China: Detained to Death

On May 3, fifteen Beijing citizens—scholars, journalists, and rights lawyers—gathered informally at the home of Professor Hao Jian of the Beijing Film Academy to reflect on the 25th anniversary of the 1989 June Fourth massacre in Beijing. Two days later, five of the participants were arrested and charged with “creating a disturbance in a public place, causing serious disorder.” All five remain in detention.

Two of the five people have serious medical conditions: philosophy professor Xu Youyu, 67, has high blood pressure and diabetes; human rights lawyer Pu Zhiqiang, 49, suffers both these conditions plus high cholesterol. Both take daily medications, but officials confiscated their medicines when they arrived at the detention facility, saying that detention-center staff are in charge of all medications. The next day both men were offered pills that they did not recognize. Xu was afraid of ingesting them and declined. Pu reluctantly accepted them.

While the detention of activists by the Chinese government is well known, there is relatively little discussion about medical treatment in detention facilities. But to anyone who thinks the concerns of Xu and Pu about their medications might be excessive, it is crucial to understand what happened to Cao Shunli, a legal rights activist who had a chronic medical condition. She died on March 14, at age fifty-one, as a result of medical complications that became life-threatening during five months of criminal detention. Like Xu and Pu, she had been charged with “creating a disturbance”—in her case for trying to board a flight to Geneva to speak to UN officials about abuses in Chinese labor camps and prisons.

When Cao was detained on September 14, 2013, she was healthy, although she had a liver condition that she was managing with medication. After she was put in a detention facility at a secret location and deprived of her usual medication, however, her liver condition dramatically worsened and her abdomen swelled; then she contracted tuberculosis and developed uterine cysts as well. When her lawyer Wang Yu saw her on October 30 it was the first time any friend or family member had seen Cao since she “disappeared” six weeks earlier. Wang reported to Cao’s family and friends that she looked frail and immediately submitted an application for release from detention on medical grounds. The authorities, who were preparing a criminal case against Cao, rejected the request. Over the next few months, Wang made several more applications for medical bail, but was refused each time.

On February 17, 2014, after Cao’s health sharply deteriorated, Chinese authorities ordered her transfer to an emergency room and then to the Beijing 309 Military Hospital. Two days later they notified the family of the move. On February 27, after Cao had fallen into a coma, the authorities now rushed to release her and forced Cao’s family to sign a document acknowledging they had done so. The apparent purpose of this last-minute paperwork was to disavow official responsibility in case Cao died. Fifteen days later, she died.

Cao’s experience, horrific in itself, is all the more disturbing because it follows a pattern that has emerged in a number of other cases. In 2006, a petitioner named Duan Huimin was beaten severely by police and sent to a detention center, where he never received any medical treatment. After 57 days in detention, he was sent home—unconscious. He died two days later. In 2007, Chen Xiaoming, a leading petitioner-activist in Shanghai, also died two days after being released from detention. Chen had been jailed, tortured almost to death, and then denied medicine. And on March 19 of this year, four days after Cao Shunli’s death, Tibetan political prisoner Goshul Lobsang, who was 43, died at his home in Gansu Province, from complications of mistreatment in detention. He had been serving a 12-year sentence for allegedly leading a protest in 2008, and following torture and deprivation of medical treatment, the authorities released him on medical grounds last fall. At the time of his death, he had become unable to speak, eat, walk, or drink.

It is well established that China’s authorities, from the late Mao years to the present, have punished critics by sending them to insane asylums. Now, Cao’s death, and the circumstances of Pu’s and Xu’s detention, raise the question of whether Chinese authorities are deliberately withholding medicine from political detainees as another way to punish them and intimidate their followers. Among well-known opponents of the government, AIDS activist Hu Jia (imprisoned 2007–2011), poet Zhu Yufu (imprisoned 1999–2007 and 2011–present), and Mongolian nationalist Hada (in prison since 1995) have, like Cao Shunli, all been denied medical parole while suffering serious illnesses in detention. And there are numerous cases involving people who are less known.

Clearly, however, prison authorities need to be careful about withholding medical care. Just as the regime needs to be careful when it stokes anti-Japanese sentiment—at a certain point applying the brakes lest Chinese “patriotism” go too far and turn against the Chinese government itself, for its alleged weakness—so the withholding of medical care in prisons can go too far if it actually leads to death. Such deaths in detention have sometimes drawn international scrutiny; the UN Committee Against Torture asked the Chinese government in 2008 to explain the growing number of such incidents. As a result, there seems to be an increasing practice of releasing detainees with medical conditions once they are on the verge of death.

Even when detainees die after their release, however, it is bad press for the Chinese government, especially in cases, like Cao Shunli’s, that get international notice. Since her death, Cao has been named one of three finalists for the 2014 Martin Ennals Award, an international human rights prize to be awarded in the fall and that is calling attention both to her work and the terrible circumstances of her death. For the authorities, this dilemma—how much to torture people on the one hand, and at what point to pull back on the other—concerns the question of how best to serve state power. The two have to be balanced.

If there is indeed a state policy on deprivation of medical treatment, it is unlikely that it is written down anywhere. The most sensitive instructions in police and censorship work in the PRC are often done orally or by tacit understanding. There are, however, two good reasons for believing such practices come from the top and are not just abuses by local officials. One is that the pattern of denying certain prisoners medicines or access to treatment seems to be consistent nationwide. The other is that there is much evidence that low-ranking people in the police system are not abusive toward rights activists unless instructed to be. Many veterans of detention have reported that low-level workers in the police system say “I am just doing my job, please understand,” and sometimes even discreetly express sympathy.

