Faces of Hope by Borky Perida

FACES OF HOPE: Communities overcoming the impact of HIV

FACES OF HOPE

Communities overcoming the impact of HIV

KHANA is the largest national, non-governmental organization providing HIV prevention, treatment and care services in Cambodia. Initially established in 1996 as a project of the International HIV/AIDS Alliance, KHANA became an NGO in its own right in 1997. It was the first Alliance Linking Organization to receive full endorsement as an accredited member in 2008. Today, we work in 20 provinces and municipalities through a network of 38 implementing partners. These partners are community-based organizations, local NGOs, and networks of people living with HIV committed to working on HIV, health and other development issues. Our programs focus on: • HIV prevention among most at risk populations such as men who have sex with men, people who use drugs, and entertainment sector workers • Integrated care and prevention for people living with HIV and orphans and vulnerable children through community based care • Impact mitigation, such as livelihood support and food security, for people living with HIV, orphans and vulnerable children and their families • Policy dialogues, advocacy and networking, bringing the voice of affected communities to national and international policy forums

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INTRODUCTION The rate of HIV in Cambodia has been reversed thanks to a combination of leadership from the government, commitment from international donor agencies, and engagement from civil society organisations. A key element of the response has been the efforts of countless people in communities affected by HIV, working tirelessly to provide and promote HIV prevention, treatment and care services, livelihoods and vocational opportunities, and nutritional support. They have benefited from a comprehensive and integrated package of services, including community based services through a network of community support volunteers, peer educators and self help and support groups. Many people in this book also play a leadership role in delivery of services to their communities, to prevent further transmission of HIV and mitigate the impact of the epidemic. All of them make a vibrant and valuable contribution to the communities in which they live. But there are still barriers and issues to be faced, and continued commitment to the HIV response is needed to sustain the successes achieved so far. We welcome you to share the lives of the people in this book, and learn more about their challenges, joys, and hopes.

Dr Oum Sopheap Executive Director, KHANA

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TABLE OF CONTENTS ORPHANS AND VULNERABLE CHILDREN

20 FACES OF HOPE

PEOPLE LIVING WITH HIV v

TABLE OF CONTENTS ENTERTAINMENT WORKERS

MEN WHO HAVE SEX WITH MEN AND TRANSGENDER PERSONS

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PEOPLE WHO USE DRUGS

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PAGE BREAKER

ORPHANS AND VULNERABLE CHILDREN Many children affected by HIV have lost their parents or care givers, or may be HIV positive themselves. Scale up of prevention of mother to child transmission (PMTCT) services can eliminate pediatric HIV through simple provision of antiretroviral drugs to mother and child during labour, childbirth and breastfeeding. To achieve this, access to maternal and child health services including antenatal care and safe delivery need to be increased. Many children affected or infected by HIV need nutritional and food support, education support and referrals to health services. Stigma and discrimination is an issue for these children which can be addressed through child support groups and advocacy in communities and schools. Awareness raising on childrenâ&#x20AC;&#x2122;s rights, protection from child abuse, and support using family centered approaches is important. Just like other children, as children affected by HIV grow older they will need access to sexual and reproductive health education.

Kath Na was born in 1996 in Siem Reap Province. She is the eldest daughter of a poor family. Selling fish is their only source of income. Her father passed away, leaving her mother to take care of the family.

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Thida was also born in 1996 in Siem Reap Province, the youngest daugher in the family. Her parents both died in 2001 from HIV related illnesses, leaving Thida and her siblings to be raised by their grandfather. When her parents got sick, the family sold the family home and household assets to cover medical expenses. After they died, the family struggled to recover financially and cover the cost of food and education for the children.

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Lin is the eldest son in his family, and was born in 1997 in Siem Reap Province. His parents both tested positive in 2006, and their poor health meant Lin needed to take on responsibility to support the family. Lin struggles hard to have a good future for him and his family, and often relies on neighbours for money to go to school and buy food and clothing.

