MA LI SMILED SHYLY and wriggled in her mother's arms. The 18-month-old's innocent face showed no trace of the deadly disease that has kept the toddler in a public hospital in Nanning, Guangxi province, for most of her short life. Asked about the child's prospects for recovery, Dr Cheng Liangqin grimaced: 'She may live, but it won't be easy.' Each year hundreds of thousands of newborn babies in China are born infected with hepatitis - a diseased passed on by their parents. Most are infected with hepatitis B, which is less deadly than the rare strain of hepatitis attacking Ma Li. She is one of the unluckiest in Guangxi province, which has one of the highest rates of hepatitis infection in the world. But many of China's peasants are simply too poor to afford the vaccination that came into worldwide use 20 years ago. Sadly, about five million babies born each year are not vaccinated. 'More than 170 million people in China, that is 15 per cent of our population, have been infected with the disease,' said Dr George Lau Kar-kit, a founder and trustee of Hong Kong-based CSY (China International) Hepatitis Research Foundation. The foundation was established by local doctors and philanthropists in 1998 and in May it launched a campaign to rid the mainland of the disease. 'About 20 to 40 per cent of these people will die of liver failure or cancer when they are in their 40s. In many places, almost everyone in the village is a hepatitis virus carrier,' Dr Lau said. Residents of prosperous coastal provinces do not need to pay for vaccinations as they are funded by local governments. But in the impoverished western hinterland, where the average income is just 100 yuan (HK$94) a month, people have to pay at least 30 yuan for the course of three injections. From next year, the Central Government hopes to provide free hepatitis B vaccinations to all newborn babies in the 12 western provinces as part of its Go West campaign to develop the rural hinterland. But many people wonder whether these local governments can afford the vaccinations. In the town of Tianden, 170km from Nanning and one of the areas badly affected by the disease, the public health bureau has complained about an acute shortage of money, staff and facilities. 'Many people here cannot even feed and clothe themselves. They cannot afford even 30 yuan,' a bureau report commented. It said the Guangxi provincial government had ordered the town to set aside 10 fen (cents) for every resident. But the town could not afford this. 'We have only a tiny budget,' the document said. 'Many countryside doctors are not paid. This makes it very difficult for them to continue work.' Dr Lau, from the anti-hepatitis foundation, said he doubted whether the Central Government's plan could be successfully implemented: 'It may provide vaccines to the 12 western provinces but the local governments have to find ways to pay for the administration and operational costs, not to mention training and hiring qualified medical staff.' With this in mind, the foundation recently launched a campaign to raise funds for a 'Hepatitis-Free Generation'. The campaign hopes to raise the hepatitis B vaccination rate above 90 per cent within 10 years. 'Hepatitis has become the scourge of Chinese people. It is not only a life-and-death health problem, it has also become a heavy financial and social burden,' foundation chairman Chan Wing-kee said. Starting with Guangxi, the foundation hopes to vaccinate 200,000 babies next year. It will then extend its work to other areas in northwestern China. 'It may take one to two generations to complete the target,' Mr Chan said. Another council member, Dr Chan Chi-kuen, said the foundation also would organise academic exchanges between Hong Kong and the mainland. The University of Hong Kong is now working with Fudan University in Shanghai on a new hepatitis B vaccine. Even though Guangxi is one of the world's most badly infected areas, few government officials are willing to admit that there is a problem and many people consider the vaccinations to be a waste of money. The most common routes of infection are through the exchange of body fluids or blood - especially during sexual intercourse. Pregnant women also pass on the disease to their unborn babies or when breastfeeding. 'To change this, we need to overcome the bureaucracy and the problem of lack of education. The foundation will not only provide money to them, we will also supervise how the money is used,' Dr Lau said. He hopes health authorities will co-operate with the foundation and help improve the standard of medical care in China's remote western region. 'This is a huge task. It is impossible to achieve it without public support. Our aim is to get the attention of Chinese people in Hong Kong, Macau and overseas,' he said. Chow Chung-yan is a reporter for the South China Morning Post's news desk.