FOX News : Health

Showing posts with label Cambodia Health Sector. Show all posts
Showing posts with label Cambodia Health Sector. Show all posts

12 July, 2019

Cambodia’s medical system is due for a check-up

The Phnom Penh Post
10 July 2019
In Cambodia, many high-ranking government officials and public figures seek medical treatment abroad – including Prime Minister Hun Sen.

With this in mind, it is not surprising that many locals also seem to often distrust local healthcare facilities.
Cambodia has one of the fastest growing economies in the region.
Read full article

See documentary video on Cambodia Health Care from AP
 

07 January, 2016

Gov't Moves to Expand Healthcare for Garment Workers

Khmer Times
Workers in the textile and footwear industry will have their medical expenses covered by the National Social Security Fund (NSSF), following a sub-decree issued yesterday , and officials at the Labor Ministry said workers would spend less than

23 December, 2010

Cambodia:Fortune-telling the Kingdom's future (2011)

 
fortune_teller_chivoan
Photo by: Heng Chivoan
Veteran soothsayer San Vannak, 53, plies his trade outside the Royal Palace. According to the city’s “spirit guardians”, he says increased political stability is likely to be on the cards for 2011.
When a new calendar year approaches, many Cambodians look to fortune-tellers for a glimpse of what lies in wait for the year ahead. While not all cosmic news is good news, Phnom Penh’s leading soothsayers say that after a grim 2010, more prosperity is in the stars for next year. 

After a year of predicted pestilence, famines and other misfortunes, 2011 – a traditional year of tevada (angels) – will apparently herald a growth spurt for the national economy, an increase in effective law enforcement and a decrease in violent conflicts.

Im Borin, director of the National Committee of Khmer Customs and Horoscopes at the Ministry of Cults and Religion, has published about 5,000 copies of a horoscope handbook in the run-up to the New Year. Im Borin, a long-time mystic, said his predictions are based on “geocentric planetary phenomena”, which he claims are reliable, a decent proportion of the time.

“I have read and analysed the characters of tevada as a traditional fortune-teller for about 10 years and about 80 percent of my predictions have been accurate,” he said.

While his most recent prophecies for 2011 augur an increase in this year’s spate of natural disasters – including flash floods and serious fires – he says that people across the country should generally remain in greater spiritual harmony than they did in 2010.

Im Borin’s cosmic predictions for 2010 were ominous at best, claiming that many people would be tragically killed in a year filled with famine, conflict and pestilence. He even goes as far as to say that his predictions foreshadowed last month’s tragic stampede at the Diamond Island bridge, which killed 353 people.

“The prediction became accurate if you compare it with the Koh Pich bridge stampede, which caused the deaths of hundreds of poor people, many of whom were working in factories,” he said.

Luckily, however, Im Borin’s darker premonitions for the past year – including a prediction of falling crop yields and a rash of human casualties as a result of declining “social morality” – have failed to come to fruition in 2010.

“The farmers must take care of the crops they have already harvested because crops this year will not be good,” he said in January, adding that “about half of the vegetable and fruit crops will be destroyed” by insects.

Window into the future

San Vannak, a 53-year-old “spirit guardian” fortune-teller who also plies his trade in front of the Royal Palace, said soothsayers are usually asked to divine the future on matters such as romance, finances, job opportunities, marriage plans, divorce and the outcome of illnesses.

He said that for generations, Cambodians have consulted fortune tellers to gain self-understanding and knowledge which could lead to personal power or success in some aspect of life.

“Individual people need to learn about their life when there are problems and they come and consult with a fortune-teller to help them make decisions,” he said.

San Vannak said his clients include government officials and business people who look to the stars to tell them “whether their rank or business will increase or decline”.
Soldier of Fortune 6 - Khmer Hit (Spanish Edition)  Fortune Teller  Summit Fortune Teller Bank  The Fortune Teller (Featuring Tim Too Slim Langford, Lauren Evans)
Art & Architecture of Cambodia (World of Art) Adoration and Glory: The Golden Age of Khmer Art Sculpture of Angkor and Ancient Cambodia: Millennium of Glory The Treasures of Angkor (Rizzoli Art Guide)

08 January, 2010

NGOs slam supplement cuts

The Phnom Penh Post
Thursday, 07 January 2010 15:03 Robbie Corey Boulet

Termination of salary supplements could jeopardise aid projects, groups warn

DEVELOPMENT organisations on Wednesday offered scathing criticism of the government’s recent decision to terminate salary supplement programmes for civil servants, a move that could cost government workers at least US$4.5 million this year in the health sector alone.

