The Cambodian government should urgently address dangerous conditions in a de facto AIDS colony it has created and immediately stop sending HIV-affected families there, more than 100 international HIV/AIDS and social justice organizations and experts said in a joint letter delivered on July 27, 2009 to Cambodia's prime minister and health minister.
In June 2009, the Cambodian government forcibly relocated 20 HIV-affected families living in Borei Keila, a housing development in Phnom Penh, to substandard housing at Tuol Sambo, a remote site 25 kilometers from the city. Another 20 families were moved there on July 23. The families were resettled into crude, green metal sheds that are baking hot in the daytime and lack running water and adequate sanitation. Just meters away, higher-quality brick housing is being built, with the assistance of a nonprofit group, for other homeless families slated for resettlement at Tuol Sambo. Even before the HIV-affected families were resettled at the site, local people referred to the green sheds as "the AIDS village."
"By bundling people living with HIV together into second-rate housing, far from medical facilities, support services, and jobs, the government has created a de facto AIDS colony," said Shiba Phurailatpam of the Asia-Pacific Network of People Living with HIV/AIDS. "It's hard to understand how a government that has received international recognition for its HIV-prevention efforts could so callously ignore the basic rights of people living with HIV."
Dozens of organizations and individuals based in the Asia-Pacific region signed the letter, joined by groups and individuals from many nations, ranging from Canada and the United States to India and Tanzania.
The letter stresses that conditions at Tuol Sambo do not meet minimum international standards for even temporary emergency housing. The shelters are flanked by open sewers, with only one public well for all of the relocated families. They are crowded into the poorly ventilated metal sheds, where the afternoon heat is so intense they often cannot remain in their rooms, and they fear their antiretroviral (ARV) medication will deteriorate.
"The housing conditions in Tuol Sambo pose serious health risks for families living there," said Rebecca Schleifer, health and human rights advocate at Human Rights Watch. "People living with HIV have compromised immune systems and are especially vulnerable. For them, these substandard conditions can mean a death sentence or a ticket to a hospital."
The organizations also expressed deep concern about discrimination against HIV-affected families in the screening and allocation process for on-site replacement housing being built at Borei Keila. After two years of denying eligibility to HIV-affected families for this housing, the authorities have now said that at least 11 HIV-affected families previously slated to be sent to Tuol Sambo are in fact eligible. Those families remain at Borei Keila, but are still waiting for the housing they have been promised.
Increasing property values in Cambodia's capital city have left thousands of urban poor people vulnerable to forced evictions to make way for commercial development. The development of the Borei Keila site was approved in 2003 with the understanding that the developer would build new housing on site for those displaced by the project. With few exceptions, however, the HIV-affected families thus far displaced have not even been screened for eligibility for this housing.
When living at Borei Keila, these people worked as day laborers, motorcycle taxi drivers, cleaners, and seamstresses. Now, most have no prospects of work at or near Tuol Sambo. Their economic situation is worsened by the fact that a return trip to Phnom Penh to go to work or to visit hospitals costs the equivalent of about US$5 -- for families who earn only $1.50 to $3 a day.
"The Cambodian government needs to establish a fair and open process for all to receive the housing and services they need," said Kevin Moody of The Global Network of People living with HIV (GNP+). "People living with HIV -- like all others -- need adequate living conditions that do not threaten their health and a way to earn a livelihood, so that they can provide for themselves and their families. Grouping families affected by HIV in this way exposes them to further stigma and discrimination; steps must be taken to end this discrimination now."
The groups called on the Cambodian government to:
- Cease moving HIV-affected families to the Tuol Sambo site;
- Improve conditions at Tuol Sambo to meet minimum standards for adequate shelter, sanitation, and clean water;
- Ensure full access to quality medical services, including antiretroviral treatment, treatment of opportunistic infections, primary health care and home-based care;
- Work with relevant agencies and consult with the families already at Tuol Sambo to address immediate and long-term concerns regarding housing, health, safety, and employment, and reintegration into society in a manner that protects their rights and livelihoods; and
- Employ a transparent and fair screening process to determine eligibility for on-site housing at Borei Keila, and allow eligible families to move in immediately (including the 11 HIV-affected families already approved). For those found ineligible, authorities should provide other adequate housing.
"Living with HIV with dignity means more than just ARVs," said Aditi Sharma of the International Treatment Preparedness Coalition. "It means these families should have a healthy environment with adequate nutrition, proper sanitation and a continuum of care that addresses the social, psychological, legal, and economic consequences of living with HIV."