Six months ago Dr Ouk Vongvathiny's office was a notorious brothel in Phnom Penh's
Tuol Kork strip. Now it is the first step in monitoring the spread of sexually transmitted
diseases and HIV among prostitutes and their clients.
The "Tuol Kork Community Dike Clinic" opened its' doors to the public in
June this year as a free medical centre for the local population, a joint venture
between the Municipality of Phnom Penh, the World Health Organisation and British
Volunteer Service Overseas.
Last month, Dr Ouk and her male colleague saw 193 patients (more than 25 percent
of them commercial sex workers) and treated 102 cases of sexually transmitted diseases.
"They come here because they are afraid of HIV, because they sometimes tear
their condom," explains Dr Ouk. "But after I give them education about
HIV, they look so sad."
Although the clinic cannot do HIV tests, Dr Ouk is qualified to carry out pre-test
counselling and then refer patients to the Pasteur Institute for testing. So far
only nine patients have enquired about the tests and just four have taken them.
"Many are afraid to know the result, because they think they will have to change
their lifestyle," Dr Ouk says."I say that it is good for them to know that
they are HIV positive because then they can look after themselves...and not have
sex any more without condoms."
Dr Ouk claims ignorance is the biggest barrier to combatting AIDS in Cambodia and
tells the story of a man peddling a bogus innoculation against AIDS and STD's on
the Strip. He charges10,000 riel a shot and would-be buyers are told they need one
every month.
About 1,000 prostitutes work from wooden shacks along the Strip. Many are Khmer but
the majority are Vietnamese.
"The youngest I met was 14, but most are 16 years old," says the doctor.
"They think if they are rich and have enough money they will go back and get
married with a good man."
Virginity fetches a high premium, especially among older Asian men who believe oral
sex with a virgin will improve their health and increase longevity. Some are prepared
to pay up to $800 for a virgin.
"The customers are always over 40 years old," says Dr Ouk who says it is
possible to get a virgin for $300 if you cut out the middle man.
From that point on, her price drops to around $100 a time for the next month and
eventually down to $2 and $4 a customer, often averaging five to six customer a day
and more at weekends.
One afternoon a week, brothel owners and prostitutes are invited for health education
at the clinic but to date attendance has been low.
Many doctors fear HIV will quickly spread throughout the country as the prostitutes
tend to be transient and return to the provinces after a year in the capital. From
Dr Ouk's research, she believes 95 percent of Cambodian males will visit a brothel
at least once.