At a meeting convened by the Cooperation Committee of Cambodia, more than 40 NGO leaders said the abrupt termination of the programmes could lead to a rise in absenteeism among civil servants tasked with staffing health centres and schools or administering other aid projects.

Under salary supplement programmes, development organisations had been bolstering salaries for civil servants in a range of sectors.

Development experts fear a reduction in public sector pay could lead to increased corruption, as civil servants look to maintain their present incomes.

A December 4 letter from Minister of Finance Keat Chhon said the programmes’ termination – the result of a sub-decree that went into effect January 1 – was “applicable to all donor-assisted as well as [government-] funded projects and programmes”.

Sharon Wilkinson, country director for Care International in Cambodia, said at the meeting that the sub-decree had caught NGOs completely by surprise.

“NGOs did not really start to comprehend that this sub-decree had come into effect until perhaps the early hours of Christmas,” she said, adding that the announcement had given them “no time to prepare for the implementation of this”.

Apart from slashing services to poor Cambodians, including the provision of antiretroviral therapy to HIV-positive patients, Wilkinson expressed concern that the termination of salary supplement schemes could set up “a parallel system” between NGOs and civil servants.

“If we are no longer allowed to support our government counterparts, it will be a true wedge between NGOs and the government, and we will be working in a parallel system, something we must not allow to happen,” she said.

In his December 4 letter, Keat Chhon justified the termination by saying that salary supplements could jeopardise attempts at broader civil-service reforms.

Wilkinson, who has worked in Cambodia for 11 years, said Wednesday that she was sceptical of that reasoning.
“The public-sector reform programme is an ongoing debate that for 11 years has not been solved,” she said.

Keat Chhon also said in the letter that incentive-based pay schemes could be seen as unfair, a claim that was echoed by Minister of Information Khieu Kanharith, who said last month that they could “cause bad feelings in the workplace and lead to declines in productivity”.

Belinda Mericourt, senior programme manager at Aus-AID, Australia’s foreign aid arm, said she was unconvinced by the argument that salary supplements were excessively “divisive”. “It can’t be any more divisive than patronage,” Mericourt said.

A December 18 letter from Keat Chhon to government officials that was distributed at the CCC meeting said the sub-decree had been drafted “per instruction of” Prime Minister Hun Sen. Council of Ministers spokesman Phay Siphan said Wednesday that the government’s “conservative” national budget had made salary supplements “unsustainable”.

“It’s sustainability we want,” he said, adding: “We have to depend on our own budget. We cannot depend on aid all the time.”

He also reiterated government concerns that salary supplements could “create an unjust environment in the workplace” before referring further questions to the Ministry of Economy, which could not be reached.

According to the December 18 letter, the government “will continue to jointly discuss with the development partners on the short-term strategy to be laid out urgently to ensure effectiveness of project implementation and to amend financing agreements affected by the termination”.

But Mericourt said at the Wednesday meeting that a request from development partners for a meeting with government officials – sent on December 17 and signed by bodies including the United Nations and the World Bank – had gone unanswered, adding that she did not expect a response before next week.

She said the government had provided little direction on how development organisations should adapt to the terms of the sub-decree, which many at the meeting described as unclear.

“There is apparent confusion and a lack of understanding of what this means,” she said, adding that there had been no word from officials regarding whether alternate forms of compensation – such as per diems – could be used in place of salary supplements.

Development partners have largely refrained from criticising the sub-decree. A statement issued Wednesday by the Office of the UN Resident Coordinator, for example, reads in part: “The UN in Cambodia will align with the Royal Government’s decision to terminate salary supplements. While we are aware of the potential short-term impacts of this decision, it is clear that restructuring civil service salaries represents an opportunity for the UN and development partners to work with the Government on salary reform.”

At the meeting Wednesday, however, Mericourt was more candid, at one point saying the move had the potential to become “a total disaster”.

“I think the emphasis has to be on the humanitarian impact, not on government politics,” she said.

Government officials and development organisations have been unable to put a dollar amount on the salary supplement programmes.

On Tuesday, Maxim Berdnikov, East Asia and the Pacific portfolio manager for the Global Fund to Fight AIDS, Tuberculosis and Malaria, said active Cambodia grants included provisions for $381,500 in monthly salary supplements, making for a 12-month total of roughly $4.5 million. A Global Fund spokesman said the fund was in compliance with the sub-decree, meaning the salary supplements had been suspended.

