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Jun 22, 2017
"Are you going to Angkor Wat?"
"Angkor Wat is amazing, you will love it."
"Cambodia is great. I spent a week in Angkor Wat and it was great."
These were the typical responses I got when people found out that I was on my way to the land of the Khmer People. It is as if Angkor Wat is the defining point of an entire country. A country with so much history and pain that today this temple compound is considered by many the only symbol of hope and development for Cambodia. Angkor Wat is remarkable, however the people with their stories, courage, and optimism, in lieu of the tragic events of the recent past – Pol Pot’s Khmer Rouge holocaust, and the present HIV/AIDS epidemic, leave any visitor, who takes the time, with a broken heart and a humbled soul.
Working on this story for a month introduced to me many aspects of HIV/AIDS that were not apparent to me prior to my departure. Yes, I did my research. I knew the science behind HIV and AIDS. I read the history of Cambodia; Studied papers on the epidemic and the theories behind its spread and development in this region; And contacted many NGOs working in Cambodia for their input. Even so, the day to day effect of the disease, and the diverse factors going into understanding how it permeates into the fabric of society, were outstanding. I found myself faced with a plethora of emotions, and confronted with my own demons – misperceptions, stereotypes, and fears. I was overwhelmed and many times shocked. Visiting a hospice for AIDS patients, a local hospital, a shelter for women with HIV, and a lone woman with her son living in a lean-to in a dump, all challenged my professionally and strength. Many times I found myself with tears in my eyes while trying to photograph. However, I was also surprised and pleased to see the great work done by many organizations and the government fighting this illness. It was a roller-coaster ride of emotions that only Cambodia can produce.
I met Chum Sopha on a warm Sunday afternoon in the dusty seaport village of Kho Khong, which borders Thailand in the south. Mr. Sopha, the provincial coordinator for CARE International, introduced me to the region and the work his office does there. With one of the highest official – as reported by the government - HIV infection rates in the country, at 5.5%, their work is never ending. Acting in three main fields, which include prevention and education, home base care, and children in need services, they are the only group working in the area. Mr. Sopha and his team also introduced me to the Cambodian hospitality. They took me around town to find a place to eat, invited me out to dinner, and never let me pay for any of any of it. I am always amazed at the generosity of people who don’t have much to give but yet give it all with their heart. Cambodia gives with her heart and soul, but you need to dig beneath the surface of misperception to be rewarded.
The warm tropical sun rose early on Monday scaring the mosquitoes into hiding until dark. I made my way to the CARE office along the dusty dirt roads. Naked kids were running around playing with whatever they could find. The streets were quiet except for the occasional motor scooter. The taxi stand was full of drivers waiting and pleading for passengers. At one of the food stalls I indulged in one of the few good ideas the French incorporated here, the baguette. Every morning the smell of fresh bread lingers in the air and is hard to resist. Soon though, my appetite would all together disappear.
Fuel was being pored into the motor scooters as I entered the office compound. We were going out to do some home care visits. The team leader Ma Suonsopheak and his team members Loeuk Bunlu and Bou Amara leave every morning to visit different patients who are HIV positive, or are suffering from AIDS. Today Ms. Sun Sithu, the children in need team leader, joined us. We rode through the back roads for a short while arriving at the home of Dy Navy. Lying on a wooden frame covered by a bamboo mat was a frail woman surrounded by many men, woman, and children all staring at her. The team went to check up on her while I waited for permission to photograph. Her two daughters and son were taken aside by Ms. Sithu for counseling and comforting. I got my permission as Mr. Sounsopheak and Ms. Amara tried to make Dy drink some water. The crowd of friends, family and neighbors stood watching with a certain acceptance of the inevitable, of their own fate in a way, the destiny of a burdened country that is only too used to suffering and death. So much so that two of the woman turned to me and asked to be photographed in their flower garden across the dirt road. Within this sadness and desperation in the air, they celebrated life and beauty in the small plot of reds, yellows, and greens.
Dy was taken away on a motor scooter to the hospital. Her children will stay with family and friends – they are lucky. Their father died a year ago of AIDS and soon they will join the growing number of orphaned children whose parents succumbed to this dreadful illness. This was my first experience with a dying AIDS patient. My heart was pounding with sadness and a sense of helplessness. I couldn’t stop thinking about the children, and their uncertain future. My day just started. Their lives are in turmoil. Dy’s life’s ending. Cambodia goes on.
