Cambodia's drug rehab system decried

Drug addicts shoot heroin in a slum of Phnom Penh. Human Rights Watch called Cambodia’s approach to supposed rehabilitation “sadistic,” and said addicts, the homeless and sex workers are rounded up wholesale to be removed from public view. (Paula Bronstein, Getty Images / August 11, 2010)

Rights groups and former detainees say it's rife with unlawful detention and physical abuse that masquerades as rehabilitation. The government denies the charges.

August 10, 2010
By Brendan Brady and Mark Magnier
Los Angeles Times

Reporting from Phnom Penh, Cambodia — He meanders through a city park with friends, sniffing glue out of a plastic bag. Many nights he passes out on the sidewalk nearby.

It's a bleak routine, but this 17-year-old prefers it to his stints at Choam Chao, one of the Cambodian government's controversial drug rehabilitation centers, where he was twice detained.

"At night, when they got drunk, sometimes they'd beat me," he said, referring to older detainees deputized by the guards to enforce discipline. His tormentors were rewarded, he said, with occasional trips out of the center's compound, when they could buy their liquor.

"When I stopped doing the [enforced physical] exercises, they'd kick me in the stomach," said the teenager, who, along with other former detainees, requested anonymity because he feared official retribution.

Although his account could not be independently verified, it is consistent with what human rights groups and other detainees say is a widespread pattern of unlawful detention in Cambodia that masquerades as rehabilitation. Those unfortunate enough to be unwillingly caught inside this harsh system are often subject to physical and emotional abuse and deprivation.

The teenager said he started using drugs at age 8, soon after his father died. He lived for a few years with his mother, who scraped by scavenging garbage, then struck out on his own, earning money watching parked cars for tips.

His first "rehabilitation" detention, at age 11, lasted six months after he was picked up in a police sweep of his neighborhood. That was followed, at age 13, by 21/2 years of incarceration, during which guards and their stooges attacked him with braided electrical wire and belt buckles. He said he was never officially charged with any crime or allowed to see a lawyer.

The teen, who said he has lost touch with his mother, said the only pretense of therapy while in detention was an occasional medical checkup, by officials from a visiting charity, and three hours of daily military drills designed to "sweat out" the drugs. New arrivals suffering severe withdrawal symptoms were lashed down to their beds at night, he added.

Civic groups said the boy's account is hardly unusual.

"Human rights abuses are intrinsic to how these centers operate," said Joe Amon, a New York-based director of Human Rights Watch, which has released a report on the issue. "Arduous physical exercise and military drills appeared to be happening everywhere, as were beatings and whippings by center staff or detainees … for disciplinary purposes."

The watchdog group characterized this approach to supposed rehabilitation as "sadistic," adding that wholesale detention of drug users, homeless people, sex workers and beggars in holding centers out of public view is common, with street sweeps occurring especially before holidays and visits by foreign dignitaries.

"This practice takes its roots from [Cambodian] history," said Mathieu Pellerin, a consultant with Licadho, a Cambodian human rights group that has campaigned against forced detentions. "It's very deep in their DNA. To this day, the government denies that it's unlawful detention."

In mid-2008, Pellerin got word of a wholesale roundup of "undesirables." He went with a team to a government detention center, where he found the director drunk.

A member of his team lured the official aside as others went inside and photographed the dire conditions being endured by entire families, the mentally disabled, epilepsy patients without medicine and pregnant women who were hauled off the street by police and government workers, most without their family's knowledge.

When Pellerin and his team presented their evidence to the government, he said, officials denied wrongdoing and said the disclosures were politically motivated.

Human Rights Watch said it has also received reports of police and Social Affairs Ministry officials making money by leasing out detainees as laborers or selling their "donated" blood.

The so-called rehabilitation system's real aims appear to be social control, profit and retribution for perceived moral failure, watchdog groups said. More than 2,000 people were detained in 11 Cambodian facilities nationwide in 2008, the vast majority involuntarily. For drug users put through the state rehabilitation system, the relapse rate was nearly 100%, according to one World Health Organization report.

Pellerin blames the Cambodian government for the alleged abuses, but he also points a finger at United Nations agencies and countries that donate aid but don't use their money or leverage to force change.

