- Silicosis is taking a huge toll on the families of miners who worked in choking conditions, often with little more than a towel to cover their face
Not long after Chang Dexiu married and moved to a remote part of southwest China in 2003, she heard fireworks go off twice within half an hour one night.
The pyrotechnics are a local tradition in Ganmi village in Sichuan province to announce the death of someone in the community.
Chang asked her husband, "Zhong", what had killed them and his reply changed her world.
"Dust lung," he said. "And I have it, too."
It was the first time Chang, now 43, had heard of the disease, an occupational condition also known as silicosis.
Her husband and many other men in the village had developed it by working in the area's lead and zinc mines. Activists say there are millions more across the country suffering from the same largely incurable condition and needing help to manage the symptoms. The authorities have introduced some programmes and legislation to ease the burden on those affected but there are also legions of families struggling to get by without their main breadwinner and patients requiring care.
Chang couldn't tell Zhong was sick when they were introduced and, after about a year, decided to get married.
It was a second marriage for both of them and Zhong earned a steady income as a taxi driver.
Even after the night of the fireworks and he explained the disease to her, she thought the illness could be cured. Then one day, he developed a cold that dragged on and grew heavier by the day.
"He had it when we got married, but it wasn't severe back then, so I couldn't tell by his appearance (that he was sick)," she said. "Later on we'd already become a family, and there was no way I could abandon him."
Zhong died in 2017, leaving Chang with two sons and a house full of debt. The older son soon left the village for work and the younger one, 11, is in school.
Over the decade she has lived in Ganmi, silicosis has taken the lives of 15 other men in the village, including three of Chang's four brothers. Gradually, Ganmi, with its roughly 1,000 people, has become known as "the widows village".
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As word of the "widows village" spread, the women have become the target of unwanted media and public curiosity. Last year, a blogger accidentally leaked Chang's phone number online, and she found herself at the centre of harassing phone calls.
"Many men called me, asking (teasingly) if I needed a husband," she said, adding that there was little concern for her difficulties. "So many phone calls and messages flooded in from all around the country."
Nevertheless, many widows in the area have remarried, including Chang's sisters-in-law, but Chang hasn't thought about it.
"My family is so poor, who would shoulder the burden with me?" she said.
Sometimes, she thinks about her late husband, wishing there was someone to share the burden with her. She survives on rice and oil from a government poverty-relief programme, and some money from her relatives.
Silicosis is a lung disease that plagues people who work in dusty environments. Over time, the silica in dust can build up in lungs and airways, leading to scarring that makes it hard to breathe. With the exception of a lung transplant, there is no cure but care can prolong a patient's life.
In 2002, China passed a law requiring employers to offer medical and living support to workers with occupational diseases.
Chinese health officials estimate that as of the end of 2018, there were 975,000 cases of occupational diseases and 90 per cent of them, or 873,000, were cases of dust lung.
But Daai Qingchen, a grass-roots group trying to help people with the condition, says the real figure is much higher " at least 6 million workers.
Hanyuan county, which administers Ganmi, is home to thousands of those people, most of them miners.
In 2014, the Hanyuan government started covering the medical bills of and providing a 100 yuan (US$14) monthly living subsidy to those officially diagnosed with an occupational disease.
But not all afflicted workers have access to these benefits " some did not sign a proper contract and could not prove they were working at the mines, and some mines had changed ownership, clouding liability.
Luo Qingyu was one of those who missed out on the benefits.
In 1991, Luo was 19 and looking to earn some money to buy a house and find a wife. Like many of his friends, he worked at Wusihe lead-zinc mine, where he drilled holes around the clock.
The mines were so dusty that people could not see each other and by the end of each shift, the miners' noses were clogged with the fine particles.
The miners had no idea that the dust could affect their health and did little more than cover their face with a towel, villagers said.
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A few years later, the villagers started developing symptoms, starting with a persistent cough and developing into a fever and chest pains.
Luo and several others missed the deadline for the benefits and were forced to cover their own medical expenses.
He died on Friday in a hospital intensive care ward. Before moving to hospital, he spent his days lying on the sofa in his rural home, attached to a ventilator and gasping for breath.
Prior to Luo's death, his wife, Zhu Zhongfen, said her only wish "is that his medical bills and our living expenses can be covered".
In another village in Hanyuan county, Li Qunying is also struggling to make ends meet.
Her husband, Lu Changxi, was diagnosed with silicosis in 2005 and could no longer work.
Li went out into the workforce, taking any job she could find, from cook to construction labourer.
A few months ago, while carrying sand and gravel at a construction site, she slipped and fell from a two-metre-high platform, breaking a leg. The few hundred yuan she had saved all went into hospital treatment. Now the family of four rely on help from their relatives and selling fruit from the trees they own.
Li raises chickens and rabbits in her yard, and buys herbal medicine and honey for her husband to help ease his symptoms.
But there is always the grinding physical toll of taking care of her sick husband.
"Sometimes he coughs all night, until he spits up blood," Li said. "I get so tired that I doze off, but within 10 minutes he coughs and wakes me up again.
"If there's a next life, I would definitely not come back as a woman."
For many of the women like Li, each day is focused on caring for their families but they know the inevitable is coming. In a WeChat group of patients in the neighbourhood, Li says she often hears about men dying " and it is heart-wrenching every time.
"It reminds me that one day my husband may face this fate," she said. "Right now, I can only concentrate on taking care of him and maybe he will have some more years."
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