Handbook on HIV for Parliamentarians developed in Cambodia

24 February 2010
UNAIDS

In Cambodia HIV prevalence has fallen to an estimated 0.7% among the adult population in 2009, down from a high of 2% in 1998. With this it is one of the few countries in the world which has achieved Millennium Development Goal 6 – to halt and begin to reverse the spread of HIV by 2015. At the same time, intensive work is underway to ensure Cambodia reaches its ambitious, yet attainable, universal access targets for HIV prevention, treatment, care and support by end of 2010.

Political commitment at the highest level is recognized as a critical factor in Cambodia’s success in creating a supportive legislative and policy environment, and building a strong multisectoral national response to HIV.

Cambodia is one of the first countries in the region to establish a Law on Prevention and Control of HIV/AIDS to eliminate stigma and discrimination and protect the rights of people living with HIV and those with risk behaviours for HIV.

It is against this backdrop that the Commission No. 8 with support from the National AIDS Authority, the UNDP Legislature Assistance Project of the National Assembly, and UNAIDS, developed the Parliamentary Handbook on HIV. It was launched at the National Assembly on January 29, 2010.

“The Parliamentary Handbook on HIV provides an opportunity to renew the commitment to scale up services for universal access. As leaders accountable to the people of Cambodia, Parliamentarians’ understanding of the HIV epidemic and response is vital”, said Tony Lisle UNAIDS Country Coordinator for Cambodia.

In a mature HIV response, such as Cambodia’s, policies and legislation must be proactive, rather than reactive. Community involvement is key to address both the individual and societal factors that make people vulnerable to HIV infection, including men who have sex with sex workers, the wives of these men, sex and entertainment workers themselves, young people, men who have sex with men, and people who use drugs.

Also, through public forums and partnerships with civil society, parliamentarians can better monitor the effectiveness of the Law on Prevention and Control of HIV. Parliamentarians have a crucial role to examine how acts such as the Law on Suppression of Human Trafficking and Sexual Exploitation and the draft Law on Drug Control affect the scaling up of universal access to prevention, treatment, and care and support.

As such, parliamentarians’ active oversight of the HIV response is imperative. This includes meeting with communities, and reviewing progress, gaps and bottlenecks with respect to critical issues, such as eliminating HIV-related stigma and discrimination, ensuring access to quality treatment and health care, and intensifying prevention among most at risk populations, as well as working with the ministry of interior to ensure that laws are properly enforced.

The Parliamentary Handbook on HIV is a user-friendly resource, presenting brief and concise information about the epidemic, its causes, responses, as well as parliamentarians’ roles and responsibilities. It is an enabling tool in Parliamentarians’ work to ensure an effective HIV response across advocacy, leadership, policy and legislative areas.

Cambodia: ending HIV stigma in hospitals

Patient in Chey Chumneas hospital

Monday, November 30, 2009
Independent Catholic News

“They turned my patient away because she was HIV positive.” Discrimination of people living with HIV is found in every layer of society. Dr Vuthy King, from CAFOD partner Maryknoll, explains how he is working to stamp out stigma in the medical profession

“Some hospitals in Cambodia do not like to operate on people living with HIV. In Phnom Penh there are eight hospitals. In my experience, only two will operate on HIV-positive patients.

“This is not hospital policy, but a decision made by the surgeons. If medical professionals discriminate against HIV-positive people, you can imagine what kind of reactions they face from the public in general.

“A few years ago, I had a patient with appendicitis. I sent the patient to the nearest hospital at 9pm. But they said they wouldn’t operate on her because she had HIV. She would have to wait until 9am the next day so they could hold a meeting to discuss her case.

“When I went back at 10am, they rejected her from the hospital. By this time she was in a critical condition. I drove her to another hospital but they also refused to treat her. Finally the third hospital I went to accepted her.

“The Maryknoll hospice opened in 2000. We were the first non-governmental organisation in Cambodia to open a free hospice for poor people living with HIV.

“Almost 1,000 patients have used this hospice since it opened. Many would have died without the care they received here. Some poor people sell everything, their land, livestock, and home, to pay for medical bills because hospital fees are expensive.

“But when they recover they have no way to support themselves. It is a vicious trap for poor people. “We treat those with opportunistic infections like TB or meningitis. We also do complicated medical procedures like lumbar punctures but we’re not equipped to perform full operations.

“Recently, we opened a specialist HIV wing in Chey Chumneas hospital. We provide consultations with the patients and assess their needs. People travel from miles around to come and see us because they know they will receive the best staff. We are teaching hospital staff to treat HIV positive people with respect and care."

Cambodian HIV Villages Draws Controversy

2009-8-13
New Tang Dynasty Television

Click here to watch the video in English

25 kilometers outside of Cambodia's capital Phnom Penh, lies a village built by the government for HIV-infected patients and their families.

Come to be known as the "AIDS colony", in the past two months the government has relocated 47 families to live in its metal and wooden sheds.

With inadequate sanitation and no running water, the area is not a health sanctuary for HIV-infected patients, who require personal attention and care.

The government maintains it is taking care of patients by building new homes and offering healthcare and ownership rights previously unavailable.

But HIV-infected people living in the village say they have not received any official recognition of ownership rights nor government compensation for their old homes.

40-year-old HIV patient Chheang Toma says even with free medical treatment, he has no real means of earning a living in the colony.

[Chheang Toma, HIV Patient]:
"I feel sluggish in my arms and on my legs everyday and I cannot walk well. I will hang on, until the day I need to go to sleep in the hospital. I wanted to go now, but I have no money to spend for food, although they give treatment free of charge."

With little prospect of work in the area due to the distance from the city, people say they must survive largely on donations from the government and NGOs.

[Suon Davy, HIV Patient]:
"I face great difficulty for my family day to day, because we live far away from the hospital, far from any job opportunities and it is very hot here."

Local human rights activist Dr. Kek Galabru says the government actions are discriminatory while the conditions could pose health risks to already vulnerable patients.

[Dr. Kek Galabru, President, Lacadho NGO]:
"It's regretful that city hall sent 40 families to Tuol Sambo village. This is a discriminatory act because by putting them together like this, everyone will know this is an AIDS community."

The "AIDS colony" is one of a number of forced evictions in Cambodia, where the government has faced escalating criticism about its mandatory relocations.

Many HIV-infected people living in Tuol Sambo previously resided in squatter areas in the Borei Keila area of the capital, forced out as the government took over the land to build high-rise buildings.

Last month, the World Bank urged Cambodia to halt the forced evictions from disputed land, saying it threatened the livelihoods of thousands of urban dwellers.