29 December, 2009

Policy shift on HIV vital: NGO

The Phnom Penh Post
Tuesday, 29 December 2009 15:03 Mom Kunthear


HEALTH NGO workers this week said they doubted the government would be able to meet its new goal of eradicating mother-to-child transmission of the virus that causes AIDS by 2020 in the absence of substantive policy changes.

Dr Mean Chhi Vun, director of the National Centre for HIV/AIDS, Dermatology and STDs, said Sunday that the government had adopted the goal “late this year”.

There is limited data on mother-to-child transmission in the Kingdom, though Mean Chhi Vun noted that approximately 3,500 of the more than 36,000 patients receiving HIV/AIDS treatment as of September were children, most of whom contracted the virus from their mothers.

The Ministry of Health will likely funnel more money towards the prevention of mother-to-child transmission in future budgets, Mean Chhi Vun said, adding that he did not know how much would be allocated.

He said new policies designed to make the goal attainable would go into effect in mid-2010. Asked what those new policies were, he said the government would encourage pregnant women to take blood tests and, if they test positive for HIV, undergo antiretroviral therapy (ART).

Expanding ART for HIV-positive pregnant women is already a target under the Millennium Development Goal pertaining to AIDS.

Cambodia has aimed to increase the percentage of HIV-positive pregnant women “receiving a complete course of antiretroviral prophylaxis to reduce the risk of mother-to-child transmission” from a 2002 baseline of 2.7 percent to 50 percent in 2015.

Mey Sovannara, communication and advocacy coordinator for the Khmer HIV/AIDS NGO Alliance, said he believed the new goal could be met, but only with new government-led policies, including those that would increase the effectiveness of provincial health centres.

“The government has to be the leader on this,” he said. “If the government does not have a strong commitment to this, then it will be a failure.”

Chan Theary, executive director of the Reproductive and Child Health Alliance, echoed this idea, saying, “Whether this is realistic or not depends
on the ministry’s commitment, and its partners’ ability to actually do this work.”

MATERNAL HEAlTH: Cash given over claim of negligence

Monday, 28 December 2009 15:02 Mom Kunthear and Chrann Chamroeun
The Phnom Penh Post

MATERNAL HEAlTH
A widower who blames staff at a prominent Phnom Penh hospital for the death of his wife during child birth has settled for monetary compensation in exchange for dropping a criminal complaint against staff at the hospital. Ly Kok Meng said he agreed to receive 4.5 million riels (US$1,079) arranged by Phnom Penh Municipal Court. Court officials brokered the deal with representatives from the Cambodian-Russian Friendship Hospital last week. Ly Kok Meng said he felt he had no choice but to take the money after court officials urged him to compromise. “I don’t feel happy at all with this small amount of money,” he said. “It can’t compensate for the death of my wife, but I must accept it because I know I can’t keep on pursuing legal action.” His wife, Ban Rany, 23, died in early November after hospital staff injected her with a serum as she was going into labour. Ly Kok Meng said the doctors and a midwife acted carelessly. Hospital staff members said that Ban Rany died from an unpreventable allergic reaction to the serum. Say Sengly, the hospital’s director, could not be reached for comment Sunday.

06 February, 2009

Rethinking the Administration and Delivery of Foreign Aid in Cambodia




Rethinking the Administration and Delivery of Foreign Aid in Cambodia

Virak Thun
February 05, 2009
The government of Cambodia has received foreign development aid in abundance for many years, largely contributed by a number of international aid organizations and donor states such as World Bank, Asian Development Bank, International Monetary Fund, Official Development Assistance (ODA), and Japanese as well as Chinese governments.

Unfortunately, this aid has not served as a constructive engine to promote economic growth and development, and has not provided tangible benefits for the targeted population, the poor and the vulnerable, in the country.

This article presents some specific reasons for the poor management and ineffective delivery of foreign aid in the nation, and offers some viable and practical mechanisms of how foreign aid should be properly administered and distributed in Cambodian society.


For three decades, several challenges have faced Cambodian people. Such challenges have embraced: (1) social aspects—land disputes, widespread human rights violations, low access to health care, gender inequality, and lack of infrastructure development; (2) political aspects such as intimidation against or imprisonment and murder of journalists, editors, and civil society activists; (3) economic aspects including deep-seated corruption and poverty; and (4) environmental aspects: unequal distribution and depletion of natural resources, deforestation or illegal logging, pollution, and unclean water as well as poor sanitation. With little doubt, these challenges have impacted on people in every corner of Cambodia, highlighted poor governance on the part of the government and the presence of ineffective law enforcement, and slowed down the development of the country.

