasons for underreporting. They suggest that official statistics are (i) merely generated from the occupational health surveillance mechanism  which covers only about 10 percent of industries CLSN (2013: 5); and (ii) omitting the figures on migrant workers who return to their home villages after they are dismissed by their employers due to their illness, and on those who give up on the tedious process of seeking compensation (2012: 38). Thus, Wang Keqin, the founder of LSP, believes that the actual number of occupationally sick workers in China should be at least ten times that of the official figures.5 In fact, his view has found support from various field reports and observations. For example, a report estimated that there were 600,000 workers suffering from pneumoconiosis in Hunan province in 2012, which was similar to the official cumulative pneumoconiosis cases for the whole China in the same year (Yan 2012). Fung and Chan (2012: 39–40) noted that while an NGO was following up more than fifty workers suffering from leukemia due to benzene poisoning in a single city (Dongguan, Guangdong), official statistics reported that there were only twenty-two cases of leukemia caused by benzene poisoning in China as a whole in 2009; there were fifty-two cases in 2011, and fifty-three cases in 2013. The second caveat is inconsistency. Based on the MoH reports announced every year since 1993, four different sampling frames have been adopted. For the year 1993, the statistical figures were said to be based on twenty-eight provinces/ special municipalities/autonomous regions. The smallest sampling frame in the past two decades was used in 2004. This frame only covered seventeen provinces, special municipalities, and autonomous regions. For the years 1994–96 and 2006, the sampling frame was composed of twenty-nine provinces/special municipalities/autonomous regions. As for years 2000–02, 2005, and 2007–14, the statistics were based on all thirty provinces/special municipalities/autonomous regions. Despite the above four different sampling frames, the MoH’s reports did not provide any information on the constituents of the sampling frame adopted in the years 1997–99 and 2003. Even more disturbing for any scholastic assessment on the trends and magnitudes of occupational disease in China is that neither were there any “official reasons” that explained why a particular frame was used rather than another, nor there was any clue allowing one to know exactly which

 2269  2016  1906  1516  1313  1068  1201  1196  1166  1300   882  501   1379   1083   1638   1171   1912   1417  1541  1040   904   795

 1315  1087  1463   854   598   510   759   785   759   590   504  301   613   467   600   760   552   617   590   601   637   486

15321 14297 13256 10228 10637 10238 11718 13218 14821 12511 4654 12212 11519 14296 13744 18128 27240 29879 27420 26393 29972 10644 10830  9871  8195  7418  8285  7495  9100 10505 12248  8364 3326   9173   8783 10963 10829 14495 23812 26401 24260 23152 26873  3584  3103  3369  2370  1911  1578  1960  1981  1925  1890  1386  802   1992   1550   2238   1931   2464   2034  2131  1641  1541  1281

1.1d

Total cases Pneumoconiosis Poisoning – Acute poisoning – Chronic poisoning

1.1c

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

1.1b

Year

1.1a

Tables 1.1a–d  Official statistics of occupational diseases (MoH) 1993–2014

Facts, theoretical gaze, and journeys Total disease cases

Pneumoconiosis case

9

Poisoning case

Acute poisoning case

Chronic poisoning case

35000 30000 25000 20000 15000 10000 5000 0

1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

1.1  Occupational disease trends in China, 1993–2014. Accumulave cases of occupaonal diseases

1,000,000 900,000 800,000 700,000 600,000 500,000 400,000 300,000 200,000 100,000 0

2008

2009

2010

2011

2012

2013

2014

1.2  Accumulative cases of occupational diseases. provinces/special municipalities/autonomous regions were missed or added in a particular year. In addition, the MoH only announced the cumulative occupational disease cases of the country in 2008, 2009, and 2010. From a review of the literature, I managed to obtain the figures for 2011–14, which were said also to be based on “official sources,” such as the National Health and Family Planning Commission (NHFPC) of the State Council (Gongren Ribao 2014; Zhonggong Net 2015). And, once again, such inconsistency, or more exactly, patchiness of data, cannot be explained in any conceivable way.6 In her work on the cultural politics of AIDS in China, Hyde (2007: 37) used the notion of “aesthetics of statistics” to describe the official Chinese figures for

10

Life in perspective

the number of people affected in the early stages of the HIV/AIDS epidemic.7 This means that the state might choose to report less than actual number of people living with HIV/AIDS in China in order to reduce the degree of public anxiety toward the epidemic.8 In the context of occupational disease, rather than facing the “aesthetics of statistics,” we are facing here, what I call, the incomprehensibility of statistics. In other words what is in question has gone beyond the quality of “aesthetics” inherent in statistics which is inextricably linked to the forms of power legitimizing the scientific knowledge process and its resulting solutions (Petyna 2002: 10). Rather, the official statistics of occupational disease in China has been characterized by inconsistent sampling frames and patchiness of data which have not only prevented members of the public from scrutinizing the impact of the problem but also hindered academics from conducting effective studies of the problem. To examine the figures and trends with the two above-mentioned caveats, it is still considerably safe to say that pneumoconiosis and poisoning have been the two most common occupational diseases in China over the past two decades; pneumoconiosis accounts for most new occupational disease cases each year. Figure 1.1 suggests that the number of newly identified occupational disease cases fluctuated roughly between 10,000 and 15,000 during 1994–2009. A conspicuous trough was seen in 2004 – a year which, ironically, marked a surge of occupational disease cases in Guangdong, as observed by Hong Kong-based NGOs (see Preface). The key reason for the abrupt drop seems to be the huge contraction of the sampling frame to cover only seventeen provinces/special municipalities/autonomous regions in 2004. To deal with the missing figures, the only option seems to be to rely on an academic paper by Zhang et al. (2013). The authors claim to have obtained the “official data” for newly detected pneumoconiosis disease cases in 2004, which were 8,423 cases (2013: 321). If the data gap was so filled (without data for non-pneumoconiosis cases) for the year 2004, I can establish the following trends: 1993–99 was a period that witnessed a gradual decline in occupational disease cases (from over 17,000 to 10,238), which was followed by a period (2000–09) that showed a gradual increase in cases (from 11,718 to 18,128). Such a gradual increase in cases can be explained by the promulgations of several important laws and regulations relating to occupational disease during 2001–04 (see Preface), which were means whereby greater numbers of sick workers could be certified as afflicted by occupational disease. In 2010, there was a surge of occupational disease cases from 18,128 to 27,240, and 2010–14 represents a period when the figures had been fluctuating between 27,000 and 30,000. The main contributor to the post-2010 surge was the increase in pneumoconiosis cases as occupational poisoning cases did not show a similar trend during the same period. Two reasons explain this surge. First, the widely publicized case of Zhang Haichao had raised awareness of occupational disease in society, which was combined with improvements accorded through the introduction of the Law of the Prevention and Treatments of Occupational Diseases revised in 2011 (Zhong et al. 2015: 4). The revisions, as will be shown later, loosened

Facts, theoretical gaze, and journeys

11

the prerequisites for obtaining formal certification of occupational disease. Second, 2010 witnessed the emergence of a policy that aimed to restructure all small-scale,  township and village coal mines in China. That year, several state departments,  including the National Development and Reform Commission and the National Energy Administration, jointly announced The Notice on Further Elimination and Restructuring of Backward Coalmines, which quickly led to massive closures of coal mines in 1,693 locations all over the country (Renmin Net 2011). The closures inevitably exposed the problem of liability of coal miners’ pneumoconiosis (CWP), which would have been largely hidden in the negotiations between employer and employee. Yilian, for example, worked closely with hundreds of sick coal miners in two major CWP outbreaks in 2010; in a report, he writes: “After the shutdown of coal mines in May 2010, more than 500 coal miners from a city of northern China were diagnosed as suffering from occupational disease. And, in the case of the CWP outbreak in a coal mine in Zhangjiakou, Hebei province, 119 workers were diagnosed as occupationally ill” (Beijing Yilian 2011: 5). Yilian also indicated that the large number of suspected pneumoconiosis cases in Guangdong in 2004 was subsequently confirmed in 2010; its report also mentioned: “In another case, Yilian was closely following up with 76 former workers of Hong Kong Lucky Gems. They were claiming occupational disease compensation owing to suffering from pneumoconiosis” (Beijing Yilian 2011: 5). In the past two decades, occupational poisoning has been the second most common occupational disease in China, accounting for 4.3 percent (2014) to 25.6 percent (1995) of newly diagnosed occupational disease cases every year. Among those diagnosed with occupational poisoning cases, official statistics show that roughly two-thirds are categorized as “chronic poisoning”, while the rest are considered “acute poisoning.” Based on a convenient sample of 172 occupationally sick workers identified in Beijing, Yilian (2011) reports that 70.2 percent of the sample were suffering from pneumoconiosis and 19.1 percent from heavy-metal poisoning, including benzene, cadmium, and lead; a paper published in the mid1980s also suggested a similar pattern (Christiani 1984). Figure 1.2 suggests that the cumulative total of occupational cases increased from about 720,000 in 2009 to 860,000 in 2014. If we assume that the official figures represent only 10 percent of the actual number of occupationally sick workers, the actual total figures for this group may reach over eight million; of these, Wang Keqin said that six million were pneumoconiosis cases. There are no figures reflecting the economic impact on society due to the presence of occupationally sick workers. Focusing on pneumoconiosis, Qu and Zhang (2004: 58) estimate the direct economic cost of the most common occupational disease was eight billion yuan with an indirect loss 30–40 billion yuan (see also Liu 2010: 9). An analysis conducted by Huang and Ye (2014) suggests that the economic loss due to occupational injury and disease to be over 200 billion yuan, equivalent to 2.5 percent of GDP (Huang and Ye 2014: 8). All these figures suggest that occupational disease afflicts a large number of workers in China, putting 220 million workers in 370,000 enterprises at risk by the end of 2012 (CLSN 2013: 3).9

12

Life in perspective

A comparative perspective Epidemiological studies in developing countries have shown that between 30 to 50 percent of workers in primary industries and high-risk sectors may suffer from silicosis and other pneumoconioses10 (ILO 2013: 6; Jeebhay and Quirce 2007). Various reports have suggested China’s situation is similar to that of a number of developing countries in Asia, such as Vietnam, India, and Mongolia, and in Latin America, such as Brazil and Columbia. In Vietnam, for instance, pneumoconiosis accounts for 75.7 percent of all compensated occupational diseases (ILO 2013: 6). In India, about ten million workers employed in mining, construction, gem polishing, and various industries are exposed to silica dust. The prevalence rate of silicosis is as high as 54.6 percent among slate pencil workers and 35.2 percent among stonecutters; and that of CWP among coal miners is 18.8 percent (ILO 2013: 6). In Mongolia, from 1967 to 2004, dust-induced chronic bronchitis and pneumoconiosis accounted for on average 67.8 percent of all occupational diseases, and cases are increasing annually (Lkhasuren et al. 2007). In Brazil, 6.6 million of its workers are exposed to silica dust (ILO 2013: 6); and a study of a group of Brazilian stone carvers reported a 53.7 percent prevalence of silicosis (Overton 2006). In Columbia, a cross-sectional study showed a 35.9 percent prevalence of pneumoconiosis in underground coal miners in two mining regions (Torres Rey et al. 2015). The data from Brazil and Columbia echoes the recent ILO report which states that a 37 percent prevalence rate of silicosis among miners and 50 percent among miners over the age of fifty were recorded in Latin America (ILO 2013: 6). One should note that the high proportion of pneumoconiosis in occupational disease is not necessarily related to the prevalence of high-dust industries. For example, in several important coal-producing countries, such as the United States, Australia, and South Africa, pneumoconiosis is no longer a high-risk occupational disease category. For example, from the 1990s to the 2000s, the prevalence of radiographic CWP in the United States was as low as 1.0 percent in small mines, and 0.2 percent in larger mines (Laney and Attfield 2010). The study by Chen et al. (2013) suggests that there have been less than 200 cases of CWP in the United States since 2007. Markowitz and Rosner (2002: vxii) claimed that the United States “had believed that it [silicosis] was, in large measure, a disease of the past, because the medical community and the professional literature had virtually stopped talking about it by the late 1940s.” In Australia, the prevalence rate of pneumoconiosis in the 2000s has been nearly zero (Joy et al. 2011), which has represented a substantial reduction since the 1950s (Glick et al. 1972; Griffits 1990). As in South Africa, according to Naidoo et al. (2004), the overall prevalence of pneumoconiosis has ranged from 2.0 to 4.0 percent in three different coal-mining regions. Similar situations are found in other developed, industrialized Western European countries; for instance, no cases of silicosis and pneumoconiosis were reported in Germany (Gongren Ribao 2014) and Spain (Orriols et al. 2006), and the last case of pneumoconiosis in Japan dates back to the 1970s.11 On the whole, with the enactment of strict workplace safety regulations to protect

Facts, theoretical gaze, and journeys

13

workers’ health in high-risk industries, pneumoconiosis has been largely controlled in Western industrialized countries (Overton 2006). The most common occupational lung disease in industrialized countries, according to Jeebhay and Quirce (2007) is occupational asthma.

Pneumoconiosis Pneumoconiosis is perhaps the world’s oldest occupational disease, and the dangers of long-term inhalation of silica dust have been known since the nineteenth century (Overton 2006). As today, pneumoconiosis is still an incurable disease of the lungs caused by the inhalation of dust. The inhaled dust then lodges in the lung tissue, gradually sinks to the lower half of the lungs, and result in scarring, inflammation, and fibrosis of lung tissue. Over a period of exposure, this will progressively debilitate normal lung functions, causing chronic cough, shortness of breath, weight loss, breathing difficulties, and, in severe cases, death. In China, different reports suggest that the period of exposure to the highdust workplace before a worker develops pneumoconiosis varies from as short as less than three months to ten years or more (Xinhua Net 2006; Huang and Ye 2014:  9) and that the fatality rate of pneumoconiosis ranges from 22 to 24 percent.12 Having witnessed many critically pneumoconiosis-sick workers, Wang Keqin remarks: “The disease results in pulmonary tissue fibrosis and damage to internal organs. Once a person contracts the disease, his lungs will be sclerotic and become as hard as stones. It is often extremely difficult for him to breathe and to walk around. Hence, he will not be productive anymore. Eventually a lot of sufferers will suffocate to death.”13

Coal workers’ pneumoconiosis (CWP) Pneumoconiosis in China is mainly associated with coal mining. According to the NHFPC, among the 750,000 new cases of pneumoconiosis identified in 2013, CWP accounts for 60 percent (Zhonggong Net 2015). Based on incomplete data I solicited from different official sources, the proportion of CWP among all pneumoconiosis cases has been rising gradually from less than 40 percent during 1949–86 to 60 percent in 2013 (see Figure 1.3). Unsurprisingly, pneumoconiosis is also the main occupational disease of Chinese coal miners. Based on statistical data on occupational diseases from 2001 to 2010, Chen et al. (2013) found that pneumoconiosis accounts for 75 percent of occupational diseases contracted by Chinese coal miners. A 2006 report indicates that over one million coal miners suffered from CWP, and the number of casualties caused by the disease was three times higher than those caused by coal-mine accidents (Zhongguo Net 2006). Another report published in 2010 suggests that more than 2.65 million coal miners work in a highdust environment, and more than 6,000 workers die of CWP annually. Based on a meta-analysis of eleven published reports, Mo et al. (2014) suggest the pooled prevalence of CWP in China to be 6.0 percent and the pooled rate of

14

Life in perspective

0.7 0.6 0.5 0.4 0.3 0.2 0.1 0

1949–1986

1996

2002

2003

2005

2013

CWP % of all pneumoconiosis cases

1.3  The proportion of CWP in pneumoconiosis, 1949–2013 (incomplete). Sources: 1949–1986 (Liu, 2010:2); 1996 (Liu, 2010: 9); 2002 (Liu, 2010: 9); 2003 (Liu, 2010: 7); 2005 (Xinhua Net 2006); 2013 (Zhonggong Net 2015)

CWP workers combined with tuberculosis to be 10.8 percent in registered coal mines, which are considered  high figures compared to the United Kingdom (0.8  percent, during 1998–2000) and the United States (3.2 percent in 2000s). In the United  States, with enforcement of the exposure limit for respirable dust in coal  mines,14 the prevalence of CWP  among underground coal-miners declined from 11.2  percent  during  1970–74 to 2.0 percent during 1995– 1999, before increasing unexpectedly in the last decade, particularly in Central Appalachia. Then, during 2010–11, the prevalence rate returned to 2.0 percent (CDC, 2012).

Chronic occupational poisoning Similar to pneumoconiosis, chronic occupational poisoning also incurs irreversible damage to the body and currently there is no effective medical cure. The treatment for chronic occupational poisoning is even more complicated as different poisonous substances have different properties, and even the same substance may have different physical effects on bodies due to degree of exposure and mediated by numerous factors such as gender, age, living conditions, and lifestyle. The medical treatments received by sick workers I met in the field are only to inhibit the progression of the disease, alleviate their pain and discomfort, and hopefully lengthen their lifespans. Various sources suggest that lead was the culprit responsible for the biggest proportion of occupational poisoning cases in China. For example, in a MoH report published in 2000, among the 1,196 cases of occupational poisoning, 41.0 percent were due to lead, 21.7 percent to benzene, and 8.9 percent to manganese

Facts, theoretical gaze, and journeys

15

(MoH 2000). Based on 2011 data, Fung and Chan (2012: 39) state that occupational poisoning is mainly due to three substances: lead (56.6 percent), benzene (10.9 percent), and arsenic (8.6 percent). In analyzing 582 worker cases of occupational poisoning in the Guangdong province during 2006–10, Hu et al. (2012) find that occupational poisoning in small enterprises (20–300 employees) and medium-size enterprises (300–1000 employees) was accountable for more than half (65 percent, 378/582) of occupational poisoning cases. The research team suggest that the reasons behind this include poor understanding of occupational hazards and poor awareness of hazard prevention and safeguarding workers’ health; shoddy provision of protective devices; and deployment of substandard and inferior raw materials, all of which would inflate the affliction rates in the workplace. In the better-developed regions of the world, for example the United States and Western Europe, it is generally believed that toxins used in factories are likely to affect the community and natural environment, the problem of occupational poisoning has developed gradually from a sectoral debate in the workplace to specific controversies in domestic and global contexts “related to medical and environmental health science, the politics of public health prevention, and regulatory  decision making” (Morello-Frosch et al. 2012: 7). Consequently, occupational poisoning becomes a general concern of public health in the wider  society. In the United States, this has led to the formation of what is called the “community labour coalition” (Mayer et al. 2012: 195), or “blue-green alliance” (Senier et al. 2012: 174); or in Italy, the emergence of “labour environmentalism” (Barca 2012, 2014). Along these lines, discussions have suggested how the struggles originally affecting the bodies of occupationally sick workers “have, on occasion, led to legislative reform in the broader field of environmental policy” (Barca 2014: 115; see also Elling 1986; Rosner and Markowitz 1986; Sellers 1997; Johnston and Mclvor 2000; Bartrip 2001; Markowtiz and Rosner 2002). In China, however, as will be seen in Chapter Three, the struggles of cadmium-poisoned workers are still confined exclusively within the domain of industrial relations.

Legal framework The legal framework for occupational disease in China can be traced back to the 1950s at the close of the first five-year plan (1953–57) when the government began to realize the emergence of work-related pneumoconiosis in state-owned enterprises. The problem prompted the State Council to promulgate the Decision Regarding the Preventing of Pneumoconiosis Hazards in Factories and Mines, and since then the work of preventing pneumoconiosis had been nominally incorporated in the national plan (Liu 2010: 1; Ding 1986: 4). Premier Zhou Enlai said in 1962 that the government “should absolutely not allow the emergence of large numbers of occupational disease cases due to problematic labor conditions. … [The government] must find ways to eradicate pneumoconiosis” (Huang and Ye 2014: 1).

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Pneumoconiosis was categorized in the official list of occupational diseases when it was first released in 1957; subsequently, the MoH expanded the category of “pneumoconiosis” into twelve types of pneumoconioses when the list of official occupational diseases was revised in 1987 (Liu, 2010: 1).15 The list of pneumoconioses remains generally the same in the most updated version released by NHFPC in December 2013.16 The issue of occupational disease had not developed into a specific social problem during the Maoist era (1949–76) when almost all enterprises were stateowned. Workers of state-owned enterprises were entitled to comprehensive from-cradle-to-grave benefits with all healthcare expenses incurred by the occupationally sick workers borne by the state. Occupational disease only became a specific problem in 1978 with the opening and reform period, which was boosted by Deng Xiaoping’s famous southern tour in 1992. Pneumoconiosis became a major concern as an occupational disease during the 1980s and 1990s. In 1987, the State Council announced the Regulations on Prevention and Treatment of Pneumoconiosis, which stipulated the standards of monitoring the hazards of airborne dust for workers in the coal-mining, non-ferrous metal production, petrochemical, and railway tunnel construction industries. For instance, it stipulated that one labor health professional should be deployed for every high-dust enterprise employing 1,500 workers, and one more health professional should be deployed for every increment of 500 workers (Yu 1997: 41–2). With the deepening of the opening and reform and the corresponding retreat of the state’s responsibility for employment, there became an urgent need for a set of laws which was designed to protect the rights of workers in the early 1990s. Promulgated on July 5, 1994 (effective on January 1, 1995), the Labor Law represented the basic legal code for the adjudication of labor relations. It provided a framework for the labor contract and collective contract systems, a system for handling labor disputes, and a labor supervisory system (Fung and Chan 2012: 31). Then, as mentioned in the Preface, a series of laws and regulations pertinent to occupational disease were passed in the early 2000s. The above laws and regulations set an overarching legal and regulatory framework for occupational disease prevention and compensation. The framework, as Fung and Chan (2012) accurately describe, stipulates basic principles governing the prevention and control of occupational diseases, protective measures, hazard monitoring and management in workplaces, diagnosis of occupational disease, health authority inspections, and the liabilities incurred by those violating the law. These national regulations also “define workers’ occupational health rights, the obligations and duties of employers to protect the health of their employees, the responsibilities of the governments at various levels, and trade unions’ representation in workers’ health protection” (Fung and Chan 2012: 32).17

Legal protection for occupationally sick workers The main feature that characterizes the legal protection of occupationally sick workers in the Chinese OHS system is the principle of employer

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liability. This means that the employer is held responsible by law, even if no fault attaches to  him/her, to uphold protection measures in the workplace and to compensate  an employee  at prescribed rates for any injury suffered by the employee  while at  work (Mouton and Voirin 1979: 474). It is under this principle that the  employer is held primarily responsible for compensation in respect of the occupational disease. One should note that other countries with more stringent labor rights, such  as the United States, Japan, Germany, and Poland, also adopt this principle; however, their compensation systems are supplemented by national  (or federal) and industry-wide insurance (see Shanker 1983; Reich and Frumkin 1988; Baur and Latza 2005; Szeszenia-Dabrowska and Wilczynska 2006). Other countries that mainly adopt employer liability as the main compensation principle, like China, include India and Nepal, and some African countries (see Carter 2011; Murlidhar and Kanhere 2005; Mouton and Voirin 1979). In China, the principle of employer liability is manifested in two ways through which a confirmed occupationally sick worker obtains compensation. One way is to obtain benefits from work-related insurance which the employer supposedly pays for the employees during the employment period. The second is that in addition to the benefits of work-related injury insurance according to law, a sick worker can claim compensation from the employer according to “relevant civil laws” based on Article 59 of the Law of the Prevention and Treatments of Occupational Diseases (revised in 2011); the article stipulates (my emphasis): “In addition to enjoying the benefits of work-related injury insurance according to law, an occupational disease patient who is entitled to compensation according to relevant civil laws shall have the right to request compensation from the employer.” Based on my fieldwork observations, the civil case lawsuits launched by sick workers generally cover five compensation items: (i) disability compensation, (ii) psychological stress, (iii) transportation expenses incurred due to diagnoses and treatments, (iv) post-illness treatment expenses, and (v) expenses on health supplements. According to Article 11 of Management Regulations for Diagnosis and Assessment of Occupational Diseases, a sick worker is required to present five documents to the authorities in order to initiate the legal process, which include: (i) the worker’s work history and history of exposure to occupational disease hazards; (ii) a copy of files on occupational health monitoring and protection for the workers; (iii) the results of occupational health checkups and diagnosis and treatment of occupational diseases; (iv) previous results of the monitoring and assessment of the factors of occupational disease hazards in the workplace; and (v) other materials requested by occupational disease diagnosis or ­identification institutes (i.e., local CDC centers). In reality, all these documents would invariably be in the hands of the employer who was highly unlikely to risk incriminating himself by handing them over to an employee demanding compensation. The case of Zhang Haichao illustrated earlier suggests how the employer is m ­ otivated not to offer documentation to the clinic and to collude with the CDC center in producing fake diagnoses.

