The new killing fields

International | Cambodia's AIDS epidemic may be as devastating as Pol Pot's mega-purge

Issue: "It's Bush vs. Gore," March 18, 2000

in Phnom Penh, Cambodia - When the sun sets and a breeze floats across the Mekong River, the red lights come on and Phnom Penh's night commerce begins. In Cambodia's capital, over 3,000 brothels and 7,000 prostitutes make illicit sex a thriving industry-and one that has spawned Asia's fastest growing AIDS epidemic. Cambodian officials now admit it could be as deadly for the country as the killing rampage of the communist Khmer Rouge, who under the direction of Pol Pot took the lives of 1.7 million people in the late 1970s. Forty years ago, Cambodia was the most developed and cleanest nation in Asia. Phnom Penh was a showcase city with public services, promenades, and city gardens. Then, in 1970, the country was plunged into the Indochina War. The country faced internal struggles between Marxists and government forces. United States B-52 bombers began dropping explosive payloads over Cambodia. When the Marxist Khmer Rouge forcibly took control of the nation in 1973, the nation rapidly deteriorated to a Third World wasteland. Today, Cambodia suffers still from the ravages of the war, the desolation of the killings, and from a decade of military occupation by Vietnam. Vast tracts of farmland stand idle. Nearly 4 million uncharted land mines, still hidden in rice paddies, keep agriculture and development at bay. Almost daily, farmers are killed or maimed by the anti-personnel devices that were planted during fighting more than 20 years ago. The United Nations is pressing Cambodia to conduct war-crimes trials for atrocities committed by former Khmer Rouge leaders. But Prime Minister Hun Sen has stalled the process. Foreign investment is held up. Cambodia's government thrives on patronage and bribery. Corruption reaches every level of government. Many officials siphon foreign aid. Police often demand bribes at routine traffic stops. Cambodia's Minister of Health agreed to take questions from WORLD about the AIDS epidemic, but his staff demanded a $200 bribe to "make the final arrangements." Despite these devastating political and economic problems, it is the HIV/AIDS infection rate that may destroy the people. By the end of this year, health officials expect 40,000 full-blown cases of AIDS in Cambodia. Randy Kolstad, director of the USAID Health and Child Survival office in Cambodia, admits that statistics are difficult to come by, but, he says, "the information we have available is frightening." Health officials say 250,000 Cambodians are already infected with HIV. The number grows by 100 people per day. When Cambodia's 7,346 "commercial sex workers" (the politically correct term for "prostitute") were surveyed, 43 percent tested positive for HIV. "Commercial sex workers" and their customers account for the spread of nearly all cases of HIV/AIDS in Cambodia, according to Mr. Kolstad. Some Cambodians say AIDS first entered the country in 1993, when a UN peacekeeping force presided over the country's first national elections. UN soldiers from Uganda and other African nations where the rate of HIV/AIDS is also high were suspected carriers. Others, like Mr. Kolstad, deny that theory of origin and say Cambodia had its first AIDS diagnosis in 1991. "Blood serology indicates the HIV virus in Cambodia is Asian in nature," he said. Whatever the source, once introduced to Cambodia, the HIV infection spread rapidly due to the culture's sexual mores. Few view prostitution as evil, or even a low-life activity. Wives are expected to be chaste, but husbands are not. A Cambodian man explains unapologetically, "It is common for men to go out for dinner together after a day of hard work. Then, after the meal, they all go to a house of prostitution and take a 'Garden Flower' to bed." A Cambodian woman expressed the cultural tolerance for unfaithful husbands by saying, "I cannot expect my husband to come home for a drink every time he is thirsty." Officially, prostitution is illegal. However, it is not only tolerated, but also facilitated by the bribe-hungry police force. Phnom Penh is full of brothels, and hundreds of establishments front for prostitution-dance halls, karaoke clubs, bars, discos, even hotels and restaurants. And it is a living. Prostitutes make $5-20 per night. Most women earn $1 per day in Cambodia's garment factories. Lili, a 19-year-old prostitute, says she has heard about AIDS and knows she has an almost sure chance of getting it. But she is defiant about her decision to work as a prostitute. "I can stay in my village and starve in three months. Or, I can come to the city, work as a prostitute and live maybe three years before AIDS kills me," she said. Cambodian pastor Sinai (pronounced 'Seen-aye') Phaeck, who leads a Phnom Penh congregation of 200, says, "Scripture is clear on the subject. We teach that fornication and adultery are wrong. And, we teach about the consequences of sin." However, he admits that not all recently converted Christians have made the transition from their former lifestyle. "Some men are struggling with the issue. And I know of one new Christian woman who has yet to forsake her job as a prostitute." Pastor Sinai has urged her to quit, but he says she is fearful that giving up prostitution will leave her destitute: "There are few jobs available and no social safety net. Without income, starving to death is a real possibility. We are praying she has the courage to trust the Lord and walk away from prostitution." As Pastor Sinai speaks, a sickly woman has entered the church. Nanmounny is a 33-year-old mother, and she explains that she has full-blown AIDS and just a few months to live. Her husband contracted AIDS at a brothel and infected her. The husband has already died. She begs the pastor to take her three children. She can no longer provide for them. The infant child, still nursing, is at risk of contracting the disease. Pastor Sinai agrees to care for her children, although he is not sure how his small congregation can help one more family. Then, he leads Nanmounny through the gospel message of hope. With tears streaming down her cheeks, she and her two older daughters pray to receive the Lord that afternoon. "Her story is not unique. This is happening almost every week," he says later. "When AIDS first began appearing in Cambodia, there was widespread denial," says Linda Chisholm, a retired Australian schoolteacher who now volunteers time with AIDS victims in Phnom Penh. "In the early years, many Cambodians claimed the disease was fabricated by Americans to take away their 'fun.'" Cambodian doctors refused to accept the AIDS reality, often diagnosing AIDS cases as "severe dizziness." Then, as the disease was recognized as a genuine illness, the general consensus switched to a belief that AIDS came from evil spirits. Buddhist monks offer to cure AIDS through incantations and spirit offerings, some charging $10,000 in fees for the service. Only recently has public awareness grown to a level at which more people are convinced that HIV/AIDS is transmitted through sexual contact. Even so, sexual attitudes have yet to show signs of change. The sale of condoms has soared to 1 million per month, but most prostitutes-according to health workers-admit that they are not used much. A recent survey found 80 percent of military personnel admitting to frequenting brothels. "Even the beggar has enough money for a prostitute," says Ms. Chisholm. "As a prostitute gets older and sicker from AIDS, her fee for services goes as low as 500 Reil [15 cents]." Ms. Chisholm sees the end result of the epidemic as she visits the AIDS ward at Soldiers Hospital daily, bringing patients soft food, offering comforting words, and telling them about Jesus. "Eight of my patients died last year," she says. "All asked Jesus into their hearts before they died." "Ultimately, it will be the power of the gospel that changes our society," says Pastor Sinai. He believes the nation can be turned around as Christians demand deep-seated changes to restore Cambodia's political and economic well-being, and to bring health.

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