"Donors seem unwilling to draw conclusions that should be drawn after two decades," he said. "Maybe they don't want to admit their own failure."

Cambodian authorities have denied the charges of abuse. At an anti-narcotics conference in March, Prime Minister Hun Sen acknowledged that the centers were not "medically appropriate," but he accused human rights groups of "blindly attack[ing] without seeing the government's charity."

Drug users should appreciate the food, shelter and training they receive, Cambodian officials say. Although some facilities may be substandard, they add, that only reflects the limited resources of a nation still recovering from decades of war.

The U.N. Office on Drugs and Crime is discussing a $9.7-million project to create voluntary, community-level drug rehabilitation in Cambodia as an alternative to the government program.

"Research tells us empathy is key to the effectiveness of drug-dependence treatment," said Juana Tomas-Rossello, a drug treatment advisor with the office who is working on the plan.

Cambodia is not alone. China, the regional powerhouse, reportedly holds half a million drug abusers in compulsory rehabilitation at any given time, civic groups and academics said. Thailand, Laos and Vietnam have recently embraced or long resorted to compulsory detoxification and punitive detention amid concern over a recent, sharp rise in methamphetamine use.

Some former detainees in Cambodia note glimmers of humanity in the system. The 17-year-old glue sniffer was instructed in traditional drums and hair cutting. And a recently released 15-year-old said his term was "easy" and included English lessons, although he was forcibly detained without charges and saw others beaten.

The basic problem, say critics and detainees, is that Cambodia's system focuses more on punishment than rehabilitation.

"Those places will harden you," said a 22-year-old former detainee, sipping moonshine in a vacant lot where he was preparing to spend the night.

mark.magnier@latimes.com
Magnier was recently on assignment in Cambodia. Brady is a special correspondent.

When a Problem Comes Along, You Must Whip It

June 26, 2010
Joe Amon
Director of the health division at Human Rights Watch
The Huffington Post

"[H]e started to whip me on my back with twisted electrical wire," said Kakada, recalling his detention in a so-called "youth rehabilitation center" in Cambodia. "I was in such pain. Sometimes I cry alone, after the beating, because it was so painful. I did not commit any mistake: why did they beat me like this?"

Picked up, suspected of using drugs, confined to a drug dependency "treatment" center without a trial, judge or jury, Kakada was forced to do unpaid labor and vigorous exercise to "cure" him of his addiction. Any violation of the rules - stepping out of line, not moving fast enough, smoking a cigarette - can lead to being whipped, beaten or given an electric shock.

Kakada is just one of hundreds of thousands of people in one of a number Asian countries locked in so-called drug "treatment" or "rehabilitation" centers. Inside these centers, at best, the treatment is ineffective. At worst - physically and psychologically scarring - it drives people to use drugs.

The fact that June 26 is both "International Day against Drug Abuse and Drug Trafficking" and "International Day in Support of Victims of Torture" has become more than a coincidence. Evidence from around the world indicates that people who use drugs are all too often victims of torture.

A number of governments in Asia run drug detention centers where people are at risk of routine mistreatment or torture in violation of international human rights law. Authorities in these countries often consider drug use a moral failing that must be "disciplined out" of people. Run by public security, military or other forces, such centers strive to build up discipline through marches, strict internal rules, and long hours of compulsory labor. In such settings, further abuses are inevitable and medically trained experts in drug dependency treatment are not a feature or a requirement.

Even children are not safe from risk of torture in so-called treatment and rehabilitation centers. M'noh, a 16-year-old detainee in Choam Chao Youth Rehabilitation Center in Cambodia, told Human Rights Watch that a staff member "would use the cable to beat people... On each whip the skin would come off and stick on the cable." Other child detainees said they had been shocked with electric batons and experienced sexual violence by staff members.

International health and drug-control agencies, such as the UN Office on Drugs and Crime, UNAIDS, and the World Health Organization, all endorse comprehensive, evidence-based drug dependence treatment services, including opioid substitution therapy, harm reduction, and psychosocial support. An important aspect of these services - from both an ethical and effectiveness perspective - is that people should have a choice of whether to use them. But in many countries, treatment - such as it is - is involuntarily.

In China, one former detainee said, : "I've tried to get clean and have been in compulsory labor camps more than eight times. I just cannot go back to a forced labor camp - [it is] a terrifying world where darkness knows no limits."