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Life in perspective

Legal “progress” in protecting sick workers Both my fieldwork and literature review have indicated “progress” in protecting the legal rights of occupationally sick workers when the Law of the Prevention and Treatments of Occupational Diseases was revised in 2011. The term “progress” is and will be in quotation marks throughout this book as I hope readers will not take the word literally but as a trigger term that activates reflection on the potential incongruity between what it means in legal terms, and how it is understood in the experience of sick workers. I consider that there are at least ten places in the revised Law of the Prevention and Treatments of Occupational Diseases that featured seemingly ‘better’ protection than the original version in reducing the institutional hurdles that had hindered sick workers from pursuing compensation and deterring the employer from offering unsafe work environments to workers. The details of this “progress” are summarized in the Appendix. In short, these revisions mainly serve to (i) facilitate the authorities to obtain documentations; (ii) illegalize employers’ actions to hold up workers’ information; (iii) facilitate the sick worker to receive diagnosis; (iv) facilitate on-site investigation; (v) facilitate on-site investigation; (vi) expand the legal meaning of “employer”; (vii) increase the accountability of the employer; (viii) strengthen the role of trade unions; (ix) increase the state’s accountability for workplace safety; and (x) help sick workers when their company goes bankrupt or their labor relationship remains unconfirmed. One should note that the first three revisions seem to have been formulated in such a way as to deal with the problems faced by Zhang Haichao in obtaining a formal diagnosis. Despite much “progress” in legal terms, however, this still does not seem able to translate into real and genuine progress for occupationally sick workers. My fieldwork observations mentioned in the Preface suggest that “less than five per cent” of litigants would be able to obtain the legally-stipulated compensation. One quick explanation is that the law which has been revised and made effective in 2011 may take more time to generate a positive impact. What I am endeavoring to argue in subsequent chapters is that “progress” in law is not necessarily conducive to promising compensation to millions of workers who suffer from an incurable occupational disease, and to explain why. So, if the law cannot help, what can sick workers do to deal with their social marginalization?

The actor–power interface Having read this far, one should be able to imagine that sick Chinese workers are constantly haunted by the fear of social marginalization and becoming long-term financial and mental burdens to their families. Knowing that the law considers the employer to be the key figure responsible for compensation, many workers attempt to press the employer to comply with the law and hold them responsible for their medical and post-illness living expenses. To ask the employer for compensation, a written promise to take responsibility for their disease, or for an offer of a free regular medical checkup constitute the only hope to attain a better quality

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of life. Along this line, my fieldwork observations suggest that the sick workers enact a spectrum of actions, including pressing the employer to uphold legal obligations, petitioning to the higher administrative levels, filing lawsuits against the employer or administrative departments, or participating in collective action, such as rallies, protests, or petitioning, against various powerholders consisting of employers, officials in the labor, health, and work safety departments, judges, and medical professionals. Sick workers are clearly aware that only a very small proportion of them could “win” their struggle, manage to transcend their physical suffering and social marginalization; they know that the vast majority will fail and eventually retreat from open resistance. It was the complex subjective calculations on the part of sick workers behind a spectrum of observable, heterogeneous responses against social marginalization that constitute the theoretical vantage point of this book – that is, the everyday experience of the occupationally sick worker is akin to the concept of the “stranger” put forward by Austrian sociologist Alfred Schutz. First appearing in the Journal of American Sociology in 1944, Schutz’s thematic discussion of the concept of “stranger” was in a dialogue with Georg Simmel, who had coined and pioneered the sociological articulation of the category of “stranger” (Wolff 1950). Being an exile from Nazi Germany, Schutz was in a particularly suitable situation to write and reflect on the social experience of estrangement in the United States from the perspective of the stranger himself (Ålund 1995). To Schutz, a stranger is akin to a migrant located in a new culture; he or she must then possess an “oscillating” attitude “between remoteness and intimacy” toward the culture that he or she approaches (Schutz 1964: 103). A stranger thus harbors hesitation, uncertainty, and distrust “in every matter which seems to be so simple and uncomplicated to those who rely on the efficiency of unquestioned recipes which have just to be followed but not understood” (Schutz 1964: 103–4). Expanding the concept beyond the case of migration, this book pioneers the idea that the post-illness experience of sick Chinese workers be considered in terms of the Schutzian “stranger.” 18 What I am trying to argue is that when one realizes that they suffer from an occupational disease – which can be incurable and fatal – one is found to encounter “new” situations which overthrew one’s old thinking-as-usual in everyday life. But, the “new” situations here in question are not akin to a migrant coming to live in an unfamiliar culture; rather sick workers find themselves to be “strangers” in an environment they used to be familiar with. Therefore, the estranged experience of sick workers should be more accurately understood in terms of another of Schutz’s concepts, that of “homecoming” (such as a sailor returning home after years of traveling abroad). Homecoming refers to a type of estrangement in which the “strangers” share the same culture as their consociates. In homecoming, the actor begins to realize that “home shows … an unaccustomed face”; and he or she finds him/herself “in an unfamiliar world, differently organized than that from which he comes, full of pitfalls and hard to master” (Schutz 1964: 106). While the Schutzian stranger has merits for understanding the complex “oscillating” attitude between retreat and resistance on the part of sick workers,

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the concept alone does not suffice for portraying the full picture of their lives in contemporary China. At the heart of their lived experience is not only the lack of familiarity (or typicality) in society but also the domination exerted from the constituted power. Most sick workers actually retreat from resistance, even though they would, from time to time, be beset by thoughts of challenging the powerholders in order to obtain (more) compensation. They would thus be usually caught in the actor–power interface as they may face years of labored breathing (for pneumoconiosis workers), decades of pain (for cadmium-poisoned workers), and eventual death on the one hand; or domination through power relations which operate to hinder them from obtaining legally-stipulated compensations on the other. The post-illness experiences of the sick worker in China thus constitute a prism through which state power is enmeshed with legality, market motives, interpersonal relationships, and cultural schema in society, and refracted in the everyday lives of the victims. It is in this sense that a theoretical framing which calls into play the exercise of power and the mundaneness of everyday life becomes highly relevant to the present book. In this light, the theoretical gaze, which implies a particular focus I wish readers to maintain throughout the course of this book, will be outlined in the following five concept discussion sections.

Marginality and life Individuals who are estranged by an illness are inevitably marginalized in society. In fact, to consider social marginalization and illness as entailing each other has been almost taken for granted among scholars. Ecks and Sax (2005) put it aptly that “[s]ocial marginality and ill health can form an unholy dyad” (2005: 190) as ill-health groups often find themselves pushed to the margins and marginalized groups tend to suffer more from illness than those at the center. Along with a critical approach to medical anthropology, recent studies – thanks to the meticulous ethnography based on participant observations and other qualitative inquiries – have further suggested that social marginalization and illness constitute an interacting duo rather than one being a cause and the other an outcome. For example, Ostrach and Singer (2012) argue that the interactions of the biological factors (e.g., hormonal, developmental, and immunological characteristics) and social and political factors (e.g., poverty, gendered power relationships, and violence) determine the spread of HIV/AIDS, sexual transmitted infections, and other drug-related diseases (see also Singer et al. 2001). Nichter (2008) is concerned with the connections between health and social development and how they determine the routes of disease transmission that affect clusters of interrelated health problems. Miller et al. (2008) attend to specific biological, behavioral, and emotional mechanisms of adverse interaction among co-morbid diseases associated with the social environments of sufferers that facilitate multiple disease clustering and deleterious interactions. These scholars espouse what is called the syndemic approach that presupposes a critical biosocial perspective to the cause of disease. An appeal of the syndemic approach within medical anthropology underscores various kinds of health-hazardous interactions in society that are facilitated either

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directly through the microscopic processes of unequal social relations, or indirectly through the macroscopic impacts from social inequalities (Singer 2009a, 2009b, 2009c; Singer and Clair 2003; Stall et al. 2007). These unequal social relations and social inequalities, which are commonly expressed as impoverishment, stigmatization, structural violence, discrimination, or marginalization in society, result in exposing certain parts of the population to adverse living and working conditions. These adverse conditions, in turn, promote the clustering of diseases (both infectious and non-infectious) and disorders (both organic and behavioral) in subordinate populations while weakening their body’s capacity for responding to disease challenges. Speaking of the risk of contracting HIV, scholars identify that people who encounter greater social, cultural, or economic barriers in society (Puig and Montalvo 2011) and greater discrimination (Roca Ortiz 2012) increase their risk of infection with HIV. The risk increases even more among subordinate populations who are mothers (Hackl et al. 1997; Aranda-Naranjo and Davis 2000; Mayers et al. 2005; Higgins et al. 2010), sex workers (WHO 2005; Lopez-Entrambasaguas et al. 2013), adolescents from disadvantaged families (DeMatteo et al. 2002; RotheramBorus et al. 2001), and addicts of illegal drugs (Pyett and Warr 1997). Recent studies on the interactions between marginality and illness that are mediated by social factors have extended from HIV infections to examining mobility impairment (Misajon et al. 2006), respiratory problems (Singer et al. 2011; Singer 2013; Juniarti and Evans 2010), chronic pain (Ware 1999), and chronic diseases, such as cardiovascular disease and biliary cirrhosis (Montalia et al. 2011). It is based on the biosocial perspective of illness that health scholars began to take steps to further their understanding of the social marginalization of disease sufferers in modern society and focus on the concept of “life.” It is through the concept of “life” that the humanist essence of sick people is extracted. They are turned into objects and targets of power; and are subject to management, regulation, control, and even violence in accordance with a specific governing rationality. In juxtaposition with the Schutzian stranger, here, I bring into discussion another key concept of this book, which is homo sacer. Agamben coined the concept of homo sacer which is associated with two ancient Greek terms: zoe and bios, both of which roughly mean “life.” Zoe refers to natural, biological life, which is “the simple fact of living common to all living beings.” Bios, on the other hand, connotes a good life lived in accordance with particular rights and dignities of citizenship which can be fully realized only in the political realm (the polis) (Agamben 1998: 1–7). Literally meaning “sacred man,” homo sacer refers to a category of tabooed person who, in the original usage of the term, can be killed by anyone without their incurring any punishment; by the same token, however, the killed cannot be honored as a sacrifice. One should note that to describe sick people as homines sacri in modern society is perhaps a recent development, but by no means novel. The concept has been already used to characterize people living with HIV/AIDS (Richey 2012), drug addicts (Montagne 2010; McLean 2011; Draus et al. 2010), and patients of vector-borne and infectious diseases (Laurie 2014; Keil and Ali, 2007; Lawson and Xu 2007). These health scholars who

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connect marginality and homo sacer essentially ask: why do people who live in a society with laws that supposedly protect those who are marginalized by poor health, and under a government with its legitimacy that is supposedly hinged upon protecting citizens’ wellbeing, allow the sick life to be marginalized, or possibly extinguished, without arousing sympathetic public attention? In essence, the thesis of homo sacer does not mean that a marginalized group is being socially excluded from mainstream society, which echoes the conventional marginality studies perspective originated in the Chicago School of sociological research.19 The conventional “social exclusion” thesis had become renowned and developed what was known as the street life ethnography (Berger and Berger 1972), and a new sociological tradition (Bovenkerk and Brunt 1976) from the 1920s to the 1960s. Instead, inherent in the concept of homo sacer is an “inclusive exclusion” thesis in which marginalized individuals become outlaws because they have been lawfully placed outside the protection of law; as a result, any action that harms or even kills them will not constitute a breach of the law. Readers should be able to pick up the relevance of conceptualizing Chinese occupational disease sufferers as homines sacri by the picture I have been portraying so far. What I mean is that a set of laws and regulations has been in place that serves the purpose of protecting the rights of sick workers, and so “progress” has been identified in revising the Law of the Prevention and Treatments of Occupational Diseases to serve the same purpose; however, this very legality has resulted in 95 percent of the sick workers failing to pursue legally-stipulated compensation. To incorporate sick workers under the legal framework, and at the same time exclude them thus points to the “inclusive exclusion” thesis characteristic of Agamben’s formulation of homo sacer. What I endeavor to argue is that both “stranger” and homo sacer represent two modes of existence of sick Chinese workers at the actor–power interface. While “stranger” is the primordial mode of sick workers who are thrown in because of suffering from an incurable and fatal disease and the experience of untypicality in everyday life due to the disease, homo sacer is the constituted mode of the sick workers created in specific contexts. What I mean is that while all occupational sick workers are by nature “strangers,” not all of them are homines sacri. They would become so only in specific contexts, and how the sick workers are constituted as homines sacri in the context of contemporary China will be examined in more detail in Chapter Two.

Life and power Agamben’s formulation of homo sacer was inspired by Michel Foucault who analyzes the historical process within which “life” emerges as the “object” of political strategies (Lemke 2011: 165). Historically and analytically, Foucault distinguishes older forms of power from more recent forms. In the conventional Hobbesian sense, sovereignty refers to the “rights and properties” of the state that “cannot be reduced to the rights of citizens, either as individuals or as a collective” (Skinner 1989: 118). Foucault takes sovereign power as possessing its own history and

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effects, and being characterized by “the right to take life and let live,” (Foucault 1979: 136), or more simply, the “right to kill” (Tully 1988: 17).20 Foucault then discerns two dimensions of, what Lemke (2011: 165–6) calls, “life-oriented power” – i.e., the disciplining of the individual body, and the regulation of the populace (Foucault 1990a: 139, 141–5) – which is the essential premise for establishing capitalism and modern nation states. In comparison with sovereign power, disciplinary power is a “subtle coercion” which aims to manipulate, shape, train the body of the subject in order to make it obey, respond, become skillful and increase its productive forces, such as speed and efficiency, desired in the modern industrial age (1977a: 136–8). Through methods of hierarchical observation, such as the use of the surveying gaze and normalizing judgment and examination, such as the manipulations of space (e.g., architecture), time (e.g., timetables), and what is considered normal and healthy activities and behaviors of people, the disciplinary power is purported to create “docile bodies” that can be “used, transformed, and improved” to become “political puppets, [or] small-scale models of power” (1977a: 136). The power of regulation refers to the technologies of the self by which a de-centered form of power is exercised through processes of subjectivization which shape the behavior, attitudes, and desires of the individual, bind himself or herself to his or her own identity and consciousness, and ultimately, promote self-regulation in accordance with a governmental rationality. Foucault terms this “biopower,” or “governmentality,” which is different from disciplinary power. Rather than exerting power on the individual as “man-as-body,” biopower is the power of self-regulation that is exercised on the individual as “man-as-species” (2004: 243). Foucault suggests that both discipline and governmentality (biopolitics) are two different technologies of power which have been “superimposed” on one another since the eighteenth century (2004: 249). In doing so, Foucault purposefully shifts his attention away from the sovereign exercise of power, which was traditionally centered in feudal states and was considered a more “costly and violent” form of power to coerce the subjects (1977a: 137). Acknowledging Foucault specifically on such a shift of attention on power, Agamben remarks that “one of the most persistent features of Foucault’s work is its decisive abandonment of the traditional approach to the problem of power, which is based on judicio-­institutional models … in favor of an unprejudiced analysis of the concrete ways in which power penetrates subjects’ very bodies and form of life’’(Agamben 1998: 5). However, Agamben also criticizes Foucault for overemphasizing the importance of biopolitics in exercising power in modern societies. With such a microphysics of power that emphasizes the productive aspects of power, Agamben deems that Foucault is mistaken in neglecting the role of sovereignty in processes of subjectivation as the modern biopolitics rests on the solid foundation of a premodern sovereign power (Agamben 1998: 5; see also Erlenbusch 2013: 49; Lemke 2011: 167). Agamben then takes these criticisms further to claim that even when just speaking of disciplinary technologies which target the body of the individual, and the biopolitical mechanisms which regulate, administer, and manage the

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Life in perspective

population through self-regulation, Foucault has failed to describe how these two faces of power may converge and develop a unitary theory of power. Agamben writes: “yet the point at which these two faces of power converge remains strangely unclear in Foucault’s work, so much so that it has even been claimed that Foucault has consistently refused to elaborate a unitary theory of power” (Agamben 1998: 5). Agamben utilizes the Nazi concentration camp as a conceptual metaphor to understand the governance of modern nation states. Characterized by the joint exercise of sovereignty and biopolitics in producing violent and totalizing effects, modern nation states effectively turn subjects into homines sacri, in other words, the “bare life” – a life excluded from the juridical order (Agamben 1998). Agamben further details how Western democracies have reintroduced a permanent “state of exception,” in which the state enacts lawful actions on certain actors who turn out not to be protected by law. These actors are literally placed outside the law, stripped of political rights, and reduced to ‘‘bare life’’ in the name of law (Agamben 2005). Butler (2004) shares Agamben’s view on the insufficiency of Foucault’s formulation of power in explaining the hybrid of sovereignty and governmentality that characterizes American anti-terrorism policies after the September 11th event. The insufficiency mainly rests upon the way Foucault’s account fails to explain the resurgence of “a violent and self-aggrandizing state sovereignty” within the field of governmentality (Butler 2004: 100). Similar to Agamben, Butler sees that the suspension of the rule of law is conducive to a situation where governmentality and sovereign power converge. Butler’s empirical analyses associate the “state of exception” experienced by homo sacer with the current “war on terror,” including extreme phenomena such as the Guantanamo Bay detention center, and “renditions” of terror suspects for torture in third countries (Erlenbusch 2013: 53). Along these lines, Hardt and Negri (2000) go even further to criticize Foucault for failing to recognize that modern biopolitics has transitioned into a postmodern era where the boundaries between economics and politics, reproduction and production intermesh to bring a vast array of actors within a coherent and unified logic of domination, and create a new stage of global liberalism and capitalist production (see also, Lemke 2011: 168). The basic hypothesis of Hardt and Negri is that “sovereignty has taken a new form, composed of a series of national and supranational organisms united under a single logic of rule. This new global form of sovereignty is what we call Empire … [i.e., a regime that] effectively encompasses the spatial totality, or really that rules over the entire “civilized world” (2000: xii). All of the above, in one way or another, criticize Foucault’s view on power, either that Foucault has gone too far so as to temporally distinguish one age of power from another age – for example, the age of sovereignty is replaced by the age of discipline, and then replaced by the age of governmentality; or analytically distinguish one face of power from another – for example, if there is sovereignty, there is no governmentality, and vice versa. These scholars seem not to have been able to read the original French version of Foucault’s 1977 lecture series on “Security, Territory, Population,” which was

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published in English in 2004. In that context, Foucault explicitly refused to render sovereignty, discipline, and governmentality with a temporal historical sequence; he writes: “there is no legal age, the disciplinary age, and then the age of security” (2004: 8). In his terms, “legal age” refers to the period when the traditional judicio-political model of sovereignty is the dominant mode of power; and “age of security” to the period when security issues are dealt with by targeting the population and involves Foucault’s analytics of governmentality to the global governance of human security (2004: 35). Foucault also cautions against viewing the three different faces of power as distinctive concepts; rather, they coexist as the hybrid of powers, that is, a sovereignty-discipline-governmentality triangle; he writes: “we should not see things as the replacement of a society of sovereignty by a society of discipline, and then of a society of discipline by a society, say, of government. In fact we have a triangle: sovereignty, discipline, and governmental management, which has population as its main target and apparatuses of security as its essential mechanism” (Foucault 2004: 108). What I observe is that when Foucault shifted his attention from analyzing micropolitics and subjectivities pertinent to the topics of madness and punishment, and focused on the analyses of macropolitics involving state and security, he felt the necessity to bring back into play the concept of sovereignty. Foucault clarifies in the latter case that this “is not to say that the problem of sovereignty disappeared” and that “neither sovereignty nor disciplinary power were replaced by governmentality” (2004: 108). In understanding the post-illness experiences of sick Chinese workers, I subscribe to Foucault’s view that they face a hybrid of powers involving sovereignty, discipline, and governmentality. But, to acknowledge the coexistence of different faces of powers in the subjective experience should only be the beginning of the story claiming that different powers are “superimposed” on one another, “converge,” or “work together.” What I mean is that to claim merely that different powers are co-present and intermeshed does not constitute a very meaningful theoretical gaze to guide one to study the experience of power. I am more concerned with precisely which face of power becomes dominant under what situation and how it comes to shape the individual’s experience; or in short, how different faces of power operate in the subjective point of view of the occupational sick workers at the actor–power interface. Before such a theoretical gaze is established, one point must be noted. While the relevance of Agamben’s concept of homo sacer to understanding the postillness experience of occupational sick workers is recognized, it is still unclear in Agamben’s publications about the nature of power experienced by the subject. At one point, he seems to share the view of Butler, and suggests that homo sacer is susceptible to the power where sovereignty and governmental converge. At another point, he seems to suggest that homo sacer faces the exercise of sovereign power only and the concepts of homo sacer and sovereignty be considered as a pair of conceptual correlates. For instance, Erlenbusch remarks: “the sovereign and homo sacer [in Agamben’s conception] present two symmetrical figures that have the same structure and are correlative: the sovereign is the one with respect

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to whom all men are potentially homines sacri, and homo sacer is the one with respect to whom all men act as sovereigns” (Erlenbusch 2013: 47). Here, I would like to suggest a view to explicate the subject’s experience of power relations slightly differently from Agamben, as well as Butler, Hardt and Negri, and probably Foucault. While I deem that it is apt to describe the occupationally sick worker as homo sacer who faces an “inclusive exclusion” which inevitably experiences coercion ranging from more subtle disciplinary power to more explicit sovereign violence, it is too farfetched, if not simply erroneous, to argue that homo sacer is the only mode of existence that the sick worker exhibits. What if the occupational sick worker steps away from the experience of overt coercion, and returns to the mundaneness of everyday life, to the mode of “stranger,” in which domination of life is at least temporarily taken for granted? Acknowledging a hybrid of powers, my own formulation to the experience of social estrangement in the context of China is premised on two pairs of conceptual correlates. The first pair is homo sacer – sovereignty; the second, stranger – ­governmentality. The first pair is mainly concerned with the experience of domination vis-à-vis state power; the second, in everyday life. The first pair considers the individual as “bare life” who is governed by others in a milieu where “individualizing and totalizing forms of power intersect” (Foucault 1990a: 145) and the individual manifests lives which can be sacrificed in the face of the disciplinary power, and even the more coercive and violent sovereign power. The second pair considers that the individual experiences domination which is soft and impersonal, and mainly in the form of governing oneself. While the first pair of correlates has already been briefly outlined in the last two sections, the next two sections will focus on examining the second pair of correlates, stranger – governmentality.