Having realized the need for addressing and dealing with the aforementioned challenges, the international donors and foreign aid agencies, namely World Bank, Asian Development Bank, International Monetary Fund, Official Development Assistance (ODA), and Japanese and Chinese governments, have contributed aid (both financial and technical assistance) to the Cambodian government to promote state capacity building, placing great emphasis on governance reforms, social order and equity, political stability, and economic development. As Beech (2007) points out: “… foreign donors — a collection of foreign governments, multinational banks and various U.N. agencies — promised to funnel $689 million of aid to Cambodia, a 15% increase from last year and an amount roughly equivalent to half the nation's annual budget.”

Of this huge amount of money, there were some main international aid suppliers who deserve to be named here.

… [T]he European Union pledged the largest amount at $170.2 million, followed by Japan at $112.2 million, China at $91.5 million, the United States at $48.8 million and 11 U.N. agencies at $64.8 million. The World Bank and the Asian Development Bank pledged $62.6 million and $74.7 million, respectively (Kyodo News International, 2007).

However, it is vital to note that, despite the growing amount of foreign aid to Cambodia, there has not been much in the way of positive change and significant progress in the country. This is due to combination of factors including Cambodia’s heavy reliance on international development assistance, deep-rooted corruption, and inefficiency of the government institutions and organizations. Instead of helping Cambodians, “the vast amount of money flooding the country has created a dependency culture and encouraged political irresponsibility and corruption” (Al Jazeera, 2008). Moreover, aid has provided considerable benefits for only a small group of elites or greedy government officials, and still the poor and the vulnerable have experienced their impoverished living conditions, while having gained little from international assistance. Al Jazeera (2008) further reports that: “after decades of foreign assistance, over a third of Cambodia's population still live below the poverty line.” (In the Cambodian context, the poverty line is equal to one dollar a day.)

Accordingly, the administration and distribution of foreign development aid in Cambodia should be revisited carefully so that the way for development can be paved and the Cambodian people can fully enjoy their lives.

II. The Importance of and the Need for International Aid in Cambodia

Prior to identifying and examining why foreign aid assistance is vitally important and frequently needed in Cambodia, we should take a moment to review the concept of international aid. A definition for the notion could be: the contribution of financial and technical support of wealthy or developed nations to poor states which are in need of such support. A contribution in the form of grants or loans is expected to help promote sustainable development of the recipient countries. Along the same lines, Cho (1995) defines foreign aid as “… the flow of resources from developed countries to developing countries. Such resources may be in the form of finance or in the form of goods and/or technical services …” (p. 59).

It should also be emphasized that international aid can be channeled through two main ways: (1) bilateral or direct form (donor-to-recipient transfers), and (2) multilateral or indirect form (foreign aid organization-to-recipient transfers). Within these two forms also exists technical assistance, “… the form of the transfer of expert personnel, technicians, scientists, educators, economic advisers and consultants” (Cho, 1995, p. 12). Such assistance is regarded as a crucial tool since human resources with comprehensive knowledge and skills are needed in the early process of paving the way for the development of a country before international financial aid is desirable.

With this definition of international aid in mind, now we should now be able to look closely at the importance of and the need for aid in Cambodia. Regardless of the kinds or forms of foreign development aid, aid has the potential to play a constructive role in promoting capacity for law enforcement, legal and judicial reforms, structural change of political and social aspects, and sustainable economic development in the country. Cho (1995) argues that: “aid will supplement scare resources, help to transform the structure of the economy and contribute towards a self-sustaining growing economy” (p. 86).

International development aid also ensures good governance of the nation that “acquires and exercises the authority to provide and manage public goods and services—including both public capacities and public accountabilities” (Global Monitoring Report, 2006, p. 124). In other words, aid has been regarded and distributed as a recipe for assisting Cambodia to generate the liability, transparency, and efficiency of the government ministries and institutions in regard to managing national revenues and expenditures in the public sectors.

III. Challenges to the Distribution and Management of International Aid in Cambodia among Donor Countries and International Organizations

Donors and international actors have funneled aid to Cambodia with the strong belief that the state will be developed socially, politically, and economically. At the same time, however, they have faced a number of challenges with respect to enhancing the effective distribution and channel of their aid and accomplishing their priority goals. Now, the burning question is why the delivery and supervision of international aid are not viable and why foreign aid does not serve as a developmental instrument to provide tangible benefits for the poor and the vulnerable in Cambodian society.

