How Serial Killers Terrorized China’s Disorganized Elder Care Industry

Lack of Government Regulation Failing an Aging Population

The 45-year-old caregiver was calm on the witness stand, but her words were jarring. He Tiandai admitted during her murder trial that she killed a 70-year-old woman she cared for by poisoning her soup with sleeping pills and pesticide, injecting her body with the same soup, and then strangling her for good measure.

On top of this, a prosecutor said that He Tiandai told police she tried to kill nine other elderly patients between June 2013 and December 2014—and succeeded seven times.

When the judge in Guangzhou Intermediate People’s Court asked why she killed He Yanzhu, the caregiver simply said: “I wanted to get my salary as soon as possible.”

The composed He Tiandai was a mix of frankness and remorselessness during her one-day trial on December 23. When her defense lawyer, Gao Shang, tried to explain why He Tiandai committed her crime, she quickly told him to stop. Then when he asked her to apologize to her victims’ relatives, she refused.

“I killed people,” she said. “I will pay with my life.”

The caregiver industry that He Tiandai worked in is as poorly supervised by the government as it is quickly growing. It is unclear what official body is responsible for ensuring caregivers are qualified, very little information is registered about them, and they do not need to get licenses.

The industry is overseen by a department within local governments around the country, but Communist Party bodies, such as the All-China Women’s Federation and the Youth League, are also involved in supervision. Critics have said this arrangement means that no one is properly watching over China’s caregivers. Meanwhile, the field is also providing ready jobs because the portion of the country’s population that is elderly is rapidly expanding.

This combination of a lack of government supervision and readily available jobs not only created the freedom for He Tiandai to kill, but authorities believe at least one other caregiver has terrorized her elderly patients in southern China. In February last year, police in Guangzhou detained a woman named Chen Yuping—who like He Tiandai bounced from job to job hoping for quick paychecks—on suspicion she killed at least six of her elderly patients.

Agencies that sell caregivers’ contact information to people wanting to hire them are easily found in the country’s major cities. The street where He Yanzhu’s daughter-in-law found He Tiandai has more than 10 of them. The care providers are usually women from rural areas aged between 40 and 60 years old—too old to want to work in a factory anymore, but too young to retire.

He Tiandai came from a rural county named Lechang that is about 260 kilometers from Guangzhou. Media reports say she left home to find work in big cities before she finished school. Recently, she lived in an apartment provided by her agency in Foshan, a major city in the Pearl River Delta, when she was between jobs.

She did not seem to be close to her family. She claimed to be married and have a child, but acquaintances in Foshan said they never saw her with a man or any children. She gave Gao, her court-appointed lawyer, a list of relatives and their contact information, but he told the court he could not reach any of them. Except for her phone number and a copy of her ID card, the agency that found her employment could not provide more information about her.

While He Tiandai was an unknown, the circle of caregivers she moved in knew something was amiss. Several of them told Caixin that it was an open secret that several elderly people she cared for had died under suspicious circumstances.

Rope, Syringes, Poison

He Yanzhu’s daughter-in-law told local media that He Tiandai was among a group of women playing cards when she visited an agency looking for someone to help her take care of the 70-year-old. The daughter-in-law was surrounded by job-seekers soon after walking through the door.

The daughter-in-law (who declined to give her name to local media) explained to them that He Yanzhu had osteoporosis, a weakening of the bones, and needed someone to help her in the bathroom and keep an eye on her at night. The crowd thinned, though, when she said all the family could afford was 2,500 yuan per month, which was about 1,000 yuan less than the going rate.

He Tiandai was undeterred by the low salary. “She didn’t demand high pay,” the daughter-in-law said. “She left me with the impression she was a diligent, honest person from the countryside.”

He Tiandai eventually agreed to take the job for 2,600 yuan per month and to start work on January 13, 2015. No contract was signed, something that one caregiver told Caixin is common in the industry so that employers can fire the help when it suits them.

The prosecutor said in court that before He Tiandai started work, she went back to her apartment in Foshan to pack. Most of her belongings wouldn’t have raised any eyebrows, such as some clothing and a quilt. But she also brought along a rope, a supply of syringes, and some pesticide and sleeping pills. Things did not go well between He Tiandai and her new employer from the start. The daughter-in-law was about three hours late when she picked up He Tiandai, who later said in court: “That was the first thing that angered me.”

Once He Tiandai arrived at her new employer’s home, she found the job was more difficult than the daughter-in-law had described, prosecutors said. Other caregivers told Caixin that in their experience it is common for employers to downplay how hard the work will be so they can lower salaries.

Shortly after starting work, the prosecutor said, the caregiver told the family she had a demand: If He Yanzhu died before she was to be paid at the end of the month, she wanted her full salary. This angered the family, but they agreed anyway.

For the next three days, all seemed well. Then on January 16, He Tiandai killed the person for whom she was caring. About 4:00 a.m. that day, she fed the elderly woman soup laced with sleeping pills and pesticide, the prosecutor said.

After He Yanzhu fell asleep, He Tiandai filled the syringes with the poisoned soup and injected it into her stomach and left hip. Then, the prosecutor said, she strangled He Yanzhu with the rope. Afterward, He Tiandai put a red turtleneck sweater on the dead woman to cover the mark the rope made on her neck, the prosecutor said.

Just after 6:30 a.m., He Tiandai woke the elderly woman’s son to tell him his mother needed to go to the hospital because she was close to death. When he arrived in his mother’s room, the prosecutor said, he found her dead. Minutes later, He Tiandai asked to be paid.

Several of He Yanzhu’s relatives arrived at the home over the course of the morning, and at first no one thought there was anything peculiar about her death, the prosecutor said. But then someone noticed her earrings and bankbook were missing.

The family suspected the caregiver took them, and called the police. Then He Tiandai’s story of being an honest caregiver from the countryside began to unravel. Police searched her purse for the missing items and found 17 syringes and a bottle of suspicious liquid that turned out to be pesticide.

Not in Foshan

When police officers pulled down the collar on He Yanzhu’s sweater, they found the injury the rope caused on her neck. A forensics expert who inspected the scene of the murder found the needle marks and moisture on He Yanzhu’s pants from soup her body did not absorb. (An autopsy later determined the cause of death was poisoning.)

He Tiandai was taken to a police station, and in her bra officers found the missing earrings and bankbook, which had been torn up. When He was asked in court why she did that, she said: “I did not want anyone to get her money.”

He Tiandai also said in court she was surprised the police detained her.

“This would not happen in Foshan,” she said. “Once an employer accused me of murdering the person I was taking care of. The police asked for evidence and said they would need to bring the case to court.”

The family in that case apparently felt it was unable to pursue the matter, leaving He Tiandai free to find more work as a caregiver and kill again.