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The Guardian, 21 November 1998
John Gittings in Phnom Penh
The story of how Sophy's husband fell ill with AIDS, beside the river at Phnom Penh, is a story about diarrhoea and debt.
His death two months ago ended the diarrhoea but it left the debt still to be paid.
Sophy tells her tale in a wooden shanty built on stilts. Children carry dirty water from the Tonle Sap through the reed
banks below. Two of her own, a boy of four and a girl of two, wriggle listlessly on the boards.
When Sophy goes to fetch water, she feels faint. She is HIV-positive. So is the little girl, Sreyvuth. It is too early
to tell whether the antibodies which showed up in the test are her mother's or her own.
Cambodia has the highest recorded percentage of adults with HIV in Asia, and one of the highest rates of increase. 'There's
not much in the way of treatment,' a United Nations official said. 'They are more or less left to die.' There are no cocktails
of sophisticated drugs to help those with HIV stave off full-blown AIDS. The only cocktail is the familiar Third World formula
of misery, ignorance and official neglect.
For Sophy's family, HIV and AIDS was an extra disaster on top of a more familiar one when their shack was wrecked by flooding
two years ago.
They borrowed money to build higher; then they borrowed more to buy medicine. Altogether it came to US$200 (HK$1,548)
at 15 per cent interest - $30 a month.
Sophy's story is a tale of misery. 'At first I thought he had diarrhoea because of the alcohol he drank every day. It
lasted about three months.During the flood time he could not stand up and got diarrhoea while sleeping. I bought some medicine
and it got better. He tried to work again as a labourer at the fishing plant, but he felt dizzy when he went out.
'We went to the hospital and he was told he was HIV-positive. They gave him two pills and the diarrhoea got better. But
it was expensive travelling there for more pills. By this time he had skin diseases and slept on the floor.
'He told me he was sorry he had gone out with girls: he drank too much and forgot to protect himself. He died two months
ago.'
Cambodia's AIDS explosion is part of an Asia-wide epidemic, but it is being accelerated by a male culture which survived
the Khmer Rouge. Most Cambodian men, says the human rights activist Dr Kek Galabrou, regard visiting a prostitute as like
'drinking a cup of coffee'.
The United Nations Children's Fund (UNICEF) in Cambodia is sponsoring a series of educational television spots and videos
to say no to casual sex, or at least use a condom.
Noone said yes to casual sex during the Pol Pot regime (1975-78) which was followed by a decade of communist morality
under the Vietnam-backed government which ousted the Khmer Rouge.
Prostitution and the spread of sexually transmitted diseases took off as the country opened up: begun by the troops brought
in by the United Nations when it sponsored the 1998 elections.
By 1995 there were an estaimted 50,000 to 90,000 HIV-positive cases. This has now officially doubled – in a
country of 10 million. Privately, the minister of health concedes that the real figures must be much higher.
Sample surveys have shown that 10 per cent of soldiers, police and prisoners are HIV-positive, and as many as one-third
of sex workers. One UN study suggests a million individuals may be infected by 2006.
Condom awareness is still very low, and AIDS is still commonly regarded as a 'foreign disease'.
The huge number of sex workers - estimated at 300,000 to 500,000 - makes the task of education even harder.
The girls in the Martini club, next to the Intercontinental, all come from Vietnam. They wait in a beer garden, watching
violent Hong Kong films, diminutive compared with the large Westerners eyeing them from the bar.
Many will go back to Vietnam when they have earned enough money for their families; some will take the HIV virus with
them. They belong to a long list of women exploited for sex; full-time prostitutes in brothels, dancing girls in the dance-halls,
beer girls in the bars, part-time prostitutes hanging around the night-time food-stalls, street children of both sexes, plus
an underground traffic in young virgins.
UNICEF is funding projects to support the rehabilitation of child prostitutes and street children. Cambodian men, it says,
prefer young prostitutes, especially virgins, believing this will increase virility and bring good luck. The spectre of AIDS
has only increased the demand.
Surveys in Phnom Penh suggest that the average age of prostitutes is falling. Between 30 and 35 per cent are said to be
17 or younger, some only 12. There is a direct connection with increasing rural poverty: more than half have been sold into
prostitution – some by their families.
Some efforts are now being made to tackle the Aids epidemic. As well as the television campaign, there is a new project
in Sihanoukville to promote total condom use on the Thai model.
And a programme with German funds to prevent “vertical transmission” from mothers to their unborn
babies has been launched. It is the only programme in Cambodia using AZT. But such programmes can only achieve limited results
unless cultural attitudes change and millions of Cambodians can be hauled out of chronic poverty and debt.
That seems even less plausible as the country plunges into a new political crisis, caused by the opposition’s
refusal to accept the result of the July elections, and foreign investors and donors holding back.
For Sophy at least the immediate problem of debt has been solved. UNICEF, which used her story in its campaign, paid off
her debts.
But with three children - a third aged seven is at school - and the stigma of a husband who died of AIDS, she has little
chance of work. 'I tried once or twice to set up a stall selling vegetables, fruit and some cakes, but no one would buy.'
The future is darker still for thousands of other Cambodians who are - whether they know it or not - HIV-positive.
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