Firstly, the poor allocation and administration of foreign development aid has derived from the fact that prior to granting aid to Cambodia, the international donors and organizations have not enriched a participatory environment to thoroughly discuss or adequately consult with local communities and non-governmental organizations (NGOs). Not altogether surprisingly, these local stakeholders have been much more aware of the essential and unmet needs of the poor and the vulnerable, and of how to contribute aid directly to them in the real-world context. Therefore, no or little consultation with the local communities and NGOs results in the ineffective distribution of aid that certainly fuels the social exclusion, injustice, and inequality and does not benefit a large segment of the targeted population in the state; “Aid, allocated according to priorities defined by donor agencies without consultation with local authorities and communities, can deepen inequities” (Halle, Switzer, and Winkler, 2004, p. 3).

Furthermore, the donor countries and international organizations have not channeled much of their development aid through the local NGOs operating in Cambodia and working directly and closely with the people at the grassroots level, but rather through the Cambodian government and authorities. Such top-down practices in the providing of aid assistance has not been favorable to serve the purposes of the targeted people, but instead, has encouraged corruption at a national level among the powerful political leaders and high-ranking government officials who have enjoyed exploiting foreign aid with apparent impunity. Crispin (2007), Asia Times Online’s Southeast Asia editor, reported that: “… last year international corruption monitoring group Transparency International rated Cambodia 151 out of 163 nations it ranked in its global government corruption index” – putting Cambodia in the top ten most corrupt governments in the world.

Secondly, since the Cambodian government has neglected and failed to attain all the stated promises from donors, and the nation has not witnessed any momentous change with the continuous influx of foreign aid for the last several years, the donor agencies have admitted that international aid has not been administered and allocated effectively. In spite of having had such a keen awareness of the deficiency of the Cambodian government’s will to promote the development of institutional and human capacities in the country, and of the misuse and mismanagement of foreign aid, the agencies have not taken any serious actions to put pressure on the government and to make aid conditional in the country – a concrete timeline and framework for when and what the government is expected to do and what should be done to guarantee the accomplishment of the national development goals.

Moreover, it is sad to say that for such a long time the donor countries and international aid organizations have not developed any specific standard criteria or indicators for Cambodia to use as a guideline and reflective analysis of how well the government has been doing to attain a higher level of performance in terms of enhancing social well-being, political stability, and economic prosperity. Great attention has also been drawn to lack of the alignment between the priority goals of the donor community and those of the government, and to the nonexistence of simplicity of the community’s strategic procedures and plans that has seemingly discouraged the government to follow and achieve.

Lastly, but importantly, foreign aid coordination and quality have not been strengthened effectively due to lack of communication among the international aid community and between the donor governments and the government of Cambodia. There has been a shortage of external audit institutions that should be established by the donor agencies to make sure that public funds are not used more for administration than for the implementation of the plans or projects, that the funds are adequately and transparently delivered to serve the needy in the targeted areas and sectors in the country, and that the agencies can avoid funding the same projects and programs which will lead to a shameful waste of money. “[T]here has still been a lack of coordinated funding, overlap in projects, and improper sector wide distribution of funding. The funding has not been properly distributed to the appropriate sectors and too much funding has stayed in the large cities …” (Van, 2004).

It is also worth noting that the foreign donors and aid agencies have not founded any independent and non-governmental research institutes in Cambodia to offer effective on-going monitoring and assessment of the implementation of the strategic development plans and the management of the public finance so as to ensure better governance systems of the government ministries in the nation. Consequently, without the existence of such research institutes, there has been lack of studies of economic performance and progress in various sectors, and more noticeably, annual reports on and publications of the transparency of the national budget expenditures as well as the effectiveness of the development plans have not been put in place.

IV. A Signal for a Realistic Hope and Conclusion

Enhancing the effective allocation and management of foreign development aid in Cambodia successfully is not going to happen overnight. Nevertheless, adopting a structural change of the government institutions and agencies is the fundamental step that we should begin with. With little surprise, the international donor community also plays a critical and functional role in providing the Cambodian people, especially the poor and the vulnerable, with a hope of ensuring poverty alleviation, economic security, and development in the whole country.

To make such a hope realistic and attainable, the community should endeavor to invest a great deal of effort and commitment in promoting the effectiveness and transparency of international aid coordination and distribution by: (1) widely consulting with the local communities and NGOs; (2) funneling more aid through the local NGOs (but not through the Cambodian government institutions and ministries) which have been working so hard to help the needy; (3) motivating and pressuring the government to enact the long-standing anti-corruption law in order to put an end to the exploitation of aid; (4) making aid conditional to the government with the clear timeline and framework of when and what national strategic goals are expected to be achieved; (5) creating the explicit and detailed performance criteria or indicators to assess how well and effectively the government has been doing to develop socially, politically, and economically; (6) increasing the alignment of the priorities between the donors and the government as well as simplifying the donors’ strategic policies and projects; (7) improving communication among the international aid actors and between the donor governments and the Cambodia government; and (8) founding external audit institutions and non-governmental research centers.