In Vietnam, 600 detained drug users recently escaped from a rehabilitation center. Vietnamese officials endorse a treatment regimen of "therapeutic labor," in which detainees work for long hours and are severely punished if they do not meet production quotas. "[T]hey beat people up, kicked the face, kicked the chest," a former resident of a rehab center near Hanoi told the BBC in 2008. "Later, people were made to work very hard. They said work to forget the addiction, work is therapeutic." These centers involuntarily detain people for up to four years.

These abuses are starting to get the attention of global leaders. The UN Subcommittee on the Prevention of Torture recently visited three drug detention centers in Cambodia; the UN Working Group on Arbitrary Detention has made detention of drug users a key focus for 2010. What is really needed, though, is clear, unequivocal statements by world leaders that these countries should ensure that drug users are never subjected to torture and that involuntary drug detention centers should be closed.

Unlike prisons, involuntary and abusive drug "treatment" centers can be abolished: they operate outside of the law and play no role in an evidence-based approach to drug issues. Detention and discipline are not a means of drug treatment- and allowing such centers to remain open ensures they will continue to abuse people whenever the monitors leave. These centers do not need to be revamped or modified; they need to be shut down.

On June 26, the UN should do more than recognize that drug policy and human rights abuses are overlapping issues; it should instruct governments to close involuntary drug detention centers where the rights of drug users are routinely violated, to end the abuse inherent in such settings.

In Cambodia, brush back against street sweeps

This government-run rehabilitation center just outside Cambodia's capital city, Phnom Penh, was used to detain people rounded up from the street. It was closed in 2008 after rights groups and the U.N. raised concerns about the legality of holding people there and the quality of the facilities. (Licadho)

Human Rights Watch condemns Cambodia's campaign to clear the capital of its poor and homeless.

March 4, 2010
By Brendan Brady
Special to GlobalPost

Skyscrapers and condos are fast rising in Phnom Penh but rights groups here say real development will remain illusory as long as the government sweeps the country’s social problems under the rug.

PHNOM PENH, Cambodia — At night in Cambodia’s capital, parks once populated by sex workers fell silent. Streets and abandoned lots in the center of Phnom Penh where drug addicts and homeless slept lay empty. The city’s underbelly had been washed away.

Then reports of abuse emerged. Sex workers said police had detained them for weeks, taking the cash they had on hand and raping them — even those who protested by saying they had HIV. There were accounts of government facilities where drug users, street kids and the mentally ill were beaten and starved. Rights workers reported a security crisis for the groups they served, and a facility was shut down after they and the U.N. raised concerns.

That was more than a year ago and the uproar has since eased. Now, a new report has put the government’s street sweep campaign front and center again.

In a report released Jan. 25, Human Rights Watch describes a climate of “sadistic violence” in the government’s drug rehabilitation centers. Drug users face beatings and arduous forced labor, while being deprived of effective treatment for their addiction, the watchdog group says.

“He had three kinds of cable … he would ask you which one you prefer. On each whip the skin would come off and stick to the cable,” the report quotes a 16-year-old identified as M’noh as saying.

In its own study, the World Health Organization found a nearly 100 percent relapse rate in people coming out of the government’s drug rehabilitation facilities. “This is a common approach globally,” says Graham Shaw, a technical adviser for the World Health Organization in Cambodia. “It’s cheap and easy and it allows the government to show the public that it’s responding to drug dependence problems amongst the population, but it doesn’t provide a solution.”

The facilities are presided over by a mix of authorities, including local government offices, the Social Affairs Ministry as well as civilian and military police. Human Rights Watch says officials running the rehabilitation centers profited by renting out detainees as laborers and by selling blood they forced detainees to donate. More than 2,000 people were detained in 11 of these facilities throughout the country in 2008, the vast majority involuntarily, according to the group.

“The real motivations for Cambodia’s drug detention centers appear to be a combination of social control, punishment for perceived moral failure of drug use and profit,” says the report.

The report sheds light on the government’s controversial use of holding centers for drug users, homeless people, sex workers and beggars — who are often rounded up before national holidays and visits by foreign dignitaries, when the capital is on display. Rights groups have long called for the closure of such facilities, citing frequent allegations of violence and forced detention, and questioned the effectiveness of the treatment programs they supposedly offer.