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Sophea was born in 1990 in Siem Reap. After her mother died due to malpractice at a private hospital, her father found another partner. Sophea lives with her aunt.

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Malai was born in 1999, the youngest daughter of Chea Lok and Chan Thuk. The family sold their rice field to support her motherâ&#x20AC;&#x2122;s medication, but her mother died despite their efforts. Her father earns a small income as a hairdresser and her brother left to find work in Thailand, but the family still finds it difficult to cover all the family needs and support her education.

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As her mother must go to the market to sell fish to support the family, Kath Na takes on responsibilities around the house to prepare food and take care of her brother and sister. Salvation Center Cambodia (SCC) helps Kath Na and her family by providing food and school materials, and buying a bicycle for her to go to school.

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SCC also supports Lin and his family with food and school materials. Thanks to their support, he has gone back to school and is able to study hard and attend school regularly. He now reads well and dreams of becoming a teacher in the future. With SCC help he will be able to continue his education.

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Support from family, community based workers and neighbours help to prevent them from becoming discouraged.

Community support volunteers educate children affected by HIV about child rights and how to take care of their health.

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With support from SCC, Kath Na is studying hard, pursuing a dream of teaching others in the future. The food support Kath Na and her family receives makes the family more secure, and helps Kath Na to attend school regularly.

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Thida plans to be a tailor and own her own shop providing clothing for wedding ceremonies. She is saving money in order to achieve her dream.

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Having received support from her grandfather, neighbours and SCC, Thida feels more confident and secure in her future. She has now taken on a leadership, role becoming a support group leader to support other vulnerable children in her community.

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Through hard work and commitment to her studies, Thida has completed many school certificates to contribute to her education. The support from SCC has changed her life by helping her attend school, have enough food to eat and knowing more about child rights.

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PEOPLE LIVING WITH HIV The rate of HIV has decreased from 2% in 1999 to 0.8% in 2010 in Cambodia. Anti-retroviral treatment (ART) for HIV is now widely available. This has changed the needs of people living with HIV from palliative care to broader issues such as livelihoods support and access to sexual and reproductive health services to support family planning and prevention of mother to child transmission (PMTCT). Models of delivery have also changed, with many people living with HIV forming self help groups through which referrals to health services, livelihoods activities, prevention education and treatment adherence can be provided. Challenges remain in ensuring people living with HIV can access family planning services as a right, and are not affected by stigma and discrimination in health facilities or the community. Screening and treatment of TB is also important, and supply of ART medication needs to be assured to support correct treatment adherence. Rebuilding peopleâ&#x20AC;&#x2122;s liveilhoods through skills training, provision of small financial or livestock grants, establishment of saving schemes and ongoing support helps strengthen self reliance and resilience.

Hay Navyâ&#x20AC;&#x2122;s husband left her with two kids and went to live with another woman. Many years later, after his other wife died, her husband came back. He wanted to live together again. Suspecting he might be HIV positive, she refused, but he threatened her with violence, and she could not say no. They started to live together with the kids from his other wife. Navy found out her husband was taking ART medication. Despite taking treatment, he got sick and passed away. She went to take an HIV test and found out she was positive also. Talking about her ex husband, she canâ&#x20AC;&#x2122;t stop crying.

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Rachana is 29 and lives in Battambang Province. She took a blood test in 2004 which showed she was HIV positive. After she shared the result with her huband, he threatened to commit suicide and kill her too. Fearing for her safety, she took her daughter and moved back to her parentâ&#x20AC;&#x2122;s house. She lives there still, raising ducks to support herself and her daughter.

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Our Vong was shocked when he found out he was HIV positive. He had gone to Thailand to work, and found a second wife there. When he returned to Cambodia and his first wife, he felt very ashamed. He hid himself at home for two years due to humiliation and discrimination. His wife passed away and he became sick and could not work, leaving his family in economic crisis.