These eight key points have served as a promising guideline to help the donor community capture viable ways of how international development aid is effectively administered and used to contribute real benefits to the targeted population—the poor and the vulnerable—and to develop Cambodia as a whole. If the community fails to implement and enhance any one of the eight points, serious reconsideration of the management and allocation of aid should be undertaken; otherwise, aid is just in vain.


References

Al Jazeera (2008). Foreign Aid in Cambodia. Retrieved January 19, 2009, from, http://english.aljazeera.net/programmes/101east/2008/07/200871613851378258.html

Beech, H. (2007). Cambodia keeps taking, gives little. Retrieved January 19, 2009, from http://www.time.com/time/world/article/0,8599,1636209,00.html

Cho, G. (1995). Aid and development. In J. Bale and D. D. Smith (Eds.), Trade, aid and global interdependence (chap. 3, pp. 56-89). London and New York: Routledge.

Cho, G. (1995). Trade, aid and global interdependence. In J. Bale and D. D. Smith (Eds.), Trade, aid and global interdependence (chap. 1, pp. 1-26). London and New York: Routledge.

Crispin, S. W. (2007). Cambodia's cowboy capitalism. Retrieved January 19, 2009, from http://www.atimes.com/atimes/Southeast_Asia/IG13Ae01.html

Global Monitoring Report (2006). Millennium Development Goals: Strengthening mutual accountability, aid, trade, and governance. Washington, DC: World Bank.

Halle, M., Switzer, J., and Winkler, S. (2004). Trade, aid and security: Elements of a positive paradigm. Canada: International Institute for Sustainable Development.

Kyodo News International (2007). Foreign donors pledge $689 mil. in aid to Cambodia in 2007 and its controversy. Retrieved January 19, 2009, from http://cambodianbrightfuture.blogspot.com/2007/06/foreign-donors-pledge-689-mil-in-aid-to.html

Van, T. (2004). International aid and democracy building process: Cambodia. Retrieved January 19, 2009, from http://fletcher.tufts.edu/research/2004/Van-Tooch.pdf


Virak Thun is currently an MA student at the United Nations mandated University for Peace, Department of Peace and Conflict Studies, in the major of International Peace Studies (Dual Campus).

28 January, 2009

Cambodian Girls Driven to Prostitution

Cambodian Girls Driven to Prostitution

Radio Free Asia
2009-01-27

Economic hardship is pushing young Cambodian girls into the sex trade while legislation drives the trade underground.

AFP

Cambodian sex workers sit on the side walk along a street in Phnom Penh on Dec. 18, 2008.

PHNOM PENH—The girl from Prey Veng province has worked as a prostitute in the Cambodian capital for five months. Hard times, she said, have brought her here to earn money for her widowed mother and three younger siblings.

“I am unhappy with myself, but I pity my mother. No girl wants to do this horrible work,” the 15-year-old, who asked not to be named, said in an interview as she looked for business near the Suriya Supermarket.

“Sometimes, I get only one client in two or three days. Some clients ask me to have sex without using a condom, but I refuse. I say that if you sleep with me without using condom, I’d rather not take your money.”

Rising living costs are forcing more Cambodian girls under 18 into prostitution in urban areas such as Phnom Penh to support their families in the countryside.

The girls, spotted easily from around 8 p.m. as they scout urban streets and parks for customers, say they lack the education to find other work.

A dangerous trade

Several Cambodian girls who agreed to be interviewed said they engage in sex work despite its dangers because they cannot afford to quit.

“Clients take me to guesthouses. I get U.S. $10 per night. They gang-rape me and beat me,” another girl, 17, from Svay Rieng province, said.

In February 2008, the Cambodian government began enforcing the new “Law on the Suppression of Human-Trafficking and Sexual Exploitation” after years of U.S. pressure to crack down on sex trafficking.

Human rights groups, however, say the law and its enforcement have made life harder for the women they aim to help.

Prostitutes caught in police raids are made to pay fines of up to U.S. $200 for their release, the 17-year-old girl said.

“They take us to district police headquarters and take our money. If we don’t have the money, we will be kept in custody for two or three days. So we have to run for our lives when we see police approaching us.”