Power and governmentality Compared to the older forms of power of sovereignty and discipline, governmentality offers a seductive strategy to neoliberal governments as it “finds its telos and legitimacy in its articulated capacity to maximize the energies and capabilities of … individuals, families, market organizations, and the state” through scientific engineering and individual technologies of the self (Nadesan 2008: 3). Coined as “conduct of conduct,” governmentality involves a regime of practices which can be deconstructed into specific uses of language, classifications, and interventions to “render reality into calculable form” (Rose and Miller 1992: 185). These power-laden discourses, classificatory schemes, and political programs were traceable back to certain powerful institutions through which experts (e.g., officials or scientists) and disciplines (e.g., statistics and medicine) invented them, and set them into operation, either intentionally or unintentionally, as the control “at a distance” (Dean 2002a: 131). Such “art of government” (Foucault 1991) can be called effective when ordinary people take on the regime of practices unconsciously with compliance rather than with improvisation or resistance. If operating effectively, governmentality can, in principle, kill two birds with one stone: it minimizes the cost of governance and societal risk from

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the perspective of powerholders, and maximizes individual well-being from the perspective of actors. But, in reality, the neoliberal technologies of the self only result in the production of self-regulating agents. Here, I share Nadesan’s contention that biopower is not simply “a technology of optimization”; rather, it “both privileges and marginalizes, empowers and disciplines” the population that creates both self-regulating agents and those who are marginalized, excluded, and disciplined (Nadesan 2008: 5); in short, both “affluent populaces” and “poorer populaces” (2008: 4). Therefore, the emphasis of my analysis is how governmentality is manifested through biopolitical technologies of the self and remote networks which bring about social marginalization and inequality to those seen as incapable of self-government – in my case, the occupationally sick workers who have failed to seek legal rescue. Undeniably, one of Foucault’s key concerns is how knowledge and its attendant technologies have mediated between power and subjectivity in neoliberal contexts, which result in ways that power can be exercised clandestinely but productively on the subjects who feel that they are free.21 However, one should be reminded that Foucault was not the one who pioneered the conceptualization of how power exerts its domination in a way unconscious to or even taken-forgranted by, the subordinate. For example, the well-known three-dimensional view of power coined by Steven Lukes has already extended the concept of power from explicit political processes involving social conflicts and decision-making mechanisms to the “socially structured and culturally patterned behavior of groups and practices of institutions” (Lukes 1974: 22). It is this through this “radical” dimension that power is covertly exercised on people who tend not to turn their needs or grievances into explicit political expressions in the first place, as in cases of manipulation or the imposition of authority (Gunn 2006:706). Antonio Gramsci, for instance, conceptualizes power in terms of hegemony, or rule by consent. Rather than political propaganda and manipulation, hegemony involves the construction of a lived reality such that the existing political, economic, and social structures would be taken for granted by the mass of the people who deem the authorities as “common sense” (Gramsci 1971: 419; Gunn 2006: 707). For Gramsci, “common sense” is “the conception of the world which is uncritically absorbed by the various social and cultural environments” in which the individual develops his or her individuality; and the “most fundamental characteristic” of common sense is that it is a conception which is “in conformity with the social and cultural position of those masses whose philosophy it is” (Gramsci 1971: 419). Pierre Bourdieu’s formulation of power rests on his distinction between a “personal strategic mode of domination,” which he terms “habitus”; and an “objective institutionalized mode of domination,” which he calls “field” (Bourdieu 1977: 182–4). To Bourdieu, habitus is “understood as a system of lasting, transposable dispositions, structured structures predisposed to function as structuring structures, that is, as principles of the generation and structuring of practices and representations [in everyday life]” (Bourdieu 1977: 72). Being embodied structures

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in the individual, habitus thus offers a persuasive account of how p ­ ower-laden, taken-for-granted substructures of knowledge in society come to shape people’s everyday life. Habitus, according to Bourdieu, is mainly a set of unspoken, takenfor-granted assumptions or “common sense” which shape people’s judgments that may contribute to unequal divisions in society. Also known as “doxa,” Bourdieu’s conception of “common sense” contributes to “an adherence [on the part of the actor] to relations of order which … are accepted as self-evident” (Bourdieu 1984: 471). What then to make of Foucault’s formulation of governmentality, so distinctive from Lukes’s ideological dimension of power, Gramsci’s hegemony, and Bourdieu’s habitus, in understanding the clandestine nature of power in shaping subjectivity and practice in domination–subordination analyses of modern power?22 Here, I contend that there are two most innovative aspects of governmentality, which are relevant both to the present study and to the theoretical discussion of Foucault’s work in general. First of all, the portrayal of power featured by governmentality is a form of impersonal domination. This feature is innovative as it is opposed to the time-honored Weberian view on power which is fundamentally interpersonal; in Weber’s own words, power (Macht) is “the probability that one actor within a social relationship will be in a position to carry out his own will despite resistance” (Weber 1978: 53). As to the conceptions of power by Lukes, Gramsci, and Bourdieu, no matter how their theories represent a domination which is non-physical, and mainly to sanction, normalize, empower, or even nurture rather than be coercive, the contours of power are always traceable in one way or another to an interest-based “ruling class.” In Foucault’s productive view on power, however, power is interlaced with knowledge, and the domination generated from this power–knowledge nexus is impersonal in a sense that even the experts who invented or activated that knowledge in the first place are unable to manipulate it as they wish. This view has been cogently put forward by Foucault when he states power “is never localised here or there, never in anybody’s hands, never appropriated as a commodity or piece of wealth” (1980: 98). Thus, power is a much more decentered and ubiquitous force acting everywhere because it comes from everywhere (1977a: 194; 1979: 92–102). Stemming from this logic, the modern state is neither the center of power nor an institution or apparatus filled with experts and political elites whose primary mission is to exploit the powerless. Rather, the state “is constituted by the set of practices by which the state actually became a way of governing, a way of doing things, and a way too of relating to government” (Foucault 2007: 277).23 I believe that the impersonality of domination is a theoretical key to making possible that power is exercised at a distance through seemingly innocuous forms of expertise and knowledge; and that the subjects effectively understand themselves as free and autonomous in the experience of domination.24 The second most innovative feature of Foucault’s concept of governmentality is its emphasis on technologies of the self through which power can penetrate into subjects’ bodies/lives, shaping their forms of action, structures of preference, and

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interpretive schemas in conformance with specific governmental rationalities (see Rose 1996; Miller and Rose 2008: 61–8; Inda 2005: 9–10; Brockling et al. 2011: 12); but at the same time, the subject maintains an outlook of an autonomous societal agent “capable of monitoring and regulating various aspects of their own conduct” (Dean 1999: 12). To extend the notion of government from merely “governing others” to identifying the way “an individual questions his or her own conduct (or problematizes it) so that he or she may be better able to govern it” (Dean 1999: 12; original bracket and emphasis) effectively transcends conventional views that power is narrowly confined by ideological or interest-based struggles. It is exactly the emphasis on the “technologies of the self” that explains how forms of political government have recourse to “processes by which the individual acts upon himself” (Foucault 1993: 203).25 I argue that the concept of governmentality – thanks to the impersonality it implicates in domination, and its emphasis on self-government – is more apt than others in conceptualizing the ways power penetrates into the fabric of everyday life and shapes the self-understandings and practices of the sick Chinese workers, which – as outlined in previous sections – can be further juxtaposed by the older forms of power involving (inter)personal domination with more direct command and control. Since the orientation of the “stranger” in one’s everyday life is exactly hinged upon the premise of unquestioned but questionable taken-for-grantedness of the quotidian experience, Foucault’s concept of governmentality does possess the potential to discern the intricate relationships between power and everyday life which is relevant to our understanding of the post-illness experience of occupationally sick workers in China, which will be discussed next.

Governmentality and the everyday life In describing governmentality, Foucault explains: “What makes power hold good, what makes it accepted, is simply the fact that it doesn’t only weigh on us a force that says no; it also traverses and produces things, it induces pleasures, forms of knowledge, produces discourse” (2002: 120). Owing to its non-discursivity and taken-for-grantedness, governmentality “applies itself to the immediate everyday life, categorizing individuals and communities, imposing ‘regimes of truth’ [i.e., the types of discourse which it accepts and makes function as true26] on them” (Foucault 2002: 331; my emphasis). The significance of governmentality in Foucault’s work thus essentially lies in its mediating function between power and subjectivity, through which the techniques of rules are imbued in the fabric of everyday life. In fact, many scholars have already picked up this cue; for example, according to Gunn (2006), the most important feature of “governmentality” is perhaps its thesis that “power relations are located in the fabric of everyday life and are not confined to “politics” in the narrow understanding of the term” (2006: 716). Cleaver (2007) observes that the “self-disciplining” of agents and their conscious or unconscious acceptance of unequal relations “ensure the reproduction of power through everyday acts and relationships” (2007: 230). Shoshana (2011) ventures even deeper along this path and looks into how self-reflexive subjects

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“translate governmental rationality and the discursive order into specific awareness of subjectivity in everyday life” (2011: 772). So much has been discussed in these studies,27 however, I consider that the concept of “everyday life” has remained largely under-theorized. My criticism is based on two senses. First, these studies do not offer any definition of the notion of everyday life, and merely consider the term as self-evident. Second, they do not distinguish conceptually the domain of everyday life which supposedly exhibits mundaneness and habitual routine from other distinctive domains which involve practical-evaluative and projective agency that may improvise the status quo.28 Taking reference from the work of Schutz, everyday life is defined as “the world of everyday life,” which refers to “the unquestioned but questionable matrix within which all our inquiries start and end” (Schutz 1973: 326–7). The concept of everyday life is hinged upon the notion of taken-for-grantedness which explains why one does not act otherwise at a particular point in time and space, in what we commonly know as typical situations. What makes take-for-grantedness and typicality possible in everyday life, according to Schutz, is due to the pre-existence of the “stock of knowledge” an individual possesses in a particular society. The stock of knowledge is composed of common typifications, systems of signs and symbols with their particular meaning structure of institutionalized forms of social organization on the basis upon which people formulate their own motives and understand others. Essentially, the stock of knowledge contains “a set of more or less loosely connected rules and maxims of behavior in typical situations, recipes for handling things of certain types so as to attain typical results” (Schutz 1970: 120). But, how is a particular situation considered by individuals as typical and taken for granted, and another as untypical leading one to question or even resist it? Schutz suggests that the answer hinges upon the concept of the “system of relevance,” which “determines not only what belongs to the situation with which … the individual has to come to terms, but also what has to be made a substratum of the generalizing typification, what traits have to be selected as characteristically typical, and how far we have to plunge into the open still undisclosed horizon of typicality” (Schutz 1973: 284). The concept is of “structure of relevance” is thus equivalent to the “interest” and “attitude” of individuals (Schutz 1973: 9, 283) 29 which explain “why … [they] anticipate certain occurrences” (Schutz 1973: 277; original emphasis). 30 What is similar in Schutz’s concept of “stock of knowledge” and Foucault’s concept of “regime of truth” is that they both point to a set of knowledge – no matter whether it is labeled “recipes” or “discourse” – which is accepted (or taken for granted) by individuals of a particular society, and made to function as real (or true) in (re)producing typical results. However, what mainly distinguishes the two concepts is that Schutz deems “stock of knowledge” as pre-constituted and reconfirmed via social interactions, while Foucault considers “regime of truth” as an outcome of power. Foucault writes that “there exists a system of power which blocks, prohibits, and invalidates this discourse and this knowledge, a power not only found in the manifest authority of censorship, but one that profoundly and subtly penetrates an entire societal network” (Foucault 1977b: 207).

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Moreover, a theoretical resemblance can also be drawn between Schutz’s concept of “structure of relevance” and Foucault’s concept of “governmentality” as both refer to a structuring frame of what action is considered typical or acceptable – no matter whether such a frame is labeled a structure of selection or “conduct of conduct.” The two concepts, however, differ largely concerning its nature of existence. For Schutz, the structure of relevance is a given which exists at the outset.31 But, for Foucault, the existence of governmentality is deeply rooted in the historical development of power relations. Foucault remarks that the practices which are made “acceptable at a given moment” in accordance with a specific governmental rationality are “not just governed by institutions, prescribed by ideologies, guided by pragmatic circumstances” but “possess their own specific regularities, logic, strategy, self-evidence, and ‘reason’” (Foucault 2002: 225). To argue that Schutz’s theory of the world of everyday life can be extended and associated with Foucault’s concept of governmentality is not only to address the criticism of Schutz’s portrayal of everyday life as an anathema to power and domination (e.g., Perinbanayagam 1975) but also to show that it echoes the post-illness experience of sick Chinese workers. As strangers in a formerly familiar environment, sick workers begin to question what was taken for granted and experience life anew in different domains, ranging from personal (e.g., self-perceived as strong and healthy versus weak and dying), to social (e.g., one’s spouse as loving versus disliking), to cultural (e.g., a man as a breadwinner versus dependent), and to political (e.g., law as protecting versus exploiting one’s rights). These subjective experiences of untypicality eventually lead to various responses, ranging from retreating from society, to establishing interpersonal relationships with officials to pursuing further compensation, to more confrontational collective actions. As will be made apparent in subsequent chapters, these heterogeneous responses not only involve Schutz’s concept of “stock of knowledge” consisting of “the loosely connected rules and maxims of behavior” and “recipes for handling things” but also reflect “safety considerations” on the part of the workers to conform to a certain governmental rationality. Therefore, rather than experiencing more tangible, or even violent coercion as homo sacer, in everyday life, the sick workers are “strangers” who experience governmentality through which power is exercised with an impersonality and emphasis on the regulation of the self. It is in this light that “stranger” is also considered a form of life susceptible to the exercise of power through self-regulation. And, similar to homo sacer and sovereignty, stranger and governmentality also represent a pair of conceptual correlates, which can be stated as follows: while a stranger is the one with respect to whom individuals are subject to the regulation of the self in ­accordance with a certain governmental rationality, governmentality exhibits a form of impersonal domination over whom all individuals are potentially “strangers” in society. Therefore, I argue that both “homo sacer – sovereignty” and “stranger – ­governmentality” are homological as each conceptual pair is connected by the same structure. However, to say that sick workers are subject to a form of domination in everyday life, which is by nature impersonal and unaware, and mainly recognized

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in the form of self-governance, I am destined to face criticism. This criticism, according to Farguhar (1994), has also been uttered by anthropologists against Bourdieu’s theory of action, which is hinged upon his concept of habitus. Farquhar (1994: 4) states that “[a]nthropologists often express a discomfort with Bourdieu’s unconcern with thought, knowledge, and intention except as epiphenomenon of unspoken bodily, spatial, and temporal practice.” Farquhar essentially points to the construct of the unspoken authority that sidelines human agency. To deal with this impasse, I concur with Farquhar’s advocacy to study human action in its historical specifics, exploring the links between intention and action, and at the same time recognizing the co-presence of choice and constraints in people’s action (Farquhar 1994; see also Hyde 2007: 14). These issues will be dealt with in detail in Chapter Six where I summarize my fieldwork observations of a spectrum of sick workers’ responses vis-à-vis social marginalization, and argue that their responses can be further discussed under the theme of legality as a technique of governmentality. For the two pairs of correlates which are homological to each other: “homo sacer and sovereignty” and “stranger and governmentality” I have established so far, two more issues need to be addressed. First, what is the relationship between these two pairs of correlates? Second, how does the proposed conceptual couplet lead one to understand how more subtle biopower operates in such a way as to remain attuned to the systems of marginalization, exclusion, and discipline experienced by Chinese sick workers at the actor–power interface?

The everyday life and marginality This section is intended to complement the “conceptual circle” constituted by the above four sections, and links back to the first section “marginality and life.” To elucidate the everyday life and marginalization in the budding anthropological literature of governmentality, this book indeed shares concerns with a number of scholars. For example Cleaver (2007) considers the participatory approaches to manage natural resource as a “technology of government.” Ethnography thus enables Cleaver to “uncover the ‘taken-for-granted’ nature of regimes of practice, [and] … illuminate the ways in which individuals ‘problematize’ their own conduct in order to better govern it” (2007: 228). Kesby (2005) observes that the “self-disciplining actors” who accept consciously and unconsciously the relations of inequality “often enroll themselves into the projects of others” by ensuring the reproduction of power through everyday acts and relationships (2005: 2047). Shoshana (2011) deals with the way individuals interpret and translate governmental rationality into specific self-understandings in everyday life. Her fieldwork endeavors to shed light on understanding the relation of the alliances between individuals and the state which preserve political arrangements in everyday life. These studies all acknowledge the co-presence of power and freedom. Put concretely, these studies both acknowledge the unspoken authority that shapes our desires, intent, and action, and the role of agency which can question and challenge constituted power. Rather than understanding agency narrowly as a

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vehicle to social change leading to self-empowerment against structural constraints, these studies suggest in one way or another that the agency of individuals may catalyze or hinder social change (McNay 2005: 5). Inspired by the above studies into everyday life and governmentality, my fieldwork is concerned with the way different occupationally sick workers strategize their actions for pursuing compensation which are supposedly determined by their attitudes and structure of preference in everyday life. It is assumed that their strategization outside the political field reflects the taken-for-granted assumptions in everyday life which allow us to glimpse into how power is interwoven into everyday life, in other words, the operation of governmentality. Then, in which ways does a theoretical gaze which consists of two pairs of correlates – “homo sacer and sovereignty” and “stranger and governmentality” – accommodate both the everyday reproduction of power relations and the freedom to question social norms and challenge inequitable resource distribution at the same time? How does the co-presence of structural constraints and agency on the part of sick workers result in challenging or increasing their current marginality? How is the framework relevant to my insistence in exploring the lived experience of sick Chinese workers from a bottom-up perspective? What exactly is the attentive gaze I endeavor to propose, and want the reader to sustain throughout the process of reading this book? Rather than seeing governmentality (stranger) and sovereignty (homo sacer) as “superimposed” on one another, “converged” or “work[ing] together” when law is suspended, I propose to see them as two distinct directives, or two separate “moments” of exercise of power in the subject’s experience of domination. My proposal is based mainly on two grounds. First, as I mentioned previously, the quintessential features of Foucault’s concept of governmentality rests upon its emphasis on the impersonality of domination, and the way power is knitted into the taken-for-grantedness of everyday life. It is along these lines that governmentality signifies a mode of power which is by nature discreet and exercised “at a distance.” While it may “superimpose,” “converge,” or “work together” with sovereignty and discipline nicely from the perspective of the state or power center, it is difficult for subjects to articulate, for instance, in the “state of exception,” in which ways the explicit (inter-)personal, and violent sovereign and/or disciplinary controls are mixed with the “art of government,” which usually operates unconsciously in their experience. Second, to distinguish between governmentality and sovereign/disciplinary power as two clear and distinct faces of power resonates with individuals’ subjective experience of domination in the context of contemporary China. As will be illustrated further in subsequent chapters, the occupationally sick workers clearly know that when sovereignty is reinserted in their path of struggle, they are likely to encounter interventions which involve uncertain degrees of violence and brutality. Therefore, to consider governmentality and sovereignty/discipline as two distinct moments in the experience of domination, and that the subjects may experience one at any one moment, and experience the other rather swiftly at another time in the actual process of struggle possesses empirical relevance for the present study.

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Such a distinction immediately places me in a position that is different from that of Agamben, Butler, as well as a critical mass of scholars who express open or implicit agreement with the view that different faces of power intermesh with one another (e.g., Nuijten 2004; Neal 2006; and Erlenbusch 2013). Shoshana (2011), for instance, tends to blend governmentality and sovereignty together by saying that the government “at a distance, beyond the state, emphasizes that the state maintains its sovereignty” through various techniques (2011: 772). Nadesan (2008) also suggests blurring the conceptual boundary between governmentality and sovereignty by highlighting that sovereign operations should be examined in terms of “the dispersal of sovereign power throughout everyday life” (2008: 190). In this light, I need to elaborate further on my position. I must state outright that what Agamben and Butler, as well as other scholars I mentioned just now, suggest is not erroneous. Foucault clearly indicates that both disciplinary and regulatory technologies of power have been “superimposed” upon one another and exercised on man as a species-being since the eighteenth century (Foucault, 2004: 249). Therefore, to say that both technologies of power “converge” or “work together” is entirely in line with Foucault’s theoretical framing. However, this view is apt only when one is to describe power relations from the perspective of the power center, or the state. It will be more productive, as I propose, to consider them as two separate moments when one examines power relations from the perspective of those who are governed by liberty; or to be more exact, by “our sense of being free” (Joyce 2003: 8). Here, I find that the time-honored “carrot-and-stick” metaphor is particularly helpful to distinguish my stance from that of the others. The metaphor shows how a man wants to get his donkey to move forward by dangling a carrot in front of it and just out of reach of its mouth. If the donkey does not move in a way the man wants it to, he will hit it with a stick from behind. From the perspective of the man – the power center, it is apposite to describe his control over the donkey as using both “carrot and stick.” However, from the perspective of the donkey, when it stares at and moves toward the carrot, it experiences what I call the “carrot moment” (governmentality moment) in which it has taken in the knowledge that the carrot is sweet, juicy, and healthy. In the “carrot moment,” its master, that is, the man is not within its field of attention, and it merely experiences the liberty to self-regulate its speed and angle when moving toward the carrot. In fact, when the donkey is moving in accordance with the will of the man, the man can even fall asleep. When this happens, it is the moment when power is no longer inherent within powerful subjects. Power becomes an impersonal force that acts and comes from everywhere because it is dispersed and decentered. The manwho-falls-asleep thus symbolizes what Foucault describes as the state of becoming “a way of governing, a way of doing things, and a way too of relating to government” (Foucault 2007:277); and only “a mythicized abstraction whose importance is much less than we think” (Foucault 2007: 109). However, when the donkey is not moving in the direction that the man wants it to go, the man will wake up. He will then exercise his power by enforcing his identity as “master.” The man may use the stick to touch or softly pat the donkey’s body in order to signal it the “correct” way of moving forward. By enforcing

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corporeal discipline via – in Foucault’s words – “meticulous control of the operations of the body” (Foucault 1977a: 137), the man attempts to determine the direction and speed of the donkey. If the donkey still does not comply with the man’s order under overt surveillance, he may shout and berate the donkey in order to let it know that he is now watching how it behaves. However, when the donkey realizes that the carrot is arranged in such a way that it can never reach it, it slows its pace; or it attempts to improvise the rules of  the game by pouncing or jumping on the carrot, which makes the man feel that the donkey is failing to govern itself and he will risk losing control over it, so the man will hit it with the stick. The use of the stick means that the former rules of the game – that is, should the donkey move fast enough, it will eat the carrot – are suspended. The suspension of the rules then makes room for the resurgence of the “stick moment” (sovereignty moment) in which beatings with a stick serve to punish, discipline, and above all, to remind the donkey who is master, and who has “the right to take life or to let live.” With various power forms exerted by the man, ranging from corporal (disciplinary) to violent (sovereign), the donkey may respond in different ways, ranging from compromising with the man’s order to openly challenge his authority. Therefore, rather than describing the donkey’s experience of power as “carrot and stick”, it is more productive to describe it as “carrot or stick.” And, given the context and subject matter of the present study, I propose to consider governmentality and sovereignty as two separate and distinct “moments” of experiencing power relations. In essence, the conceptual framework of this book can be distilled into a pair of theoretical homologies: “homo sacer–sovereignty” and “stranger–­ governmentality.” It is the former where the actor experiences sovereign and disciplinary power, and the latter, self-regulation with educated consent. Subsequent chapters endeavor to illustrate under what social, political, economic, and cultural conditions actors choose to question established power and subject themselves to (the danger of) overt repression, and under what conditions actors stop questioning and return to taken-for-grantedness according to a particular governmental rationality. Guided by the suggested theoretical gaze, the discussion of this book thus will eventually point to the unspoken and often unconscious authority that shapes individuals’ attitudes and structures of preference in their everyday life. This unspoken authority reflects how the established power governs people as life via technologies of the self most of the time, and how it exercises more overt surveillance control and corporeal disciplines on those who are seen as incapable of self-government. In question is a group of occupationally sick workers who are subject to a hybrid of powers privileging and consolidating the established power, and at the same time, marginalizing and disciplining the sick life.

