• May 15, 2015

Dying to Breathe—A Short Film Shows China’s True Cost of Gold

Sim Chi Yin

Each time I arrived in Hongjun village after a 12-hour journey by plane, bus, and motorbike, I took deep breaths of the crisp mountain air—as if that could clean out my Beijing-polluted lungs.

It did not take long for the irony to hit me. This alpine landscape in central China is home to hundreds—perhaps thousands—of men too sick to breathe normally.

Picture of silicosis patients holding their chest x-rays
Photographer Sim Chi Yin has made portraits of more than 30 former gold miners suffering from silicosis. Pictured holding their chest x-rays, clockwise from top left: Song Dengfa, died 2013; He Quangui, diagnosed with silicosis in 2004; Wang Yiyin, died 2011; She Faxue, died 2012.

Once farmers, these men left en masse in the late 1990s to work in gold mines—part of the army of migrant workers who powered China’s economic boom in recent decades. They dug deep into the mountains for treasures. Years later, they came back with the lung disease silicosis, and now wait in their homes for death.

Picture of He Quangui
Former gold miner He Quangui at home in Shaanxi province, China. He is suffering from silicosis—an incurable, but preventable, lung disease that scars and hardens the lungs.

For years, I’ve been a regular visitor to one of those former gold miners: a man named He Quangui, who lives in an old earthen house with his wife, Mi Shixiu. Mr. He has been struggling with silicosis for over ten years—surviving longer than most in his area. He keeps a notebook to record the names of those who’ve succumbed to silicosis. Flipping through it, he tells me: “I’ve watched them die, one by one. I know one day it will happen to me too.”

This is the unseen cost of gold mining in China—the world’s top gold producer. In China, silicosis is considered a form of pneumoconiosis, which affects an estimated six million workers who toil in gold, coal, or silver mines or in stone-cutting factories. It’s the country’s most prevalent occupational disease.

Picture of Mi Shixiu preparing an injection.
Mi Shixiu prepares an injection for He Quangui as a lung infection and fever persist into a fourth week. She is wife, confidante, and nurse to him. It turned out to be severe tuberculosis.

What the statistics can’t capture are the miners’ slow deaths. The men waste away, their lungs gradually scarring or becoming hardened from the dust they breathed years earlier. The disease is irreversible—a lung transplant is the only known cure—but is preventable with protective gear and ventilation while drilling. Mr. He says the type of mines he worked in lacked such safety measures.

In recent years, mining conditions have improved, but out here in hardscrabble rural China, most workers cannot track down mine owners to cover medical bills and don’t get treatment until it is too late. Most just give up as costs mount. Some commit suicide.

Picture of He Quangui and his wife playing the flute.
Seen in 2012, four months after surgery on both lungs, He Quangui, jokes around with his wife, Mi Shixiu, while she plays the Chinese flute. They have been married 19 years.

I wanted to try to tell one deep, personal story, in the hope of showing what the disease does to a person and family in its final stages. Like most documentary photographers, I hope that Mr. He’s story might move people to action.

When I first met Mr. He, I thought I had come to document his slow death, but I soon realized I was shooting a love story. I watched him and his wife kid around like teenagers freshly in love—tactile and affectionate in a way I’ve rarely seen in Chinese couples. When he could still sing, I sat by them as they belted out their favorite songs, in hearty, loving duet. I watched her tend to his needs as he lay in bed fearing to do more than just breathe. He calls her Xiao Mi—“Little Rice”; she calls him Guazi—“Idiot.” Seeing them together, it’s easy to believe Mr. He when he says her love has kept him alive.

Picture of He Quangui being carried by his wife.
When He Quangui is too sick to walk, his wife carries him. They have a very close relationship, and according to a relative, are “still like two teenagers who just fell in love.”

But he confided to me—out of her earshot—his multiple attempts and plans to kill himself, by electrocution (submerging his hands and electric wires in water), by drinking pesticides, and while he could still walk, by jumping into a nearby river.

