BEIJING — Over the past few years, trips back to my home village, Huaihua Di, on the Lanxi River in Hunan Province, have been clouded by news of deaths — deaths of people I knew well. Some were still young, only in their 30s or 40s. When I returned to the village early last year, two people had just died, and a few others were dying.

My father conducted an informal survey last year of deaths in our village, which has about 1,000 people, to learn why they died and the ages of the deceased. After visiting every household over the course of two weeks, he and two village elders came up with these numbers: Over 10 years, there were 86 cases of cancer. Of these, 65 resulted in death; the rest are terminally ill. Most of their cancers are of the digestive system. In addition, there were 261 cases of snail fever, a parasitic disease, that led to two deaths.

The Lanxi is lined with factories, from mineral processing plants to cement and chemical manufacturers. For years, industrial and agricultural waste has been dumped into the water untreated. I have learned that the grim situation along our river is far from uncommon in China.

The nation has more than 200 “cancer villages,” small towns like mine blanketed with factories where cancer rates have risen far above the national average. (Some researchers say there are more than 400 such villages.) Last year the Ministry of Environmental Protection acknowledged the problem of “cancer villages” for the first time, but this is of little comfort to my parents’ neighbors and millions like them around the country.

More than 50 percent of China’s rivers have disappeared altogether, and few of the surviving waterways are not completely polluted. Some 280 million Chinese people drink unsafe water, according to the Ministry of Environmental Protection. Nearly half of the country’s rivers and lakes carry water that is unfit even for human contact.

And China’s cancer mortality rate has soared, climbing 80 percent in the last 30 years. About 3.5 million people are diagnosed with cancer each year, 2.5 million of whom die. Rural residents are more likely than urban residents to die of stomach and intestinal cancers, presumably because of polluted water. State media reported on one government inquiry that found 110 million people across the country reside less than a mile from a hazardous industrial site.

I have lived away from my hometown for years and only return for brief visits, usually during the Chinese New Year. I am becoming more and more a stranger there. And yet my journey as a fiction writer started from this humble place. It has been a literary gold mine for me, giving me endless inspiration. The once sweet and sparkling water of the Lanxi frequently appears in my work.

People used to bathe in the river, wash their clothes beside it, and cook with water from it. People would celebrate the dragon-boat festival and the lantern festival on its banks. The generations who’ve lived by the Lanxi have all experienced their own heartaches and moments of happiness, yet in the past, no matter how poor our village was, people were healthy and the river was pristine.

Now there is not a single lotus leaf left in our village. Most of the ponds have been filled in to build houses or given over to farmland. Buildings sprout up next to malodorous ditches; trash is scattered everywhere. The remaining ponds have shrunk to puddles of black water that attract swarms of flies. Swine fever broke out in the village in 2010, killing several thousand pigs. For a time, the Lanxi was covered with sun-bleached pig carcasses.

The Lanxi was dammed up years ago. All along this section, factories discharge tons of untreated industrial waste into the water every day. Animal waste from hundreds of livestock and fish farms is also discarded in the river.

It is too much for the Lanxi to bear. After years of constant degradation, the river has lost its spirit. It has become a lifeless toxic expanse that most people try to avoid.

Its water is no longer suitable for fishing, irrigation or swimming. One villager who took a dip in it emerged with itchy red pimples all over his body.

As the river became unfit to drink, people began to dig wells. Most distressing to me is that test results show the ground water is also contaminated: Levels of ammonia, iron, manganese and zinc significantly exceed levels safe for drinking. Even so, people have been consuming the water for years: They have had no choice. A few well-off families began buying bottled water, which is produced mainly for city dwellers. This sounds like a sick joke.

Most of the village’s young people have left for the city to make a living. For them, the fate of the Lanxi is no longer a pressing concern. The elderly residents who remain are too weak to make their voices heard. The future of the handful of younger people who have yet to leave is under threat.

I posted a message about the cancer problem in Huaihua Di on Weibo, China’s popular microblogging platform, hoping to alert the authorities. The message went viral. Journalists went to my village to investigate and confirmed my findings. The government also sent medical professionals to investigate. Some villagers opposed the publicity, fearing their children would not be able to find spouses. At the same time, villagers who had lost loved ones pleaded with the journalists, hoping the government would do something. The villagers are still waiting for the situation to change — or improve at all.

My hometown’s terminal illness and the death of Lanxi River have been heartbreaking for me.

I know the illness does not just affect my village and my river. The entire country is sick, and cancer has spread to every organ of this nation. In our society, profit and G.D.P. count more than anything else. A glittering facade is the new face of China. Behind it, well-off people emigrate, people in power send their families to countries with clean water, while they themselves consume quality food and clean water through the networks that serve the privileged. Yet many ordinary people still refuse to wake up, as if they were busy digging at the soil beneath their own feet while standing on a precipice.

After my visit home last year, I started to paint. I try to capture from memory the pristine river and my beautiful village. Now that the river has died, I hope it finds its paradise in my paintings. But what about the people who lost their clean water? Where is their paradise?

(Translated for the NYT April 6 2014)