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Saravuth was an officer in the Cambodian army, and went to war in 1988 when his son was just 10 days old. In 1990 when he returned, he found his wife had remarried, thinking he had died in the fighting. He found a new wife and together they travelled to Thailand. But she got sick and died, and he also started to suffer poor health. Returning to Cambodia, he went to live with his aunt, but had difficulties supporting himself and dealing with discrimination from his family.

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Sinanâ&#x20AC;&#x2122;s first husband left her after she gave birth to their son. In 2004 she found out that both herself and her son were HIV positive, and deicided to send her son to live with an NGO in Phnom Penh. She suffered from stigma and discrimination from her neighbours, and people refused to buy from her stall in the market. She met her second husband Leung Visoth at a self help group for people living with HIV, and together they started a new business.

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When people in her community knew Navy was HIV positive, many refused to come to her small tailor business and she experienced financial difficulties. After receiving ART, Navy returned to good health and she was able to access a grant from the organisation Buddhism For Development (BFD) to start a small shop. Today her business is successful and growing and she is able to support herself and her family.

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When Rachana was first diagnosed with HIV she suffered from stigma and discrimination from her neighbours, who refused to eat with her, speak with her or come to her home. At school, other classmates refused to play with her daughter. SCC worked with members of her community to educate them about HIV and her neighbours eventually welcomed her back into community life.

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Our Vongâ&#x20AC;&#x2122;s life began to change when he was put in touch with Buddism for Development (BFD). The organisation helped him and his family with food support, school materials and referred him for ART. With this support Vong was able to return to work, and help to support his family.

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Saravuth was also referred through BFD to receive ART. His health has improved and he now works part time as a community support volunteer with the organisation, providing education and support to other people living with HIV. BFD provides training on basic health care, referrals, HIV prevention and other health issues. He is also able to raise chickens and ducks on his relativeâ&#x20AC;&#x2122;s land to become more self reliant.

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Through support from BFD, Sinan recieved a small grant as start up capital for a business. She was able to buy merchandise for a store to support herself and her husband.

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Just like Saravuth, Navy is also contributing back to her community by working as a community support volunteer. She coordinates self help group meetings for people living with HIV, as well as one on one support.

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With support from SCC, Rachana is now able to raise poultry and feed her family. Rachana is now focused on staying healthy, and raising her daughter so she can have a better future.

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People in the village now know more about HIV and no longer discriminate against Vong. He is able to work building boats for people in his village to take care of his daughters. One day he hopes there will be a cure for HIV.

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Sinanâ&#x20AC;&#x2122;s husband Visoth would like to travel to other parts of Cambodia to look for work to contribute to the family income. This is difficult as he must visit the ART clinic every month to access ART medication. He hopes one day to be able to access several months medication in one visit so he is more free to travel to search for employment.

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With ART Saravuthâ&#x20AC;&#x2122;s health is better, so he is able to think about his future. He dreams of owning his own land to farm rice and be self supporting.

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ENTERTAINMENT WORKERS The women who work in entertainment establishments such as beer gardens, massage parlours and karaoke venues are vulnerable to HIV through sexual tranmission from clients, sweethearts or regular partners. They are also vulnerable to gender based violence from establishment owners, clients and partners. Other issues include stigma and discrimination and alcohol and drug use. Provision of services to these women is made more difficult by the legal and policy environment. The Law on Suppression of Human Trafficking and Sexual Exploitation and the Village and Commune Safety Policy make entertainment workers harder to reach as establishment owners can be reluctant to allow peer educators access to their establishments for fear of police raids.

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Pen Sokha is 21 and currently lives in Battambang. Her family could not afford to continue her education, so she had to stop.

In 2007 at age 16 she left Cambodia to work in Malaysia as a domestic worker so she could send money home to her family. But due to the long working hours and poor conditions she decided to return home, first waitressing in a restaurant, before finding a job in a karaoke venue as a karaoke worker.