Why Cambodia? Why is the spread of HIV/AIDS like a wildfire there? The answer is as complex as Cambodia itself. Most people working in the field of HIV/AIDS in Cambodia believe that, in one way or another, the disease made its way from Thailand. We need to remember though, that a deep-rooted mistrust and historical rivalry exists between the two countries. And, some legitimacy to this theory exists. Mr. Sum Min is a 30 year-old HIV positive moto driver who takes people on his motor scooter like a taxi. Prior to falling ill, he was, like most men in Kho Khong, a fisherman. Often he would spend time fishing and resting in Thailand where he most likely contracted the disease from sex workers. He is but one example of a common trend. Among the fisherman community here there is a 12% HIV infection rate. Thailand also contributed by way of border brothels where many Cambodian military personal would visit. So, there is some truth to this idea of cross border transfers. Some researchers also found that the deployment of the United Nations Transitional Authority in Cambodia (UNTAC) between 1991-1995, increased the rapid spread of infection. Twenty thousand soldiers from around the world came to stabilize Cambodia in the early after years of Vietnam rule. Their presence created a booming sex market with brothels appearing at every corner of the country. This phenomenon is ingrained in the cultural norms of Cambodia. It is socially accepted and expected of young men to visit brothels but to marry virgins. So the idea of prostitution was not unfamiliar, but the quantity of prostitutes, and the sex industry that developed in response to the demand, accelerated the infection rate immensely.
Today the sex industry still plays a part in the transmission of the disease. It is interesting to note that as a population at risk, sex workers are showing a decrease in infection rate. This to the credit of Dr. Tia Phala, Cambodia’s minister of AIDS, who instituted a 100% condom use policy in brothels beginning 1998. As a regulated establishment there is better control, and maintaining healthy workers is important legally. The risk is from the unregulated sex workers. The beer girls in the many restaurants, the girl vendors who set up stands at night in public spaces, kereoke girls and more are all at risk. I met a 23 year-old girl in the slums of Phnom Penh. So much suffering and pain for such a young woman with an old soul. At the age of 17 her aunt sold her to a brothel, where she was forced to work for a year. She started working as a construction worker, fell in love with a co-worker, got married and moved to his village. After giving birth to a son her husband kicked her out and with no where to go, she came back to the capital to sell her body on the street. That is when she contracted HIV. Today she sells fruit and herself at night. She lives in a small shack with promotional posters for Number One condoms decorating her bamboo walls. She wants to remain anonymous since her family doesn’t know what she is doing or about her HIV status. There is still a lot of shame and discrimination from even close family members. In Sihanoukville, in southern Cambodia I visited a discotheque during the day for a sex education session conducted by the Reproductive Health Association of Cambodia (RHAC). At night this place is a busy front for a brothel. About twenty girls ranging from 17 to 25 years old were discussing with the counselors safe sex methods, condom use, sexual transmitted diseases (STD), and woman’s rights. These programs are key to fight the ignorance among many of the population regarding the spread of HIV/AIDS. The real issue, though, is tackling the demand for the sex workers.
"I want to document the education work not the workers." I was trying to get permission from a brothel owner to take pictures during a night education session conducted by RHAC in Siem Reap – the gateway to Angkor Wat. As the RHAC worker translated another woman stood in front of the young sex workers who were sitting in three rows each raised higher than the first all done up with pretty clothes and makeup. The woman pulled out a wooden phallus and started demonstrating the proper way of applying a condom. "You are not the topic of the story. I want to show people only the work that RHAC is doing." I tried again through my translator. "He said only a few pictures, but none of entire group," was the response. I took a few pictures as some of the very young girls – as young as 15-16 years old, stepped forward to try and put the condom on the wooden phallus. It was seven in the evening and a moto driver pulled in with an American, the first customer of the night. Immediately, the education session subsided, a chair was pulled up in front of the girls, and the American customer sat down. I tried to hide myself from this embarrassing moment. I was disgusted by him, by this moment, by my maleness, by the degradation, by it all. But this did not stop this man in his early 40’s to choose a sixteen-year-old, pay $30 to the owner and go to the back. As long as there is demand both locally and in the tourist sex industry, there will be sex workers and a population at risk.
When defining a population at risk in Cambodia one to take into account the sexual norms of the culture, namely the acceptance of young men visiting brothels. So it is no surprise that most transient workers are at risk. This group includes individuals who travel away from their homes for extended periods of time as part of their work. The military, motto drivers, factory workers, policemen, and fishermen are the most common. Fortunately, there are many people working to educate and prevent the infection within these groups. Major Tan Sokhey of the Cambodian military single handedly created the office of HIV/AIDS education in the military. As head of this office he created a trickle down effect where educators are in charge of different bases around Cambodia. Official statistics are almost impossible to get and most likely are inaccurate, but the consensus is that the military has one of the highest infection rates in the country. This in turn passes the disease to the wives back home and then to the children. Major Sokhey believes in change at many levels including behavioral and norm changes for the military. However, he is also realistic. His main goal is the reduction in the overall infection rate. "First you try abstinence, then reduction and infrequent visits to the brothels, and finally you educate on condom use." His point being that the soldiers will continue visiting brothels so they must be prepared to have safe sex. In the long run the change of the social norms are at stake. "This country has a low immune system. We are poor, uneducated, and have social customs that allow the disease to spread." His eloquent description of this remarkable land could not have been more honest and humbling. I felt honored he took the time to meet with me. He is battling an unseen and misunderstood enemy within his ranks and doing so admirably.