“Police arrest us in the hope that the brothel owners will pay, but if we don’t have anyone to pay for our release we will be sent to one of the nongovernmental organizations (NGOs). It’s o.k. to live at the NGOs, but then our families have nothing to eat,” she said.

“If [the NGOs] want to help me, they should also help my family. Otherwise I can’t quit.”

Increasing poverty

Lim Mony, program manager for women’s issues at the nonprofit group ADHOC, the Cambodian Human Rights and Development Association, said the number of girls and women involved in sex work is increasing because of higher living costs and the lure of modern luxuries.

“Voluntary sex work by girls on the streets is difficult to define. Many of these girls first were lured and tricked into being sex workers by traffickers. Then, because of that, they began voluntarily selling their bodies. Other women have been voluntarily engaged in prostitution from the start,” she said.

According to Article 35 of Cambodia’s law on “Suppression of Human Trafficking and Sexual Exploitation,” the prostitution of children is punishable with a jail sentence of two to five years and a fine of four to 10 million riel (U.S. $1,000 to $2,500).

But Ean Pheara, an assistant at the Phnom Penh-based People Improvement Organization, said impoverished and uneducated children remain among the most vulnerable workers in the sex industry.

This year, he said, the People Improvement Organization—which provides education and vocational training—taught 240 children the skills they will need to avoid being trafficked.

Heng Sithon, deputy director-general of the Ministry of Women’s Affairs General Directorate for Social Development, agreed that anti-trafficking efforts must focus on Cambodia’s youth.

Sithon, whose work with the ministry provides education to rural children and their parents on how to protect themselves from trafficking, said more children and women are subject to trafficking “partly due to the migration of rural women looking for work who then are tricked into working in the sex trade.”

More awareness needed

ADHOC, along with the Cambodian League for the Promotion and Defense of Human Rights (LICADHO), says that despite public awareness campaigns, law enforcement against prostitution and human trafficking remains ineffective.

“Really what [they] should be looking at is, if someone gets into a situation where they are forced [into prostitution] or where they are being severely exploited, how can they remove themselves from that situation and how can they best get the help that they need,” Elaine Pearson, deputy director for Asia at Human Rights Watch, said.

“The basic effect of [enforcing the law] has been to drive the industry further underground. It certainly doesn’t mean that people have stopped selling sex altogether in Cambodia,” Pearson said.

“It’s become more difficult to monitor the conditions inside brothels, and it has made it more difficult for outreach workers ... to provide health services, to provide condoms to sex workers, and to provide education services which would actually improve the health and safety in that industry.”

In its most recent report on human rights around the world for the preceding year, the U.S. State Department noted that while the Cambodian Constitution prohibits prostitution, “there is no specific legislation against working as a prostitute.”

“Trafficking in women for the purpose of prostitution was a serious problem, despite laws against procuring and kidnapping for purposes of sexual exploitation. There were reports that police abused prostitutes,” the report said.

“Despite sporadic crackdowns on brothel operators in Phnom Penh, prostitution and related trafficking persisted. Estimates of the number of working prostitutes ranged from 14,725 to 18,250. Sex tourism was a problem, fueled by pervasive poverty and the perception of impunity.”

Original reporting by Seang Sophon for RFA’s Khmer service. Service director: Sos Kem. Translated by Sothea Thai. Written in English for the Web by Joshua Lipes.

08 January, 2009

Children Increasingly Living With HIV/AIDS in Cambodia; Officials Focusing on Prevention


Source:
Kaiser Daily HIV/AIDS Report, Kaisernetwork.org
[Jan 07, 2009]

Cambodia has shifted the focus of its HIV/AIDS prevention efforts from young adults to children in response to 2008 statistics that show an increase in rates of antiretroviral use among children and mother-to-child transmission of the virus, the Phnom Penh Post reports. Mean Chhi Vun -- director of the National Center for HIV/AIDS, Dermatology and STDs -- said that the government has begun a program to provide "HIV testing for 6,745 pregnant women [this year] in 68 health centers across five of our operational districts." Thirty-five of the women tested positive for HIV and received follow-up care and medicine from the center, according to Vun. Teng Kunthy, general secretary of the National AIDS Authority of Cambodia, said that the government also is focusing on a national registration program to coordinate treatment for children living with HIV. The program "has been running smoothly so far and has encouraged more children to seek treatment," he said.

Vun said that between January and September of 2008, about 2,913 children received antiretroviral drugs, an increase from about 1,800 in 2007. He added that nationwide pediatric HIV/AIDS figures are determined by the number of children receiving antiretroviral treatment through the nation's clinics, adding that the figures do not include the estimated 600 children living with HIV who are not yet receiving treatment or who have not been tested for the virus. Chan Ry, deputy director of the National Pediatric Hospital, said that 300 children were treated at the facility in 2007 and now it is providing treatment to 1,155 children.

