Award for Cambodia's "Rouge" Lady

Dr Nafis Sadik of the UN presents Cambodian first lady Bun Rany an award for her role in combating HIV/AIDS and reducing discrimination against those living with the disease at the Red Cross Headquarters in Phnom Penh on Tuesday. (Photo: Kim Sovannara, The Phnom Penh Post)

“This award is a slap in the face for Cambodians living with HIV and those most at risk, especially sex workers, homeless people and people who use drugs” - Joe Amon, director of health and human rights for Human Rights Watch

A rich nation crippled by poverty [-A view into Cambodia's future?]

Economic misrule by Myanmar's military government has made the resource-rich country one of the poorest in the world

TUESDAY, NOVEMBER 06, 2007
By Dinah Gardner in Yangon
Al Jazeera

Min Lwin U was 5-years-old when he found out he was HIV positive. That was three years ago. His doctors now say he has three months to live unless he gets anti-retro viral therapy (ART) soon.

Every day Lwin U is at a Medicins Sans Frontieres-run clinic in one of the poorest suburbs of Yangon. He comes to eat the three free meals of rice and curry the humanitarian organisation dishes out a day to malnourished and HIV positive children.

Even so his tiny arms are like sticks. His growth has been so stunted by the virus that he looks no more than four.

His dirty T-shirt and shorts hang loosely on his tiny, bony body. He scoops up the rice with his fingers and stares listlessly at some infants sprawled on bamboo mats being fed their meals.

Mismanagement

According to the World Health Organisation, 32 per cent of all children under five in Myanmar are seriously malnourished.

Your Views
"Until the generals' military hardware is crumbled, they won't listen to anyone" -
Oomlwin, Yangon, Myanmar

Decades of economic misrule by Myanmar's military government have made this resource-rich country one of the poorest in the world.

The ruling generals earned more than $2bn from natural gas exports last year, but the country's impoverished millions do not have free access to even basic healthcare.

And with the average daily income around $1 a day, many families cannot afford to pay doctor's fees – around $1-2 – when they get sick, much less the $35 price tag on a month's worth of ART.

The poverty here is crippling. In many ways it was the trigger that ignited September's protests.

Ten of thousands of people followed marching monks in the country's main cities and towns until the army moved in to crush the rallies on September 27.

While Western media stressed a public desire for democracy, for most in Myanmar, the demonstrations were about having enough food to eat and the right to basic healthcare.

"Most people here don't care about politics," says Su Hlaing Htwe, a doctor at the MSF clinic in Yangon's slum suburb of Hlang Thayar.

She waves her hand at the wooden and corrugated iron homes clustered behind the centre; an emaciated dog leaps over a ditch - a swill of filthy water cluttered with rotting debris.

Survival

The average daily income in Myanmar is around $1 a day [GALLO/GETTY]

"The people just want a chance to earn enough money to survive. Many of them can barely write. Mostly their education is very basic – just primary level."

Myanmar does not publish its budget but most experts agree that it probably spends less than a paltry dollar a person on health each year.

That's among the lowest level in the world.

It's left to a few UN agencies, MSF and a handful of other NGOs to do what they can, but their efforts are just a drop in the ocean.

Myanmar's poor suffer not just because their military government ignores them but also because the international community – citing discomfort over working with the generals – has been giving the country the cold shoulder for years.

And even among the few agencies that entered the country, some have pulled out.

Global Fund and MSF-France quit in the past two years citing excessive government interference in their humanitarian programmes.

According to 2005 World Bank figures, overseas development aid (ODA) per capita in Myanmar was about $2.90.

In nearby Cambodia, ODA per person in 2005 was about $38.50.

Double blow

"Now you have a people with a government that doesn't do anything for them, and an international community that also doesn't do anything for them" - NGO worker

"So now you have a people with a government that doesn't do anything for them, and an international community that also doesn't do anything for them," one long-term expatriate NGO worker in Yangon says.

"What little ODA you do have goes mostly on UN salaries anyway. So the people get nothing."

The four doctors at MSF-Holland's Hlang Thayar clinic see around 200 patients a day – mainly malnourished children and sufferers of HIV and TB.

Despite the surrounding slums and the plainness of the centre – basically a large wooden shed on stilts – the staff have made the place a comfortable escape from despair.

Doctors joke with their patients, local pop songs are piped over the speakers and there is a television in the waiting room.

But there is real suffering beneath the smiles.

Many of the women are widows – husbands already dead from Aids, their only legacy the virus in their wives' bodies.

Too sick to work, many of the women with HIV sport cropped hair, transforming them into teenage boys, because they can earn about $1.50 from selling their locks.

But their shaven heads act as a badge, alerting their neighbours to their likely HIV status.

Many are wholly reliant on the MSF's daily handout of rice and beans to its patients on ART.

Aids challenge

The WHO says 32 per cent of all children under five in Myanmar are malnourished

Min Min comes into the consulting room with a brilliant smile but within minutes her eyes begin to mist up and she crumples into her chair.