The vicious cycle of infection from spouse to spouse to children is the most heart breaking problem Cambodia is facing. The innocent children are suffering. They are orphaned, sick and alone. It is an unjust cruel existence that tears your heart out with pain. Twenty-one orphans aged 3-5 all HIV positive live in a small home in Phnom Penh. Their uniform white gowns barely cover their small frames let alone the pain and sadness their hearts must feel. Trying to keep the tears from swelling, I spent some time with these wonderful and beautiful children, all the while asking myself what kind of future will they have. True, they have a place to live, food in their bellies, games and some basic medicine, but the fact remains that they will continue in this system for most of their lives – however long that may be. Ong Suphea, a beautiful 7 year old girl wearing a large black T-shirt imprinted with an image of Brittany Spears, was wailing outside the orphanage: "I want to go home. I want to go home. I want to go home." Eyes swollen from shedding so many tears this poor girl is an example of the complexities the NGOs are facing. Her mother died of AIDS. Her father, I was told, had to be institutionalized in Vietnam due to mental problems. Her aunt took in her younger brother. Ong is HIV positive and her aunt is afraid of having her live with them, so she was sent to the orphanage. Unfortunately, this orphanage only takes children up to 5 years old, so she will be moved somewhere else. One of the biggest challenges in Cambodia is fighting ignorance, discrimination, fear, and prejudice against people with HIV/AIDS. This girl fell through the cracks, and broke my heart many times over. She has no home to go to. She has no family. She is all alone at seven years old. I left with a heavy heart, not knowing what the future will hold for Ong, but knowing her crying eyes will always be burned in my soul.
I spent a week in Siem Reap, the gateway to the temple ruins. For the first four days I worked on this story, meeting sex workers, NGOs, AIDS patients, and seeing education sessions. Just outside town, and in the farther village of Pouk, I had two home visits that affected me deeply. After three weeks of intense emotions I felt hardened, thinking I’d seen most of the hardships the people here face. I was so wrong. His name is Chhean Sophea. He is 5 years old. I met him in his mother’s arm and no amount of stickers or candy made him smile. His frail, fragile and oh-so-skinny skeleton barely contained all his sadness. Dying of AIDS, Chhean is an acute reminder for the need to stop this dreadful disease before it kills the future generation. His HIV positive mother held him close to her chest afraid to let go for a second too soon. She is only 26 years old and her husband died a year ago. Receiving some help from a local NGO, Caritas, she is able to survive. Her son will soon be gone. In a poor country like Cambodia, where medical treatment is limited, there is little hope for the many sick and dying HIV/AIDS patients. Only recently have anti retro viral medicines become available, and too few people are receiving them. For Chhean it is too late, but there is hope for the future. There is always hope in Cambodia. They have to hope. Otherwise they will suffocate on the overwhelming suffering.
I met a grandmother so stoic and composed. She asked for my help in finding resources for her family – four young children, orphans to parent who died of AIDS. Alone she is caring for these remarkable kids who will have to leave school and start working for survival if she can not find some support for them. My hope is that my work will compel people to act, and perhaps bring some change and help to the people of Cambodia. The most disturbing element of her story, though, like many others in her predicament, is her history and the need to care for young ones again. Like anyone over fifty she had a family to protect during the Pol Pot’s regime. To survive such a recent devastating experience, while protecting your children from the killing fields, only to have them die later of a new enemy, is beyond comprehension. Just how much suffering can one people take?
Sitting at sunrise in Angkor Wat, thoughts of Cambodia, its history, its people and its future all swirled in my head and heart. The great Khmer kingdom is, for many people, a history book entry with these temple complexes the only memory and evidence for a once fruitful and resourceful people. The thousands of camera touting tourist who walk the halls of Angkor Wat, or enjoy the ba relief carvings of the Bayon and its 200 or so staring heads, are amazed and in awe of the grandeur and spirituality of the place. They take their pictures, go back to their nice hotels and go home "seeing Cambodia". Ankgor Wat, the Bayon, and the tree covered Ta Prohm are remarkable, beautiful, even sensual. And yes they do represent an elaborate culture that is not here any more. However, the people of Cambodia hold in their souls a direct line to this culture. They are the true beauty of the Country. They represent the hope, the optimism, the belief in a better future. Walking through Ta Prohm I find solitude in the winding passages. I find a doorway covered by huge roots and Apsara dancers (woman dancers to the gods in Hindu mythology) sculpted into the rock. The light is perfect. I set up my tripod and camera, measure the light, set the angle and capture the moment on film. There is a feeling about this shot that is not clear right away. Upon my return to the States and development of the film, I find what it is. A beam of light came over the ruin’s wall highlighted one of the Apsara’s statue’s head. In this temple that was left as it was found and, where the jungle is fighting to ruin the human building endeavors, and the history of the Cambodian people is celebrated, I found one sign of light. The photograph is about hope. About realizing the past and looking forward. Today the teaching of the Apsara dances to young girls is reviving a lost tradition. There is hope for the future. The children carry the torch forward. Now we just must make sure they live.
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