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Is Cambodia’s war on drugs working?

Mith Samlanh programme beneficiaries at the organisation’s headquarters in Phnom Penh. MARTIN de BOURMONT
Mith Samlanh programme beneficiaries at the organisation’s headquarters in Phnom Penh. Martin de Bourmont

Is Cambodia’s war on drugs working?

Thavy, 24, spends her days avoiding the police, looking for a quiet place to sleep and trying to keep her heroin withdrawal at bay.

“Before the campaign started, I could stay in one place,” she said, remembering a time when passersby and police officers would ignore her as she used heroin or slept beside her children in public.

Like thousands of other drug users, Thavy, who asked to withhold her full name, was caught up in a nationwide crackdown that began in January. To date, more than 8,000 people have been arrested as part of the sweep, according to National Police statistics.

Branded as a six-month endeavour at the outset by the government, the crackdown should be reaching its end, though a senior official told The Post yesterday that a July meeting will help to determine if it will continue beyond the half-year mark.

While the crackdown’s effectiveness in deterring drug use overall is unknown, a few things are clear: it has led to significant disruptions in outreach programmes, put pressure on crowded prisons and has received harsh criticism from human rights observers.

According to National Police spokesperson Kirth Chantharith, the first 163 days of the campaign saw the arrest of 4,298 suspected drug dealers and traffickers and 3,569 drug users. Observers say that despite the high number of “traffickers” arrested, the actual campaign tells a different story.

While emphasising the importance of halting the drug trade, the United Nations Office of the High Commissioner for Human Rights spokesman Sovanna Mann expressed concern that “equal treatment is meted out regardless of the quantity of drugs found, the level of profits gained or whether medical attention is needed, rather than incarceration”.

Human rights observers also called attention to overcrowding in Cambodian prisons, which Cambodian Center for Human Rights Advocacy Director Duch Piseth said has drastically increased the number of Cambodians awaiting trial in detention.

“The use of extended pre-trial detention was already a problem in Cambodia before the recent crackdown. With this huge influx of new detainees into Cambodia’s already over-stretched criminal justice system, disproportionate and unjustified restrictions on the liberty of those facing criminal charges, as well as their right to be presumed innocent, are only likely to worsen,” Piseth said.

The drug crackdown has caused alarm among local HIV prevention NGOs and the World Health Organization (WHO), who fear it will cause a spike in the already high HIV rate among injecting drug users, which was nearly one in four as of 2012. According to WHO Country Medical Officer Laurent Ferrandini, for arrested users, accessing antiretroviral drugs was “difficult or impossible in some detention locations”.

“People using drugs were more difficult to reach through prevention programmes as they tend to avoid contacts that could lead to their identification as they become more afraid of being arrested,” he said. He believed this fear accounts for a dip in the number of people visiting NGO-run drop-in centres providing basic HIV care and prevention services.

Mith Samlanh, an organisation that provides HIV prevention services, noted an alarming drop in programme beneficiaries receiving services, with the organisation distributing 17 percent fewer clean needles and syringes in the first five months of the year, compared to the same period last year, because fewer beneficiaries had lined up to collect them.

“In order to ensure the quality of services, the [people who inject drugs (PWID)] need to at least receive three to four needles and syringes a day,” explained Sem Sithat, a Mith Samlanh representative.

Another reason for the decline may be that the police have targeted people with any equipment related to drugs – including clean needles – for arrest.

“When [the police] go for the crackdown, they don’t care if you are using drugs; if they find equipment related to drugs, they will arrest,” said Mith Samlanh outreach worker Thearith, who did not want to disclose his name because he was a former user himself.

Data collected by Mith Samlanh showed a 10 percent overall decline in PWID participation among the 430 people in the NGO’s programmes.

Sok, 35, tells of his battle with addiction over coffee last week in Phnom Penh.
Sok, 35, tells of his battle with addiction over coffee last week in Phnom Penh. Hong Menea

According to another representative, Pin Sokhom, around 100 of the organisation’s beneficiaries were arrested during the campaign. Last year, the organisation was able to reach about half of its 430 participants more than twice week.

“But right now [we reach] less than 15” people more than twice a week, he said. “They [are] afraid to access services.”

HIV prevention NGO Khana, which serves as the flagship organisation for HIV services provider Korsang, also reported a high number of arrests – 41 out of more than 300 people they serve. Of these, a recovering heroin addict with HIV named Thhan Dang died in early May, having been unable to access methadone and antiretroviral therapy during his incarceration at the Prey Speu detention centre in Phnom Penh.

While medical services do exist in prisons and detention facilities, Khana Executive Director Chob Sok Chamreun said, they do not respond to the needs of an ever-growing population of incarcerated drug users. “They just treat based on the symptoms,” he said. “If you [have a] fever, they give fever medication; you are shaking, they give medication to prevent shaking. Is that drug treatment? No.”

Despite their reservations, neither Khana nor Mith Samlanh condemned the anti-drug campaign. Representatives of both say they support the initiative, but hope for better collaboration between the government and organisations providing support to drug users.

“Our definition of success might be different from the government,” said Sithat.

“For us, we can say that if the victims are arrested, they can have the appropriate services, access social services when they are released, they can have opportunities like other people, and they have no chance of relapsing and are healthy. Then it is success.”

Sithat proposed the government share information with outreach programmes about which users have been arrested and about needed services. Expanding methadone substitution therapy to prisons and other facilities would also help. Currently, the Khmer-Soviet Friendship Hospital in Phnom Penh houses Cambodia’s only methadone clinic.

Prisons Department spokesman San Keo dismissed worries that prison conditions were not adapted to the needs of drug users, stressing that the users have a personal responsibility to improve their lot. “They receive food and medical treatment like everyone else, and when they change their behaviour and attitude [to become] like normal people, they will receive skills education,” he said, citing sewing classes for women, and woodworking and welding classes for men.

Among six drug users interviewed by The Post last week, three had spent time in prison and detention centres. Of these, all continued using drugs, with two reporting that substances remained easily accessible within prison walls.

Asked whether the government could do more to cooperate with civil society, National Authority for Combating Drugs Secretary-General Meas Vyrith proposed via SMS that NGOs “come to [the] NACD for discussion”.

Vyrith said that he considers the campaign a success and suggested it could be extended, though the government has not decided whether it will do so. This decision, he said, depends on the outcome of a meeting planned for early July involving “the NACD, relevant government institutions and provincial governors”.

However, Phil Robertson, deputy Asia director for Human Rights Watch, criticised the measures that have already been taken, saying drug users face “extortion and violence” from police followed by more abuse in rehabilitation centres, and that the drug war should be getting wider attention internationally.

“What’s amazing is this story on Cambodia’s own drug war has almost been almost invisible in the international news, perhaps because it’s hard to compare to the savagery of the Philippines’ shoot them down on the street drug war, and international editors see only room enough for one drug war story,” he said.

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