UK Press Features
Aids – the latest spectre to haunt disaster-ridden Cambodia
Times Saturday Magazine – February 14, 2004
Chim Ouk is lying facing out towards the fields. The landscape is vibrantly beautiful. The rice paddy glows a shocking, healthy, emerald green. The sunlight on the lanky sugar palms is golden, and there are chickens squawking drunkenly underfoot. But she isn’t looking. She is too weak to life her head; too sick to talk. She lies on her side with her eyes open. “I can’t see any more,” she mutters. She doesn’t even acknowledge her two little sons who have just biked back from school, and are now curling up anxiously around her in their navy and white uniforms, stroking her wasted arms.
Everyone knows this 38-year-old woman is dying. The hushed neighbours; her skinny mother; the saffron-robed Buddhist monk, with his kindly face, who is standing in the shade of the palm-leaf hut murmuring, “the best way now is emotional support”.
The children know too. Leo Wi and Leo Li might only be ten and nine years old, but they have already seen one parent die of Aids. Their father wasted to death after getting a construction job in town. Like hundreds of thousands of other Cambodians, drifting from the fields to building sites for a subsistence wage, he brought back home to his family the virus he contracted from a casual sexual encounter.
In this still, golden vista, it is almost impossible to grasp the scale of the trauma being visited by HIV/Aids on this small country of some 14 million people. Death and distress seem out of tune with the seductive loveliness of the scene, a panorama of the soft umbers and soothing ochres that, in the West, are almost interior-design code for meditative happiness.
Yet the Aids statistics – the skull-beneath-the-skin reality – make horrifying reading. A raging epidemic has affected nearly 3 per cent of Cambodians, making this South-East Asia’s worst-hit country. There is no real hope for anyone who gets the virus. Cambodia is too poor for the anti-retroviral drugs that keep symptoms at bay in the West. In Cambodia, it is more a question of dying of Aids than living with it. And that is creating ripples of reflected misery, loss and poverty: 60,000 children have been orphaned and 60,000 more will be orphaned in the next two years.
But in a society where anger is thought of as a sign of madness, people shy away from discussing their troubles. Most would rather just smile with enigmatic calm. This is the Cambodian paradox. There has been precious little Buddhist serenity in 50 years of tormented independence. For as long as many can remember, this has been a land of violent death. Aids is only the latest tragedy – but each has been met by its victims with the same poignant, passive grace.
The reason this landscape seems so strangely familiar is that we’ve seen it at the cinema. These are the Killing Fields, where one of the 20th century’s most hideous crimes against humanity was committed a generation ago and brought to popular consciousness by David Puttnam and Roland Joffe’s film. The perpetrators, Pol Pot’s Khmer Rouge, were murderously austere visionaries. They wanted to strip away modern corruption and start a permanent agrarian revoliton from what they called “Year Zero”. So, in 1975, youths in black pyjamas, chequered neckscarves and pistols emptied the Cambodian cities of their meek, unquestioning people. Herded out into the rural areas, families were deliberately separated. A million people were exterminated before the revolution devoured itself.
Any Cambodian over 28 (nearly half today’s population) is a survivor of the Khmer Rouge years, and lives with memories of losing parents or siblings or children. And anyone over 18 has been exposed to military brutality: Cambodia’s 10-year occupation by a younger army from over the border in Vietnam, which finally drove out the Khmer Rouge in 1979. These “liberators” were better than the ”oppressors” they replaced – but not by much. Only in 1989, when the Vietnamese Army finally went home, allowing the UN to ease Cambodia back towards ruling itself, did a kind of peace return. Refugees came home. The ghost cities filled up again.
But the legacy of so much murderous violence is a poisonous fog of mistrust. Parents do not trust their children; children cannot talk to their parents; no one trusts the Government. In this almost uniquely guarded society, no common language has been established either to discuss the past or to lay its ghosts to rest. Ask most Cambodian adults where they were in the Pol Pot years and all you’ll get is a short, glassy-eyed recitation of fact, stripped of feeling. “I was sent to such-and-such a province. Eight of my ten siblings died. Afterwards, my mother and I settled in such-and-such a plaice.” The only answer to any question about what they felt is “sad”.