“If you die in a work accident, it’s quick, short pain. If you get this disease, it’s like you can’t die and you can’t live,” he tells me. “If there was a medicine I could take that would make me not feel anything, I would take it, pay anything for it.”

Picture of He Quangui after collapsing.
Collapsing a second time in the same day, Mr. He struggles to breathe, while his son, He Jingbo, fans him with a piece of cardboard. His wife and his father, He Decheng, hold him, crying. That night he tried to kill himself.

Through months of getting to know one another and after being by his side through a traumatic hospital stay, the He family granted me a rare bedside view of an ordinary Chinese family going through a long emotional crisis. I did what I could to document it. I took notes, recorded sound, and eventually turned on the video mode on my camera and made this film (top of page), trying to do justice to the story of the final years of this unusually articulate and musically talented miner who has become a friend.

Over the past three years, I have watched Mr. He, once a healthy 143 pounds, deteriorate to a mere 88 pounds. I witnessed his repeated collapses, and one suicide attempt in the middle of the night. He has said good-bye to me many times, and then miraculously fought off severe tuberculosis and other ailments, living through another winter—the season silicosis patients fear most.

Picture of He Quangui
A shadow of his former self, He Quangui once weighed 143 pounds and is now a skeletal 88 pounds. It is tradition in rural China that a person die in their own home.

The wooden coffin he built for himself sits under a dusty plastic shroud in the attic. For five years, his wife has been preparing the hand-sewn cloth shoes, five shirts, and three pairs of trousers he will wear to his grave as dictated by custom. After one of his many collapses, I watched him whisper instructions in her ear: Buy thick white paper to line the coffin, do not spend too much money on religious rites or he will come back and haunt her, and wash his favorite faux leather jacket so he can wear it in death.

This project was supported by a grant from the Pulitzer Center on Crisis Reporting.

Sim Chi Yin is a photographer based in Beijing, and is a member of VII photo agency. She was a reporter and foreign correspondent for the Straits Times for nine years before quitting to shoot photos. She sometimes dreams in mute, black-and-white mode, but in real life is fascinated by color and light.

See more work on her website and follow her on Twitter and Tumblr.

There are 60 Comments. Add Yours.

  1. Dr Fatahiya Kashif
    October 4, 2015

    I lost my dearest brother Mohsin on 12 January 1995. He had always been my source of inspiration and hope. From the time I was a little kid I remember him as a very loving and caring elder brother.I have still kept the picture books that he presented me and his letters as my little treasures. We were six siblings and he was the eldest. Now after almost 21 years his memories are still fresh in our minds and even my kids know him even though they never saw him.
    He had been struggling with cancer for past one year. Like Mr He, he became very very weak, he also loved music and played the keyboard. In our distress we used to sing praises of God and we always had our faith in HIm. He was a doctor and he knew the consequences of his illness. I was a medical student at that time. The story of Mr He reminds me of my brother. Mrs He’s love and dedication made me cry. I think anyone who watches this documentary would hate the luxuries of life and believe in the power of love. Everyone on this earth will pass away but what remains is the love that we share and the attributes of humanity that we practice.

  2. Fannie
    September 10, 2015

    Mr. He Quangui passed away on Aug. 1st, 2015. Deepest condolences to his family and may his soul rest in peace.

  3. Carolyn McCourt
    June 2, 2015

    Sim Chi Yin what a great thing you have done by documenting this brave man and his family. H’s pain and suffering touched me deeply and the love for He and Mi is pure beauty. Love to you, Carolyn

  4. Joycie3
    June 1, 2015

    The life of miners is filled with hard work and danger. I understand they are willing to do it because they can make more money than in most other occupations.
    My own grandfather died in a coal mining accident in Pennsylvania, USA, in the mid-1920’s. He did not live long enough to get silicosis or see his 5 children grow up.
    I think the mining laws in USA are stronger now, so it is not as dangerous. But I still would not want anyone I love to be a miner – gold, platinum, diamonds, uranium, or coal.

