Nongovernment Organizations and Civil Society

Cambodia Braced for Upsurge in HIV from Injecting Drug Use

Before 2000, injecting drug users were unknown in Cambodia. But just four years after the first case was reported that year by local NGO Mith Samlanh, injecting drug use accounted for almost 10% of the total drug use in the streets of Phnom Penh.

There is now growing concern that drug use – bringing with it HIV/AIDS infections – could spread rapidly through the provinces, unless the population is informed and prepared to combat the twin threat.

There are no official figures in Cambodia on the extent of drug use, but local and foreign NGOs estimate there are between 2,000 and 2,500 injecting heroin users. These are mostly in Phnom Penh. But some cases have been reported in Siem Reap, a popular tourist destination, and nearby Kampong Cham, neighboring the capital and heavily populated.

The agencies estimate HIV infection rates to be running at between 20% and 30%, with the drug injections presumed to be a major driver.

Anecdotal evidence suggests that drug use and the spread of HIV is traveling fast with a commuting population traveling from Phnom Penh up north to Siem Reap, Battambang, and the Thai border.

“We have seen evidence that people have stopped in our town and injected drugs,” says a team leader from the Department of Social Affairs, Veterans and Youth (DSAVY) in Kampong Speu. “We have seen the needles and syringes next to the road.”

Friends-International, an NGO partner of Mith Samlanh, is implementing an ADB financed project, NGO Initiatives to Prevent HIV/AIDS in Asia and the Pacific in the country. Friends-International is collaborating with seven local NGOs across Cambodia, and with DSAVY officers of two provinces – Kampong Speu and Kratie.

The collaboration involves training the officers to implement projects, developing awareness about the linkage between drug use and HIV/AIDS, setting up day centers to care for vulnerable children and youth, and establishing outreach services.

The training, says the DSAVY officer from Kampong Speu, will enable the officers to start running “when the first smoke appears,” and not wait to “fight a bigger fire” later.

The Hard Road to Recovery

One example of a little smoke the NGOs have put out before it becomes a big fire is the case of 19-year-old Nol, a street kid in Kampong Speu who was addicted to smoking methamphetamine or “yama” in the local dialect.

“I used yamato keep me awake to work, to stop feeling hungry, and to feel better,” he recalls. But he couldn’t stop. “I had to keep taking it. If I didn’t, my skin would crawl like snakes, I would get a pain in my gut, and feel very sad. The yamawas my medicine to stop these things.”

As he became sicker, Nol went to a DSAVY day center. It then referred him to a clinic in Phnom Penh for treatment. His withdrawal days at the Green House drug treatment center run by Mith Samlanh were tough. He remembers: “It was very hard. I got sick and crazy in my mind, but people helped me and I got clean.”

After 10 weeks of detoxification, he was offered training as an electrician. He needs to continue his education for another year. Meanwhile, the DSAVY helped him reconcile with his estranged family.

Nol is now drug free and goes home to visit his folks twice a month, usually accompanied by a friend from the DSAVY office because he always felt nervous.

“I don’t feel sick now, I feel strong,” he remarks. Often he flashes back to his yama-addiction days. But, he concludes, “I am reminded how sick I was before, and on the streets. I don’t want to go back there.”