The 24-year-old mother is recovering from stage 4 HIV – the point at which a patient's immune system is so battered she is on the brink of being diagnosed with full-blown Aids.

Her soldier husband – dead now for four months – gave her the disease.

She is pleading with her doctor to let her have a month's worth of ART so she can leave Yangon for the southern city of Mawlamyine where her parents-in-law live with her five-year-old son.

But her doctor wants her to stay in Yangon. She is too sick and needs to stay close to the MSF clinic.

UNAIDS estimates there are around 360,000 people living with HIV/Aids in Myanmar and only a fraction of those can ever hope to get treated.

The bulk of the care is carried out by MSF. The group has committed to treating 16,000 sufferers but has reached the limit of its resources and announced a cap on new patients in July.

But that still means "tens of thousands of people die from Aids every year and nobody does anything about it", says Frank Smithuis, MSF-Holland's country director.

In some ways Lwin U is one of the lucky ones. He is already on MSF's list.

The organisation put him on ART when he was first diagnosed with HIV. But two years later, his mother, who is also HIV positive, took him out of the city, cutting him off from the drug that was keeping him alive.

Now he's back and very sick. But the clinic cannot restart his treatment until it is sure his family will stay put in Yangon and properly administer the therapy to him.

Stopping and starting ART can render it ineffective as the virus may become resistant to the cocktail of drugs.

"This situation is very common," says Hlaing Htwe. "Many patients here are poorly educated; they don't understand how important the drug is, and how important it is to take it properly."

The international community may be focusing on UN envoy Ibrahim Gambari's visit and meeting with the generals to persuade them to start a dialogue with the opposition, but Hlaing Htwe is concentrating on getting Lwin U's family to oversee his treatment.

"We are trying to persuade Lwin U's parents to commit to giving him the drug. But it is very difficult."

She smiles as she watches him take his bowl into the kitchen to be washed.

"But we are trying our best."

Norwegian People's Aid Helps Clear Landmines in Cambodia

2007-05-16
By Kittisak Siripornpitak
ScandAsia.Norway

With around 840 landmine victims annually, Cambodia has the third highest number of casualties worldwide and projects have been carried out by the Cambodian Mine Action Center (CMAC) which are supported by the Norwegian People's Aid (NPA) to reduce this problem.

NPA has been supporting CMAC's development projects since 1993 to help with the development and implementation of technical survey project and is currently providing two technical advisors to the CMAC Mine Detection Dog Program.

With aims to clear mines and ensuring fair distribution of land, the NPA gives funding and is monitoring the CMAC Demining Unit 1 in the Beantey Meanchey province.

Landmine Monitor Report for Cambodia: www.icbl.org/lm/country/cambodia

Chhouk Rin Taken to Hospital for AIDS Treatment

Reaksmey Heng
VOA Khmer
Phnom Penh
25/03/2007

Chhouk Rin, the former Khmer Rouge commander convicted of killing three Western backpackers and 13 Cambodians in 1994, was taken from Prey Sar prison to a Phnom Penh hospital for the treatment of AIDS-related illnesses, a prison official said Saturday.

Chhouk Rin spent about an hour at the Russian Hospital before returning to prison, Prey Sar Warden Mong Kim Heng said. He was inspected by the agency Doctors Without Borders, the warden said.

"He carries the AIDS virus," Mong Kim Heng said, adding that doctors had treated him for some symptoms but had not given him "delay medication."

Earlier this month, Chhouk Rin appealed to Western aid agencies for medication, and his wife said he was suffering from illnesses related to AIDS.

Jailed ex-Khmer Rouge commander sent to hospital for AIDS

Chhouk Rin (Photo: AFP)

March 24, 2007
Agence France-Presse

PHNOM PENH - A former Khmer Rouge commander, who is serving a life term for his role in the murder of three Westerners, was sent to a hospital Saturday for AIDS treatment, an official said.

Chhouk Rin, 54, will receive antiretroviral treatment at the hospital in Phnom Penh, said Mong Kim Heng, the director of Prey Sar prison in the outskirts of the Cambodian capital.

"He is still strong and healthy," he said, adding Chhouk Rin had requested a hospital transfer.

His wife, Yem Sao, told AFP Saturday he has lost weight and is suffering from severe headaches.

"I am very worried that he cannot live a long life," she said.

Chhouk Rin is serving a life sentence over the 1994 murder of three Western backpackers.

The trio -- Australian David Wilson, 29, Briton Mark Slater, 28, and Frenchman Jean-Michel Braquet, 27 -- were snatched from a train travelling between Phnom Penh and the southern coastal city of Sihanoukville.

Thirteen Cambodians also died in the attack and the Westerners were held for two months by Khmer Rouge rebels before ransom negotiations failed and they were murdered.

Along with Chhouk Rin, two other former Khmer Rouge members, Nuon Paet and Sam Bith, are serving life prison sentences for the backpacker killings.

The Khmer Rouge terrorised Cambodia during their leader Pol Pot's "Killing Fields" regime from 1975 to 1979, leaving up to two million people dead due to starvation, overwork and from execution.