  5. A. Lino Amorim
    June 1, 2015

    China is paying the price for “hackering the world…

  6. Regula
    June 1, 2015

    A sad and inspiring movie. I wish this family the best that life can bestow on them and admire their immense courage.

  7. Angela
    June 1, 2015

    It’s a sad thing that as a Chinese I have to read about this on a foreign website. You don’t get to see people’s plights on Chinese TV or web nowadays.

  8. Angela
    June 1, 2015

    It’s not just the story that’s sad…It’s also sad that as a Chinese I have to read about this on a foreign website. On Baidu there’s nothing but gossip. You don’t get to see people’s plights on Chinese TV nowadays.

  9. barb mann
    May 31, 2015

    I am an artist, sitting here alone inToronto, too old for new friends, no family, watching. I have lung cancer again, three times and fear this is my fate as too little lungs to operate. Chemo I know would kill, poison me, I seek alternate treatment. I feel like this man and know you readers will be holding my head.

  10. Robert Carl Cohen
    May 31, 2015

    As an assayer in 1950 at the Archer Mercury Mine outside of Coalinga, California, I can attest that workers in many US industries were exposed to such easily remedied hazards prior to the passage of the OSHA in 1970:
    Every nation in the world permits, and taxes, cigarettes, which kill five million people per year, thereby knowingly profiting from sickening and murdering its citizens.

  11. Artur A
    May 31, 2015

    A deeply saddening story and a great documentary. Hope this raises awareness and helps to raise safety standards…

  12. Hammerbox
    May 31, 2015

    Living in America, I find it a tragic sight to see the men dying of a disease caused by their labor to inusre their country could own a vast amount of my country. As a man who suffers from Emphysema and knows the horrble struggles of breathing, My heart goes out to him. And to know the people who own the mines are not taking care of the men that made them rich only lowers my hope that one day this world we all live in will not be full of greed but be more full of unity peace and a quiet fulfilling lifetime. My Wife of 33 years also has a long road ahead as my disease progresses. The toll it takes on humanity is horrible.

  13. Lynn Cai
    May 31, 2015

    my grandmother died of 2 cancers in 2004. I was about four or five back then. She died in the hospital(contrary to the Chinese custom of having a dying one to pass away at home). I could still recall the days visiting her in the hospital with my mother and other relatives. In grandma’s room, we tried to spend as much time as possible with her. Sometimes, everything gets extremely emotional because every single visit we paid was probably the last one. We visited her everyday, and it almost became a ritual. Even after she died, I still asked why we aren’t seeing her anymore everyday. I did not know that my family was going through an emotional crisis, and they were afraid to break the news because they felt that I was too young to grasp the concept of death. I truly send my prayers and thoughts to Mr. he and his relatives.

  14. barbara emerson
    May 31, 2015

    I want to reach into the film and take “Little Rice” into my arms. I too helped my husband die young and what you show in this film is gut-wrenching reality. Bathing, hugging, medicating, but most importantly singing, playing and laughing. Plain,unencumbered love.
    Her buoyancy is remarkable — carrying him down the road and laughing. Laughing! in the face insurmountable sadness.
    We need more Little Rices in the world for she is a gifted woman indeed who faces the worst possible situation with not an iota of self-pity.
    We all face adversity in our lives. My hope is that each person who sees this film chooses to face it with the levity and strength of Little Rice. God bless her.

  15. Michael Lim
    May 31, 2015

    The Goverment must compensate these families. Harm is done and lesson should be learned.

  16. Anikesh Ashwin
    May 31, 2015

    Love is the cure.

  17. Jane U
    May 31, 2015

    Heart breaking and humbling. Your film and narrative so powerfully show the real costs of our desire for cheaper goods.

  18. Charleen Fondrevay
    May 31, 2015

    Do families such as He Quangui receive any financial help from the Chinese government?