My journeys Similar to all other ethnographically-based fieldwork accounts, partiality and non-representativeness are also involved in mine. My biographic background and the way I became interested in this topic has been outlined in the Preface; the

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fact that I was introduced to different field settings by Hong Kong-based NGOs at an early stage of my research, and then by China-based NGOs in a later stage of my fieldwork all played a part in determining my access to certain informants in certain places more readily than other people in other places. Frankly speaking, my life in Hong Kong as a young faculty member who has teaching commitments every semester and as a young father of two with family commitments throughout the year have prevented me from conducting prolonged ethnographic fieldwork lasting for months. As to the topic in question, unlike residents living in one community, occupationally sick workers represent diverse individuals who are geographically scattered all over the country. Therefore, conventional ethnographic methods which involve a prolonged stay in one or two locations are both impossible and inappropriate for the present project. Spanning over five years (from February 2010 to November 2015), my fieldwork comprised over a dozen visits to three cities in Guangdong province, namely, Shenzhen, Huizhou, and Dongguan municipalities (Map 2); and six visits to locations beyond Guangdong, namely, Lianyuan and Loudi municipalities in the Hunan province, Luzhou municipality in the Sichuan province, Liangping, Zongxian, and Kaijiang counties, and the Wenzhou district of the Chongqing special municipality (Map 3–5); and three visits to Beijing. The length of my field visits to different locations in Guangdong and to Beijing ranged from one to five days; and my visits to other locations in Hunan, Sichuan, and Chongqing ranged from five days to three weeks. To conduct fieldwork in multiple sites is to capture the informants’ post-illness experience both in their home villages/towns (Hunan, Sichuan, and Chongqing) where they have returned and in Guangdong where they are still working, living, and continuing to fight for (more) compensation. My visits to Beijing and a couple of short trips to Shenzhen were mainly to interview NGO workers, legal experts, and volunteers, and seek their views on the problems faced by occupationally sick workers in China. Apart from the fieldwork in mainland China, I also did fieldwork in Hong Kong when sick workers came to protest against their Hong Kong employer, attend conferences organized by Hong Kong-based NGOs, and receive medical checkups. Needless to say, I have kept in constant contact with a number of NGO workers and academics in Hong Kong who are familiar with occupational disease in China. Most of my time in Hunan, Sichuan, and Chongqing was spent in the villages where, as I was told, there were a number of sick workers living nearby. Living for short times with the families of sick workers in the village, my ethnographic experience was thus dominated by informal conversations with the sick workers, their family members, and occasionally their neighbors; buying food in the market with them, then cooking and eating together; walking through the mountainous paths with sick workers to visit other sick workers in the village; and observing and sometimes participating in the conversations of sick workers who recalled their good old busy days working in the factory, which were followed by their bitter struggles after falling ill. In the urban area, I spent most of my fieldwork at

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local NGO centers which organized legal consultation, healthcare education, and welfare activities for the sick workers. In the centers, I mainly acted as an observer and occasional volunteer. My fieldwork was exclusively in the urban areas of Guangdong. In the main, I paid visits to the homes of sick workers; observed discussions between Hong Kong NGO workers and sick workers on the strategies for pursuing (more) compensation at NGO centers; and sat in the consultation sessions between lawyers and sick workers at the lawyers’ offices. On a couple of occasions in Huizhou, I was lucky enough to pass through the security checks at the entrance to the municipal hospital for occupational prevention and treatment, to interview the hospitalized workers in their wards, and observe their living environments. With the objective of gaining rich qualitative data, all my journeys – long and short, at and away from home – have brought me to be in touch with 126 occupationally sick workers, and roughly one-fifth of their family members and neighbors, and more than two dozens other informants, including NGO workers, academics, legal and healthcare professionals, and volunteers, yielding a substantial volume of transcribed information and descriptions, as well as visual materials, such as photographs taken in the field and those provided by NGOs and the sick workers themselves. Among the 126 occupationally sick workers, forty-three were battery-factory workers (female) suffering from excessive cadmium levels or cadmium poisoning; thirty-nine were gemstone/jewelry workers (male) suffering from pneumoconiosis; nine Japanese-style mat workers (male and female), pneumoconiosis; and thirty-five coal miners (male), CWP. The age of the sick workers ranged from twenty-nine to sixty-two. Thus, the approach to ethnography adopted in the book is “multi-sited.” It aims to expose the researcher to multifarious field experiences with shifting personal positions in relation to his or her subjects, and fluid knowledge (discourse) and power relations pertinent to one site overlapping with other sites (Marcus 1998: 98). The multi-sitedness involves both coastal and inland regions, both urban and rural areas of China; and ranges from home settings, NGO centers, and lawyers’ offices to the settings of protests and conferences both in Hong Kong and China. The informants include sick workers, their family members, sick workers having turned activists, relevant academics, medical professionals, lawyers, and volunteers. This being said, readers must be aware that my methodology has been biased in particular ways, which has ultimately shaped the quality and also my interpretations of the findings. Since the idea of the project was conceived and inspired in Hong Kong (see Preface), over half of the sick worker informants I met were directly and indirectly related to Hong Kong-based NGOs. The reason I chose to conduct fieldwork in a particular city, county, or village is mainly because these NGOs informed me that there were a certain number of sick workers living there. For a similar reason, I began my fieldwork in the coastal province of Guangdong, rather than Xiamen or Zhejiang. Once I was in the field, I got in touch with informants through convenient means – which were further constrained by the limits of the fieldwork, such as its geographic regions, time,

38

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and length – but could not claim to fully reflect the experience of sick Chinese workers as a whole. More specifically, the proportion of sick workers who had successfully overcome their illness and adapted to new lives in the sample was underestimated. The reason was that I had less access to some in critical health conditions because they were unlikely or unable to travel to the local NGO centers for an interview. My visits to them were always constrained by limited fieldwork time and resources. As for those who successfully adapted to a new life, it was possible that they were compensated and had set up businesses in other places. This was not uncommon as the sick workers sometimes told me that they knew some of their former workers had set up their own businesses in other places after obtaining compensation. These workers, however, were not easy to contact. Also, the proportion of sick workers who had overcome their illnesses and who became activists helping other sick workers was likely to be overestimated in my sample. Since I was introduced to the field by NGOs, I was able to get to know several victims-turned-activists that they had hired, and these activist workers were systematically included in my sample. Since the informants were mainly acquaintances of these activist workers, many of them were former allies in the struggle for compensation; it is believed that the proportion of workers who received sizable compensation in my sample is higher than that in the population of occupationally sick workers overall. Therefore, I have not much to claim about the generalizability of this study. The only claim to generalizability is probably the face value of my fieldwork data. When I discussed my observations in the field with NGO workers and legal professionals, they generally agreed that my samples covered most of the typicality exhibited by lapidary workers suffering from pneumoconiosis in coastal provinces, factory workers suffering heavy-metal poisoning, and peasant coal miners suffering from CWP. To outline my vantage point in the present study (both empirical and theoretical) as well as the bias of my methodology in this chapter and in the Preface has marked my effort to achieve the “participant objectivation” coined by Bourdieu. Participant objectivation undertakes to explore “the social conditions of possibility” of the researcher’s “subjective relation to the object” (Bourdieu 2003: 282). To do this is not to produce an analysis which is valid once and for all but merely to keep readers sharply aware at every moment in reading this book of the social position of the researcher, and the theoretical gaze by which the researcher judges his findings.32

Notes  1 The story of Zhang Haichao depicted here is based on several recent TV and newspaper interviews I accessed on the internet and his own open letter dated December 5, 2012.  2 CLB reported that Zhang was awarded 615,000 yuan (2010: 32) in an interview on January 29, 2015 shown on Phoenix TV (www.youtube.com/watch?v=-s0eRDexSXc); he said that he was awarded 1.2 million yuan. I judge that the latter was more creditable.

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 3 Zhang Haichao’s open letter: http://blog.ifeng.com/article/21648452.html.  4 An interview on January 29, 2015 shown on Phoenix TV. www.youtube.com/ watch?v=-s0eRDexSXc; last visited on March 17, 2016.  5 Interview in Beijing with Wang Keqin on March 19, 2015.  6 When I applied the following formula to check the official data in Table 1: “newly reported case in year 1” + “cumulative case in year 0” = “cumulative case in year 1,” inconsistencies were identified.  7 According to Hyde (2007: 37), Mary-Jo DelVecchio Good (1995) was the first who used the term to describe how positive statistical outcomes are presented to anxious cancer patients; presenting the best possible scenario meant statistics retained an aesthetic quality (see also Good 2001 and Gould, 1996).  8 Hyde (2007: 38) then concludes that what is “normal” and “pathological” is not simply determined by statistical and scientific analysis; rather “these concepts are steeped in political, economic, and technological imperatives.”  9 In 2005, officials of the MoH warned that over two hundred million workers in China were threatened by occupational disease (Beijing Youth Post 2005). 10 Pneumoconiosis is an umbrella term for a range of occupational lung diseases which are caused by the inhalation of certain dusts and the lung tissue’s reaction to the dust. Different forms of pneumoconiosis are defined in terms of the kind of dust or the occupation that caused the condition. According to the information from Centers for Disease Control and Prevention of the United States, silicosis is one of the main types of pneumoconiosis and it is an occupational lung disease caused by the inhalation of silica dust, which gives rise to inflammation and scarring in the upper area of the lungs. Silica is a common compound that is found in a number of materials such as sandstone, marble, flint, slate, soil, mortar, plaster, or sand. Therefore, the workers in construction, mining, non-metallic mineral products, pottery, and  glass industries may be at risk of exposure to levels of silica dust which when inhaled can lead to silicosis. Other primary pneumoconiosis is CWP and asbestosis. www.cdc.gov/niosh/ topics/pneumoconioses/; last visited on March 17, 2016. 11 Interview with Wang Keqin, November 30, 2015, Shenzhen. 12 According to an MoH report issued in 2001, the fatality rate for pneumoconiosis (based on the data of 2000) is 23.9 percent (NHFPC 2001). Till 2005, MoH data suggests that the crude estimate of the fatality rate of pneumoconiosis is 22.6 percent (Xinhua Net 2006). 13 Interview with Wang Keqin, March 21, 2015, Beijing. 14 In the United States, the Coal Mine Health and Safety Act of 1969 established the current federal exposure limit for respirable dust in underground and surface coal mines. The Act also established a surveillance system for assessing prevalence of pneumoconiosis among underground coal miners, but this surveillance does not extend to surface coal miners (CDC 2012). 15 The twelve types of pneumoconiosis include (i) silicosis, (ii) CWP, (iii) graphite pneumoconiosis, (iv) carbon black pneumoconiosis, (v) asbestosis, (vi) talc pneumoconiosis, (vii) cement pneumoconiosis, (viii) mica pneumoconiosis, (ix) potters’ pneumoconiosis, (x) aluminosis, (xi) welders’ pneumoconiosis, and (xii) foundry workers’ pneumoconiosis. 16 There was a thirteenth item in the most updated list, which is: “Other Pneumoconioses diagnosed by Diagnostic Criteria of Pneumoconioses and Pathologic Diagnostic Criteria of Pneumoconioses.” See www.minquan.gov.cn/view_2073.html. 17 What is worth mentioning is that China did show a certain commitment to improving

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19 20 21

22 23

24 25

Life in perspective labor conditions and the upkeep of international standards. For example, China signed the International Covenant on Economic, Social and Cultural Rights (ICESCR) on October 27, 1997, and ratified it on March 27, 2001 (Fung and Chan 2012: 31). One should note that the Article 7 of the ICESCR recognizes one of the basic rights of people is to work under “just and favorable conditions,” in particular, “safe and healthy working conditions.” (See official website of ICESCR, www.ohchr.org/EN/ ProfessionalInterest/Pages/CESCR.aspx; last visited on March 17, 2016). China also ratified ILO Convention 155 on Occupational Safety and Health, 1981. This convention laid down a broad and comprehensive framework in order to ensure that the scope of national policy, law, and practice in the area of OHS can be applied to all branches of economic activity and to all workers in these branches (ILO 2009: 11). Ratifying the convention on January 25, 2007, China, however, admitted later in an ILO survey that the pertinent applications of laws and regulations “are subject to certain exceptions” (ILO 2009: 11, fn3). Schutz himself also proposed to expand his concept of “stranger,” and apply it to include actors other than migrants. To him, it can also be applied to “[t]he applicant for membership in a closed club, the prospective bridegroom who wants to be admitted to their girl’s family, the farmer’s son who enters college, the city-dweller who settles in a rural environment, the ‘selectee’ who joins the Army, the family of the war worker who moves into a boom town [etc.]” (Schutz 1964: 91). One of the exemplars of the Chicago School of sociological research on marginality studies was The Hobo of Nels Anderson, which is also the first sociological study of homelessness in the United States (Anderson 1923). To Foucault, sovereignty is very broadly “a mechanism of power that was effective under the feudal monarchy (1980: 103). According to Flynn (1985, 1999), Foucault is concerned with the link between power and subjectivity throughout his work from Madness and Civilization to The History of Sexuality. Guided by Erlenbusch (2013), one should note Foucault’s own contention in “On Power” (1982a) that his archaeologies had always been concerned with power, as well as his insistence in “The Subject and Power” (1982b) that “during the last twenty years” his goal had been “to create a history of the different modes by which, in our culture, human beings are made subjects” (Erlenbusch 2013: 49 fn21). For further discussion on comparing power-related concepts among Lukes, Gramsci, Bourdieu, and Foucault, one may consult Dean (1994), Valverde (1994), Crehan (2011), Gunn (2006), Burawoy (2012), and Silverman and Gulliver (2006). Such a view echoes his suggestion that power “must be analyzed as something which circulates” (1980: 98); and therefore, governmentality studies, as astutely summarized by Gordon (1991), are to unravel the government rationality by identifying the ways in which a particular set of practices become “thinkable and practicable both to its practitioners and to those upon which it [is] practiced” (1991: 3). I would humbly suggest my previous work Ho (2011) in which I first proposed to consider Foucauldian conception of power in terms of impersonal domination. It is useful to read my analysis of the two most innovative features of Foucault’s concept of governmentality against Brockling et al. (2011) which highlights five methodological characteristics inherent in Foucault’s governmentality perspective. First, the investigation into the “art of government” does not emphasize hierarchical dichotomies which are generally adopted in conventional power analyses. Rather than focusing on the inequality inherent in the state–society, structure–actor, patron–client, idea–practice, power–subject dichotomies, governmentality studies “look for the systematic ties

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between forms of rationality and technologies of government” (2011: 12). They underscore “the significance of knowledge production and its connection with mechanisms of power” (2011: 12) which make domination possible. Second, the analytical gaze of governmentality studies follows the principle of an “ascending analysis” (Foucault 1980: 99) and starts with “local patterns of rationality and governmental practices” which extend to “a description of macro-phenomena” (2011: 12). Third, they reject the true–false distinction in conventional critique of ideology, and investigate “the discursive operations, speakers’ positions, and institutional mechanism through which truth claims [i.e., knowledge] are [selectively] produced and which power effects are tied to these truths” and subsequently, to how problems are defined and how they should be tackled (2011: 12; original emphasis). Fourth, the concept of governmentality “technology” or “technique” refers to a whole spectrum of tactics in which power and knowledge are enmeshed. It includes “technical artifacts, strategies of social engineering, and technologies of the self; [and] both arrangements of machines, medial networks, recording and visualization systems, and so forth to a range of procedural devices through which individuals and collectives shape the behavior of each other and themselves” (2011: 12). Lastly, it focuses on how “divisions and distinctions [in society] are established … [in particular] how subjects are invoked as autonomous, emancipated, responsible citizens in technologies of government” (2011: 12). While my suggestion concerning impersonal domination as the theoretical premise underlying Foucault’s concept of governmentality echoes Brockling et al. (2011)’s point one, three, and five, my remark on its emphasis on self-government echoes Brockling et al. (2011)’s point two and four. 26 Foucault writes: “Each society has its regime of truth, its ‘general politics’ of truth: that is, the types of discourse which it accepts and makes function as true; the mechanisms and instances which enable one to distinguish true and false statements, the means by which each is sanctioned; the techniques and procedures accorded value in the acquisition of truth; the status of those who are charged with saying what counts as true” (Foucault 1980: 131). 27 Other studies which associate governmentality and the everyday life include, at least, Joyce (2003), Kohrman (2005), Kesby (2005), Neal (2006) and Nadesan (2008). 28 One should note that my terminologies of “habitual routine,” “practical-evaluative,” and “projective” agency adopted here take reference from Emirbayer and Mische’s 62-page article “What is agency?” published in 1998 in The American Journal of Sociology. Emirbayer and Mische (1998) set out to analytically disambiguate agency in a wider arena of discussion into its components, and suggest their own conceptualization of agency. They identified three analytical, but empirically interrelated, components of human agency: iterational (habitual), practical-evaluative, and projective. These three components are defined as follows: “[The iterational component of agency] refers to the selective reactivation by actors of past patterns of thought and action, as routinely incorporated in practical activity, thereby giving stability and order to social universes and helping to sustain identities, interactions, and institutions over time. … [The practical-evaluative component] entails the capacity of actors to make practical and normative judgments among alternative possible trajectories of action, in response to the emerging demands, dilemmas, and ambiguities of presently evolving situations. … Projectivity encompasses the imaginative generation by actors of possible future trajectories of action, in which received structures of thought and action may be creatively reconfigured in relation to actors’ hopes, fears, and desires for the future” (Emirbayer and Mische 1998: 971; emphases original).

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29 Schutz (1973: 284) uses “relevance” to replace “attitude.” He says, “There is no attitude at all involved, except in the metaphorical sense.” 30 Schutz writes (1973: 227) “what I am anticipating is one thing, the other, why I anticipate certain occurrences at all” (emphases original). 31 To Schutz, the structure of relevance is by nature similar to the intersubjectivity of everyday life in which individuals’ interactions are based on the doctrine: “I know he knows that I know.” Schutz asserts repeatedly that “[o]ur everyday world is, from the outset, an intersubjective world of culture” (1973: 10, 133). 32 This endeavor upholds what Max Weber terms as “objectivity” in social science research; he writes that it is important to “keep readers and [researchers] themselves sharply aware at every moment of the standards by which they judge reality and from which the value-judgment is derived, instead of, as happen too often, deceiving themselves in the conflicts of ideals by a value mélange of values of the most different orders and types, and seeking to offer something to everybody” (Weber 1949: 59).

2

Sick workers as homines sacri

Chapter One conceptualizes the post-illness experience of sick Chinese workers in terms of the dual concepts of “stranger” and homo sacer. While the former refers to the primordial mode of existence of the sick worker in everyday life, the latter refers to the constituted mode of existence the sick worker exhibits vis-à-vis the constituted power. However, the previous chapter only mentions in passing that homo sacer is created by the mechanism of legality in terms of “inclusive exclusion.” This means that on the surface the rights of occupationally sick workers are legally protected, but in reality most are deprived of any legal recourse. This chapter endeavors to establish sick Chinese workers as homines sacri with more fieldwork data. Its major argument is built upon the creation of a “zone of indistinction” which constitutes the post-illness experience of occupationally sick workers in China. Not only does it effectively constitute sick workers as homines sacri susceptible to more violent forms of power but also largely hides the problem of occupational disease from members of the public.

A zone of indistinction Compared to the plethora of work on Chinese labor, there is a relative paucity of scholarly work in English on the problem of occupational disease.1 In the available literature, relatively more attention has been paid to industrial accidents leading to death and injuries (e.g., Wright 2004, 2007; Liu et al. 2005; Homer 2009; Zhang 2009). Such a striking disparity in scholarly attention seems not unjustified as the International Labor Organization (ILO) maintains that accidents represent less than a quarter of the total of work-related fatalities while occupational diseases account for most deaths (George and Pandita 2012: 11). Unlike occupational injuries that result in physical disabilities, occupational disease is subject to more contestation as the damage to the body is usually less visible, and therefore needs a great deal more evidence to establish a causal relationship to the workplace. Hence, by its nature, occupational disease requires academic attention beyond calling for better safety measures and legal protection in the workplace. Since occupationally sick workers often face a lifetime of illness which might stretch for decades, occupational disease involves complex issues concerning physical

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suffering, medical treatment and rehabilitation, individual and family livelihood, discrimination, social marginalization, and struggles for legal justice and compensation. However, existing scholarly studies on occupational disease in China are mainly concerned with the structure of OHS legislation (Su 2003), certain background information about specific occupational diseases (Wang and Christiani 2003); the lack of rigor (Pringle and Frost 2003) or consistency (Chen and Chan 2004) in the implementation of OHS measures; or the process of worker resistance (Leung and Pun 2009). That being said, the lack of, or somewhat skewed, academic concern with occupationally sick Chinese workers is not something I will pursue in this chapter, nor this book. Rather, I wish to point out that even though there are well-proven medical grounds about the incurability of most occupational diseases, and awareness of the plight of the victims and their family members, sick workers’ bitter struggles in obtaining compensation are still largely met with little sympathy by members of the public, despite the case of Zhang Haichao. While Zhang Haichao is obviously a special case, his decision to undergo surgery is unlikely to be repeated by other sufferers as the hospital which conducted the surgery was sternly criticized by the Hunan Provincial Bureau of Health for breaching the Law of the Prevention and Treatments of Occupational Diseases which does not allow that hospital to conduct occupational disease diagnosis or identification (Henan Shangbao 2009). The key argument of this chapter is to further establish the post-illness experience of Chinese workers as an instantiation of Agamben’s concept of homo sacer  – the ultimate biopolitical subject whose life is located outside the “normal” political, economic, and cultural practices and hence is rendered silent and unintelligible in the public realm. Occupationally sick workers are considered unwanted or “tabooed” people insofar as the specific set of social regulations and power relations have created a sense of “double ambivalence” among the sick workers. Coined by Weisberger’s (1992) theory of marginality, “double ambivalence” refers to the subjectivity of the actor who feels that he or she is “neither this nor that.” In concrete terms, as we will see, sick Chinese workers are constantly and disturbingly caught in between the public and private, the productive and unproductive, and the culturally normative and the culturally deviant. Just to recap: homo sacer refers to a category of tabooed person who, in its original usage of the term, could be killed by anyone without incurring punishment; at the same time, however, those killed could not be honored as a sacrifice. According to Ziarek (2008) Homo sacer thus refers to “the remainder of the destroyed political bios” (2008: 90) and represents a form of life which is seriously damaged and stripped of its political significance. Agamben argues that, in modern governmental rationality, bare life by no means exists outside state power. Rather, as succinctly put by Ziarek, bare life is captured by the political in a dual way: “first, in the form of the exclusion from the polis … and, second, in the form of the unlimited exposure to violation, which does not count as a ‘crime’” (2008: 90).2 Hence, homo sacer is said to occupy “a zone of indistinction” between beast and man (Agamben 1998: 170; Diken and Lausten 2002), a realm Agamben terms the “state of exception.” Rather than “a dictatorship,” Agamben writes that

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the state of exception refers to “a space devoid of law, a zone of anomie in which all legal determinations – and above all the very distinction between public and private – are deactivated” (Agamben 2005: 50). At the heart of the sovereign’s power, thus, is the power to “ban,” which determines who is included in the polis and who is condemned as homo sacer.3 Agamben himself examines how the category of homo sacer is epitomized by the prisoner in a concentration camp, who is at once both within and outside of society. Human lives in the camp are subjected to excessive power to control, manage, and correct, but possess no right to state protection. They make no defense or recourse in the face of naked power other than the physical resistance and struggle for survival that any animal in captivity would exercise (Coleman and Grove 2009; Draus et al. 2010: 668). Enlightened by the work of Agamben, scholars have increasingly applied the concept of homo sacer, which occupies a “zone of indistinction,” to examine the situations of different marginal groups, such as residents displaced by Hurricane Katrina (Giroux 2007); internally displaced persons (Seshadri 2008); homeless populations (Feldman 2004); heroin addicts (Draus et al. 2010); impoverished aboriginal groups (Povinelli 2007); asylum seekers (Diken 2004; Darling 2009); prisoners held by the United States military at Guantanamo Bay (Gregory 2006), disadvantaged young people in the school-to-work transition service (Chadderton and Colley 2012), and Third World nations that are labeled “economically unsound” by international agencies (Best 2007). Unlike persons physically disabled due to occupational injury, most occupationally sick workers I met in the field do not feature an overt bodily alterity, which, according to Kohrman (2005: ix), involves a socio-politics that mediates the relation between the body, the self, and the other. For the occupational illnesses covered in this book, sick workers are usually not immediately visible to others, but once they are detected or revealed, their status will deteriorate quickly in concrete and measureable ways.4 For instance, they will be discriminated against by the employer under the aegis of capitalistic logic which expects the whole population to participate fully in the competitive market-driven economy. The sick body usually hinders them from undertaking basic cultural roles such as men as breadwinners of the family, or women as being mothers of healthy babies. It is then common to see them conceal their identity as “patients” in order to avoid being marginalized in the economic and cultural realms. In other words, they are located within society while simultaneously banished from society by a variety of formal and informal mechanisms of exclusion: legal, economic, and cultural. They exist within a “civilized” society where that society’s legal system, economic logic, and cultural norms fail to apply to them. Subsequent analyses outline how homo sacer is created in the specific set of social regulations and power relations, and illustrate how victims of occupational disease are stigmatized and designated as a category of people to be avoided, whose pain, social suffering, poor health, and subsequent death are largely unquestioned by society at large. And, for a small number of victims who choose to usurp the power structure, their resistance is usually considered invalid, and their (bare) lives – being in the state of exception – become vulnerable to the naked power of the state.