Kong Villa, a handsome, articulate young man working for Save the Children on HIV/Aids projects, looks away when I ask him how he describes the Khmer Rouge years to his ten-year-old son. “I don’t,” he says briefly. “We’ve never talked about it. People just want to forget all that happened.”
That’s part of the joy of Cambodia to Lee, a 40-year-old Canadian engineer taking time out from reality in Phnom Penh, where he has settled, more or less, after riding a motorbike around South-East Asia. He doesn’t know if he’s here forever, but he thinks it’s great. “It can’t get more laid back than here. Sure, people have sometimes talked to me about Pol Pot’s time, saying ‘my father was killed, my mother was killed,’ but they have the Asian thing of not holding on to the past,” he says happily.
I meet Lee after midnight at a red-walled, surprisingly sophisticated expat bar called Heart of Darkness. He never turns his head towards the loo door when, as periodically happens, it opens and a Cambodian girl shimmies out, followed a second or two later by a sheepish-looking Western man. And he’s not bothered about Aids: “Hey, it’s not the big killer here, if you look at the figures. The real danger is traffic.”
Perhaps it’s unsurprising that the westerners here – usually round-the-world travellers, or aid and development workers, since state corruption still puts off most businesses – would turn a blind eye to the darkness just below the surface. It’s easy to do. Phnom Penh still looks poor, but it’s bustling and beautiful again. Its French-colonial mansions are painted, repaired and shuttered. Bright jacaranda and bougainvillaea plants fill parks, or trail over garden water pots filled with waterlilies and goldfish. The streets might be potholed and untended, but that doesn’t stop vast numbers of moped taxis, with improbable numbers of people on board, swarming from red light to red light.
But what seems remarkable is that Cambodians whose own lives are not directly touched by the latest sorrow of HIV/Aids also ignore it, as determinedly as they ignore their past. Tia Phalla, boss of the National Aids Authority, chuckles a lot, especially when he is talking about the Cambodians’ habit of taking multiple sex partners: “In the West you talk about love triangles – but Cambodians have octagons,” he laughs. But he takes the serious view that Cambodia’s past trauma makes it especially vulnerable to HIV/Aids now. “We have to overcome our lack of trust,” he says. “We’ve lost confidence in one another, which has left us with a very fragile social fabric. We can’t stop HIV attacking the body’s immune system. But the reason HIV/Aids enters the body is because the immune system of our society is so weak. We need to rebuild the immune system of society.”
Easier said than done. It will take a lot to raise trust in government. The Prime Minister, Hun Sen, an ex-Khmer Rouge cadre, has run Cambodia since he escaped to Vietnam halfway through their rule and then became the figurehead for the next, Vietnamese-installed, government. The King, Norodom Sihanouk, is now in his eighties and has also been allied with all the nasties of the past. Elections are flagrantly dirty. The Government has for years side-stepped the idea of putting the surviving Khmer Rouge bosses on trial.
To its credit, the Government does worry about HIV/Aids. Since the late Nineties, it has been behind a high-profile consciousness-raising campaign to try to educate people to have safe sex. But what money is earmarked for HIV/Aids trickles away. As one development expert puts it: “You wouldn’t get a spending figure out of the Government, and whatever figure they did give would be nine times higher than what was actually disbursed. They have problems at every level.”
Meanwhile, poverty and HIV/Aids feed destructively on each other. Cambodia’s sex industry is’t the brassy business of neighbouring Thailand. It’s quieter and more desperate – a few unmarked brothels in town; rough shacks by roadsides a few miles out of the centre, filled with migrant workers away from their wives. And half-prostitution: girls selling oranges in the park, but informally open to offers of commercial sex. Hundreds of thousands of young rural women flock to Phnom Penh to work sewing clothes for The Gal or Banana Republic, a practice which earns most of Cambodia’s export revenue. Away from home, they struggle to get by; many take “boyfriends” to help them with money. “The danger is not about sex for money, but about the heart,” Kong Villa says sadly. “Those girls will all have someone they love, and because they love them they will want to sleep with them without a condom. And that’s how HIV spreads.” So husbands pass HIV to wives; girlfriends to boyfriends; mothers to babies. Physical love, the easiest expression of feeling for a tongue-tied post-conflict nation, has become a risk, not a remedy – the bitterest irony of all.