  19. KM Tang
    May 27, 2015

    They are the real heroes of the economic miracle which is China. It’s painful to see millions like Mr He suffering this way, after spending the best part of his youth trying his best to provide for his family. I want to focus on the positive messages in this video. Firstly, Mrs He’s love and affection for her husband is beyond anything I’ve seen. Not forsaking him and still taking great pains to care for him. I truly have the greatest respect for Mrs He. As much as Mr He is suffering, I hope he will fight on, for the sake of his loving wife. My prayers are with the He family and the many families suffering the same fate. I’m humbled and inspired at the same time. Thank you for making this great video.

  20. bpmaiti
    May 26, 2015

    Great human story of love.

  21. Rob
    May 26, 2015

    i used to work in coal mines in australia. the saddest part about this story is that something as simple as water sprays is enough to prevent this disease. that countless human lives are less valuable than a bit of simple plumbing is something ill never understand

  22. Bryan
    May 26, 2015

    My hearts and prayers to He Quangui and his family.

    Really touching story.

  23. Sim Chi Yin
    May 20, 2015

    Many thanks for all your thoughtful comments. It was an emotional process filming and photographing the story of Mr He and his compatriots. If you’d like to reach out to him or offer concrete help, feel free to drop me a note at chiyin.sim@viiphoto.com. Many thanks.
    Chi Yin


  24. Mona Hwang
    May 20, 2015

    I have long-time been a member of volunteers in the main Chinese dust lung assistance agency “Love Saves Pneumoconiosis”. And it’s really moving to see a one-of-a-kind effort here to help voice such a dominating health issue in the country. Check our website here to find out more: http://www.daaiqingchen.org/list.php?fid=49 You may not agree with our work methods, or some of our values, but i believe we are working on the different paths to the same end.

  25. 项景尧
    May 20, 2015


  26. Gurdeep
    May 19, 2015

    I hope next time someone buys a gold ring for their partner, remember the human cost of getting that small piece of metal. How many tears a golf ring beholds.

  27. Patricia H
    May 18, 2015

    I really wish that He Quangui’s dilemma, and others in China who are also suffering from silicosis, had been broadcast years ago, when he was healthy enough to undergo a lung transplant. I’m certain, through social media, that he would have been helped. Is it too late, now, in his extremely weakened condition?

  28. dinara
    May 18, 2015

    So much pain and love in these pictures

  29. Tim
    May 18, 2015

    huge respect. thank you for this soul stirring video. my prayers are with you and your family Mr He

  30. Leon
    May 18, 2015

    love how they sing and he continued to play the flute. probably what helped him keep up for 10 years post-diagnosis. Anyone know the music he played on the flute? Such a touching story and short film. Great work on showing this. Thank you.

  31. Lawrence Lau
    May 17, 2015

    I am not a gullible person who accepts at face value what is presented in print and pictures. For all I know, it is not inconceivable that what was presented is anti-China propaganda ! which the ever self-styled “heroic” and “progressive” US (opportunistic and self-styled “exceptional and indispensable” US , to be exact) will exploit, sooner or later, in their constant pursuit of regime change in countries they consider a threat to its global dominance.

  32. eileen west
    May 17, 2015

    I live in Arizona where the ground water is so contaimated anyone born in a certain area of Phoenix in my generation dies of one form or another of cancer. Such was the fate of my wonderful,funny,brillant David Penrod. So I feel your sorrow,deep and to the quick.

  33. sudhir
    May 17, 2015

    It is really painfull to go through the story and facts of miners and What is India doing in such cases, it is a known fact once people worn out of work or bedridden with poor financial support what happens to them,

  34. Dr. Siddiqui
    May 17, 2015

    a tale of the ravages of dust even if gold and the eternal human spirit to overcome the inevitible..very nicely written and photographed..

  35. David Chen
    May 17, 2015

    The only thing we keep hearing from the Chinese government is how rich and glourist the country is. Still over 1 billion Chinese have left behind the economic reform whereas the few showing off their blend name goods.

  36. Sudip Kumar Dutta
    May 17, 2015

    I joined “March of the Volunteers” (to die). I dug gold for my socialist, communist country, I become sick for my socialist, communist country, I continue to live only for my family, after much suffering I die for my socialist, communist country. Hail socialist, communist , People’s Republic of China.