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In between the public and the private Is occupational disease a public matter under which the afflicted workers are protected by law, and the state bears the ultimate moral responsibility? Or, is it a private (inter)personal matter such that both the costs and moral responsibility incurred in the disease should be borne by the employee, or shared in one way or another by both the employee and employer? At first sight, it is not a private matter as a specific set of laws and regulations are in place pertaining to the diagnosis and classification of occupational diseases and the calculation of compensation. However, the distinction between the public and private becomes blurred as underlying these laws and regulations is the principle of employer liability. Stemming from this principle, as mentioned in the previous chapter, the proof of a current “labor relationship” with the employer becomes essential in relation to the payment of occupational disease benefits. What seemed to be a public issue thus becomes akin to a(n) (inter)personal matter. Evidently, such a legal framework has led to a strong motivation on the part of the employer to minimize his/ her liability to the occupational disease victims, or simply to shrug off his/her responsibility for compensation. Wang Keqin, quoted earlier, said that less than 5 percent of workers in China have signed a formal labor contract with their employer. An official report in 2005 suggested that less than 20 percent of workers working in middle and large scale non-state enterprises have a labor contract (Huang and Ye 2014: 11). The authors argue that for small private enterprises located in the poor inland regions, the proportion of workers who have signed a labor contract with their employer will be much lower than 20 percent (Huang and Ye 2014: 12). Employers are also well aware that once an employee leaves the company, it is much more difficult for them to obtain compensation. It is thus common to hear informants report of the difficulty getting their employers to hand over all the documents necessary to prove the labor relationship. The employer often refuses to provide workers with copies of the documents, or simply denies that the workers actually worked for them in the past. Many former gemstone/jewelry workers I interviewed also recalled that while the company had arranged a physical examination for all workers, the employer refused to let workers know the results of the examination. At the same time, workers realized that more and more employees were being sacked without obvious cause. The “reasons” ranged from breaking company rules, making them redundant by saying their particular job skill is no longer required, or forcing them to resign by telling them they had to transfer to a less stressful position which did not yet exist. A Hunan-based jewelry worker told me in Shenzhen about his painful experience which involved the police breaking into his home and interrogating him at the police station; he said: A group of policemen suddenly broke into my home. They had documents suggesting that I was operating a company. … They took me to the police station, and accused me of operating a business organization without a license. … The documents were obviously fake! … [Afterwards] [m]y boss sacked me. He said

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that I had breached the Labor Contract Law. He said that my contract does not allow me to set up my own business. … Of course, everything was made up. They would do whatever they could to wrong you5

Stories I heard while doing fieldwork revealed that when workers rejected the directive to leave, the employer usually resorted to brutal action, such as deploying burly security guards to physically remove workers from company premises. Some employers attempted to make a deal with the workers by offering them minuscule compensation payments and asking them to return home and take care of their health. For cadmium-poisoned workers, an employer even bribed medical professionals to persuade the workers to leave the company. As one worker recalled: [In 2004,] [w]hen many workers were diagnosed with suffering from over-­ exposure to cadmium, we experienced a high level of panic. Everyone during that time thought that we would die very soon. … We protested and refused to work.  … They [the company] later attempted to soothe workers’ nerves, and hired some [medical] professionals from Beijing to deliver a talk to us. … They told us that the cadmium in our bodies would eventually be excreted by drinking more water! … So, what we needed to do was to quit the job, go back home, and take a rest. … We know now that all this was lies! But, many did believe the company [and the professionals from Beijing] and signed the [job termination] agreement and returned home.6

Even in cases where the labor relationship has been proved, an employer may disagree that the occupational illnesses were caused by poor working conditions at his or her company. Whenever disputes of this kind between employer and employee arose, the worker’s quest for compensation would take a long-winded detour and become a labor dispute mediated by arbitrators of the local Labor Dispute Arbitration Committee (LDAC). Being a state-backed administrative body, the LDAC often rules in favor of the employer, or asks the employee to accept a level of compensation far lower than it would be if pursued via the normal legal channels. In cases where the employee disagrees with the arbitration ruling, the worker may file a lawsuit against the employing unit in a local court and seek a judicial ruling. If the local court agrees to the original arbitration ruling, the employee may have final recourse as to appeal the ruling in a higher court. Evidently, all these complicated and time-consuming administrative and judicial procedures constituted virtually insuperable obstacles to most sufferers of occupational disease. Even for workers who possess the requisite employment records and choose to file their cases in a court, stories solicited in the field suggest that the employer would deploy different ways to exert pressure on the victims to limit their claims. For example, a group of four coal miners suffering from pneumoconiosis in Hunan revealed during an interview that their employer persuaded them to accept a small amount of compensation by saying that he would never pay the level of benefits ruled by the court. Even in cases where the court finally judges in favor of

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the employees, the employer would adopt all means possible to evade their legal responsibility to the victims. For example, they might have their companies go bankrupt, close their companies down, change legal ownership, or even move to another place and re-open for business using a different name. In Hunan, coal-mine owners adopted the tactic of delaying payment by telling affected workers that the company did not have enough money to pay their compensation. According to one coal miner, his boss even persuaded sick workers to continue working for them until the company had enough cash to pay the compensation.7 In Guangdong, an owner of a jewelry company used the tactic of dividing the lump sum compensation ruled by the court into monthly payments, and suggested that they pay this total amount of money over the next five years. Needless to say, there are also cases where employers simply refused to compensate sick or injured workers despite the court ruling, or the sick or injured workers failed even to locate their previous employers. As for poisoned workers, the case was even more complicated. The court originally judged in 2004 that a company needed to pay no less 300 yuan per month to each sick worker for the purchase of health supplements. However, as mentioned in the Preface, the “supplements” supplied by the company turned out to be of low quality as the cadmium-­poisoned women later found that the calcium tablets were simply “unpalatable,” and the milk powder contained melamine, which led many to suffer from kidney stones. When speaking of the principle of employer’s liability inherent in the Chinese OHS system, Wang Keqin states: According to the law, occupational disease patients are entitled to work injury compensation, free medical assistance, and social insurance protection. But, in years of visits, I myself never saw even one corporation in China that took the initiative to shoulder the responsibility on behalf the victims. Therefore, to say that corporations are held responsible for the compensation is totally empty talk.8

The above-mentioned findings should suffice to portray a common situation faced by occupationally sick workers: despite there being a law to ensure compensation is paid, their rights are ignored, if not exploited, according to the very same law. They are virtually experiencing a state of exception within which the law is – in Agamben’s terminology – “in force without signifying,” and consequently, “all the legal determinations” with the very distinction between public and private becoming invalid (2005: 50).

In between the productive and the unproductive Suffering from an incurable disease inevitably means a serious financial burden to workers from peasant households. The widely known medical treatment for pneumoconiosis is lung lavage, the effect of which is to wash away dust lodged in the patient’s lungs. The effectiveness of lung lavage, however, has been questioned by sick workers, NGO employees, medical professionals, and volunteers I

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met in the field. The consensus among different stakeholders is that lung lavage is only suitable to patients suffering from mildly severe pneumoconiosis. This treatment seems to work most effectively in the first several months of the treatment, after which its effectiveness declines. Furthermore, the treatment costs over 10,000 yuan, which is beyond the reach of most impoverished migrant workers. Understandably, during my fieldwork, all sick workers reported that their illness had adversely affected their normal work lives. For example, coal miners afflicted by CWP often found it difficult to work for another coal mine as they could not pass the pre-employment health check. Sick gemstone/jewelry workers, who returned to the rural areas after developing symptoms of pneumoconiosis, revealed that they could no longer handle farm work which demanded heavy physical exertion. As for the cadmium-poisoned women, they reported that their body pain and frequent respiratory tract infections prevented them from having a full-time job. At first sight, the occupationally sick workers had no choice but to consider themselves unproductive in society; however, in reality, their experience in the economic world is much more ambivalent. Since the post-1978 reform period, the Chinese state has appropriated the discourse of quality (suzhi, 素質) as the hegemonic strategy of the state to produce status and identify people who are recognized as “civilized,” hence more competent in adapting to the socialist market economy without causing chaos to governance (Kipnis 2006). Under the discourse of suzhi, to suffer from an incurable occupational disease would not only mean a physical trait but also infer a moral inferiority in the victim’s body. Sigley (2009) has rightly pinpointed that suzhi – in its most extreme form – functions as “a measure of human value which … constructs a hierarchy of worthiness and utility (of “low” and “high” quality, for instance)” (Sigley 2009: 539; original brackets).9 It was common to hear respondents describe themselves as “useless,” “rubbish people” (feiren, 廢人), or “neither human nor ghost” (ren buxiang ren; gui buxian gui; 人不像人, 鬼不像鬼). All this, in one way or another, points to their low worth and low productive value to their family in particular and society in general. For example, a cadmium-­ poisoned woman stated emotionally: I feel like I am of no use. I did not have much schooling when I was young. Then, I went out to work. I made no money and it turned out that I made myself ill. … We are exactly a group of people in society without quality. … I now become a burden to my family. My husband did not say anything, but I know that he dislikes it. … I feel that my health is deteriorating rapidly year by year. And, I sometime feel very scared. I sometimes dare not think about what will happen in the future.10

My fieldwork further reveals that most of the sick workers are in serious debt. This explains why respondents often lament that they cannot afford “high-­quality” education for their children. Their narratives imply that they are worried about the intergenerational transfer of “low quality” (as well as “low worth”) as the

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Life in perspective

suzhi-based stratification system in post-socialist China is closely related to academic attainment (Bakken 2000). However, the occupationally sick workers’ subjective perception of being “low quality” due to their inability to move upward socially only portrays one side of the story. Unlike many who are occupationally injured, most occupationally sick workers appear normal and healthy. The fact that they are unable to work and produce normally has indeed created a social marginality in which many of their neighbors, relatives, and friends would consider them not explicitly as “victims,” but more often as “strange” (qigui, 奇怪). Adding ambivalence to their experience of marginality is that most of these workers, who have returned to their rural homes, do not receive welfare benefits from the state, such as MLP, like many families with a member who has been injured or who had died on the job. This phenomenon is related to what has been discussed earlier, that occupational disease is caught in limbo between the public and private within the existing legal framework. Against this biopolitical backdrop, both sick workers and welfare authorities usually fail to convince each other that a victim of occupational disease who looks physically sound should depend on state welfare rather than seek his/ her employer’s compensation as stipulated by law, or simply return to the market. Sick workers thus experience varying degrees of struggle to decide whether to expose or conceal their illness to others because both ways seem to fail to help them avoid economic exclusion. Under one-fifth of gemstone/jewelry workers who received sizable compensation (300,000 yuan or more) in my sample chose to set up their own small businesses, such as stores selling construction materials or groceries, in the urban area. Some, however, preferred to return to their home village. Since farm work becomes too arduous for the pneumoconiosis-stricken workers, many choose to earn a living by rearing poultry or pigs or by growing cash crops. But the profit is subject to the fluctuating market, which frequently incurs losses rather than gains. Others choose to work in small enterprises, or in informal jobs, such as hourly paid construction work, which do not require medical checkups for new workers. Even so, they need to take great care to conceal their illness as they know they would be sacked if the employer finds out that they are sick. Living in Shenzhen, one former gemstone worker who suffers from pneumoconiosis remarked: Employers now are clever. When they hire you, they need you to pass a body check. Once they know that you suffer from an occupational disease, they will refuse to hire you. They know that they would be held responsible for the medical costs involved [as stipulated by law].11

He then explained that in order to get the security guard job he currently had he needed to find a fellow townsman (tongxiang, 同鄉) for help in faking his identity and passing the body check. Other stories narrated by respondents suggested that even if the employer did not require a body check at the recruitment stage, their illness, which would usually lead to frequent sick leave, would quickly arouse the concern or even dissatisfaction of the employer. Rather than revealing their

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illness to the employer, they would simply quit the job. These experiences thus echo the notion of homo sacer that the lives of sick workers are both external and internal to the world. They are poised to struggle between participating in a normal working life and accepting their role as a sick person. At the same time, they also experience double ambivalence as both identities fail to be understood by society. In other words, they are not recognized by economic and political institutions as a constituency; rather, once their identity as “sick” is exposed, they are deemed a kind of deficit or “problem” to be controlled and managed. But unlike most victims experiencing abject poverty, the deficit of occupationally sick workers often arouses less sympathy in society, but rather the sentiment of these individuals being “strange.” Furthermore, unlike committing crime or suffering from a serious health hazard such as AIDS and drug addiction, the “problem” of occupational disease often arouses less fear and condemnation but greater social neglect and apathy. It is in this general way that I observed that most occupational disease victims find themselves caught in between the productive and unproductive in society.

In between the culturally normative and deviant There was a report about Zhang Haichao I saw on TV the other day. It was particularly meaningful. A journalist asked Zhang’s son to call Zhang “papa” in front of the camera. His son did so. I feel that Zhang really possesses a sense of humor as he said, “This kid calls me ‘papa’ now; but next year, he may call another man ‘papa.’”12

One aspect of occupational disease which has received almost no attention in the literature is its impact on one’s (in)capability to uphold his/her cultural roles. These impacts are particularly distressing to victims as their outlook on life is still deeply influenced by the cultural schema emphasizing traditional gender roles. Such cultural schema predisposes that a husband is the figurehead and breadwinner of a family, whereas the wife plays almost exclusively the reproductive and emotional roles. Such gender-based division of labor, albeit less rigid in the post-socialist era than before (Hsieh and Burgess 1994), still exerts effective sanctions on the Chinese family. Role reversal between spouses, for instance, is relatively rare and generally viewed negatively (Zuo and Bian 2001). Against this cultural backdrop, it was common to hear occupationally sick workers express their deep regret for failing to meet cultural expectations. For example, many respondents suffering from pneumoconiosis admit that their illness has created insurmountable barriers to fulfilling their culturally normative roles as a husband, a father, a son, or even as a man. A former jewelry worker said that “as a man” (zou wai yige nanren, 作為一個男人) in their thirties or forties, one should “do big things” (gang dashi, 幹大事), and achieve success in their careers; however, all that he could manage to do was to struggle with his illness in order to just stay alive. Former gemstone/jewelry workers told many similar stories of how they have had failed to provide a “better living” or a “hope for the future” for their

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wives and families. As in the rural area, my interviews with peasant coal miners suggest that lung disease, which substantially reduced their physical fitness, had lowered their dignity “as a man.” On this point, a victim-turned-activist working for a Hong Kong NGO explained to me: Think about when a peasant can no longer do farm work; a [coal-mine] worker can no longer mine coal. Think about how he faces his wife, his kids. … In the rural area, poor health means the loss of productivity; loss of productivity means that you are like a “rubbish person.”13

About two-third of former gemstone/jewelry worker interviewees who return to their rural home with meager or no compensation all express frustration at being dependent on their wives for their livelihood. In my fieldwork, an oft-mentioned topic among gemstone/jewelry workers during lunchtime was wives who had left their husbands due to their illness. A couple of well-known cases even involved wives taking all of the husband’s compensation and running off with another man. On one occasion, an interviewee mentioned the “joke” quoted at the head of this section which pointed to the deep sense of bitterness of a sick man for not being able to uphold roles as husband and father with dignity. As for peasants who spent over a decade working in urban areas, then pursuing lawsuits with their employers and the administrative authorities, they usually experienced strong regret for being poor fathers. For example, one jewelry worker said: I feel sorry for my son. I am just not a good father. When I returned home [to Hunan], we just did not have that kind of [father–son] feeling. He is now fifteen years old. I worked away [in Guangdong] when he was young. When he got older, I spent six to seven years away pursuing lawsuits. Now, our feelings for each other are very slight. I feel like that I am really not a good father.14

Another respondent felt deep remorse when he told me his experience of not being able to show the correct filial piety to his mother: In 2005, I was very sick. I was hospitalized in Guangzhou Municipal People’s Hospital. … At that time, I knew my elderly mother in Sichuan was dying. I really wanted to go back home to see her for the last time. You know that we Chinese are very concerned with [children] accompanying the elderly to complete their final journeys. I was really very, very upset. … As a son, I really felt like I could not uphold filial piety. But, I could do nothing as I suffer from this illness. … When I got out of the hospital, she had already passed away.15

As for female workers suffering from cadmium poisoning, their physical pain is exacerbated by mental and social suffering relating to problems with their pregnancies. I could not hide my shock during the first meeting with a focus group of cadmium-poisoned women when I found out that one-fourth of them had had a miscarriage during the period when they worked at the battery factory. One burst into tears when she said that she had suffered four miscarriages in the workplace.

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The respondents generally agreed that husbands dislike having an unhealthy wife who has problems having babies. Husbands would end the marriage relationship once they knew that their partner suffered from an occupational disease. Looking healthy, unmarried poisoned women, similar to many pneumoconiosis patients, thus tended to hide their illness from their boyfriends or husbands. A victim of cadmium-poisoning who later became an NGO worker told me that several former battery workers consistently refused to answer her phone calls in order to conceal their illness from their family members. For those who have managed to have a successful pregnancy, the health of their offspring is usually problematic. Their children usually possess a high degree of susceptibility toward infectious diseases such as influenza. One respondent choked up with emotion as she reveals that her six-year-old son was recently diagnosed which hydrocephalus – a disease which she believes to be related to her own disease. Feeling handicapped to fulfill their culturally normative roles, cadmium-poisoned women often experience discrimination from their in-laws and extended family members who blame them for bringing poor health to the younger generation. Like the pneumoconiosis patients, because the cadmium-poisoned workers look normal, the public sees the sick women as “strange” rather than “victims.” It echoes how occupational disease victims are considered being placed in a “zone of indistinction” in which the individuals are not recognized as a constituency by existing social institutions such as family. In fact, they would be quickly turned into cultural deviants when their identity as patients became known.

State violence and the rule of exception This chapter has shown how the character of occupational disease patients is elided between the public and the private, the productive and unproductive, and the culturally normative and deviant in situations where the biopower inherent in the specific set of social regulations and power relations has been exercised rather efficaciously. Akin to the situation of bare life, their political life is marginalized as a basic level of legal rights; material living and social well-being are no longer protected. One consequence is that the marginality experienced by occupationally sick workers gains no sympathy with the public. As emphasized earlier, such a public scotomization does not necessarily infer their political exclusion. Rather, Agamben suggests that bare life is the “inner hidden norm” of modern sovereignty, and “gradually begins to coincide with the political realm” (Agamben 1998: 130). Calling it a “disjunctive inclusion,” Ziarek explains that bare life “still remains the target of sovereign violence” (Ziarek 2008: 91). What I mean here is that when the occupationally sick workers attempt to resist existing social regulations and power relations which render them the status of homo sacer, they – in Agamben’s words – nakedly confront violence “without any mediation” (Agamben 1998: 171). In speaking of the capacities of bare life in subverting the sovereign control, Leung and Pun (2009) seem to portray a rather optimistic picture. In their study of

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pneumoconiosis patients in the gemstone industry, they examined the process in which workers’ resistance had developed from a single means to multiple means, from single-factory to cross-factory participation, from engaging only in legal action to launching collective action. However, if our gaze is extended beyond a single-time, single-place case study, it becomes apparent that the resistance of occupational disease victims is actually rare. Such a phenomenon can be understood in terms of the ambivalence of the target of resistance. As mentioned earlier, once the employer notices a worker suffering from an occupational disease, he or she would use a variety of means to sack the workers in order to shrug off the responsibility of paying compensation. In the case of gemstone/jewelry workers, many had received minuscule compensation and signed an agreement with the company that their dispute with the company had been settled. Only a small proportion of workers resorted to legal redress by taking their employers to court. But very often, the court’s rulings favored the employers, the result being a convoluted process involving seeking resolution through administrative reviews, pursuing labor dispute arbitration, and taking the case to court again and again. In these cases, both the employers and the court seem not to be the targets of resistance as everything has ostensibly followed the rule of law. There were cases where the workers felt that the employers had bought off the court, and that the rulings were unjust. Sick workers might stage protests in front of the court, and the case in Haifeng resulted in a prolonged protest lasting over a year at the Haifeng mid-level court.16 However, since everything is done according to the law, sporadic resistance does not possess a “rightful” basis.17 The slogan “Demanding a just ruling” usually chanted by resisters in their protests was essentially a moral accusation rather than a discourse that possessed legal substance. This phenomenon harks back pointedly to what had been discussed in the notion of homo sacer, that bare life is not located outside juridical power and made indifferent to it. Rather, homo sacer is produced exactly due to the marginalization enforced by the legal framework. It is under such a juridical order of exception that bare life is “exposed and threatened on the threshold in which life and law, outside and inside, become indistinguishable” (Agamben 1998: 28). In Hunan, four coal mine workers interviewed said that they were once approached by a labor arbitrator who offered to help to them for free. However, the lawyer was eventually found to be related to the employer as the lawyer attempted to threaten and intimidate them and push forward a compensation deal in favor of the employer. In Guangdong, victims-turned-activists employed by Hong Kong NGOs complained that their work to help occupational disease victims faced constant harassments from the state. All the victims-turned-­activists found themselves blacklisted when they were denied visas to go abroad to protest against their former employers during “politically sensitive” periods such as the 2008 Beijing Olympics. State officials had kept pressurizing landlords not to let apartments to an NGO that would act as a workers’ center. Even when there was a group meeting at the center, attendees would come at different times and leave individually or just in small groups. On a few occasions when the gathering was large, they triggered notice from resident committees and the arrival of police

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who questioned them on their activities. In Haifeng, five gemstone workers suffering from pneumoconiosis protested in the front of the court for over a year. Their demand was to press local judges to force their employer to compensate workers according to a previous court ruling. Their action of holding up banners and shouting slogans was occasionally met with physical violence from the security guards. On several occasions, workers were seriously assaulted. The most serious bloodshed occurred in August 2010 when over a hundred cadmium-poisoned workers protested outside the battery factory in Huizhou.  The protestors were beaten up by around a hundred-strong mob of unknown origin. One worker was seriously injured and subsequently hospitalized alongside another dozen workers. Denying any connection with the mob, the factory refused to pay for any resulting medical expenses, and the workers had to raise funds among themselves in order to pay the hospital bills. When narrating their experiences of resistance, respondents all strongly stated that their demands went unheard, their rights were dispensable, and their lives miserable: “No police came after dialing 110”; “No one cares when we go to the police station”; “We called the media, but no journalists came”; and “We looked like neither humans, nor ghosts.” Implicit in such an exercise of power is that the lives of the occupational disease victim becomes an object and target of power through which the state (or the state-backed force) deploys different technologies, including legal and social means, to control the freedom of the governed. This explains why most victims experience deprivation of legal recourse by various means, and feel that they are considered social “problems” both economically and culturally. When the state sees that the resistance of occupationally sick workers poses a threat to the social order, the state exercises its power to “ban” all relevant laws, social regulations, and established principles of human conduct. Clearly aware of the power to activate such a rule of exception, victims of occupational disease live in the shadow of implicit threats, and behind them all lurks the cruel face of state power – the power to reduce them to a state analogous to that of bare life. The creation of homo sacer thus represents the latent power of the state to marginalize, exclude, or even dispose of unwanted people in the name of growth, progress, and development. What has been examined above is a portrayal of sufferers of occupational disease as biopolitical subjects whose lives are located neither inside nor outside “normal” political, economic, and cultural practices. These people fail to be categorized as “normal” in the population; or in the experience of the sick workers, they are self-described as “without suzhi,” “strange,” “useless,” “rubbish people,” or “neither human nor ghost.” They are at once both internal and external to society. They occupy a socially constructed and maintained space designated for those who are abnormal, or fundamentally the other (Draus et al. 2010). In the face of state power, they are placed in milieus where the law can no longer afford them protection, and are reduced, theoretically speaking, to a state analogous to that of bare life. They become a “tabooed” people who are always susceptible to policing and violence while simultaneously banished from society by a variety of formal and informal mechanisms of exclusion: legal, economic, and social. It is

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exactly this biopolitical power to ban, the abandonment of subjects to a condition of bare life, that strips them of basic political rights (Agamben 1998: 29) and constitutes the origin of sovereignty in terms of rule by exception. One consequence is that when a small number of victims attempt to resist the power structures, they experience oppression either enforced or endorsed by the state, which cannot be effectively countervailed by any possible public means, neither legal nor mass media. The accounts in the following chapters will offer further empirical support for this claim.

Notes  1 For example, a keyword search through the EBSCOhost database in February 2012 pulled up 1,191 entries for “China” and “labor” and 1,227 entries for “China” and “worker” appearing in the abstracts. The figures dropped to one and two respectively when the keyword “occupational disease” was added to the search.  2 On the ambiguity of the notion of bare life in Agamben’s work, one may read Mills (2004), Patton (2007), and Durantaye (2009).  3 To Agamben: “The ban is the force of simultaneous attraction and repulsion that ties together the two poles of sovereign exception: bare life and power, homo sacer and the sovereign” (Agamben 1998: 110).  4 A similar point has been raised by Draus et al. (2010) in the case of the marginalization of drug addicts.  5 Zhiwai, born 1970; interviewed in Shenzhen, May 26, 2011.  6 Dangshang; born 1972; interviewed in Huizhou, May 20, 2010.  7 Cuishan; born 1961; interviewed in Lianyuen, July 3, 2011.  8 Interview with Wang Keqin, March 21, 2015, Beijing.  9 I observe that the increasing bureaucratization of the market and the lack of a vibrant civil society have led to more frequent occurrence of politically contentious disputes in which resisters are increasingly portrayed as “uncivilized,” hence subjected to a field of biopolitical techniques and practices. For example, persistent petitioners in the national capital are regarded as dissidents, or even mentally disturbed. An example from March 2009 is a case in point. Psychiatrist Sun Dongdong from Peking University told a magazine that 99 percent of persistent petitioners were paranoid and mentally disturbed, and should be forcibly sent to mental hospitals to keep them from disrupting the social order. 10 Ruihong, born 1971; interviewed in Huizhou, June 8, 2011. 11 Yangsheng, born 1972; interviewed in Shenzhen, May 26, 2011. 12 This quote was a “joke” shared by a pneumoconiosis-inflicted worker over a lunch with a dozen others diagnosed with the same disease in Shenzhen, May 26, 2011. 13 Yundong, born 1969; interviewed in Liangping, July 19, 2011. 14 Zewan, born 1970; interviewed in Shenzhen, May 26, 2011. 15 Mengguo, born 1973; interviewed in Shenzhen, May 26, 2011. 16 This story was told by four former gemstone workers from Haifeng (a city in Guangdong province) to Shenzhen for a focus group meeting on 26 May, 2011. 17 “Rightful resistance” is a concept widely applied in grassroots politics of contemporary China. See O’Brien (1996). This will be discussed in more detail in Chapter Five.

