The term “cancer villages” first appeared in the media in 2001 and was acknowledged by the Chinese government in 2013. It refers to villages with a high incidence of cancer and high mortality rates. As Chen Ajiang and his co-authors point out, there is as yet no official definition of the term but people usually attach to it a shared assumption that there is a causal relationship between cancer and pollution. Chinese “Cancer Villages” is a pioneering sociological quest to understand the pollution–cancer relationship and discursive practice in and around “cancer villages” in contemporary China.
The book makes two main arguments. First, the authors use “ins and outs” as a lens to illuminate two competing perspectives on the aetiology of cancer clusters as well as their contested nature. While the media and public discourse tends to centre on the “outs,” i.e., external pollution, as underlying factors, Chen and his colleagues argue that living conditions and local lifestyles should never be neglected in understanding the causes of the disease. Proving the existence of cancer clusters and their causality at the village level is notoriously difficult, but the authors take the bold step of tackling the uncertainty by seeking and weighing different sources of evidence. In fact, they demonstrate that the village can be a valuable unit of analysis, bridging the gap between epidemiology and clinical medicine, and allowing for integrated analysis that draws on social and medical sciences in the identification, diagnosis and treatment of cancer.
The authors’ second argument is that the dispute over the causes of “cancer villages” is by no means a controversy only in the medical sciences. The pollution–cancer relationship exists under certain social conditions. Emotions, economic interest and social structures affect the attribution of responsibility and the way in which conflicts are framed and negotiated between villagers, industry and local governments. Cancer patients and their families are often disadvantaged by their limited scientific knowledge and their negative feelings towards the government when they attempt to construct a meaningful explanation for the occurrence of the disease. In consequence, their actions against perceived inequalities within and beyond their communities are far from being merely a struggle for a reasonable distribution of environmental rights and burdens. As Chen points out, it is difficult to apply a simple environmental justice analysis to the issue.
Following the introductory chapter, which offers Chen's retrospective thoughts on the phenomenon of “cancer villages” and their evolution against the backdrop of China's industrialization, agricultural development, urbanization and environmental policy, the book presents nine village portraits, each focusing on a particular aspect: knowledge clashes on the aetiology of cancer; strategies of grassroots mobilization; evidence seeking and presentation; stigmatization and the construction of villagers’ identity; and local forms of risk management. Chen's team also sheds light on how these issues are embedded in the particular socio-economic settings and environmental history of these villages, which include a former state-farm, two villages close to a metal mine, and a community living near to an incinerator. Through thick descriptions, they demonstrate their nuanced understanding of complex worlds in which the real human suffering of the local people is situated within a broader picture of social transformation in rural China. Stemming from their reflexive positionality, Chen's team maintain an appropriate distance from the villagers while demonstrating empathy. The book exemplifies how “cancer villages” can and should be approached by sociologists; as Spinoza writes, the aim is not to mock, lament or execrate, but to understand.
Methodologically, this volume is an analytical summary of the team's multi-sited fieldwork in Jiangsu, Guangdong, Zhejiang, Henan and Jiangxi. Chen and his colleagues adopted mixed approaches to data collection, ranging from observation, interviews and archival work, to small-scale surveys. When I interviewed Chen back in 2014, he had even equipped the team with simple water-quality test kits to facilitate evidence tracing at suspected pollution spots. Numerous forms of evidence are presented and critically evaluated in this volume, including statistics released by governmental agencies, insights about local factories’ manufacturing processes, and informal data gathered either by or from villagers. Another important methodological contribution of the research is its historical perspective. Chen and his team effectively bring in environmental and social history to understand the deeper roots of the “cancer villages” by linking the evidence with ethnographic examination of the development trajectory in different localities.
Chen's decision to confront the problem of causality behind the cancer clusters makes the book stand out from the existing literature on this topic, which tends either to take pollution victims’ claims at face value and focus on mobilization or to set the question of causality aside and explore lay understandings of and responses to such risks. Underpinning the authors’ serious attitude towards causality – although they do not express it explicitly – is that understanding causality matters not just for the sake of responsibility attribution, but also as the fundament of successful intervention. The volume further presses for careful selection of intervention measures suited to local contexts. It presents the experience of existing “cancer villages” as a warning call to the hinterland and west of China, which are likely to follow a similar development pathway. In this sense, the book is not only a significant piece of academic work. It also disseminates an important message to policy makers and the general public – to understand the long-term trade-offs involved in industrialization and support a more cautious approach to development.