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Sreynet lives in Phnom Penh and is 30 years old. Her former husband was very violent, and finally left her with two sons to care for. Her husband had had many other girlfriends while they were married, once even bringing one to the family home to sleep. To support the children, Sreynet found a job as a waitress, where she met her current husband, also a waiter in the restaurant where she works. The family is poor, so to earn additional income she meets with clients from the restaurant without her husbandâ&#x20AC;&#x2122;s knowledge.

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Saran is 22 and lives in Phnom Penh. She comes from a poor family, with her father working as a motor dup driver, and her mother in a laundry service. To contribute to her family income she left her studies and went to work in a garment factory, however the wages were too low to meet her familyâ&#x20AC;&#x2122;s needs. A friend was working in a karaoke venue and invited her to join. Saran decided to start as a karaoke worker. In her job she has to drink lots of alcohol with clients, and after drinking they sometimes become aggressive and violent.

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Arn Dana is 27 and lives in Battambang. When she was younger she was raped, and the parents of the man forced the two to marry. She fell pregnant, however her husband had another girlfriend in Siem Reap, where he was working as a taxi driver. Dana decided to separate from him. She found a job as an entertainment worker serving beer. In her job Dana faces stigma and discrimination from friends and family, but without support from her husband, she has to work to support herself and her child.

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Tong Cheng Ly is 30, and comes from a poor family. In 1997 when her younger sister died and her older sister became sick, she had to stop her studies and work to support her family. Lack of education made it difficult to find a good job. Neighbours and friends were not supportive. With worsening financial situation her family had to move to their farm, far from town. Finally she decided to start working as an entertainment worker serving beer.

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Sokha feels that getting a job with a high salary wasa the best moment of her life, as she was able to help her mother, and see her family smiling and relaxed again. But discrimination, isolation and stigma are big challenges for Sokha. She does not like to spend time alone, seeking out the company of friends and neighbours instead. Peer educators from Menâ&#x20AC;&#x2122;s Health Social Service help her to feel connected and not so alone in life. They help her to learn how to protect her personal safety and her health while she is an entertainment worker.

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Dana too was happy to have found a job with a good salary. She also meets with peer educators from MHSS, who give her education on HIV prevention and other health issues. With their support she reminds herself to stay focused on her future and not to give up hope.

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Cheng Ly is also a mother, and sends her son to school each morning riding along dirt roads. Before going to work as a peer educator in the afternoon and entertainment worker at night, she does the household chores for her family.

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Saran uses the KHANA Community Womenâ&#x20AC;&#x2122;s Center to get support and access information on protecting her health and well being. She drops in to get her make up done at the beauty salon that is part of the center. The salon provides vocational training and links entertainment workers to other health services and awareness raising services through the center. The salon also offers services to the general community to reduce stigma and discrimination towards entertainment workers. Saran hope one day to have her own cosmetics shop.

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Cheng Ly received training from MHSS to work as a peer educator, helping other entertainment workers to protect their health, access HIV testing services, and improve their negotiation skills. She enjoys working to support others, and hopes maybe one day to find a full time job doing similar work.

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With support from their peers, family and friends, Saran, Sokha, Dara and Cheng Ly can stay safe and protect their well being. Thanks to work from MHSS to reduce stigma and discrimation in their communities, the women feel hope for the future and donâ&#x20AC;&#x2122;t feel isolated and alone.

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MEN WHO HAVE SEX WITH MEN AND TRANSGENDER PERSONS

In Cambodia, men who have sex with men (MSM) often term themselves as either short hair MSM (which includes gay, bisexual and non identifying men who have sex with men), or long hair MSM (which includes transgender persons). Men who have sex with men and transgender persons are vulnerable to HIV due to a range of biological, structural and societal reasons. Stigma and discrimination from family, communities, and health workers serve to marginalise these groups. Men who have sex with men and transgenders persons are often targeted by law enforcement officials and are vulnerable to violence, extortion, sexual assault and other harassment. Access to livelihoods is a key issue due to discrimination in the education system and workforce. To prevent HIV transmission, men who have sex with men and transgender persons need access to voluntary and confidential testing and counselling, anti-retroviral treatment, access to condoms and lubricant, STI testing and treatment, and prevention education. Peer networks are an important way to reach this community.