Part II

Responses to marginality

3

Cadmium-poisoned women: contesting for sick role status

My fieldwork with cadmium-poisoned workers b egan in Huizhou where I met Xuhong. Born into a poor family in rural Huizhou, Guangdong province, Xuhong went to urban Huizhou and became a battery-assembling worker in a factory called Advance (Xianjin, 先進). The factory was owned by a Hong Kong company, Gold Peak Battery International Ltd. It produces good quality batteries under the brand GP. The company has established supply agreements with some of the world’s biggest consumer brands, including Black & Decker, Canon, and  Casio. Since the company was a success, Advance together with two other factories – Power Pack (Chaoba, 超霸) also in Huizhou, and Jet Power (Jieba, 捷霸) in Shenzhen – became magnets for workers who aspired to a good and stable monthly salary in the early 1990s. At one point, the company employed over 2,500 workers in three factories. Like many other workers who joined the GP battery factories at that time, twenty-year-old Xuhong was required to pay the recruiting officer a bribe of several hundred yuan in order to obtain a position. That year, she began her career at Advance as a common worker at the assembly line. After half a year, she was promoted to line manager till she was diagnosed as having an “excessive cadmium level” (ge chaobiao, 鎘超標) in 2004. To Xuhong, and many sick battery workers I talked to in the field during 2011–13, their efforts to bribe the recruiting officer to hire them was rather ironic. Xuhong was popular among her fellow workers, most of whom were from Sichuan province, and she became a leader of the sick workers when the outbreak appeared in 2004 and led to over 500 cadmium-poisoned workers. Both Xuhong and Ruiping, another sick worker who worked at Power Pack, were later employed by Globalization Monitor (GM), a Hong Kong-based NGO, helping other cadmium-poisoned workers fight for their rights. Both Xuhong and Ruiping became my assistants during my fieldwork with cadmium-poisoned workers in Guangdong and Sichuan. What is exactly meant by “cadmium poisoning”? Xuhong gave me a detailed explanation. Precisely speaking, “cadmium poisoning” encompasses two different meanings: (i) “excessive cadmium level” refers to cases in which cadmium levels  in the body exceeds a specific l evel i n u rine ( over 5 µmol/L [ micromoles per liter]), or in blood (over 45nmol/L [nanomoles per liter]); (ii) “cadmium

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poisoning” (ge zhongdu, 鎘中毒) refers to cases that are pathologically more serious than “excessive cadmium level.” “Cadmium poisoning” – in quotation marks in this book – refers to an illness that has advanced to serious kidney malfunctioning with β2-microglobulin level in urine of over 5µmol/L, or with a urinary retinol binding protein level of over 5.1µmol/L. For the sake of convenience, unless specified, cadmium poisoning and cadmium-poisoned – mentioned in this book without quotation marks – refer to both conditions. Since workers suffering from “cadmium poisoning” (the second meaning) require hospitalization with treatment which the employer is held legally responsible for, Xuhong said that the employer often reduces the number of “cadmium-poisoned” workers by manipulating the results of diagnosis. At the time of my fieldwork, there were only seventeen workers diagnosed with “cadmium poisoning” and hospitalized in Huizhou Municipal Hospital for Occupational Prevention and Treatment. The view that the employer has been manipulating the diagnosis to reduce the number of “cadmium-poisoned” workers is widely shared among all forty-three cadmium-poisoned workers I interviewed in Huizhou (Guangdong) and Luzhou (Sichaun). Their estimates of the actual number of “cadmium-poisoned” workers ranged from four to ten times more than the number of workers currently hospitalized.

The outbreak What I am about to portray here is an experience-near account of the 2004 outbreak based mainly on primary data collected during fieldwork, including individual interviews and informal conversations with the sick workers, and several group conversations among sick workers I observed during and after meals in Luzhou.1 In the GP battery factories, workers produced nickel-cadmium batteries of which cadmium was a key constituent in battery production.2 During production, the workers were exposed to red-colored cadmium oxide powder – a carcinogenic substance which can cause long-term damage to body organs and tissues, especially the kidneys and skeletal structures. Xuhong told me that the appearance of cadmium oxide as a red powder later inspired documentary filmmaker Karin T. Mak who completed a film documentary called Red Dust.3 The twenty-minute film captures the lives of several cadmium-poisoned women, including Xuhong and Ruiping, whose physical pain had adversely affected their daily functioning, and how they had engaged in lawsuits demanding compensation from their employer under fear of state repression. At the end of 2003, workers at Advance and Power Pack started falling ill and two workers at the latter factory died. The workers at Power Pack’s milling shop began to panic, and some staged a go-slow campaign. The company management was alerted that the cause of the workers’ illnesses might be due to the excessive cadmium levels in the workplace. In December 2003, Power Pack arranged doctors to draw blood from the first batch of workers for testing, and conducted testing for the second batch in February 2004. Those who were found

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with a serious excess of cadmium were sent to hospital. Since Advance and Power Pack are both located in Huizhou, and many of their workers had come from rural  Sichuan, the news of the sickness and deaths quickly spread from Power Pack to Advance. Xuhong and the majority of the cadmium-poisoned workers I met in Luzhou had been working at Advance. At the close of 2003, they began to worry as they heard that the cause of the deaths were work related. Workers at Advance also began to demand that the company offer better protection and benefits to them. Shaonan, one of the workers at Advance, describes it most vividly: In late 2003, we [who were working at Advance] heard that two workers at Power Pack had died, and that the cause was work related. We were scared and we began to realize that maybe the protective measures the company took might not be enough. We required senior management to issue better 3M masks to us, but they refused. They thought that the 3M masks were too expensive. According to what they said, a 3M mask cost 3.8 yuan, whereas a paper mask only cost twenty cents. They were just saving money at the expense of workers’ lives. We wrote a statement in protest, demanding a salary raise and the provision of 3M masks. The statement was circulated among workers. But they refused and the workers did not do anything more after that […]. In March 2004, three workers paid to get their cadmium levels tested at Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment. They were all diagnosed as having excessive cadmium levels. The doctor told them that their disease was incurable. When they returned to the workshop and shared this news with other workers, everyone thought that the disease was like cancer and that those who had excessive cadmium levels would die very soon. We all panicked. Workmates on the second assembly line did not want to work anymore. […] They demanded a salary raise, better protective measures for workers, and a body check for all workers. But the management did not agree. Workmates on the second assembly line then went on strike. Despite the management’s repeated efforts, the workers refused to resume work. These workers encouraged those on the third assembly line to go on strike as well. The management could not but agree to the workers’ demands.4

Workers’ testimonies from both factories revealed that the company’s persistent negligence of occupational safety and non-compliance with related laws had put their health at risk, resulting in their illness. Workers were provided with neither effective protection nor occupational safety training.5 Many accounts from workers suggest before the 2004 outbreak that the work situation in the two factories had been dusty, and workers had not been given any effective protective measures when handling toxic substances. For example, Meiyan who was working at Power Pack said: Around September 2000 onward, the management refused to provide anti-dust face masks for the powder shop [fenfang, 粉房]. They just gave us a packet of single-use masks, which is cheap. I heard that these masks are worth just fifty cents each. A mask of this kind did not possess any effect to screen out dust.

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Responses to marginality […] I heard that it was the idea of the factory chief Xie Qijiang and the production department manager Liu Xinhua. Superficially, it was a measure to cut costs, but it was a way to curry favor with the boss, and pursue personal interests. […] Without the anti-dust face masks, I felt that I was becoming more unwell the longer I worked. I often felt cold and dizzy.6

Similar complaints were heard from workers at Advance; for example, Xuhong said: At that time [in the 1990s], maybe owing to the backwardness of machines, batteries were difficult to manufacture. Workers had to work overtime without extra payment in order to meet production goals. Since there was neither warnings concerning the toxicity of the nickel-cadmium batteries, nor good-quality protective measures [e.g., clean protective gloves] provided to us, many workers’ hands became blistered. The milling shop which was full of reddish cadmium powder was very dirty and smelly. The conditions were exceptionally poor during hot weather when fans blew the powder everywhere. … The shop became very foggy. When the fans blew, workers’ hair, noses, and faces were all covered with the reddish powder. […] After working some time, more than 80 percent of workers’ noses began to run, and they all suffered from rhinitis and faucitis. The senior management paid no attention to workers’ health. They only gave us paper masks that had no protective effect whatsoever. … These masks would be punctured just by a sneeze of the worker. […] In order to cut costs, the management just gave workers used gloves which had been washed. This had led to the blistering and festering of workers’ fingers.7

From March to May 2004, dozens of workers from the two factories paid for their own tests and found that their bloodstream contained excessive levels of cadmium. In early May, seventeen workers from Power Pack, who had paid for their own tests and were found to have excessive levels of cadmium, went on strike. The company, however, denied the accuracy of the tests and refused workers’ demands for an official examination. Some workers then complained to the Guangdong provincial and Huizhou municipal governments. With intervention from the government officials, the company yielded to pressure, and took steps to arrange for all workers from both factories to have their blood tested during May and early June 2004. The management first held up the test results, then, upon pressure from workers, distributed to each worker a strip of paper with the worker’s name and test results on it. To prevent further panic among the workers, both the management and local government hired so-called “medical experts” to assure and advise the workers that that human body could discharge cadmium through urine by “drinking more water.” Unconvinced, workers from both factories went on strike to press management to give them the original blood test reports, and they succeeded. In June 2004, among 540 assembly line workers at Power Pack who had blood tests, 126 were found to be suffering from excessive cadmium levels; at Advance, of 450 assembly line workers tested, more than 130 were diagnosed with excessive cadmium.

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Shiwai

3.1  Shiwai’s paper strip, indicating name and the level of blood cadmium. In Luzhou, I stayed at the home of Shiwai who had worked at Advance since 1992. When speaking of the blood test organized in June 2004 by the management, she immediately rushed back to her room, and brought back a plastic bag full of related documents. She said that she wanted to keep all materials intact as she said: “Even if I am destined to die [of the disease], I don’t want to die without a cause (wo buxiang side buming bubai, 我不想死得不明不白].” She first took out a strip of paper and said: “This is the paper strip I talked about. We did have a fierce quarrel with them [the management]. We said that we would not resume work. […] You see, what a medical report is this!?” (Figure 3.1). Then, she showed us a piece of paper, and said: “About a week later, they gave us this, the medical report. But still, the quarreling went on. … Look! There was no official chop on it (Figure 3.2). How could we know that it was not fabricated somewhere!? We simply did not trust them. Then, finally, they gave us one with the chop (Figure 3.3). […] So, we had many quarrels, and we got something extra for every quarrel we engaged in.”8 Shiwai’s reports indicated that she was suffering from an excessive cadmium level as the cadmium level in her blood had reached 90 nmol/L, which is double the highest acceptable level according to medical standards. Shiwai said she was one of the workers having the highest level of cadmium in their blood at 300 nmol/L. At Advance, Shiwai, and 130-odd other workers, including Xuhong, who were also diagnosed as having excessive cadmium levels fell into a panic. At an informal meeting after a lunch in Luzhou, five former workers at Advance, including

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Shiwai

3.2  Results of Shiwai’s blood cadmium test without an official chop.

Shiwai

3.3  Shiwai’s blood cadmium test result with an official chop.

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3.4  Sick workers reminiscing about the past over a lunch in rural Luzhou. Xuhong, Shiwai, and Shaonan recalled the situation once they had received the test report in June 2004 (Figure 3.4). Shaonan said: I still cannot forget the feeling when I was diagnosed with excessive cadmium. It seemed like the end of the world to me. Workmates cuddled each other and cried, and we all thought that we would die very soon. … Factory manager director Xi Yingguang who came from Hong Kong reassured us that we did not need to worry about the illness. He said that as long as we stayed away from the work environment for a few days, lived in the hospital that the factory arranged for us, and drank as much water as we could, the cadmium inside our bodies would be naturally excreted out. … All these things finally turned out to be lies.9

With so many workers suffering from excessive cadmium levels, it was the workers at Advance who took more radical action to press the management to offer medical treatments to the sick workers. Being one of the emerging worker leaders at Advance, Xuhong recalled: After that [knowing the test results], workers were very pessimistic as if it was the end of the world. They were in no mood to work. […] However, the senior management did not want to take responsibility for our illness. […] They even put up a notice saying that those who left their positions for three days or more would be regarded as having voluntarily resigned. […] They also said that those who would like to continue to work would be awarded 500 yuan. […] Some workers

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Responses to marginality were swayed by the notice and wanted to resume working. Workmates on the second assembly line scolded them, and persuaded them not to fall into the management’s trap. […] One worker saw in the newspaper that the same incident had happened in Japan [many years ago] as well, which was called “ache-ache disease” [itai-itai disease, イタイイタイ病], and that it could be passed on to the next generation. […] Workers were so scared and more than a hundred people left immediately. […] We were all very frustrated and fearful. But they still told us that if we did not want to work, we could just leave. We were extremely mad! Workers then discussed with each other that even if we leave, we should do so after our disease was cured. We demanded the management send us to the hospital for treatment. However, they declined. We then decided to block the gates of the factory and then the highway outside the factory. […] The management had no choice but to arrange for us [sick workers from both factories] to go to the hospital for treatment from 29 June 2004.10

With the workers’ collective action, the Huizhou municipal government stepped in again. They set up a task force stationed at Power Pack to deal with the workers’ unrest at both factories. The company then organized urine cadmium tests for all workers. This time, the management announced that the urine cadmium test would be more accurate than blood cadmium in determining the cadmium level in the human body. Subsequently, over one hundred workers at Power Pack who were found to be suffering from excessive cadmium levels were sent to Huizhou municipal hospitals for a week’s treatment, and another twenty-two workers with more serious conditions to Guangdong provincial hospitals for six weeks. As at Advance, over a 130 were diagnosed as having excessive cadmium. They were later sent to Huizhou municipal hospitals for two weeks. When all the sick workers were discharged from hospital, they were told that their health was “normal.” Shiwai shared her story with me about her hospitalization in July 2004. She was admitted to Huizhou Municipal Hospital of Chinese Medicine on July 15, 2014. On the first day, her urine cadmium report indicated 47.2 µmol/L (Figure 3.5), which was a lot higher than the highest acceptable level of 5 µmol/L according to medical standards. Shiwai said that she was the second most serious patient of all the sick workers at Advance. She said: “Officials from Huizhou municipal government came to visit us. They told me not to worry as I [being a serious case] would be transferred to a provincial hospital in two weeks’ time.”11 However, after thirteen days in hospital, her urine cadmium level report showed that her level had dropped to 28.0 µmol/L (Figure 3.6). Other sick workers also received reports  of varying degrees of decreases in urine cadmium. As a result, only a couple of workers were transferred to the provincial hospital. On July 28, the hospital ordered that all other workers be discharged. Finding the reports unbelievable, most of the workers stayed in the hospital and refused to leave. On the night of July 29, dozens of police arrived and forced all the workers who refused to leave the hospital into three big trucks. “It was a heavily raining night. Many workers were crying,” according to Shiwai. After being discharged, Shiwai and several other sick workers went to petition different administrative departments, including the health bureau, labor bureau,

Cadmium-poisoned women

Shiwai

3.5  Shiwai’s urine cadmium test result, indicating a level of 47.2 µmol/L.

Shiwai

3.6  Shiwai’s urine cadmium test result, indicating 28.0 µmol/L.

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Shiwai

3.7  Shiwai’s urine cadmium test result, indicating a level of 17.3 µmol/L. and the municipal office. Not believing the last test result, Shiwan paid for her own test in the local CDC center. However, unlike what had happened in the past, the CDC center refused to conduct a test for urine cadmium itself, which cost only 80 yuan. Instead, the CDC center would only help those workers who were willing to pay 300 yuan for a basket of tests including urine cadmium. Suspecting that the CDC center was in collusion with the company and the local government to demotivate GP battery workers to get them not to do the test, Shiwai still opted to pay for this expensive test. The result she obtained on August 24 indicated that her urine cadmium level had dropped even further to 17.3 µmol/L (Figure 3.7). “Shortly after just forty days, my urine cadmium level had dropped as much as that! Would you believe it?! I surely do not believe it!” Shiwai exclaimed.12 Owing to huge discrepancies between test results, sick workers’ grievances resulted in intermittent resistive action involving go-slows and strikes in both factories. In August and September, the management began to find the situation intolerable and forced the workers to resign “voluntarily” and accept minuscule compensation. The compensation scheme was as follows. Each worker obtained: i) a lump sum compensation in proportion to the number of years of service (one year in service is equivalent to one month’s salary); ii) six months’ standard wage; iii) a one-off compensation (e.g. 3,000 yuan for the first time the worker is diagnosed with an excessive cadmium level; 8,000 yuan if diagnosed with

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excessive cadmium level two consecutive times; and 20,000 yuan if diagnosed as “cadmium poisoned.” According to my informants, about four-fifths of affected workers in both factories signed the resignation agreement and obtained compensation. Following the action initiated by the workers and pressure from the Hong Kong mass media, the company later agreed – starting from 2005 – to let the workers who had resigned to return every year for medical tests to check their cadmium levels. My last update by mid-2013 suggested that 253 workers had received or were currently receiving an annual medical checkup. When it began in 2005, only about 110 workers returned to Huizhou to receive the annual checkup. The number has been increasing as more and more workers began to realize the problems of cadmium poisoning, and are willing to return to Huizhou for the checkup. However, each year, eight to ten workers would be diagnosed as “normal.” And, if a worker is diagnosed as “normal” for two consecutive years, she would not be entitled to the annual checkup. In mid-2013, 165 workers were included in the annual checkup scheme. Among the 253 workers mentioned earlier as having received or who were currently undergoing annual medical checkups, 104 were living in Huizhou or peripheral regions, while the remaining had returned home. Those who stayed included thirty-eight workers from Guangdong province, and sixty-six chose to stay in Huizhou or its peripheral regions to work and live. Seventeen workers were also hospitalized after being diagnosed with “cadmium-poisoning.” These workers constitute the target population of my fieldwork, which will be further examined in the coming sections.

The stayers Almost all workers who continued to stay in Huizhou after the 2004 outbreak were from Advance. The major reason was that Power Pack started operations before Advance and the former attracted peasant workers from relatively ­better-off rural areas.13 Thus, many who worked at Power Pack after the outbreak chose to return to their rural homes after the outbreak. Since most workers from Advance came from relatively poor and remote rural areas, more of them in fact preferred to stay in Huizhou than their counterparts at Power Pack. Perhaps for the same reason, workers from Advance were more united in their fight for compensation. My interview with cadmium-poisoned workers usually began with the workers telling me of their deep regret at having worked for the company. The following echoes the general sentiment of most workers: To have worked in that factory is something that I will feel the most regret about in my life. I left my home hoping to earn money. My time has been wasted. I have earned nothing. All I got were illnesses all over my body (dele yishenbing, 得了一身病)!14

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Juxtaposed with feelings of regret were complaints about their physical suffering, which included headaches, back pain, throat infections, and insomnia. While these symptoms appear to be minor, the severity and persistent pain have greatly impacted their daily lives. For instance, it was common to hear them complain that their body pain had resulted in their inability to sleep uninterrupted throughout the night, or simply had made them unable to get out of bed, and that the condition could last for weeks. Some reported that their throat infections could not be cured even after months of medication. Sick workers generally expressed a significantly lower quality of life in their post-illness lives. All informants reported that their illness had adversely affected their normal work lives. Some related the experience of rejection from employers upon learning that they were ex-GP battery workers. These employers would cast doubt on the health status of ex-GP battery workers and fear that they were “troublemakers” and that these new employers themselves might be held legally responsible for the workers’ occupational disease. Unable to find full-time jobs in sizable companies, many who stayed in Huizhou took daily or hourly paid work (e.g., on construction sites). A small number chose to set up small businesses selling food and groceries. These coping strategies, however, seemed to be ineffective in helping them escape economic marginality as over half of the cadmium-poisoned workers reported being in serious debt. Apart from economic hardship, their diseases also led to insurmountable family problems. In a group meeting with sick workers staying in Huizhou, I was shocked to learn that four out of the twelve informants involved had experienced  at least one miscarriage during their working life at the factory. One informant burst into tears, revealing that she had experienced four miscarriages. They generally agreed that their husbands disliked unhealthy wives, particularly because unhealthy wives might give birth to unhealthy babies. Stories about how husbands ended the marriage once they knew that their wives were suffering from an occupational disease were shared among the informants. As they looked healthy on the outside, cadmium-poisoned women are able to and would tend to hide their illness from their boyfriends or husbands. Both Xuhong and Ruiping told me that several former workers consistently refused to answer her phone calls in order to conceal their illness from their families. These responses suggest the social stigma attached to the disease, and the patients were not willing to acknowledge their illness because they thought it would lead to social marginalization.15 For those who had managed to have babies, the health of their offspring was usually problematic. As mentioned in Chapter Two, sick workers usually reported that their children were constantly affected by health problems, ranging from less serious infectious diseases, such as influenza, to more serious hydrocephalus. Feeling that their children’s health problems were related to the excessive cadmium level in their bodies, cadmium-poisoned workers generally expressed a sentiment of being handicapped in fulfilling the normative role of continuing the family line according to Chinese cultural tradition. It was common to hear that they experienced discrimination from their in-laws and extended family

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members. Xuhong shared her anguish: “I feel very angry about my mother-inlaw who keeps saying that the poor health of my son is due to my disease. I will remember that until the final second of my life!”16 Another victim-turned-activist, Ruiping who came from a poor village in western Hunan (Xiangxi¸湘西) bitterly admitted that: I cannot return to my village … We belong to an ethnic minority, and the people there have a very conservative mindset. They will never understand why a woman at my age does not get married; or if I do get married, they wouldn’t understand why a woman would not have babies or those who have babies are [physically] problematic.17

The lack of understanding of the disease in society further increases the feeling of social estrangement among the sick workers. For example, some informants told me that some of their friends and relatives even wrongly thought that their illness was contagious. The sick workers thus would feel isolated when they found that their significant others suddenly turned into cold-hearted onlookers oblivious to their suffering. While the literature suggests that family support plays a central role in the care of people suffering from a disease with social stigma (He 2010), the notes from the informants however reflected family estrangement: When I think of this occupational disease and my future, I feel like having a  nervous breakdown. My sickness gives me huge pressure. I cannot hold my head up. I look like a normal person, but only lead “half a life” (ban tiao ming, 半條命). When I think about my problems, I just cannot sleep. When I think of my husband, my children, my parents, I just cannot accept my life anymore.18 Our society is full of love; if a person gets into trouble, others will help. But when it comes to occupational diseases – a hidden killer – that cannot be seen, I am afraid that it is very difficult for those without personal experience to understand. … [I] felt the wind was pretty strong and the temperature colder than yesterday. I felt as if I was sleepwalking through unfamiliar streets.19

Apart from feeling like “strangers” in their economic and familial milieus, cadmium-poisoned women also stated that they felt marginalized as citizens when they faced issues of law and order. The meaning of the “rule of law” and “protection of rights” (weiquan, 維權) was never questioned before they contracted the disease. But, when they endeavored to take the legal route to obtain compensation, they realized that the legal system actually poses an insurmountable obstacle to their rightful claims. As readers should now be fully aware, China’s OHS system stipulates, as a key principle, that employers are responsible for the compensation of employees who sustain an injury at work, and it is thus made mandatory for employees to prove evidence of an employment relationship between them and the employer. However, as mentioned earlier, many workers were forced or persuaded to sign resignation agreements in 2004. Those who resigned thus felt helpless in the face of the law when they attempted to fight for (greater) compensation.