The issue came into the spotlight in 2008, after the government launched a contentious law that outlawed prostitution. In the months following the law's implementation, police carried out a series of raids on brothels and street-based prostitution that rights groups said gave police free rein to rape and rob sex workers they detained. They say the law has done little more than drive prostitution deeper underground, making sex workers more vulnerable to trafficking and pushing them further away from the public health groups that have been instrumental in curbing the country's HIV/AIDS rates.

“This sort of ‘cleaning’ the streets of undesirable people has been happening for a long time, but there’s been more attention towards it recently,” said Mathieu Pellerin, who works with the local rights group Licadho.

According to Pellerin, when a Licadho outreach team was able to gain access to one of the government’s main poorhouses in 2008, they found an elderly women in her dying moments being left untreated and a young mother nine months pregnant who would have given birth in her cell without any assistance had they not been able to convince the facility to release her.

The government has denied reports of violence and mistreatment in its facilities. “There’s no violence, rape, nothing like that” in the drug centers, said Neak Yuthea, who is head of the government’s rehabilitation program. “Drug addiction is a new problem in Cambodia. This is good for them. … Maybe Human Rights Watch wants to see the drug users living on the street.”

The government says most drug users are interned at the request of their families and that many homeless volunteer to live temporarily in the centers because they are given food, a roof over their heads, and, in some cases, basic vocational training. It has also cited a lack of resources in some cases to explain substandard facilities.

Licadho’s director, Naly Pilorge, says, however, it isn’t simply a matter of underperforming social welfare. “You have people who have done nothing wrong who are detained like criminals,” she said. “It could be a construction worker who doesn’t look like he belongs on the street where he is … or a poor-looking kid who is just walking along the street.”

Skyscrapers and condos are fast rising in Phnom Penh but rights groups here say real development will remain illusory as long as the government sweeps the country’s social problems under the rug.

Water Festival fears for illegal detainees in Cambodia [-The Kingdom of Horror & Abuse Wonder?]

November 10, 2008
ABC Radio Australia

A human rights group is concerned that the upcoming Water Festival in Cambodia could see another surge of illegal detentions and hidden abuses for the capital Phnom Penh's homeless and sex workers.

Writing etched into the walls of one so-called "social rehabilitation center" suggests that people are being detained against their will and abused, according to rights group LICADHO.

The group has called on the Cambodian government to shut down the centres, including one that was once a Khmer Rouge death-camp in the 70s.

In recent years the camp has been turned into what the Government describes as a "Social Rehabilitation Centre."

Human rights group LICADHO says, however, it's one of several illegal prisons that keep the homeless and destitute off the streets and out of sight.

The Cambodian Government has repeatedly claimed the island camp and other similar centres are voluntary and have denied accusations of abuse.

But last week LICADHO monitors gained access to a facility in Kampong Speu province.

LICADHO'S director, Naly Pilorge says what they found was evidence that contradicts Government claims the centres are for rehabilitation.

"My colleagues entered the facilities and went into the rooms where people were detained," she said.

"Immediately they saw drawings and writing both in Khmer, in Thai and also in English of obviously former detainees that had written appeals and their situation here in those rooms. There was a number of drawings of women who implied that they had been sexually abused and raped. There was one writing in English - on one hand they said 'life' and the other was 'hell'. And there was also counts of days like you see in prisons at times all over the world where people count how many days and how many nights they have been detained.

"We have interviewed people, we have seen people who are neglected, abused and with these drawings it's obvious to us that this is a place where people are unlawfully detained and seriously abused," she said.

She says those interviewed are describing situations of the "worst you can imagine."

"Starting from not having food and water and this was obvious from the first time we went to these centres, as soon as the gates were open people ran to the grounds outside and started eating grass and leaves, so it was obvious that people were not getting enough to eat.

"We have allegations of gang rapes and sexual abuse. We also have information about beatings, very severe beatings leading to the death of people," she said.

Ms Pilorge says during many public holidays and particularly Water Festival, the Cambodian Government "wishes to maintain its image of the 'Kingdom of Wonder' and therefore the government continues to detain people who they believe contradict that image.