The particular “disturbance” that led to Cao’s detention, and then to her death, is further evidence that the regime’s concern for its own power is its highest priority. A legal scholar who studied at Peking University, Cao will someday be in China’s history books for her courageous, persistent defense of Chinese “petitioners,” the common people who travel to the capital to entreat authorities to address injustices they have suffered in the provinces. But what led to her final detention were her efforts in recent years to promote transparent reporting of human rights conditions in China to the international community.

In late 2008, China was preparing to undergo its first human rights review by the United Nations, a so-called “Universal Period Review” in which the government in question is asked to provide information to the UN after “broad consultation with civil society.” Cao had already tried—repeatedly—to offer her findings to the Chinese government. Since it was now a UN request that civil society be consulted, she initially thought that she might be helping the government.

The authorities, though, refused her materials, which documented hundreds of individual cases of rights abuses. The government’s subsequent report to the UN did not refer to any materials from any genuinely non-governmental source, yet claimed that “broad public consultations were conducted via the website of the Ministry of Foreign Affairs.” No one had watched that ministry website closer than Cao, and she knew that her government had told the UN a flat lie. Incensed, she organized a public rally in Beijing on April 12, 2009. Eight days later she was sentenced to a year in a labor camp for creating a public disturbance.

At the camp, Cao refused to admit wrongdoing and began protesting the abuses she witnessed by telling camp authorities that they were violating the law. Her efforts led to retribution, and she was subjected to torture, including, at one point, five days of no food followed by three days of force-feeding through a nasal tube.

She was released from the camp in April 2010—as it happened, right at the moment when authorities were busy locking up activists in order to prevent trouble at the upcoming Shanghai World Expo. Two weeks later, after protesting her earlier detention and taking part in a small demonstration, she was back at the labor camp for another 15 months.

Released again in July 2011, she turned her attention to the “Human Rights Action Plan” that the Chinese government was then working on. This was another document it was preparing for the UN review and claiming to be representative of views from civil society. Cao and some colleagues again offered information on rights conditions for petitioners and in labor camps, but again, when the report appeared in June 2012, it bore no sign of any input from any non-governmental source.

Using a law called the Government Information Disclosure Act, Cao filed a request, co-signed by about a hundred petitioners, to disclose how the Action Plan had actually been drafted. The request was not answered, but in the following days many of the petitioners who had co-signed it were seized and sent back to their hometowns. Two of Cao’s colleagues who had helped with it were criminally detained.

Still undeterred, Cao focused next on China’s second UN Periodic Review, which was scheduled to take place in October 2013 in Geneva. In June 2012, she submitted to the State Council another Information Disclosure request, this time asking how the review was going to be done. In November a reply came from the Ministry of Foreign Affairs that the UN review involves China’s diplomacy and is therefore a “state secret.” By now too experienced to be stunned by an absurd answer, she continued through winter and spring of 2013 to demand that the authorities consider the information that her group had collected.

In January 2013, we met Cao at a human rights workshop in Asia. She was energetic, optimistic, and determined. If the Chinese authorities would not tell the truth to the UN, she would go to Geneva herself, she said. In April, she and her colleagues filed a lawsuit against the Ministry of Foreign Affairs challenging its claim that its methods of consulting with civil society are a state secret. By June they had no answer, so they organized a sit-in at the ministry to demand one. The sit-in lasted almost three months, sometimes drawing as many as two hundred participants.

In August, a Beijing court rejected the lawsuit, ruling that UN reviews do indeed involve “diplomatic actions” that cannot be subjected to citizens’ lawsuits. At that point Cao became more determined than ever to go to Geneva—a decision that crossed what would be a fatal line with authorities. The regime could play cat-and-mouse with her at home, bullying as necessary, but if she spoke to the outside world, she would be harming its vital interests.

Ever since the June Fourth massacre in 1989, China’s authorities have faced challenges from the international community about their human rights record. Initially—and especially in addresses to the Chinese people themselves—the argument of government officials was that human rights are “Western values” that come from different cultural roots and “do not accord with China’s conditions.” Human rights are not needed in China. In recent years, though, there has been a clear change of strategy, especially in dealings with the UN. Now the government’s pitch is that China champions human rights and is even a standard-bearer for them, while China’s state media instead takes every opportunity to discuss alleged rights violations by the U.S. and other Western countries. Using diplomatic pressure and financial incentives, the Chinese government has campaigned successfully to get itself elected, and twice re-elected, to the UN Human Rights Council.

But there is an obvious danger for the government in this strategy: the Great Secret of what actually happens inside China must be kept sealed inside. This is why independent voices from China’s civil society must not be heard at the UN. And it is why Cao Shunli risked her life when, finally, she would not accept that fact. Indeed, Pu Zhiqiang and other scholars were arrested even for talking about the memory of June Fourth in private—the authorities seem to fear that their gathering could send a message to others on the eve of the anniversary. Can we expect anything different from a leadership for whom maintenance of authoritarian power is the top priority? Is human rights “reform” possible under such a regime? We doubt it.

Pu Zhiqiang and Cao Shunli have both been galling to the Chinese government not just as inveterate defenders of underdogs but because they have done so by standing up for China’s own laws and strictly following the rules the government itself claims to uphold. This leaves no legitimate grounds for silencing them. In the end, though, both may have underestimated how far the regime will go to protect its vital interests. The fate of Pu Zhiqiang, whose given name in Chinese means “strongly determined,” remains uncertain; Cao’s no longer is. Her given name, Shunli, means “all goes smoothly,” but life had a different script for her.