A place with hope and dignity: Increasing numbers have only the street to die on.

KY, a 28-year-old masonry worker, has been sick for a long time, but it wasn't until

three or four months ago that he found out his sickness was AIDS.

Now Ky sits listlessly in the Maryknoll Hospice - one of only two such homes in Phnom

Penh - his skeletal frame wracked with severe pain. Without the hospice's help he

has no idea where he would have gone.

Ky's situation is typical according to staff at Maryknoll, who know it is becoming

more common for AIDS sufferers to lose their jobs - and their homes.

"The situation is critical. We're going to find more and more people who are

desperately sick just living in the streets," said Maryknoll's Father Jim Noonan.

Lately, he says, the hospice has had to turn away increasing numbers of prospective

patients.

"In the last few months we've been completely overloaded. We have to turn people

away every week," he explains.

Maryknoll's small facility, just off Route 2, has room for twelve severely ill AIDS

patients. For them the hospice represents a last hope. Only the most desperate cases

are admitted.

Phnom Penh's only other AIDS hospice, run by the Sisters of Charity, the Catholic

order started by Mother Theresa, in the north of Phnom Penh, is suffering the same

pressures of space experienced by Maryknoll. Both establishments cater for patients

like Ky who have nowhere else to go.

"Ky can't leave while he is in this much pain," says Dr Sam-neng, a new

graduate who took his first medical position at the hospice four months ago.

The patients at Maryknoll, in the final stages of their battle with HIV, are thin

and wasted and suffer from opportunistic infections. Many have vicious sexually transmitted

diseases; one man has skin lesions so severe that they have turned his body purple.

Dr Hor Bun-Leng, deputy director at the National Center for HIV/AIDS, Dermatology

and STD, says that there are no statistics on demand for AIDS hospice beds in Phnom

Penh.

"We know that the scope is very large."

"We are requesting help from pagodas and are hoping to have one hospice open

soon in Sihanoukville," he says. He adds that he would like to see this strategy

applied in Phnom Penh, but that currently no decision has been made to do so.

The prognosis for patients may be bleak, but the atmosphere at Maryknoll is deliberately

upbeat.

"Meet Osama bin Laden," says one staff member of a wisp-bearded patient,

raising a rare laugh.

The facility opened in January 2000 and has been full to overflowing ever since.

A recent addition is a porch area, which serves as a makeshift bedroom where a couple

of extra patients are sometimes placed on fold-out beds.

Hospice care is the last hope for many.

"We're trying to respond to those who have no home, no family. Often people

live where they work and when they become too sick they lose their job and so they

lose everything," says Father Noonan, who has been ministering to Phnom Penh's

poor for the past ten years.

"We are dealing with very dire need here. If we weren't here they'd die very

quickly."

However, the hospice does more than simply keep patients until they die.

"If we get them in time they rebound really quickly," says lay missioner

John Tucker. "You'd be surprised. Just with good nutrition and some really simple

medicine - and I'm talking paracetamol - they really improve."

Those patients that do improve are moved on, often into a group home run by Maryknoll

where they care for themselves until such time as they need to come back to the hospice.

Others have become well enough to travel and return to their families in the provinces.

That frees up beds for other patients but demand is constant and it is increasing.

In the past six months Maryknoll has admitted 66 patients to the hospice. One-third

have died.

"Sometimes we have two or three patients die in a week," says Father Noonan.

Others have made the hospice a home almost since it was opened. He adds that the

psychological boost of not living in fear on the streets is enough to improve the

health of some.

By rearranging the position of the beds at their hospice, the Sisters of Charity

recently managed to increase their capacity from 12 to 18 beds. That, however, is

scarcely sufficient to cover the burgeoning number of AIDS sufferers in the capital.

The Sisters also run Phnom Penh's only hospice for children with HIV, catering for

between 15 and 20 children and infants.

Despite the obvious need for more AIDS beds, Maryknoll has no desire to expand its

service. Instead Father Noonan hopes others will emulate the org-anization's work.

"We try to do it very simply so it can be easily reproduced by others. All you

need is a place to put people and then staff who are very dedicated, very compassionate

people," he says. Until that happens, many more of Phnom Penh's worst-off will

continue to be turned away from the city's all too limited facilities.