Suon Sara comes from a large family, sixth among ten children. Since he was young Sara behaved like a girl child. As he grew older he started to transform his appearance by dressing like a woman. When he was ten, his mother brought him to school, but the teacher would not allow him to enter as he was dressed in a skirt. Sara was determined, and stayed outside the classroom, waiting to come inside. The teacher asked him to leave, and forced him to return home. His mother was angry and beat him, telling him to stay outside, refusing to feed him.

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Sara decided to transform himself into a woman when he was 16 years old. His father was so angry, saying he was no longer his son and expelled him from the house. Two years later Sara met his parents again in Battambang Province, and his parents agreed to let him move home again. But one day when his father was drunk, he again started to shout and curse Sara for being a man but dressing and behaving as a woman. Sara felt isolated and alone, and was also having problems with his boyfriend. He decided to commit suicide, and took an overdose of medicine. Luckily, a neighbour found him, and rushed him to hospital.

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Sou Sorin is 33 years old, and living with HIV. In 1993 he got a job with a good salary away from home. He is the eldest son, and at the time he was the only one supporting the family. He met a man, and they fell in love. But when his parents learned they were together, they intervened and separated them. Sorinâ&#x20AC;&#x2122;s health started to deteriorate, and his mother took him to Siem Reap for care. The doctors tested him for HIV. He wished he had sought out services earlier, as the doctors were able to treat some of his health issues, and make him feel better.

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Yada was born in 1983 in Siem Reap Province. He is happy now, living with a man as husband and wife. However, when he was younger and started to dress as a women, he suffered from violence from within his family. His father threatened to kill him, and chained him inside the house to stop him from behaving like a woman. Other men in the village were also violent against him. Yada is the eldest child and has six siblings. Finally his father found another women, leaving Yada to take care of his sisters and brothers and support the family by selling cakes.

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San Samnang was born into a middle class family, with his father working in the media, and his mother running a small business. Samnangâ&#x20AC;&#x2122;s relationship with another man was exposed to his parents. When they found out the truth about Samnang, they threatened to disown him if he did not separate from the man.

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Sam Ol is 28 years old. When he was young, his family was very poor, as his father had died. To support the family, his mother and Sam Ol’s older siblings left their home town to work in Siem Reap. While they were away, Sam Ol fell in love with a classmate. The boy was from a rich family in Phnom Penh, but had moved to the provinces to study. He supported Sam Ol with money and clothing. They started to having sex, but did not use condoms as they thought they could not get HIV from sex between men. When the boy’s parents found out about the relationship they separated them, moving him back to Phnom Penh. The parents blamed Sam Ol, shouting harsh words at him. Sam Ol’s mother also did not support him and does not allow Sam Ol to dress as a woman in the family home. However, she is happy that Sam Ol is working as a peer educator.

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Sorin was working as a hair dresser when he heard that there was an organisation called Dragonfly House which needed staff. Dragonfly House was working to support lesbian, gay, bisexual and transgender persons, including men who have sex with men. He decided to apply, and got the job in July 2011. At Dragonfly House, Sorin was welcomed by the friendly staff and friends in the organisation. He was trained and attended awareness raising workshops to pass on his experiences to his peers. Sorin plans to work to promote men who have sex with men in Cambodia and prevent the discrimination that he received when he was young.`

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Sorin hopes that one day there will be no more stigma and discrimination towards men who have sex with men and transgender persons.

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Yada hopes the next generation of men who have sex with men will be welcomed in society, and not suffer the ridicule and intimidation that many currently experience.

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Stereotypes of men who have sex with men and transgender persons need to change. Without support from friends, family and the community it is easy to give up hope for the future.

