Testing on anxious villagers began in earnest yesterday as Health Ministry officials arrived in Peam, the Kandal province village recently discovered to have 14 confirmed HIV diagnoses.
The initial results were a relief for many villagers, as the new, wider sample taken produced only four positive cases.
“This afternoon … we tested 279 people. Of those, there were four positives: three female, one male,” said Ly Peng Sun, director of the Health Ministry’s National Centre for HIV (NCHADS).
Village chief Oun Khann said yesterday that a team from Khemara, Cambodia’s oldest existing NGO, was responsible for the initial round of testing on 47 people on February 13.
Those tests produced 14 positive diagnoses that were then confirmed with a second round of testing at Kandal’s Samdech Euv Referral Hospital.
While Khemara’s tests were seemingly borne out, Kandal district health department director Kuoy Bunthoeurn said yesterday that his office was considering taking action against the NGO for providing HIV testing without permission.
However, NCHADS director Peng Sun, who confirmed the positive tests at Samdech Euv on Friday, took a more understanding view of the situation.
“Whether they were doing without any permission, I don’t know,” he said. “If they did it in a proper way though, that’s what we wanted to happen. We covered 80 per cent of the country [with HIV testing], but we still have about 10 per cent without access to health care.
“We want these people to have access to HIV care. If [Khemara] do it properly, it’s not a problem. Whether they did not inform the local health authorities, I don’t know.”
Representatives of Khemara were unreachable yesterday.
It is not known if the 14 cases flagged by Khemara were among the 279 persons who volunteered for testing yesterday. District health director Bunthoeurn said his department plans to begin checking now that the new testing is complete.
But NCHADS director Peng Sun said the technology to do so is not in place.
“We don’t have tools to eliminate re-testers, unlike before, when we took fingerprints. We don’t have that here in Kandal, only in Battambang [did we use fingerprinting] to eliminate repeat testing,” he said.
While a number of villagers initially interviewed said that they suspected the syringes of a local doctor were the source of the rash of infections, Peng Sun yesterday said there were no immediate plans to investigate the physician.
“I don’t think for the moment [that we will investigate] because there’s no objective link or evidence,” he said.
The doctor, who on Friday told the Post he did not reuse needles, declined to comment further last night.
With little on which to hang their suspicions, numerous villagers proffered a new theory yesterday.
“I think it might not be the doctor; I think it might be the time of the land boom,” commune chief Nhem Yoing said yesterday.
Yoing was one of numerous villagers to explain that between 2008 and 2011, investors became interested in nearby land, much of it owned by older men from the village, who they subsequently plied with cash for visits to KTV parlours.
Fifty-seven-year-old Rith Khen, whose wife has HIV, although he said he does not, said he went on the trips but did not pay for sex.
“I also go to KTV,” he said. “But just to eat. Girls come and sit by me and kiss me, but nothing more. The land brokers give money for the KTVs; if we don’t take it, we’re losing money.”
Sav Rith Keep, 63, said he had also been on these excursions. Rith Keep said money came from the land brokers in two forms. First, as reimbursements for land sales, and secondly, by paying for “entertainment”.
One woman, who said her own husband had had an affair, maintained that scores of older men in the village had frequented KTVs for sex.
According to National AIDS Authority statistics, spousal transmission accounts for 48 per cent of all HIV cases in Cambodia, but officials yesterday cautioned against leaping to conclusions about the causes of the Peam cluster until a thorough investigation has been carried out.
Dr Laurent Ferradini, WHO Cambodia’s team leader for HIV, said last night the authorities will have a better understanding of the situation later in the week once the process of investigating and verifying information has been completed.
“We don’t know yet if we’re in a Roka-type epidemic, it’s too early to say,” he said, referring to the 2014 HIV outbreak in Battambang that saw 282 people diagnosed as HIV-positive.
When presented with villagers’ accounts, Ferradini noted that Kandal is a high-risk province for HIV, and that KTVs and massage parlours there would have been targeted for prevention measures.
However, while he and Penh Sun acknowledged the possibility of transmissions via sex workers, both urged people to withhold judgement until the investigation has concluded.