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AIDS Orphans: Cambodia
Many families in Cambodia have been devastated by the effects of HIV. Parents have been rendered too ill or impoverished by medical fees to care for their children and thousands of children have been left orphaned. Two organisations – Maryknoll and Karol and Setha – are working to address different aspects of this urgent issue.
Cambodia saw a rapid increase in transmission of HIV during the 1990s which now seems to be declining, but among countries in South East Asia it still has the highest reported prevalence, with an estimated 170,000 adults living with the infection.
This would be devastating for any country, but Cambodia’s troubled history had already left a legacy of family breakdown and poor health. The Khmer Rouge forcibly separated children from their parents and prevented their access to essential health services.
This era and the conflict that followed left Cambodia particularly vulnerable to the spread of HIV. Communities were divided and livelihoods decimated. A generation of children grew up without positive role models and many professionals went abroad or were killed. Now, domestic violence, rape, prostitution and drug misuse are on the increase and there is a shortage of medical personnel and facilities to diagnose and treat HIV infection.
As well as medical care for people living with HIV, Cambodia needs family-based support for approximately 60,000 orphaned or otherwise affected children; and measures to prevent the spread of HIV that are appropriate to the local context.
Maryknoll, a Catholic mission movement, has been working with adults affected by HIV in Phnom Penh since 1996. Its Seedling of Hope programme is based in the Chakangre Krom industrial area, home to some of the poorest communities, and offers practical support, diagnostic services and antiretroviral treatment.
Whenever possible, the programme encourages and supports extended families to care for sick relatives, but for those who are too ill or have been abandoned by their families, it also offers shelter, rent subsidies and a hospice service.
The main concern of people affected by HIV is ensuring their children are cared for. In response to this in 2001, Seedling of Hope established the Little Folks project, which now cares for 500 children who have lost one or both parents or whose parents are unable to care for them. Children who are themselves infected receive treatment through another project.
The first priority is to keep siblings together by placing them with extended family members or carefully screened foster carers with whom children can develop loving relationships. Carers receive long-term support from Field Workers who visit the families regularly, which also helps to dispel the fear and prejudice surrounding families affected by HIV which is rampant in many communities.
Maryknoll provides a caring, family-like environment to enable children whose life has been turned upside down to resume their education and address emotional issues. A Learning Centre helps the children catch up on missed education and offers therapeutic activities such as dance and art.
When children lose their parents they also lose treasured memories, so the children are helped to put together ‘memory books’ in which they can express their feelings and record their past to keep it alive.
Some of the older children are also referred to Karol and Setha, a project started by Maryknoll but now an independent organisation, which believes in a holistic approach to sexuality and HIV prevention and also aims to help reduce the incidence of teenage pregnancy and delinquency.
Karol and Setha works with older children, young people, couples and
parents, offering training to develop critical thinking on issues of relationships
and sexuality. It helps people to reflect on their rights and responsibilities
in sexual partnerships and
the effect of adult relationships on children. The project helps to improve
understanding within families and equips young people with skills to enjoy
positive relationships free from abuse.
As they grow up, the children Maryknoll supports are helped to acquire vocational skills to become independent, but they can return for help if they need it, so even those who have lost their immediate family still have a home to go to.
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