By NICHOLAS D. KRISTOF

China’s biggest health disaster isn’t the terrible Sichuan earthquake this month. It’s the air.

The quake killed at least 60,000 people, generating a response that has been heartwarming and inspiring, with even schoolchildren in China donating to the victims. Yet with little notice, somewhere between 300,000 and 400,000 Chinese die prematurely every year from the effects of outdoor air pollution, according to studies by Chinese and international agencies alike.

In short, roughly as many Chinese die every two months from the air as were killed in the earthquake. And the problem is becoming international: just as Californians can find Chinese-made shoes in their stores, they can now find Chinese-made haze in their skies.

This summer’s Beijing Olympics will showcase the most remarkable economic explosion in history, and also some of the world’s thickest pollution in both air and water. So I’ve returned to the Yellow River in western China’s Gansu Province to an isolated village that has haunted me since I saw it a decade ago.

Badui is known locally as the “village of dunces.” That’s because of the large number of mentally retarded people here — as well as the profusion of birth defects, skin rashes and physical deformities. Residents are sure that the problems result from a nearby fertilizer factory dumping effluent that taints their drinking water.

“Even if you’re afraid, you have to drink,” said Zhou Genger, the mother of a 15-year-old girl who is mentally retarded and has a hunchback. The girl, Kong Dongmei, mumbled unintelligibly, and Ms. Zhou said she had never been able to speak clearly.

Ms. Zhou pulled up the back of her daughter’s shirt, revealing a twisted, disfiguring mass of bones.

A 10-year-old neighbor girl named Hong Xia watched, her eyes filled with wonder at my camera. The neighbors say she, too, is retarded.

None of this is surprising: rural China is full of “cancer villages” caused by pollution from factories. Beijing’s air sometimes has a particulate concentration that is four times the level considered safe by the World Health Organization.

Scientists have tracked clouds of Chinese pollution as they drift over the Pacific and descend on America’s West Coast. The impact on American health is uncertain.

In fairness, China has been better than most other countries in curbing pollution, paying attention to the environment at a much earlier stage of development than the United States, Europe or Japan. Most impressive, in 2004, China embraced tighter fuel economy standards than the Bush administration was willing to accept at the time.

The city of Shanghai charges up to $7,000 for a license plate, thus reducing the number of new vehicles, and China has planted millions of trees and hugely expanded the use of natural gas to reduce emissions. If you look at what China’s leaders are doing, you wish that President Bush were half as green.

But then you peer into the Chinese haze — and despair. The economic boom is raising living standards hugely in many ways, but the toll of the resulting pollution can be brutal. The filth is prompting public protests, but the government has tightly curbed the civil society organizations that could help monitor pollution and keep it in check.

An environmental activist named Wu Lihong warned for years that Lake Tai, China’s third-largest freshwater lake, was endangered by chemical factories along its banks. Mr. Wu was proved right when the lake filled with toxins last summer — shortly after the authorities had sentenced him to three years in prison.

Here in Badui, the picture is as complex as China’s development itself. The government has taken action since my previous visit: the factory supposedly is no longer dumping pollutants, and the villages have been supplied with water that, in theory, is pure. The villagers don’t entirely believe this, but they acknowledge that their health problems have diminished.

Moreover, economic development has reached Badui. It is still poor, with a per-capita income of $100 a year, but there is now a rough dirt road to the village. On my last visit, there was only a footpath.

The road has increased economic opportunities. Farmers have dug ponds to raise fish that are trucked to the markets, but the fish are raised in water taken from the Yellow River just below the fertilizer factory. When I looked in one pond, the first thing I saw was a dead fish.

“We eat the fish ourselves,” said the village leader, Li Yuntang. “We worry about the chemicals, but we have to eat.” He said that as far as he knew, the fish had never been inspected for safety.

This really doesn't bode well for China as a whole, or our own dependence on Chinese imports. If their government would sit by and leave a village to grow deformed and handicapped by pollution, then sell their polluted fish on the market with no quality control to unsuspecting consumers, it makes me wonder what they are shipping overseas to our own shelves. Unfortunately not every country supports the people's right to protect themselves from destructive industry.

Mike,

What they're shipping to us is anything and everything we want. Along with it comes poisonous pet food and children's toys painted with lead-based paints.

But American has its own claim to shame: in order to sell more baby formula American corporations have launched huge "education" campaigns extolling the virtues of formula over breast milk. They did this even though the cities that were targeted for the formula-is-better-for-your-baby campaigns didn't reliably have safe drinking water.

And then there's the hundreds of atomic bombs the US government set off on US soil. The fallout sometimes drifted hundreds of miles where it fell on the lawns and playgrounds of US citizens. 

Here's another classic:

Tuskegee Study of Untreated Syphilis in the Negro Male