An old prophecy has it that Cambodians will one day be forced to choose between being eaten by tigers or swallowed by crocodiles. Today’s crocodiles and tigers are the lumbering Cambodian bureaucracy, on the one hand, and the powerful but sleepy international HIV/Aids bureaucracy on the other. The Global Fund for Aids, a world body set up in the late Nineties to get money to developing countries needing help fast, has allocated $24 million to Cambodia so far. But clumsy accountability mechanisms mean almost all this money is still sitting uselessly in Geneva. As one exasperated foreign development worker, who asked not to be named, says: “People in Cambodia are beside themselves over this – because the Government really tried to get it right.”
But it’s not all gloom, or it needn’t be. A clever project set up by Save the Children is showing one way to break out of the vicious circle: through grassroots work with the Buddhist monks around whom so much of Cambodian life revolves – reactivating Buddhism as a powerful, practical force for good. The Buddhist pagoda is the centre of local life. A government school is often located within the pagoda grounds, and local houses are considered part of the pagoda complex. All young men, at some time, become monks, whether for a few weeks or months or longer, giving themselves up to contemplation, poverty, good works and learning. This combination of local links, learning and respect from their communities makes the celibate monks a potent force against HIV/Aids.
Save the Children’s brainwave has been to show the monks how to update Buddhism’s already compassionate teachings to include discussion of HIV/Aids. That means reinterpreting the Buddhist concepts of non-judgmental loving kindness, and the direct action of generosity – caring for those with HIV/Aids and lessening the stigma of being diagnosed with it. No medical care is involved. Save the Children’s interrelated projects, each confined to a few provinces, include training monks to explain HIV/Aids and tell people how to keep safe and be kind to those who are ill. The charity also runs a sexual and reproductive health programme. There’s been teething trouble, though. Many monks, especially older ones, were horrified at first, saying HIV/Aids teaching is about sexual intercourse and not a monk’s job. But the mood is changing. Since Cambodia’s leading Buddhist, the Patriarch, began openly supporting HIV/Aids education, others have come round too.
At Dombol Khpous pagoda, on the edge of Phnom Penh, Venerable Sukh Muny describes his work – teaching meditation “to make HIV/Aids people calm”, which, monks say, also keeps their condition stable. Muny knows about caring for people with HIV/Aids from his own experience. His own brother and sister-in-law have died of Aids, leaving nephews to be looked after by their grandmother. Since then, Muny has helped many others, whose early symptoms – diarrhea and a yeasty tongue are common signs – had meant they were ostracized by fearful neighbours. He moved one man into his own cell. “Before he died, he developed a lot of skin diseases. It was ugly, and people didn’t want to get close to him. But I put his ointment on and looked after him. Kindness is important. We need to support people in that last stage to make them hope – so that even if they die, they die with love and not with discrimination.”
Bleak though life must seem to Leo Wi and Leo Li, they are, at least by Cambodian standards, relatively lucky. It is part of the cruelty of life here that they know it. They are among ten children with HIV/Aids in the family to receive money from Save the Children. They have uniforms and books and can go to school without paying private “contributions” to teachers supplementing their subsistence salaries. That means their grandmother can feed them. And that gives them the chance of a future.
Today, Leo Wi has left school early to meet the foreigners from Save the Children. He wants to tell his story. “Before, we had to borrow rice to eat … Before, my granny had to keep me at home to help in the house … and the other children didn’t want to play with me.” He ends his little recitation with a Buddhist wai salute, fingers steepled over his nose, damp eyes down, and the simple words, “Thank you”.
For more information about Save the Children, visit www.savethechildren.org.uk or call 0845 600 8241.
ENDS