CAMBODIA has an estimated 30,000 AIDS orphans and their numbers are expected to increase

to 140,000 over the next four years, warns the Khmer HIV/AIDS NGO Alliance (Khana).

A mother in the final stages of AIDS ponders the fate of her children after her death

Cambodia's HIV/AIDS epidemic is already the most serious in Asia with some 3.5% of

the population - 170,000 people - now infected with HIV, the virus that causes AIDS.

Some 8,000 adults and 200 children under the age of five are already battling the

deadly disease.

According to Ministry of Health (MoH) statistics, the number of people sick and dying

of AIDS is expected to jump to 40,000 by the year 2005.

Evidence from African countries, now experiencing the full onslaught of AIDS, suggests

that Cambodian children who lose one or more parents to the epidemic will face severe

poverty and malnutrition, and will become vulnerable to exploitation as child prostitutes

and laborers.

In Cambodian families it is normally the father who first falls ill and dies of AIDS.

"Very often the illness and subsequent death is not known to be related to AIDS

and the mother will only find out that she has been infected if she becomes pregnant

and the baby then dies. Sometime after, she too will become ill and die, leaving

the remaining children as orphans," says a Khana report.

The report says the most vulnerable group of AIDS orphans are those aged seven to

twelve. "This age group was considered to no longer attract the protection afforded

to babies and infants; to be old enough to work, but to lack the life skills and

the physical strength to protect themselves."

One of Cambodia's 30,000 AIDS orphans.

Linda Chisholm, Country Director for Awareness Cambodia, runs an orphanage in Kompong

Speu primarily for children whose parents have died, or are dying of AIDS.

Chisholm said a growing number of destitute widowed mothers and their children are

drifting to Phnom Penh from the country to live on the streets, having sold everything

in an effort to find a cure for the fathers who have already died of AIDS.

For young girls in this situation there is a great danger of being sold to brothels

if they are not taken in by orphanages before their mothers with HIV/AIDS become

too ill to protect them.

Not only do children face worsening economic and security circumstances, but globally,

about one third of children born to HIV-positive mothers will be infected by the

virus within the first year of their life. The infection can occur in the womb, during

birth, or while breast-feeding, says a Khana report.

Pok Panhavichetr, Executive Director of Khana, said Cambodia's Government must prepare

to confront the AIDS orphan crisis.

"The number of AIDS orphans will be a big burden to our society. Already our

economic situation is difficult and the Government has little money to support orphanages,"

said Panhavichetr.

Many children prefer living on the streets rather than in Government orphanages because

conditions there are so grim, she said.

Oum Sopheap, HIV/AIDS Program Co-ordinator for World Vision (WV) Cambodia, said caring

for mothers and children affected by the disease will be a huge challenge for Cambodia.

In the past three years WV have seen the numbers of children who have lost parents

to AIDS rise sharply.

"When we first started the care and support services for people with AIDS, we

didn't see so many children, but now we see a lot of other social problems and the

increasing numbers of orphaned children is a major concern," said Sopheap.

Sopheap said WV is now developing community-based programs to oversee the care of

AIDS-affected mothers and children, as well as facilitating a foster family program

to care for the predicted boom in children orphaned by AIDS.

Hor Bunleng, Deputy Director of the National Center for HIV/AIDS, Dermatology and

STDs (NCHADS) told the Post that there is also growing concern about the vulnerability

of children to the HIV virus.

Bunleng said there are now an estimated 3,500 children born HIV- positive in Cambodia

every year and 2.6% of women volunteering for blood tests at ante-natal clinics are

found to be HIV-positive.

Though unprotected heterosexual intercourse is still the most common route of HIV

transmission, spread of the deadly virus between pregnant women and their unborn

children has become the fastest growing rate of HIV transmission in Cambodia.

Bunleng said the MoH has just launched a trial project in Battambang and Phnom Penh

to stem mother-to-child HIV transmission.

The Preventing Mother to Child Transmission (PMTCT) project will initiate a counseling

and education program which aims to enable women to prevent contracting HIV.

And to block mother-to-child HIV transmission, HIV-positive pregnant women participating

in the PMTCT project will be offered the anti-retroviral drug Nevirapine just prior

to giving birth. Then the infant will receive a single dose of Nevirapine within

72 hours of being born..

Benleng said it is hoped that this anti-retroviral therapy will reduce the rate of

mother-to-child transmission in Cambodia from as high as 50% to about 8% by the year

2005.

Geoff Manthey, Country Program Advisor for UNAIDS said the anti-retro-viral treatment

about to be trialed in Cambodia has proved effective in other countries. However

most prevention efforts are still focusing on sexual transmission because it is the

easiest to stop, he said.