NGO calls to improve living quality of HIV/AIDS patients in Cambodia

February 23, 2007

Cambodia should strive to improve the living quality of its HIV/AIDS patients rather than just support them to live, the Khmer HIV/AIDS NGO Alliance (KHANA) said on Thursday.

The kingdom is now faced with new and different challenges in its anti-HIV/AIDS campaign, such as moving beyond meeting the basic needs of the patients, KHANA said in a press release issued along the inauguration of the two-day Stakeholder Conference on the HIV/AIDS Response in Cambodia.

Let's "think of living, not only surviving," added KHANA, organizer of the conference and major HIV/AIDS fighter in the kingdom since 1997.

Cambodia also needs to assure that the aid programs are well governed and accountable, and that the people of Cambodia have access to a range of opportunities to ensure their health and well- being, said the press release.

Meanwhile, a report issued by the Joint United Nations Program on HIV/AIDS (UNAIDS) at the conference confirmed that the HIV/AIDS epidemic is no longer growing rapidly in Cambodia, which means that the kingdom has "turned the tide" in the period from 1991 to 2005.

The HIV/AIDS prevalence rate among the Cambodian adults has dropped to the current 1.9 percent from three percent in 1997 and the people living with HIV/AIDS also decreased from 179,000 in 1998 to the current 135,100, including 123,100 adults and 12,000 children, it said.

According to government statistics, HIV/AIDS has killed about 100,000 Cambodians so far.

Source: Xinhua

WFP Hopeful Food Programs To Restart Soon

Wednesday, February 7, 2007

By Elizabeth Tomei and Kuch Naren
THE CAMBODIA DAILY

The World Food Program's country director said Tuesday that he was "cautiously optimistic" that donations will be pledged by Friday to restart the WFP’s feeding programs in Cambodia, which were halted last week due to a lack of funds.

But even if the money is pledged, the programs, which provide food for some 750,000 people, are still unlikely to be relaunched before May due to the time needed to reorganize them, Thomas Keusters said in an interview.

"We are cautiously optimistic that we will be able to resume [the feeding programs] no later than May," Keusters said, adding that resuming feeding programs for 70,000 AIDS patients will be a top priority. The programs, which were halted Thursday, cater to 650,000 schoolchildren and nearly 100,000 AIDS and tuberculosis patients.

Several countries have indicated that they will provide funding by the end of the week, Keusters said, though he declined to name those countries.

The WFP warned last month that its feeding programs in Cambodia would come to a halt in February unless $10 million in aid materialized to caver the programs for the next six months. That money failed to materialize.

Australia and Japan have previously been among the biggest donors to the programs, together contributing 68 percent of the programs' funding in 2005, according to the WFP.

Australia provided $62 million in 2006 for the programs, an Australian Embassy spokesperson wrote in an email Tuesday.

Funding from Australia that was originally earmarked for the UN agency's programs in 2007 was advanced in November to help alleviate funding pressures, the spokesperson said.

AusAID has been "in close dialogue" with the WFP about funding, the spokesperson added.

"Australia...is aware of the current resource shortfalls," and continues to support the WFP, the spokesperson wrote.

The Japanese and Canadian Embassies both said Monday that they are considering contributing to the programs, though they did not say how much they might provide.

Erik Illes, first secretary at the Swedish Embassy, said his embassy has not received a formal request from the WFP for funding, but would consider finding funds if it was asked directly.

Keusters said the WFP has appealed to at least 25 foreign embassies in Phnom Penh and Bangkok but could not immediately confirm whether Sweden had been included.

A German Embassy official said Monday that Germany is a regular funder of the WFP internationally but that he was not sure if funds would be earmarked for Cambodia this year.

US Embassy spokesman Jeff Daigle wrote in an email that "due to high demands of emergency needs around the world, the US has not pledged development funds to WFP since 2004."

Given limited resources, emergency food aid from the US goes to the most urgent cases, he said.

Leng Soley, a finance official in the Kompong Chhnang provincial education department, said he is worried that school children in his province will be significantly impacted.

Some of the 34,109 students who received meals at school from the program in Kompong Chhnang might stop coming to school, he warned, though he added that this has not yet happened.

"The suspension of the World Food Program will strongly affect those students from impoverished families," he said.

Dr Mean Chhivun, director of the National Center for HIV/AIDS Dermatology and STD Control, said that a shortage of nutritious food could have an immediate impact on AIDS patients, particularly those undergoing anti-retroviral treatment.

"These patients need supplemented nutrition. It is a very urgent need," he added.

Tuberculosis patients undergoing standard six-month treatment have a similar need for a supplemented diet, Mean Chhivun said.

Dr Keo Chandara, who works at the Kompong Cham provincial health department, said he received a letter from the WFP on Monday stating that food supplies had run out. The supplies are distributed at local hospitals, he said.

"We are very concerned over the suspension of feeding TB victims because it will discourage TB patients from coming to the hospital for treatment," he said.