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Cambodia Links HIV Outbreak to Needle Reuse

  • Robert Carmichael

Health experts in Cambodia were alarmed when a cluster of villagers living near the country’s second largest city, Battambang, tested positive for HIV in December. Some 212 people there are now known to have contracted the virus. The government blames an unlicensed medic who was allegedly reusing needles, and has pledged a nationwide crackdown against bogus doctors.

Doctors say the worst hit village in the area’s HIV outbreak appears to be Roka village where 12 percent of villagers tested so far have proven positive - 20 times the national rate.

Cambodians are commonly treated with intravenous drips or injections for ailments. Officials attribute the spike in HIV infections here to an unlicensed medic reusing needles. The fake doctor, who practiced here for two decades, is awaiting trial.

Seventy-two-year-old rice famer and commune councilor Serm Chom tested positive last month, as have at least a dozen family members, from infants to the elderly. He says people are angry.

“First, we have lost our children to this. Second, we don’t have energy to earn a living and feed our families," Chom states. "Third, I want to know the real reasons behind this. Also I want to see that doctor jailed.”

The outbreak is a serious blow to HIV prevention efforts. Over the past 15 years, the infection rate has dropped from 2 percent to 0.6 percent.

Cambodia’s battle against HIV is run from the government’s NCHADS office in Phnom Penh. The man at the helm, Dr. Mean Chhivun, says authorities are trying to determine if what happened in Roka Commune is an isolated incident.

“So the reason why our near-future plan is to conduct the HIV prevalence study, and then we can say, OK, it’s no problem: the outbreak is only occurred in this commune," notes Chhivun. "Until now, still unclear. So when we get clear result from this study, we can say."

UNAIDS is a key partner in the effort to combat HIV. The link to needles and unlicensed medics has proven a wake-up call for health experts, says country coordinator Marie-Odile Emond. She says the Roka outbreak will not undermine the focus on working with high-risk groups such as sex workers.

“Because again all the estimates are that the epidemic is mostly concentrated in some key affected populations," Emond explains. "At the same time this isolated incident at the moment needs to be explored further with the ongoing investigation to see where there’s other risk, whether there is need for further investigations to prevent any such incident to happen in any other places in the country. "

The government says it will bar unlicensed medical practitioners from working. But there has been legislation to that effect for years, and clearly it was not enforced in Roka. Serm Chom’s family is just one paying for that failure to act.

Under Cambodian law, the media must obtain the consent of any HIV-positive person before identifying them publicly. VOA has complied with this requirement – Serm Chom has given his consent to be identified.

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