  37. monique
    May 17, 2015

    I cried. This is very moving. A love story 🙁

  38. Rudolph.A.Furtado
    May 17, 2015

    Every profession involving “MINING” has its own occupational hazards in every country let alone China.I had toured the “KAWAH IJEN” sulphur mines on Jawa Island in Indonesia and was amazed in the manner in which the sulphur mine workers worked, one of the World’s toughest and most dangerous jobs.I am sure that none of these Sulphur mine workers of Kawah Ijen mines would ever retire at age 58 or 60 years as the “Sulphur Fumes” or a “accident” could abruptly terminate a workers job or worse a life. The same case seems to be with the Chinese Gold miners and workers of Hongjun villagfe in China.silicosis is the ultimate disease that destroys the life of most of these gold mine workers.

  39. April Hung
    May 16, 2015

    Thank you for bringing us this beautiful, and vital story. My family is from Taiwan. I remember my paternal grandmother also had a milder form of the disease from manufacturing tombstones(somewhat ironic, I guess). Though she lived to her 80s, the disease’s effect on her was devastating. To this day, Silicosis is still one of the most suffered disease by labors in Taiwan and China. I hope more awareness can bring improvements to worker’s safety.

  40. rosalind
    May 16, 2015

    it’s hard to believe that he worked in such unsafe conditions…despite how cheap it costs to protect oneself from the mining dust! that really highlights the tragedy of it all….

  41. John Chen
    May 16, 2015

    If you’re Chinese, you should know the government and the mine owners don’t care about the poor. To them, these people are replaceable and just a number. I use to live in China, people are are too consumed with greed and materialism, it’s sad.

  42. L
    May 16, 2015

    One of the best short docu i’ve seen.

    Is he still alive?

  43. liz kerch
    May 16, 2015

    what a loving couple they are and my heart goes out to them.

  44. Pinky
    May 16, 2015

    To expose this kind of true story, I am afraid the reporter Ms. Sim will soon be taken by the Chinese government and put into jail. Chinese government does not let anyone report facts that deteriorate their image!

  45. Sevval
    May 16, 2015

    Thinking of you,lots of love.

  46. Yu
    May 16, 2015

    This really touched me, ‘the true cost of gold’, indeed, this clarifies and differs my view towards value of gold, wish the He family all the best.

  47. Greg J
    May 16, 2015

    This was wonderfully done. What a sad look into the lives of these wonderful people.

  48. Anna F.
    May 16, 2015

    This is a beautiful love story – how sad to have acquired this lingering and painful disease – from working – and with such an inevitable end. My heart goes out to this family.

  49. Viola
    May 16, 2015

    The fault in our stars in real life. T_T

  50. Laura
    May 16, 2015

    This is heartbreaking. As an occupational safety & health professional I think this vid and story should be used as an educational material.

  51. marcella marcelli
    May 16, 2015

    It is painful to see so much love and suffering. Is it ethic to film this private suffering? I am not sure it is. I am sure they were offered money to be filmed, and in the dire situation they are they could not refuse it. If it could be useful to reduce the opportunity of exploitation rich jump at with uniinformed people, at least it would be of some use. But will it?? I really doubt it.

  52. Mer
    May 16, 2015

    Is there anything we can do to help this family?

  53. kathy oracoy
    May 16, 2015

    So sad to read.

  54. Janet Yu Xu
    May 16, 2015

    How sad I am!I’m a Chinese.Did the government ever try to help them?

  55. anon1
    May 16, 2015

    This is so sad…knowing rich people value gold more than people lives

  56. Yulu Chen
    May 16, 2015

    There will be more Chinese getting silicosis in the future.

  57. Geri Twomey
    May 16, 2015

    very sad but important to make people aware. Thanks for producing.

  58. Gopa Kundu
    May 16, 2015

    i am speechless!

  59. Matt S
    May 15, 2015

    Wow, what a story my prayers are with the families in this situation..

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