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The law also requires sick workers to obtain medical proof in accredited clinics or hospitals to certify that the disease they are suffering from is work-related. In reality, medical professionals were often bribed by an employer to produce fake diagnoses. It was common to hear informants assert that they had been diagnosed with an abnormally high blood cadmium level in medical centers or hospitals located in the workers’ home provinces. For example, in Luzhou, Shiwai told me the story of her elder sister who had being working at Advance for ten years. “Her test result from the factory was 3.9 [µmol/L of cadmium in the urine]. She did not believe it. She went to the clinic and did [i.e., paid for] the test herself. She received a result of 24.3 [µmol/L].”20 However, when the affected workers were diagnosed in the accredited institutions, the outcomes – very often – were “normal-ed” (bi zhengchang, 被正常).21 The present legal framework is even more problematic because, unlike other occupational diseases such as pneumoconiosis, the assessment does not offer a gauge of the damage level to labor capacity for those who suffer from cadmium poisoning. Therefore, there is no way that the level of compensation can be determined.22 A contributing factor is the lack of pathological evidence to establish accurately how different degrees of cadmium poisoning are associated with loss of work capacity. Cadmium poisoning is thus considered a “contested” illness with its cause unascertainable in the medical scientific domain; hence its legal liability becomes a site of contestation (Brown 2007; Moss and Teghtsoonian 2008). Cadmium poisoning is also akin to what Dumit (2006) refers to as an illness “you have to fight to get.” Dumit remarks that for some “new” illnesses without established medical evidence, patients must then “prove” their illness and their suffering through mobilizing the facts; or doctors, government, and insurance agencies would deny the patients a social sick role and even deem them “just plain crazy” (2006: 577–8). In essence, while sufferers of cadmium poisoning report a significant reduction in the functions of their everyday life, and in their health status and quality of life, there is a lack of well-established biomedical evidence proving a relationship between the severity of the disease and its impact on patients’ well-being. Seen in this light, the compensation accorded to workers was contingent upon court judgment, pressure from the media, and the attitude of the employer and the local government. For example, in 2007, a group of eighty-five workers filed a lawsuit against a company for not providing healthcare support to those with excessive cadmium levels. The case was reported on the national broadcaster, China Central Television, and the company also came under pressure from protests targeted at buyers of GP batteries in Europe. The court finally passed a judgment that the employer needed to pay no less than 300 yuan per month to every sick worker for purchase of health supplements. However, as mentioned in the Preface and Chapter Two, the sick workers only received calcium tablets of low quality, and the milk powder contained melamine, causing many I interviewed (twelve out of forty-four workers – 27.3 percent) to suffer from kidney stones. Another bitter win was registered in 2010 after a series of painful struggles. This emerged in 2009 when workers of Advance and Power Pack in Huizhou

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found out that the company offered greater compensation to cadmium-poisoned workers at Jet Power located in Shenzhen. When Jet Power closed down in 2009, each of the sick workers received about 15,000 yuan in total and an additional 300 yuan each month as a nutrition fee.23 However, workers in Huizhou did not get the same treatment when they left the factory in 2004. A lawsuit, in representation of 152 workers in Huizhou, was filed in late 2009 in the local court to fight for equal treatment for the workers in Huizhou. The workers expected to receive a court judgment six months later. However, when the court did not issue a ruling in June 2010, they feared that the court, which was allegedly complicit with the employer, had adopted a delaying strategy. Several workers’ leaders, including Xuhong and Ruiping, planned to organize a rally which could last for months till November 2010 when Guangzhou – capital city of Guangdong – would be about to host the Asian Games. Xuhong and Ruiping said that since July 2010, they had trained among themselves like military troops, including rehearsing what slogan to chant, who was to supply food and water, and who was to watch out for police or other people who might interfere in and sabotage the rally. They told me that their strategy was to have fewer workers rallying in the morning, and more in the evening; and to have fewer in August and more in November. All these strategies were designed to show the company that the rally was gaining momentum with time. From August 15 onwards, dozens of cadmium-poisoned workers rallied outside the court. They held a banner with “Demand for fair judgment” (yaoqiu gongzheng panjue¸要求公正判決) written on it and chanted slogans: “Same disease, same compensation” (tongbing tongchang, 同病同償), and “Sternly punish the murderer” (yancheng xiongshou, 嚴懲兇手) (Figure 3.8). To attract wider attention,

3.8  Workers rally outside the court building in Huizhou.

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they kneeled down together in front of the court building. The act of kneeling had brought unintended disturbance to the court staff as the gesture represents the Chinese way of paying tribute to the dead – thus perceived as inauspicious. Apart from violating a cultural taboo, the workers caused another problem by occupying the lobby of the court building for three nights. The court authority demanded that the workers leave the premises. As the workers refused to yield, the police were called in to expel them from the court building. The workers were crowded into a big truck and were taken to the “help station” (jiuzhu zhan), which is a place for detaining people “with problems” (you wenti) or people who “sabotage social harmony” (pohuai hexie), but the workers were not formally charged according to the normal legal procedures.24 As conditions at the help station were unbearable, the workers agreed with the authorities that they would not occupy government buildings again and were later released. They then decided to shift the site of their rally from the court building to the Power Pack factory. On the morning of August 24, the protesting workers were surrounded and beaten up by a group of over one hundred people whose identities were not known. In the assault, two workers were badly injured, and a dozen more were hurt in varying degrees of severity. Xiaohong (born 1969) was one of the badly injured. She reported that she was pulled out by the men and was punched in the face. Her nose was broken and bled severely. After the attack ceased, she shouted to her accompanying workers: “Take a photo!! Take a photo!!”25 (Figure 3. 9).

3.9  Protesting outside Gold Peak Battery International Ltd, Hong Kong after its violent suppression.

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When recalling the incident, many informants seemed still to be in shock; one informant who was with Xiaohong said: “Xiaohong was bleeding seriously and several others fainted. We thought they might die …The rain just poured heavily. We were in deep sorrow. Our situation at that time was really desperate!”26 Another informant who was outside the factory at the time of the assault narrated in tears: “My daughter was with me. When I was beaten, I heard my daughter cry, “Don’t hit my mother! Don’t hit my mother!” It was really miserable.”27 All the workers believed that the assault was part of a well-thought-out plan. First, the two victims-turned-activists – Xuhong and Ruiping – in fact decided to leave the crowd that morning. They had to attend a meeting called by the judge in charge of hearing their case. The day before, the judge suddenly changed his attitude and told them over the telephone that he would rule in favor of the workers and asked for a meeting the next morning. Xuhong recalled: We did have a good discussion with the judge. He agreed with everything we pressed for. […] In the middle of the meeting, his mobile phone rang. He took up the phone and the voice from the other end was so loud that even we could hear it clearly. […] The voice first asked him [the judge] whether we had come for the meeting. […] Then, we heard the voice say: “I have already arranged over one hundred people to deal with them.” […] Knowing that we were listening attentively, the judge cut the line abruptly. … We did feel that there was something wrong, but we just kept silent. It was because we were too carried away by the positive attitude of the judge. […] When we later heard that they [the protesting workers] were beaten, we then knew that the judge belonged to their [i.e., the company’s] clique!28

Even the manner in which the workers were beaten was said to be “thoughtfully organized,” as one worker described: Many elderly women holding sticks first came and surrounded us. We knew that something bad was going to happen, but we did not know what to do about these old women. All of a sudden, these elderly women began to beat us with sticks … or their umbrellas. Immediately, young men at the back [of the elderly women] rained fists on us. … Obviously, this strategy was pre-arranged.29

In the assault, the police were said to be accomplices of the perpetuators. One worker who was beaten outside the factory said in an agitated tone: “Just before the men [i.e., the mob] entered the place, a policeman on his motorcycle came in. He drove away after going around in a circle. […] The police must be involved!”30 When the workers later found out that the company had refused to pay for the medical expenses of the injured, they turned to the Petition Bureau. To their surprise, the officials at the Petition Bureau asked them to go to the Police Bureau, where the workers actually received reimbursement for their medical expenses. This constituted another piece of evidence that the police were involved.

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Two years after the incident, the informants were still filled with rage, shock, and a deep sense of helplessness when I met them during my fieldwork. Facing imminent threat, the workers had called the police, the ambulance service, and the local media. However, no one came to their rescue. Xiaohong said, “No police came after dialing 110!” 31 Another echoed, “We called the media, but no journalists came!” 32 In this scenario, the injured workers could not but walk away slowly from the scene in the heavy rain until the ambulance arrived thirty minutes later. During their stay in the hospital, no doctor was willing to treat them. Xiaohong said that a “kind-hearted” doctor persuaded her to leave after being in the ward for several days. He explained that the injured workers were taking very poor-quality medication worth only three yuan per day. At the time, outpourings like “We looked like neither humans nor ghosts” (ren buxiang ren, gui buxiang gui¸人不像人, 鬼不像鬼) were common. Their frustration intensified because no one came to their aid. A rightful protest had suddenly turned into a brutal battle with the whole process under the coordination of the local government, and apparently also being manipulated. The bloodshed shocked the Hong Kong-based NGOs which had been assisting the workers. Protests were organized at the company’s headquarters in Hong Kong (Figure 3.9). The main owner of the factories Mr. Lo Chungwing is not only a Hong Kong capitalist but also considerably influential in Hong Kong’s political sphere. He was a member of the Executive Council of the Hong Kong SAR government (2005–09), and had a number of important official appointments, such as non-official member of the Advisory Committee on Innovation and Technology as well as of the Economic Development Commission.33 It is believed that Lo was willing to yield and compensate the workers after the violent suppression because he was a known personality in Hong Kong, and the incident had damaged his public image. Another factor leading to the success of the workers’ resistance is that the event aroused the attention of the media in Beijing. Xuhong was later told that Beijing’s News Weekly (Xinwen zhoukan, 新聞週刋) called up the head judge of the court and the mayor of Huizhou municipality to take up the case. The workers generally believed that the pressure from the court and the local government caused the company to finally yield to workers’ demands. The court later ruled in favor of the workers, and granted them a compensation claim of 6.03 million yuan. Although the lawsuit was brought by the 152 workers who filed the claim, 110 workers who did not file the lawsuit but who also suffered from excessive cadmium levels were also compensated. Each worker received between 15,000 and 25,000 yuan, making it the largest amount of compensation awarded since 2004. Furthermore, the employer agreed that the company would offer annual checkups till 2014 to those who were diagnosed as having an “excessive cadmium level” even if those workers had formally resigned. Within this period (2010–14), those who were diagnosed as “cadmium-poisoned” would resume working for the company, and would be entitled to law-stipulated occupational disease compensation with a monthly salary offered by the company, and medical expenses subsidized through social insurance. Understandably, the workers considered all these “awards” a bittersweet victory.

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The hospitalized At the time of my fieldwork, seventeen workers were diagnosed as “cadmium-­ poisoned” and thus hospitalized in Huizhou Municipal Hospital of Occupational Disease Prevention and Treatment. These seventeen workers were officially identified by the company’s management as having been diagnosed with an occupational disease. As stipulated by law, the company was required to re-establish the employer–labor relationship with the workers and provide them medical support if they had resigned. I met twelve of the hospitalized workers, four of whom had been living in the hospital for the longest duration, that is, for eight years (since 2004).34 All the hospitalized workers revealed that they literally had nothing “serious” to do every day. Speaking of the treatments received, they admitted that the doctors had no knowledge whatsoever of how to cure their disease. The medication prescribed to them was mainly to alleviate their symptoms, such as pain and viral infections. Health supplements, such as vitamins, were also given to them to better maintain their health. An informant from Jiangxi complained that she was sometimes unable to breathe even if she had received treatment; she also added: “My hair is falling out. … I feel pain all over my body, my head, my back, and the hospital has simply found no way to treat it. I feel really worried.”35 Missing her husband and ten-yearold son in the village, she expressed hope that she would fully recover. However, as soon as she had said that, all the other informants in the meeting chimed in almost at once: “This is just wishful thinking!” (zhe shi xiangde, 這是想的). The hospitalized workers actually appeared like normal people when they were not suffering from symptoms of their conditions. Their two main daytime activities were watching TV and playing with their mobile phones. The photographs of their living space portrayed the monotony of their everyday life (Figures 3.10 and 3.11). As the quality of hospital food was poor, some hospitalized workers jointly rented a small place near the hospital to cook their own meals (Figures 3.12 and 3.13). Cooking with fellow workers undoubtedly added some color to their mundane lives and painful existence of long-term segregation from their families in the rural area.36 Seeing no sign of real recovery, they generally agreed that what they were experiencing was analogous to an entire lifetime of “house arrest” (ruanjin, 軟禁). For example, a worker whose family was in Sichuan lamented over her plight: I have been living in the hospital since 2006 [five years at the time of the interview]. … After suffering from the disease, I have not received any effective treatment. Now, I cannot be with my family. This is virtually house arrest. … [I feel upset that] I am separated from my family members and cannot fulfill my filial obligations.37

A divorced worker from Guizhou told me of her distress that her long-term residence in the hospital had wrecked her marriage. However, despite being hospitalized, the workers were entitled to an “average salary for society” (sheping gongzi,

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3.10 and 3.11  Sick workers’ living arrangements in the hospital. 社平公資), equivalent to a monthly salary. This amount was generally higher than what they would receive in their village. They also felt fortunate that all their medical expenses were covered by the company as they suffered from far more complex symptoms than their non-hospitalized counterparts. For example, hospitalized workers reportedly suffered from serious illnesses such as kidney enlargement, hyperosteogeny, cyclomastopathy, hypertension, anemia, and subcutaneous hemorrhage. Therefore, if not for these financial provisions covering the medical expenses, they would have refused to endure such an endless “detention.” One needs to remember that according to the Law of Social Insurance for  Occupational Injuries, Article 33 states that the employer supplies a salary for twelve months, and then the period may be extended after a reassessment of labor capability but normally should not extend for more than twelve more

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3.12 and 3.13  The residence rented by hospitalized sick workers. months. For some unknown reason, however, the MoLSS did not require the hospitalized workers to be re-assessed after the twelve-month deadline. Xuhong guessed that the authorities might have been afraid that the reaction of the sick workers would be too harsh. She also suspected the hospital wanted to observe the ­“cadmium-poisoned” workers for longer as they were normally “hard-to-reach” subjects for medical research. When asked what the future has in store for them, they just said: “Can we still have any future?,” “We can only live like this,” or “We can only walk one step at a time” (women zhineng jianyibu zouyibu, 我們只能見一步走一步). Others simply responded by heaving a deep sigh followed by a reluctant smile. They seemed to realize that after the interview session, they would return to a doubly ambivalent world in which they were caught between behaving like a normal person (since

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they looked healthy) and being a patient with an incurable illness; between being a beneficiary and a victim of the compensation system; and between being a stranger (a non-local peasant in the city) and a well-established citizen (after working and living in the city for years).38 After the session, I had a personal talk with Xuhong to show my appreciation for the arrangements made to meet with the hospitalized workers. In response to  my observation that not all of the informants were talkative and willing to open  up, Liu said that all the hospitalized workers were considered “honest” (laoshi, 老實) – the Chinese euphemism for ineptitude and inarticulateness. She explained that the management “hand-picked” those who were diagnosed as suffering from “cadmium poisoning,” not on a pathogenic basis but on the degree of resistance they had shown against the company. She said that it was a shrewd strategy on the part of the management to choose workers who were willing to be hospitalized in Huizhou so as to demonstrate its magnanimity in taking care of the sick, and at the same time to maintain a more controlled environment for the company’s management in Guangdong.

The returnees During the authors’ field trip to Sichuan (Luzhou), they managed to talk to thirteen returnees. Apart from two who ran a business with their husbands or worked in the city, others had returned to their villages. On June 12, 2012, a lunch gathering was organized for ten workers (Figure 3.14). The lunch took place at Shiwai’s home. From grocery marketing to cooking, to feasting, the entire session was filled with joyous talk and laughter. During the reunion, albeit for a brief period, their physical suffering and emotional pain seemed to dissipate. When I interviewed them, however, they had to confront their problems once again. All the informants who went back to their villages admitted that their skeletal  pain had reduced their ability to do farm work. What offered them some form  of relief is the good air quality in the rural area, as they and their children are less susceptible to respiratory tract infections than their counterparts in Guangdong. Apart from the physical problems, the returnees generally had difficulty explaining their disease to others. For example, an informant who was divorced and then remarried said that people living in her husband’s village simply did not believe that she was sick. She explained: I did try to tell my neighbours that I am sick. But, they just said, “You’re lying. You are quite chubby. You look very healthy. How can you be sick?” … When they learned that I needed to go back to Guangdong [Huizhou] for my annual health checkup, they even gossiped behind my back that I went there to see my ex-husband. … I was quite upset when I first heard that. … [However,] [w]hen they saw that I was unable to carry heavy loads, … and that I tire easily and it is hard to catch my breath when doing farm work, they began to believe that I was actually sick.39

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3.14  Cooking together at Shiwai’s home in rural Luzhou. According to my informants, only a very small number of returnees received welfare benefits from the state, such as MLP. In fact, the reason they received MLP was not primarily due to their occupational disease.40 Both the sick workers and welfare authorities had seemed to fail to convince each other on the entitlement to MLP. As for the sick workers, they thought that they were entitled to MLP as they did suffer from a serious illness. But, as for the state authority, officials usually disagreed, believing that a sick worker poisoned by cadmium would not look as physically sound as they did. And, even when the officials deemed their disease genuine, they thought that the victim should seek compensation from the employer as stipulated in law rather than receiving state welfare. Although their medical expenditures were subsidized – like all villagers – by the new rural cooperative medical insurance scheme (Wagstaff et al. 2009), they were unable to purchase private medical insurance which would offer them extra protection. They shared similar experiences with insurance companies that refused to sell them insurance products. By typing the names on the computer, the insurance agents would be able to trace the workers’ previous medical records including hospitalization dates and medical prescriptions. These experiences – once again – pointed to the “contested” nature of occupationally derived illness. Feeling anxious about the future, the workers held out the hope that GP would take the initiative to offer more compensation. On the other hand, they also understood that the chances that their employer would sympathize with their difficulties were slim.

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I made an interesting observation about the returnees when they were asked to speak about their future. One informant said that she envied those who had been diagnosed with cadmium poisoning and currently hospitalized in Huizhou. She explained: “I just want to be hospitalized. I could then really take a rest and my health would be taken care of by doctors … And, I could earn a salary every month as well! How good would that be!?”41 When the authors mentioned to other informants that some of their fellow workers “longed to be hospitalized” (henxiang zhuyuan, 很想中毐), they gave similar sardonic responses. Almost all wished to be admitted to the hospital where their illness would be attended to professionally and their livelihood financially secure. Often, the discussions were swiftly intercepted by ecstatic expressions, such as: I really want to be [“cadmium-]poisoned”! (wo zhende henxiang zhongdu, 我真的很想中毐)42 It would be great if I could live in the hospital for several years! If I cannot live there for several years, one year is okay!43 It will be like heaven living in the hospital! I feel very happy just thinking about it! 44

When I queried further what they thought would be their chances of being hospitalized, they were, however, pessimistic. It was a common understanding that an employer would only choose those who are “well-behaved” (tinghau di, 聽話的) to live in the hospital and they were deemed too “unruly” to be chosen. For this reason, some put it rather ironically that: “I shall never be [‘cadmium-] poisoned’!” (wo yongyuan buhui zhongdu, 我永遠不會中毐). From a certain perspective, compared to women workers who had stayed in Guangdong, women workers who returned to their home village experienced less social estrangement in terms of physical inferiority and economic marginalization, and this is attributable to better air quality in rural areas, the expectation of men to assume greater responsibility for the household finances and the lower cost of living. However, the returnees shared similar experiences to those who remained behind in Guangdong when they attempted to explain their suffering to their significant others, and when they faced discrimination for not being entitled to MLP and not being entitled to purchase private medical insurance. These circumstances and experiences had led to the returnees’ perception of being diagnosed as “cadmium-poisoned” and having the opportunity to be hospitalized as a heavenly escape.

Social estrangement with a contested occupational disease Being turned into “strangers” in society, the cadmium-poisoned workers realize that the past “recipes for living” can no longer be taken for granted. Their family, their employer, the state, the police, and medical and legal professionals, have all

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displayed an unexpected face to them. Akin to Schutz’s concept of the homecoming “stranger,” they find their most familiar living milieu become unfamiliar and they need to define each situation anew. As mentioned earlier, such experiences of estrangement in terms of untypicality are commonly shared with other health victims in other societies, such as drug addicts, HIV carriers, and mentally ill patients. However, a unique characteristic of the cadmium-poisoned workers in question is they can easily be turned into targets of oppression of state sovereignty. They are actively portrayed as “problems” or “troublemakers” in society instead of victims. They must therefore be controlled, monitored, and managed or the stability of society would be threatened. The narratives of cadmium-poisoned workers suggest that they usually find themselves in situations where specific rules and regulations are enforced, but their rights are being exploited. For instance, cadmium poisoning is stipulated in the national laws as an occupational disease, but it is not allied or associated with any scheme to ensure proper compensation; the law stipulates that only test results that are conducted in “accredited institutions” are recognized but these are the places where medical professionals are easily bribed and workers’ diseases easily become “normal-ed”; the employer indeed would follow the court ruling to provide workers with healthcare subsidies, but would offer health supplements that were of poor quality and milk powder that was toxic; workers had  the  constitutional right to protest, but would receive no positive treatment from the local government, police, and hospital when faced with violent suppression; the company would cover all expenses incurred by the hospitalized workers, but in a manipulative manner (e.g., submissive workers are more likely to be hospitalized); and workers would be entitled to national health protection, but the  state and private insurance companies would not show any empathy (e.g., no MLP from the state). Under these circumstances, the sick workers are turned into homines sacri and their experience of estrangement may be understood in terms of a “state of exception” in which the law is “in force without signifying” (Agamben 2005: 50). This explains that when workers attempted to openly resist the existing power structure (e.g., by rallying), they would simply be confronted with violence inflicted on them “without any mediation” (Agamben 1998: 171). That said, I must emphasize that the use of naked violence was not the usual means of control in the everyday life of the cadmium-poisoned workers. Rather, the exercise of power usually takes the form of social estrangement through which the victims’ cries for help are silenced, and their plights are rendered invisible in the public realm. All of this suggests that the control of the sick workers is by nature more disciplinary than violent. In fact, two victims-turned-activists and some workers complained of harassment from plain-clothes police who monitored their movements during important domestic45 and international events.46 One of the activists, Ruiping, revealed that she was unable to renew her passport several years ago when she planned to make a trip to Hong Kong to protest against her former employer, and to Europe to submit an appeal to certain international organizations. The reason for “blacklisting” her, according

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to state officials, was that she would “threaten the security of the country” (weihai guojia anquan, 危害國家安全). As for other workers, they could not hide their indignation at their employer’s ruse to conceal the danger of cadmium poisoning, manipulate test results, and collude with the police and judges to violently suppress them. Amid this social estrangement, what taken-for-grantedness of everyday life has been unraveled? How is this connected with governmental rationality? To answer these questions, I must point to the sick workers’ preference to be ­officially diagnosed as “cadmium-poisoned” and to be legally and formally registered as being “occupationally ill.” All workers diagnosed only as having excessive cadmium levels rather than as being “cadmium-poisoned” in one way or another acknowledge this as the preferred way of obtaining law-stipulated benefits, rather than advocating revision of the current legal framework, or increasing the enforcement of OHS measures in the workplace by NGO workers or legal professionals. This “preferred” way may be considered to be the trend followed by sick workers who wish to acquire a “sick role” constituting a legitimate basis for claiming their law-stipulated compensation and benefits. The term “sick role” was coined in the 1950s by Talcott Parsons. To Parsons, the “sick role” of individuals suffering from an illness signals “a withdrawal into a dependent relation” and “provides … a point of ‘leverage’ for social control” (Parsons 1964: 284). Parsons used the term to describe a sick person as deviance who needs to be sanctioned, to be monitored, usually by healthcare professionals. However, the cadmium-poisoned workers consider it a safe and the most desirable way to obtain benefits from the existing structure and to fight against social marginalization. The craving for sick role status thus reflects the governmentality which has effectively shaped the attitudes and structures of preference of the cadmium-poisoned workers as “strangers” in their everyday life in accordance with specific government rationality, that is, to act in accordance with the law. Rather than questioning the appropriateness of the law or political legitimacy behind it, cadmium-poisoned workers prefer to seek ways to take advantage of the existing legal framework, and to be diagnosed as “cadmium-poisoned” is one of these ways. The relation between the sick role aspiration and governmentality will be revisited and discussed further in Chapter Six in conjunction with the post-illness experiences of lapidary and Japanese-style mat workers in the coastal regions, and coal miners in the inland region, which will be explored in the next two chapters.

Notes  1 A booklet entitled No Choice but to Fight! A Documentation of Battery Women Workers’ Struggle for Health and Dignity was published by GM in 2009. Written mainly from the perspective of a group of workers from Power Pack, it documents with considerable detail the critical events leading up to the 2004 cadmium-poisoning outbreak. Some of the information in my account, such as dates and locations, are gleaned from the GM booklet.

