HIV/AIDS in Cambodia: Graduate student Makna Men travels to his native country and finds a group of people living with little more than hope.

by Makna Men

After decades of civil war that ravaged the country, Cambodia faces another crisis: HIV/AIDS, a disease that has shattered family structures and left many children homeless.

Since the first Cambodian AIDS case was reported in 1993, the virus has claimed more than 90,000 lives. Currently, there are about 25,000 people who have late-stage AIDS, and more than 170,000 who are infected with the disease. The government promotes condom use, and the number of new infections is declining. The challenge, however, is caring for AIDS patients and for the families left behind as more and more people with full-blown AIDS are unable to work.

I am a graduate student in the Program of Development Studies at Brown. I was born in Cambodia and resettled in Providence as a refugee about 22 years ago. In June of 2004, I traveled to Cambodia to conduct my master's thesis research on HIV/AIDS. In four weeks, I interviewed 38 people: Four were Buddhist monks from four different temples; eight were government officials; six were nongovernmental organization (NGO) staff; and 20 were people living with HIV/AIDS. My goal was to study the effectiveness of responses from various entities to the needs of people living with HIV/AIDS.

During my interviews, most of the people living with AIDS cried as they described their struggles. Most of them do not have a spouse because he or she has died of AIDS. Many cannot afford to stay in their homes because they had to sell their land to support their daily needs. They have no cows or pigs and only a few personal belongings.

Of the 25,000 people who need antiretroviral (ARV) drugs for their late-stage disease, only 5,000 are fortunate enough to receive them from nongovernmental organizations. They travel to another province to obtain the drugs - a monthly trip that costs 100,000 riel, or about $25. It is an expensive trip for people with the disease, many of them so poor that they live in quarters a Buddhist temple rented for them.

When I visited a Buddhist temple to set up an interview with people living with HIV/AIDS, I brought 200 kilograms of rice and 6 kilograms of dry fish to donate to the temple. Forty-one orphaned children live at the temple. Some have AIDS and some look very healthy, but looks can be deceiving. Before I left, one worker asked me whether I would be able to give some cash to the temple to buy milk to feed the babies there. Everywhere I turned there were people in need.

How long would the 200 kilograms of rice last? I asked one worker. About three days if they were lucky, he said. The rice not only feeds the children at the temple but also the people suffering from HIV/AIDS who live around the temple as well: When they have no rice, they come to the temple seeking food.

In the end, what good had I done? They would eat for a day or two. But people are entitled to eat for a lifetime. People living with HIV/AIDS need food, transportation to get their drugs, milk for their babies, and shelter.

One other major problem is the stigma faced by people living with HIV/AIDS. Knowledge about how the disease is transmitted is still low, and there are those who fear that by coming into contact with someone living with HIV/AIDS, they, too, will "catch" it. Such attitudes have costs some vendors who are discovered to have HIV/AIDS their livelihoods. The government and NGOs are working to alleviate this fear by educating people about HIV/AIDS and its transmission.

The Cambodian public health strategy is in the process of moving in to care for the growing number of AIDS patients. However, the government is unable to provide all the care needed for AIDS patients and is working in conjunction with NGOs to coordinate many of the programs around the country. Even so, there are many people living with HIV/AIDS that do receive no services or support. More work needs to be done to alleviate the suffering.

When I asked those living with HIV/AIDS how would they like the government to help, all said they needed rice, transportation to and from the province where they receive ARV drugs, milk for their babies, someone to take care of their children when they die, and shelter. As many spoke, tears rolled down their cheeks, and I offered to end the interviews. But they were eager to continue: They wanted the world to hear about their suffering because they believe that publicizing their situation is their only hope.

[The four weeks of research in Cambodia would not have been possible if I had not had help from people like Dr. Seng Sut Wantha, deputy director of the National Center for HIV/AIDS, Dermatology and STI; and a Khmer local nongovernmental organization, Project AIDS Khmer in Cambodia, to facilitate contacts and made the arrangements for me to meet with government officials, NGO staff, Buddhist monks and people living with HIV/AIDS.]