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With help from Menâ&#x20AC;&#x2122;s Health Center, Ol learned about HIV and health, condom use and prevention of STI. Nowadays Ol finds that discrimination is less than before. He has many jobs including hair dresser, tour guide, designer and performer. Even neighbours who previously looked down on him have now changed their attitudes towards him, and treat him as a neighbour and friend.

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Yada belives that support from society, friends and family is so important. If men who have sex with men are not supported, it is difficult to learn how to live a good life. Love from your parents is especially valuable, and parents should try to accept and love their children who are men who have sex with men.

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Many men who have sex with men dream of running their own businesses, such as wedding organisers, beauty salons or tailoring shops. Financial independence is what we want as then no one can look down on you any more... and of course, living with your true love is important too!

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PEOPLE WHO USE DRUGS

When working with people who use drugs, key HIV prevention services needed are access to needle and syringe programs to prevent transmission through shared injecting equipment, and use of methadone as a more manageable substitution to other opioid substances. A comprenhensive package of basic health care, overdose treatment, legal, psychosocial and livelihoods support is also needed to minimise the impact of drug use. Women who use drugs also need services which address their gender based vulnerability to HIV tranmission, cross over with entertainment work, and sexual and reproductive health needs. Using these types of interventions are termed a harm reduction approach, as they aim to reduce the harms of drug use on the individual. A harm reduction approach also contributes to reducing the harms of drug use on communities, by reducing the transmission of HIV, improving health outcomes for people who use drugs, and providing livelihoods and vocational training opportunities. Currently in Cambodia however, there is a conflict between provision of hard reduction services, with law enforcement approaches. The Law on Drug Control and the Village and Commune Safety Policy both make people who use drugs hide themselves to avoid arrest and detention, and make them reluctant to seek support from HIV and health services.

Dara is 22, the fourth child in his family. He stopped high school in Grade 7. After recieving an injury from his brother that left him blind in one eye, he felt isolated from friends and society, started to use drugs. To support his drug use, Dara turned to stealing from his home, taking money or household goods that could be traded for money.

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Samnang, 24, comes from a poor family in Phnom Penh. In 1998, his friends convinced him to start using drugs. The organisation Mith Samlanh tried to help him, offering vocational training and support. But Samnang was involved in a ganster group, and kept getting into fights. He ended up being arrested, and spent eight and a half months in prison. After his release, he returned to the group and kept fighting with others.

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Srey Moa is 31 and has two kids. When she was young, her mother died, and her father remarried to a woman who kept beating Moa. She could not stand the violence at home any longer, and left her home town for Phnom Penh. In the city, she was tricked into selling her virginity for the amount of $20. After this, she started to work as a karaoke singer. In 2000 she started to use drugs, injecting heroin. Her husband broke up with her because she was using drugs, and took the children with him to Battambang. Moa had contracted HIV, and started having serious health problems.

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Tha is now 36, and is the second child of three. He lives in Phnom Penh with his mother, grandmother and siblings. In 2000 Tha started using drugs to cope with financial difficulties and unemployment. He was not only using drugs, but also distributing them, and in 2008 was arrested during a police operation and sent to prison for one year with a fine of 1 million riel ($250). Tha now works as a peer educator at the KHANA Meanchey Drop in Center (KMDC) for people who use drugs. He provides outreach to link people who use drugs with the center, and refer them to health services and psychosocial support.

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Chen Kim Neang was born in 1983, the eldest of three siblings. His family is poor, and when he was five, his parents divorced and abandoned the children. Neang had no choice but to leave his studies and work to earn money. As life was hard, Neang started to use drugs, becoming a pick pocket to support himself. From all the hardships that Neang had experienced, he felt like his life had no value.

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For Dara and Samnang, everything completely changed when they met Korsang. The outreach team made them feel like they belonged, and Korsang provided them with support and rehabilitation. Both got better physically and mentally, taking a more positive approach to life. In 2011, Data and Samnang decided to join the Korsang outreach team and help educate other people who use drugs about HIV and drug use. Samnang feels proud of himself, that he has become a new person and is making a contribution to society. He notes that everyone who uses drugs wants to make their lives better, but often donâ&#x20AC;&#x2122;t know how to make it happen.

