THEY enter the pagoda discreetly, early in the morning or late in the afternoon when
the light is weak and people are scarce. They sit with the monk Pal Hon, seeking
his comfort and his believed cure: small plastic bags of bark and wood for tea and
two-liter soda bottles filled with a murky wine of botanicals.
In return, they present what has become the calling card of Wat Svay Dang Kum: a
thin white paper from Institut Pasteur du Cambodge - marked HIV-positive.
In the end, the people with HIV or AIDS receive a container of treatments and a heavy
dose of hope. Pal Hon receives less encouraging evidence of the HIV/AIDS crisis in
Cambodia: another document for his bulging pile of positive test results.
He is receiving up to roughly 170 people per month from throughout the country. On
a recent day, nearly 20 people from Kampot, Kompong Cham, Svay Rieng, Kompong Thom
and Phnom Penh visited him. Most who make the pilgrimage are young, some are foreign
and a few are already very sick - but they all have one thing in common: they are
desperate for care and desperate for a cure.
A 30-year-old woman seated on the floor of his receiving room recently made a second
trip all the way from Kampot for Pal Hon's medicine.
"I think he can make me better," she said, pulling at the skin of her arm.
"I've already gained weight from the tea." Pal Hon pulled his pipe from
his mouth to interject: "She is cured."
The woman's husband, a taxi driver, died three months ago of AIDS at age 33. He went
to the hospital with an unknown ailment, learned he had full-blown AIDS, and died
one week later, leaving his wife with four children faced with no income and a lot
of anxiety. When asked how her husband contracted the disease, she said it was "a
Her children have tested negative, but she was not so fortunate. The hospital gave
her the results, then recommended she visit Pal Hon. She scraped together $10 with
help from her mother's profits from selling rice and went to the pagoda, hiding her
condition from her community. Pal Hon gave her the medicine at this reduced rate.
Soth Sina, a researcher for the Cambodian AIDS Social Research Project, has interviewed
many of Pal Hon's visitors. She said many actually manage to afford the hefty $50
price of the wine treatment. Their payments help to offset the poorer people with
HIV and AIDS, who are charged less or nothing.
Wat Svay Dang Kum, with its many seekers of counsel and remedies, sits practically
in the backyard of the Ministry of Health, home to the National AIDS Program. The
symbolism of the location is apt. As the AIDS program struggles in vain to build
care facilities that will keep pace with the spread of the disease, people just outside
the halls of bureaucracy are seeking alternative solutions.
For those with HIV and AIDS, there is simply no time to wait for rhetoric to become
Dr. Hor Bunleng, program coordinator of the National AIDS Program, hopes that will
change in the coming months.
He said that the Ministry of Health would like to allocate money and equipment with
the help of local and international NGOs and the UN for a center for AIDS patients.
Sihanouk Hospital has been set aside as the site for this center, and in December,
Bunleng predicted it would be operational by March of this year.
But on a recent visit to the hospital, there were no signs of progress. The hospital,
once run by the Soviets, is suffering from a lack of resources, and the peeling walls,
cramped, dark rooms, antiquated equipment and dearth of medicines are barely adequate
for many routine treatments, much less a highly specialized AIDS center.
"The number one problem here is lack of funds," said Dr. Senya Chhin, chief
of the hospital's infectious service.
He has treated an average of seven HIV and AIDS cases per month and seen seven of
these patients succumb to AIDS. "I have been buying medicine with my own money
to help them," he said.
Dr. Chhin said he uses treatments that mix traditional and modern medicines.
However the success of these treatments is hard to measure because Cambodia has no
laboratory that can thoroughly test their effect on the immune system.
Chhin claimed that blood samples of treated patients that were sent to the United
States showed some improvement.
The hospital offers what medical attention it can for the physical toll of HIV and
AIDS, but counseling for the emotional toll faces even greater challenges.
Dr. Chhin said that patients who go to have their blood tested personally learn of
their condition; however, if he diagnoses a patient with HIV or AIDS, he informs
the family rather than the patient.
To avoid the increasing problem of families abandoning the patient out of fear -
without the patient ever knowing why - he said he instructs the family on how the
disease is contracted so they will not be afraid to care for the person with HIV
Unfortunately, acceptance and understanding remains low.
This creates a troublesome catch. Those who don't know their condition may not receive
care from their families and those who do know of their condition may not receive
care for themselves. Either way, they are often frightened and confused.
Ol Ny, coordinator of the new AIDS counseling center, said: "The people who
come here are afraid and often in denial. They find it very difficult to talk about
HIV and AIDS."
Some of the 50 people who have visited the center since it started last June have
been suicidal. It's difficult work and "sometimes I cry with my clients,"
Last August, a 24-year-old university student from Battambang appeared on the doorstep
of the center.
Extremely ill and suffering from a severe skin condition, he said a hospital had
told him he was incurable.
Afraid to tell his family, he said he was alone with nowhere to go. Ol Ny helped
to find a place for him to be cared for - a group of nuns took him in.
In the end, it is the nuns and monks of Cambodia who are the last refuge for many
The hospitals - and sometimes even the very families of those who are sick - may
turn them away, and so they go to the pagodas.
Pal Nol, at least, will receive them warmly and with comfort, if not a cure. The
woman from Kampot, sitting quietly in the corner of his receiving room, came for
that very reason.
"I am scared I will die and I am afraid for my children," she said, her
wide eyes worried. "But now I'm beginning to feel better."