It's midnight in a Kreung minority village, and a girl about 14 waits for her potential
husband in a small house built on stilts in front of her family home.
Her suitor arrives each night about midnight and stays until 3 or 4 a.m. When - and
if - he decides she is "the one", he will stay until sunrise, an act that
shows the girl's family he is ready to wed.
Kha So Phai, 37, a member of the Kreung minority and an HIV/AIDS community health
educator, explained that in previous generations this ritual was an accepted and
innocent act of courting. Over a number of months, the two young people would simply
talk, get to know each other and "definitely not have sex".
These days, however, the boys sometimes have other girlfriends in neighboring villages,
Phai said, and the innocence is being lost because of the risks of spreading HIV.
Provincial health staff and NGO workers in Ratanakkiri province have long battled
to overcome cultural and language differences in order to teach the indigenous populations
about HIV/AIDS and how to prevent it. A new volunteer HIV/AIDS testing and counseling
clinic in Ban Lung opened by the Ministry of Health last month should help.
Health Unlimited project manager Caroline McCausland said the clinic is a significant
step and opens the way for home-based care for AIDS patients, as well as providing
an opportunity to further educate the population.
Until now, health staff at the provincial hospital could test the blood of people
they suspected to be HIV positive, but they were legally prohibited from informing
the patient of their status due to the absence of counseling facilities.
Dr Eng Kun Vuth, Ratanakkiri's provincial health department director and HIV program
manager, said two people visited the clinic on its first official day May 27.
Vuth said Ratanakkiri is the last province in Cambodia to receive a testing clinic,
and he said is it long overdue.
"Ratanakkiri has had to wait a long time," he said. "Some people in
the world have had information about [the virus] since the 1980s, but [the indigenous
people] don't know about it."
Vuth explained the risk of HIV infection among the indigenous population is on the
rise due to increased mobility and interaction with outsiders.
"Roads have improved and Khmer businessmen go to the village for a few days
and want to be with a woman," he said.
He said the problem is reversed with men from the village having more access to the
"This year there is good money from the cashew nuts and village men have a lot
of money, they can buy motos and beer and go to the brothels in Banlung," Vuth
McCausland said the Health Unlimited program reaches 53 of the 249 villages in Ratanakkiri
and publicizes condom use through community theatre targeted at teenagers and married
She said the program promotes condom use for HIV/AIDS prevention as well as "birth-spacing"
- a technique to prevent mothers from the health risks of having two children within
The birth-spacing technique, McCausland said, is a way for wives to encourage condom
use without appearing to be distrustful of their husbands.
She said condoms are now being sold at the local village stalls - 300 riel for a
four-pack. Brothels also now stock condoms, which they offer to their clients for
Dr Sim Kimsan, chief of advocacy and communications at the National Aids Authority,
said the trends for HIV/AIDS are encouraging, but noted that Cambodia still had the
highest infection rate in the region.
The most recent Aids Authority figures show a drop in the total number of HIV cases
in the 15- to 49-year-old age group from 157,500 people (2.6 percent of the population)
in 2002 to 123,100 people (1.9 percent) in 2003.
But 20 people are being infected every day, Kimsan said, and Ratanakkiri is a problem
because HIV is spreading from sex workers to husbands and wives.
"With such a strong traditional culture, it is difficult to encourage condom
use because it is so strange to them," he said.
But with better education, and health facilities like the new testing clinic, the
Kreung's age-old customs could be preserved despite the threat of HIV.