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The Korsang outreach team extends their helping hand to neglected corners where other services do not reach. They give out health kits containing sanitation materials, support clients with basic health checks, and invite people to visit the Korsang drop in center for medical assistance. Such work helps to improve health outcomes for people who use drugs and contributes to a safe community for all.

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Strengthening capacity and ensuring participation of people who use drugs helps reduce stigma and discrimation from the broader community. Peer educators are able to reach people who use drugs in hidden and hard to reach places. Support from peer educators helps people who use drugs feel like they belong and encourages access to health services. Their work is difficult due to the legal and policy environment, stigma and discrimation, and fear of arrest and detention among people who use drugs. The educators however believe every life is valuable and everyone deserves to receive help and support.

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Availability of methadone for a small number of people has restored stability to some lives, enabling a return to work and family life. Neang is able to access methadone through the program, enabling him to take up the role of peer educator at the KHANA Meanchey Drop in Center. In addition, the needle and syringe program run by Center helps to make clean injecting equipment available for people who use drugs. From 2012 the Ministry of Health will oversee provision of needle and syringe programs, hopefully enabling a scale up of this service.

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Provision of harm reduction services by Korsang and KHANA to people who use drugs is an ongoing struggle. Stigma and discrimination, law and policy, and a difficult operating environment are all barriers, but the benefits to people who use drugs and the wider community are enormous.

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The next stage of the response to HIV will need to be targeted, innovative and cost effective. The epidemic is concentrated in most at risk populations, including entertainment workers, men who have sex with men and people who use drugs. But even within these groups some people are at higher risk, and interventions need to targets these people. To achieve this will require innovation and creativity, with communities affected by HIV leading the way. The role of people living with HIV, children affected by HIV, entertainment workers, men who have sex with men and transgender persons, and people who use drugs will be critical to the ongoing success of the response. Commitment from communities will need to be matched by commitment from international donor agencies and the Royal Government of Cambodia to provide resources and technical support to the effort. With the global financial crisis affecting funding for HIV programs, sustainability and self reliance can also be fostered at the community level through support for livelihoods interventions.

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COPYRIGHT Copyright © 2011 by KHANA All rights reserved. No part of this work covered by the copyright hereon maybe reproduced or used in any form or any means - graphic, electronic or mechanical, including photocopying, recording, taping or information storage and retrieval systems - without permission of the publisher. PHOTOGRAPHY BY: Gabriel Mark “Borky” Perida borky.perida@gmail.com / www.theborkyperidaproject.weebly.com DESIGN BY: O REPUBBLICA www.orepubblica.com PRINTED IN THE KINGDOM OF CAMBODIA

ACKNOWLEDGEMENTS KHANA wishes to thank Buddhism for Development, Dragonfly House, KHANA Community Women’s Center, KHANA Meanchey Drop in Center, Korsang, Men’s Health Cambodia, Men’s Health Social Service, and Salvation Center Cambodia, and their staff, for supporting arrangements for this publication.

KHANA IS SUPPORTED BY:

EUROPEAN COMMISION

#33 Street 71, Tonle Bassac, Chamkarmon, Phnom Penh P.O. Box 2311 Phnom Penh 3, Kingdom of Cambodia Tel: (855) 23 211 505 | Fax: (855) 23 214 049 http://www.khana.org.kh

FACES OF HOPE Communities overcoming the impact of HIV

The rate of HIV in Cambodia has been reversed thanks to a combination of leadership from the government, commitment from international donor agencies, and engagement from civil society organisations. A key element of the response has been the efforts of countless people in communities affected by HIV, working tirelessly to provide and promote HIV prevention, treatment and care services, livelihoods and vocational opportunities, and nutritional support. The people in this book come from communities affected by HIV. They have benefited from community based services through a network of community support volunteers, peer educators and self help and support groups. Here are their stories told through pictures.