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 2 The company closed down all its nickel-cadmium battery production lines in Guangdong in 2008. However, according to GM, the production of this type of battery was in fact outsourced to a factory in Hunan province, out of sight of Hong Kongbased NGOs.  3 Red Dust can be watched online, at http://.en.labournet.tv/video/6349/red-dust (last visited on March 17, 2016). The film won an iSunTV Documentary Award in 2012.  4 Shaonan, born 1965; interviewed in Luzhou, June 12, 2012.  5 For example, Article 35 of the Law of the Prevention and Treatments of Occupational Diseases (revised in 2011) stipulates: “Employers shall provide pre-job occupational health training and regular on-the-job occupational health training for employees, disseminate occupational health knowledge, supervise employees in abiding by laws, regulations, rules, and operating procedures on the prevention and control of occupational diseases, and direct employees to correctly use occupational disease protective equipment and occupational disease protective items for personal use.”  6 Meiyan, born 1972; interviewed in Huizhou, May 8, 2012.  7 Xuhong, born 1970; interviewed in Luzhou, June 11, 2012.  8 Shiwai, born 1967; interviewed in Luzhou, June 11, 2012.  9 Shaonan, born 1965; interviewed in Luzhou, June 13, 2012. 10 Xuhong, born 1970; interviewed in Huizhou, May 9, 2012. 11 Shiwai, born 1967; interviewed in Luzhou, June 11, 2012. 12 Shiwai, born 1967; interviewed in Luzhou, June 11, 2012. 13 Almost all cadmium-poisoned workers I met in the field were from Advance and Power Pack. Only two were from Jet Power located in Shenzhen. 14 Ranhe, born 1967; interviewed in Huizhou, June 8, 2011. 15 Similar response patterns were also identified in other health studies in China on  other  epidemics, such as HIV infections (Zhang 2010) and cancer (LoraWainwright 2013). 16 Xuhong, born 1970; interviewed in Huizhou, June 8, 2011. 17 Ruiping, born 1969; interviewed in Huizhou, June 8, 2011. 18 Lianqin, born 1966; interviewed in Huizhou, June 8, 2011. 19 Excerpts from the blog of Wang Fengping (born 1963), translated by The Wall Street Journal, at http://online.wsj.com/article/SB119972343587572351.html (last visited on March 17, 2016). 20 Shiwai, born 1967; interviewed in Luzhou, June 11, 2012. 21 I invented the term when conducting interviews with informants, who liked the term. It means the outcome of the diagnosis is manipulated by the authority rather than as a result of objective and scientific examination. 22 Under the existing OHS framework, upon certifying the diagnosis of occupational disease, the next step is to submit an application to the local Labor Capacity  Authentication Committee to determine the precise level of occupational disability and reduced working capacity. According to The Standard Assessment of the Severity of Work-Related Injuries and Occupational Diseases, issued by the MoLSS in 1996, there are ten grades of disabilities, with grade one being the most serious. 23 This fee would be paid until their physical checkups proved that their condition had returned to normal. 24 According to the informants, the help station became crowded on some occasions or on important occasions of big national or international events. At the time, the Guangzhou municipality was about to organize the Asian Games in November 2010. In the help station, the workers saw beggars, mentally ill people, and many others

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whom the workers believed to be petitioners from the countryside. The informants made special mention of meeting a group of occupationally sick workers who suffered from pneumoconiosis but were arrested as they were about to fight for compensation. 25 Xiaohong, born 1969; interviewed in Huizhou, October 3, 2012. 26 Xiaoqing, born 1965; interviewed in Huizhou, October 3, 2012. 27 Shunmin, born 1964; interviewed in Huizhou, October 3, 2012. 28 Xuhong, born 1970; interviewed in Huizhou, October 3, 2012. 29 Faxian, born 1970; interviewed in Huizhou, October 3, 2012. 30 Xueli, born 1959; interviewed in Huizhou, October 3, 2012. 31 Xiaohong, born 1969; interviewed in Huizhou, October 3, 2012. 32 Caoliang, born 1967; interviewed in Huizhou, October 3, 2012. 33 Under Hong Kong’s mini-constitution, the Basic Law, the Executive Council is an organ for assisting the Chief Executive in policy-making. The Executive Council normally meets once a week. The Chief Executive presides over its meetings. Except for the appointment, removal, and disciplining of officials and the adoption of measures in emergencies, the Chief Executive shall consult the Executive Council before making important policy decisions, introducing bills to the Legislative Council, making subordinate legislation, or even dissolving the Legislative Council. 34 By mid-2013 I was told that one patient had been hospitalized for two and a half years; two patients for four years; one patient for five and a half years; six patients for six years; and seven patients for nine years. 35 Qingbei, born 1968 (hospitalized since 2010); interviewed in Huizhou, August 3, 2011. 36 Among the seventeen hospitalized workers, only two came from Guangdong. 37 Leiwen, born 1964 (hospitalized since 2006); interviewed in Huizhou, August 3, 2011. 38 According to the informants, since 2004, about sixty “cadmium-poisoned” workers were discharged after one to two years of hospitalization. However, it was believed that workers were discharged not because they had made a full recovery but because the hospital was pressured by the company to maintain a small number of hospitalized workers. 39 Xiling, born 1967; interviewed in Luzhou, June 11, 2012. 40 In order to qualify for state benefits, the household is deemed to have family members who suffer from disabilities or members who have passed away. 41 Shanglai, born 1968; interviewed in Luzhou, June 12, 2012. 42 Qinshi, born 1966; interviewed in Luzhou, June 12, 2012. 43 Peilei, born 1969; interviewed in Luzhou, June 12, 2012. 44 Shanglai, born 1968; interviewed in Luzhou, June 12, 2012. 45 For example, the annual meetings of the NPC and Chinese People’s Political Consultative Conference (CPPCC). 46 For example, the 2008 Beijing Olympics, 2010 Guangzhou Asian Games, and 2011 Shenzhen Universiade.

4

Pneumoconiosis-afflicted workers: toward rightful resistance

If cadmium-poisoned workers are largely barred from the protection of the legal framework due to the contestability of the disease, pneumoconiosis-stricken workers in the coastal region would, relatively speaking, feel less estranged in the current OHS system. This is because, unlike cadmium poisoning, pneumoconiosis is one of the world’s oldest occupational diseases, hence its diagnosis, classification of severity, and how different categories of severity correspond to the ability to work is well-established. Unlike the coal miners in the inland region who will be examined in the next chapter, many sick workers who worked in gemstone/ jewelry and Japanese-style mat factories in the coastal provinces (Guangdong and Zhejiang) possessed a labor contract with their employer, thus facing fewer institutional hurdles in pursuing occupational disease compensation via the legal route. According to a survey conducted by a workers’ center based in Shenzhen, it was found that about 75 percent of respondents reported having signed labor contracts with their employers in the PRD and Yangtze River Delta for enterprises with over one hundred workers. As for enterprises with fewer than one hundred workers, the proportion of formally-contracted workers was much lower (Fung and Chan 2012: 35–6). In my fieldwork, due to the bias of my sampling mentioned in Chapter One, I contacted workers at medium-to-large factories which had between 200 and more than 1,000 workers. All the forty-eight workers I met in Guangdong, Hunan, and Chongqing had a formal labor contract with their employer. Although this group of sick workers as a collective experienced comparatively less estrangement than the cadmium-poisoned workers and coal miners, as will be apparent, the sick workers in question suffered both physically and socially in specific socioeconomic contexts. They faced a fatal disease and its attendant threat of death and substantial medical costs, a prolonged and painful struggle to obtain legal compensation, and at times state-backed violence. Their rights are ostensibly protected by law, but they usually felt helpless when pursuing the compensation that they were legally entitled to. They also suffered from self-doubt over their ability to uphold culturally desired gender roles, in particular men as the traditional breadwinners of the family. In order to present the subjective experience of occupationally sick workers I met at different times and places in a more systematic manner, the narratives of

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the informants will be categorized and inspired by Weisberger’s (1992) theory of marginality. Originated in migrant/ethnic studies, Weisberger’s theory contends that persons/groups who are marginalized in society are usually caught – as I introduced in Chapter Two – in a structure of “double ambivalence.” Akin to the description of the Schutzian “stranger,” his notion of “double ambivalence” refers to a state of “neither this nor that” in one’s subjective experience. However, Weisberger further extends his proposition to how the marginal persons/groups “construct weapons … to resolve or alleviate their double ambivalence” via use of one or more of four response patterns: assimilation, poise, return, or transcendence (1992: 426). In brief, “assimilation” entails the marginal group’s absorption of the dominant group’s cultural standards; “poise,” the experience of insurmountable ambivalence between the two cultural statuses; “return,” the determination to return to the old way of life; and “transcendence,” attempts of the marginal group to overcome the opposition of two conflicting cultures by creating a third culture that is supposed to surpass/reconcile them (Roberton 2006). While Anderson and Levy (2003) has already appropriated and extended Weisberger’s “response patterns” to marginality beyond migrant studies to understanding elderly drug addicts, I consider that certain minor conceptual adjustments are required so as to make the “response patterns” more applicable to the pneumoconiosis-stricken workers covered in this chapter. My rationale is as follows: unlike migration, the term “assimilation” seems inappropriate to describe pneumoconiosis patients. Also, unlike other illnesses, such as drug addiction, “return” to a pneumoconiosis patient is logically impossible. Furthermore, for emigrants, the response of “poise” might mainly entail the refusal or inability to resolve the ambivalent sentiment between their own and the new cultures. But, in my case, the meaning of “poise” is more complicated as it may involve an element of resistance – both mental and actual – against the existing power structure. Such a resistance can also be considered as a coping tactic on the part of the victims to reduce the level of ambivalence experienced. In addition, unlike migrants, death or being in a critical health condition are possible and probable “responses” of social marginality, given the nature of the disease and presence of various institutional barriers that hinder them from receiving suitable diagnoses and treatments. Therefore, based on the uniqueness of the informants, in the following, their post-illness experiences will be examined under the subheadings of “critical health,” “adaption,” “retreat,” “poise,” and “transcendence.”

Critical health In China, every hour, 1.5 rural migrant workers in the prime of their life will be suffocated to death. In order to alleviate the pain in their lungs, they almost have to kneel down to breathe at this final stage of their life. They are a bunch of rural people living on the lowest rung of society and reduced to such an undignified position when death approaches. … Their blood and sweat went into the highrise buildings and the booming economy we enjoy today. I deem that they do not deserve such menial existence and such a painful death.1

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Death had been a taboo, but an unavoidable and recurrent theme throughout my fieldwork with pneumoconiosis-stricken workers. When I talked to Yaoyuan who had decided to return to his rural home in Liangping (Chongqing) after working for eleven years at Lucky Gems in Shenzhen, he spoke sadly that over ten of his fellow villagers had died of pneumoconiosis after working in high-dust factories in Guangdong.2 Informants generally reported that their respiratory systems were highly vulnerable to viral infections, especially during winter. The resulting pneumonia, when serious, could be fatal. There is yet no official information on the fatality rate of pneumoconiosis caused by the inhalation of different mineral dusts and/or fibers. I have summarized the information from various official sources in Chapter One and indicated that the fatality rate of pneumoconiosis in China ranges from 22 to 24 percent. Moreover, by observing the records of pneumoconiosis patients across a longer time frame of over sixty years, one scholarly report suggests that the fatality rate can reach nearly 60 percent.3 Furthermore, in quoting figures from a deputy director of the Guangdong Provincial Department of Health given at an official meeting, an NGO report revealed that the cumulative total of pneumoconiosis-afflicted workers in Guangdong was 15,000, of whom more than 5,000 had already died (CLB 2005: 4). On the whole, various sources suggest that the death rate of pneumoconiosis could be as high as 20 to 30 percent. This estimation roughly matched my fieldwork observations. My informants had the impression that about one to three out of every ten sick workers they knew had died. During fieldwork, the shadow of death loomed large. I remembered when dining in a restaurant in Lianyuan, my fieldwork assistant Mengguo walked away and had a conversation with a waitress working there. After the conversation, he told me that the waitress’s husband was a former colleague in a gemstone factory in Dongguan. The waitress became a widow two years ago after her husband died of pneumoconiosis. In Liangping, Yuedong is a sick worker who became an employee of an NGO center financed by LAC. After days of observing the activities he organized for the sick workers, who consisted of former gemstone/jewelry workers and local coal miners, I realized that he always showed an online video clip to the pneumoconiosis-afflicted workers who were new to the center.4 The seven-minute clip was shot by non-professionals. It captures the final days of a sick gemstone worker, Tang Jiqing. In the clip, Tang was lying on a hospital bed, breathing heavily through an oxygen mask, and appeared to have lost consciousness. Beside him were his wife, ten-year-old daughter, and two former co-workers. It was mainly filled with images of his weeping wife and the co-workers crying out: “Hang on! (tingzhu, 頂住) You must hang on!” The clip ended with words stating that Tang took his final breath on April 19, 2011, and that his daughter wished him to live well in dust-free heaven. Not having received any compensation, Tang died at the young age of thirty-four. Yuedong admitted that he used the clip to “educate” newcomers at his center as – being a sick worker himself – the disturbing images of the dreadful consequence of pneumoconiosis could strengthen their determination to legally pursue their compensation despite the many difficulties that lay ahead for them.

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In my fieldwork, two informants were found to have been deeply marginalized due to severe health problems with the likelihood of premature death. The first one was the bedridden Juhong I met in Lianyuan. His story was briefly mentioned in the Preface. He was formerly working at Lucky Gems in Shenzhen from 1991 to 1997. He did not know that he was suffering from an incurable disease until 2002 after he felt sick and had a medical checkup in a hospital. Speaking about the working environment: The entire production workshop was full of dust. You couldn’t see from one end of the workshop to the other; it was extremely noisy, and you couldn’t hear clearly what workers sitting next to you were saying. […] You work twelve hours a day, nine hours during the day, and another three in overtime at night … and only two rest days per month. […] There is overtime at least five days a week, and when goods need to be shipped we don’t even get a single night’s rest. […] You are fined if you don’t do any overtime. […] At that time, the wage was 1,120 yuan, nothing extra, only that small wage. […] The factory boss would have an inspection once a month but we don’t have any opportunity to talk to him. The boss would not talk to the lowest level of worker. […] The boss only cares about production going well, and he will only talk to the manager.5

Soon after he found out that he was suffering from pneumoconiosis, he left the factory. He was worried about his health, and just wanted to seek proper treatment. When he realized that it was his employer who should be held responsible for his disease several years later, it was already too late. He was no longer eligible to pursue compensation via legal channels. He then sought help from Pingkwan who exposed his case to the mass media and mobilized a number of Hong Kongbased NGOs to protest against Lucky Gems while the company was having a commercial exhibition in Hong Kong. In 2004, Lucky Gems agreed to offer Juhong compensation of 200,000 yuan. He then returned to his village and eventually found that his deteriorating health prevented him from doing farm work or any productive activity. At the time of the interview, he was wearing nasal cannulas which delivered oxygen through his nostrils (Figure 4.1). The cannula tubing was connected to a compressor oxygen tank. Each single tank could support his breathing for twenty-four hours. His family, including his wife, two teenage children, and elderly father who had heart disease, was mainly supported by his compensation, his wife’s farm work, and the humble MLP benefits of 270 yuan per month for a five-person family. His wife said that his left lung had completely stopped functioning; his right lung only had limited function. He needed to take medication every day to ease the fever caused by the lung inflammation. During my visit, Juhong was completely incapacitated and relied on an oxygen tank to breathe. We did not discuss how long this situation would continue; but he agreed that what he must do for the rest of his life was to lie in bed where he could just manage to breathe. I met the other critically ill worker Qinsheng three weeks later in Zhongxian (Chongqing). I was invited to observe an activity organized by Jiqiang Service Point (JSP) in Zhongxian to equip pneumoconiosis patients with the information

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4.1  Juhong in his home in rural Lianyuan. to maintain health. JSP is a Chinese NGO founded by Chen Yuying who was a survivor of the Zhili Fire in 1993 (see Preface). In that activity, I met Qinsheng’s wife Yinxin. The couple had been working in a Japanese-style mat factory in Ningbo, Zhejiang province from 1995 to 2002. Speaking of how the couple first knew that they were suffering from pneumoconiosis, she said: We worked right up to the end of 2002, and workers who had worked at the factory the longest [ten years] began to have difficulty breathing, which hampered them and they felt tired easily. … At that time they could only talk to their families about this, and were afraid that if they were to mention they were ill to the factory, they would not be able to work. Like me, they didn’t know that it was an occupational disease, just thought it was another disease, but because workers here come from different provinces, some had family members who had worked in stateowned enterprises and on the railroad who knew about occupational disease and knew that his illness was similar to those who had such diseases. … A couple of people went to the hospital for an x-ray. The doctor who checked the x-ray called them into the x-ray consulting room, asked about their work, and then declared they had the occupational disease, pneumoconiosis. … These workers returned to the factory and told the factory head as well their close workmates what the doctor had said. … So began the occupational disease outbreak in our factory.6

The couple and a dozen other afflicted workers quit the factory in 2002. Knowing that the company had refused to be held responsible for their illness, they began

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to act collectively via legal channels. At the same time, they protested in front of the factory and petitioned higher authorities in Ningbo. After seven years of doing this, the couple won their court case in 2009, and received a sum of 460,000 yuan. Qinsheng was affected more seriously than his wife, suffering from hemoptysis (coughing up blood). At that time, he came across a newspaper advertisement describing how a pneumoconiosis patient totally recovered after having a lung transplant. Qinsheng thought this was one way to solve his health problems once and for all even though he knew that the surgery was costly (approximately 300,000 yuan) and that he would need to live on anti-rejection drugs for the rest of his life. However, he thought that the surgery would be worth it in the long run as it could bring him back to health and normal economic productivity. Unfortunately, the lung transplant surgery turned out to be the beginning of a long round of hospital admissions. His new lung suffered from inflammation three days after the surgery. He then returned to hospital for treatment. When the symptoms died down, he returned to his home in Ningbo. Several days later, his lung became infected once more. He was admitted to the hospital in Ningbo for several days before going back to Shanghai again for further treatment. A month later, his situation stabilized, and he decided to return to his rural home in Zhongxian. The fresher air there, however, could not prevent his lung from picking up another infection. He was then admitted to a town-level hospital nearby. The whole painful process cost the family 500,000 yuan – well beyond the amount of compensation they had obtained. When I met Qinsheng at his home, his wife Yinxin told me that he was in “very good condition.” Yinxin said that several months ago, Qinsheng had lost consciousness at home. Since she was exhausted both physically and mentally, she was willing to let him die. The family of three (they had a thirteen-year-old son) had been in deep financial difficulty since Qinsheng’s costly lung transplant. However, Qinsheng did not die four days after losing consciousness and without any food or water. Yinxin changed her mind and decided to stand by him. Qinsheng regained consciousness two days later. During my visit, I was accompanied by a young NGO worker Wenfang (born 1986) from JSP. He was a recent university graduate and new to his job. Listening to the story of Yinxin for the first time, Wenfang was impressed by the self-sacrifice of Yinxin for her husband and family, and he could not help exclaiming: “Such a wife is so difficult to find in the village these days.” I then took the opportunity to praise and encourage Yinixin in view of her care to her husband. I then asked Yinxin what their thirteen-year-old son thought about his father’s illness. His son was at home during my visit. Wearing an embarrassed smile, Yinxin said: “Our son thinks that his father is selfish. […] We all suffer in order to treat his illness. … I told him too [pointing to Qinsheng] that he was selfish.” On hearing this, Qinsheng just kept his head down, stared at the ground, and remained silent. Like Zhang Haichao who had a lung transplant, Qinsheng also needs to take anti-rejection drugs, anti-asthma drugs, and antibiotics every day for his survival.

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4.2  Qinsheng in his home in rural Lianyuan. A plastic container containing his phlegm is on the table. Not covered by state medical insurance, the expensive anti-rejection drug costs him around 1,000 yuan per month. Qinsheng has completely lost his ability to work. Becoming the breadwinner of the family, Yinxin handles all the family chores herself. When less occupied, she collects herbs from the mountain and resells them in the market, which adds another four to five yuan to the household finances. Despite receiving MLP of 1,800 yuan per year, the family was in serious debt. Friend and relatives are no longer willing to lend money to them as they know the chances of it being repaid are slim. Even during his “good days,” Qinsheng still suffers from minor lung infections which makes him cough up about a half-liter of phlegm every day; otherwise he cannot breathe properly (Figure 4.2). During my visit, he said he did not regret having had the lung transplant. What he did admit was that he was unable to make any future plans due to his serious ill health; he said: “I don’t have any real plans [for the future]. I just live from day to day.” 7

Adaptation Sick workers who express the will and competence to cope with the competitive logic of the market economy while social marginalization caused by the disease was perceived as not imminent are called “adapters.” Among my informants, three (out of forty-eight) could be categorized as “adapters.” Undeniably, this

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small number of sick workers experience less estrangement. What I mean is that while they still feel themselves “strangers” in society, they are less likely to be turned into homine sacri and subject to state violence. Since sizable corporations normally require new employees to undergo medical checkups prior to taking up their positions, many pneumoconiosis sufferers are thus barred from the employment market. Therefore, if their health condition allows them to take part in economic activities, many attempt to set up their own businesses. Three informants who were – at the time of my fieldwork – successful in adapting to the competitive market economy were Wenwai, Qifa, and Jiehang. Before realizing he had pneumoconiosis in 2002, Wenwai had been working in various lapidary factories in Guangdong since 1991. The last factory he worked in was located in Huizhou. When he began to feel sick in the early 2000s, he suspected that his illness was work-related. Since the law only considers an occupational disease diagnosis legitimate when it is conducted in a specific CDC center, Wenwai went to consult the CDC center in Guangdong province. The diagnosis was that he was not suffering from pneumoconiosis. Suspicious of the accuracy of the result, he consulted a hospital back home in Sichuan, which found him to be suffering from “stage-two pneumoconiosis.”8 With this diagnosis, he returned to Guangdong and requested a re-diagnosis. The hospital quickly “changed its mind,” and confirmed him as having “stage-two pneumoconiosis” in 2002. Since his employer refused to compensate him and he was not aware of how to pursue his rights via legal channels, Wenwai joined a group of twenty sick workers and spent two years petitioning various bureaus in Guangdong and Beijing. His case was settled with the intervention of the mayor of Huizhou. His former employer agreed to give him 100,000 yuan in 2004. With the financial support of relatives, Wenwai returned to Chongqing the following year, and opened a shop selling construction materials at Kaijiang (Figure 4.3). Although the business has been running smoothly since then, he is still extremely anxious about the future. During the interview, he told me that his health had been deteriorating, and even walking upstairs was a burden. The fear of death was never far from his mind. He said: “I felt worried when I saw them [former colleagues] die one after another. I really don’t know whether it [death] will be today or tomorrow. [If I die,] [t]hen all my [business] investments will become meaningless.”9 Qifa had worked in a gemstone factory in Guangdong since 2001. When he returned home in Chongqing to get married in 2005, he did not detect any serious health problems. However, two years later, stories from former workmates (including Wenwai) prompted him to return to Guangdong for a diagnosis which confirmed “stage-one pneumoconiosis.” Since he had left the factory over two years earlier, he was ineligible to apply for occupational disease identification and confirmation. At the beginning, he did not hold high hopes of obtaining compensation. The line manager of the factory, however, helped him press the boss for money in exchange for receiving kickbacks for any future compensation that Qifa obtained. Contrary to Qifa’s expectations, the employer agreed to give him 260,000 yuan as compensation, and Qifa gave the line manager 50,000 yuan

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4.3  The store where Wenwai and his wife did business and lived. in return. Qifa suspected that the reason behind the “generosity” on the part of the employer was that in the mid-2000s, there had already been successful cases through which pneumoconiosis victims were compensated with more than 400,000 yuan via lawsuits. With this happy surprise, Qifa returned home, and bought an apartment where his family could live and do business selling groceries at Liangping (Figure 4.4). He admits that his humble business has been doing

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4.4  The grocery store owned by Qifa. The LED torches shown were the bestselling items at the time of the fieldwork. well since then though it has to support a family of six, including this wife, two elderly parents, and two children (aged four and fifteen). He feels lucky that he has obtained compensation. When I asked him to compare himself to others who had been compensated through legal channels, he said: “I already feel satisfied. Tang Jiqing did not get any compensation before he died.”10 Jiehang was a car salesman when I met him in Kaijiang. He began working in a gemstone factory in Dongguan in 1996, and he suspected that he was suffering from pneumoconiosis in 2003. However, he was told that he only had tuberculosis. He then went to Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment which diagnosed him as suffering from “stage-one pneumoconiosis.” The factory made a note of this and proposed to compensate him to the amount of 20,000 yuan. He refused because the amount was too small. After that his case went through the LDAC. The result, however, went in favor of the employer. He then pursued his case through the courts. The first ruling was to compensate him to the tune of 30,000 yuan. Jiehang refused to accept this amount. Subsequently the case was settled in the final court in which the judge raised the amount to 60,000 yuan. He accepted the compensation reluctantly and suspected that the courts and judges had been bought off by the employer. He then returned to Chongqing in early 2005. He wanted to set up a business but he did not have enough money. In 2007, through “connections” (guanxi, 關係), he became a car salesman. Since his job status was

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“self-employed, the company did not require him to undergo a medical checkup. His relatively high educational level (high-school graduate) and more eloquent manner have made him a quite  successful salesman. He deeply regrets having worked in the gemstone  factory, since it had given him an incurable disease. Although he does not  need to take medication regularly, he catches influenza easily and cannot handle jobs requiring a high degree of physical strength. When speaking of the future, he says: “I just want to live my life plainly (pingping dandan, 平平淡淡). I have no big hopes [for the future]. Happiness is of the utmost importance.”11

Retreat As mentioned earlier, a return to “normal” was impossible. The response pattern of return in Weisberger’s theory thus needs to be revised in order to fit the uniqueness of the present subject matter. Here, the concept of “retreat” was chosen. My choice was inspired by Merton’s time-honored strain theory with retreat being one of the human reactions to anomie. In Merton’s wording, “retreatists” reject both “culturally acclaimed ends” and “institutional means”; they are “in society but not of it …” (Merton 1968: 207; original emphases).12 In this section, those who exhibited retreatist responses to marginality expressed a high degree of withdrawal or escape from society. They appeared to have lost their will to fight for (more) compensation, or to make concrete plans to achieve success as defined by society (e.g., earning more money, improving living standards). In my fieldwork, no matter whether the retreatist respondents were situated in the urban or rural context, they tended to describe themselves as “doing nothing,” “(just) playing around” (daochu wanwanr, 到處玩玩兒), “taking a rest,” or “retired” (without reaching the retirement age). Among my informants, twelve (out of forty-eight) were considered retreatists who could be further categorized into two types: one had no or only meager compensation (