The increase in the number of cases involving MTCT "testif[ies] to the fact that women are not able to access good" prenatal care to prevent transmission, the Post reports. A 2006 UNAIDS report shows that while prevalence among young people ages 15 to 49 has decreased to 1.9% in 2003 -- compared with 3% in 1997 -- one-third of new HIV cases are because of MTCT. According to the Post, there are about 461,000 live births annually in Cambodia -- mostly outside of health centers and hospitals -- and an estimated 9,700 pregnant women are living with HIV. UNAIDS data indicates that without any intervention, about 3,000 infants may be born with HIV through vertical transmission. According to Tan Vouch Chheng, an undersecretary of state at the Ministry of Health, antiretroviral drugs are dispensed at 26 locations and HIV testing is offered at another 212 facilities. However, she added, "We have to expand our programs for prevention and the spread of HIV/AIDS from mothers to children."

The Post reports that the exact number of children living with HIV/AIDS is unknown but "experts support the proposition" that it is "rising fast." Seng Chhunleng, coordinator for the Orphans and Vulnerable Children program at World Vision, said the number of children living with HIV/AIDS will continue to increase if something is not done to stop vertical transmission. "This is a problem that we still have to commit to solving," he said, adding that Cambodia "should provide better education and more medicine to stop transmission between mothers and children" (Leakhana/Kunthear, Phnom Penh Post, 1/6).

30 December, 2008

Controversial doc opens sch

Dec 30, 2008
By Ben Bland , FOR THE STRAITS TIMES
Dr Richner has set up five children's hospitals in Cambodia. -- PHOTO: WWW.BEAT-RICHNER.CH
SIEM REAP: - A controversial Swiss doctor who has frequently clashed with international health experts is continuing his fight to bring world-class healthcare to Cambodia's children by setting up an academy to train doctors and pouring additional millions into one of his hospitals.

Dr Beat Richner, who has set up five children's hospitals in Cambodia with funds from private donors, has built a new wing at his hospital in Siem Reap, close to the renowned temples at Angkor Wat, to solve a chronic shortage of beds. He refuses to turn patients away and many children are currently treated on mats on the floor.

The US$12 million (S$17 million) extension, which incorporates a state-of-the-art MRI scanner as well as 200 extra beds, is being launched today, alongside a new academy to train young doctors who are keen to pursue similar humanitarian projects.

The opening ceremony is being presided over by King Norodom Sihamoni, who has been a strong supporter of Dr Richner's work ever since he set up his first hospital in Phnom Penh in 1992.

The Kantha Bopha hospitals provide free treatment to 85 per cent of all sick children in Cambodia and Dr Richner claims that his foundation saves 90,000 lives a year.

An accomplished cellist, he plays twice-weekly fund-raising concerts at his Siem Reap hospital to tourists visiting the Angkor Wat temples.

His hospitals cost US$25 million a year to run and most of the funding is from private donors. Many of his backers are in Switzerland, where he is something of a celebrity. The Cambodian and Swiss governments also contribute 16 per cent of his annual budget.

However, his methods have brought him into conflict with international health groups such as the World Health Organisation. They argue that reliance on individual foreign donors and use of expensive equipment and drugs make his approach unsustainable.

They say efforts to improve Cambodian health standards should focus on state-run hospitals and the promotion of basic health care and hygiene.

The Kantha Bopha Academy of Pediatrics, which will hold its first six-month course in July next year, is being launched in part as a response to these criticisms.

'They say we are not sustainable but I want to help train the next generation of doctors so we can have more Kantha Bophas around the world,' said Dr Richner.

By avoiding corruption and using international-standard technology, he insists that his approach has provided economically efficient and medically correct health care.

The academy is aimed at 'promoting this positive experience and creative know-how to other parts of the world with similar conditions and needs', he added.

Although the academy will be open to all fully qualified physicians, the focus will be on training young doctors from developing nations in South-east Asia, Africa and other parts of the world.

The fees are likely to be subsidised for those who cannot to afford to pay. Courses will be run by doctors from the Kantha Bopha hospitals as well as visiting professors from Switzerland.

Dr Richner first worked in Cambodia in 1974 but was forced to flee when the murderous Khmer Rouge took control of the country in 1975. He returned in 1991 to rebuild the main children's hospital in Phnom Penh at the request of former king Norodom Sihanouk.

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