The first case of HIV in Cambodia was detected in 1991. In March 1992 the United Nations Transitional Authority in Cambodia (UNTAC) began arriving in the country. Over 20,000 military and civilian personnel from 100 countries were deployed to oversee normalisation of the country as decades of civil war was officially brought to an end. This “normalisation” included the return and resettlement of 360,000 refugees and the first allegedly free elections. I say allegedly because, held in March 1993, these elections were clouded in controversy, intimidation and a persistent although weakened Khmer Rouge offensive whose international support was finally crumbling.
It is a tragic irony that UNTAC’s presence in Cambodia, intended to bring stability and progress, is identified as the biggest catalyst of the spread of HIV in Cambodia. By 1998 the country’s HIV prevalence rate had reached 2%. Since then, in large part due to a devastating number of deaths from AIDS, but also thanks to targeted public health prevention programs, the prevalence rate declined quite rapidly, to 1.2% in 2003 and 0.6% by 2011. The continuing aftermath of this decimating epidemic continues with over 1,000 AIDS deaths occurring each year even now, in the era when anti-retroviral treatments can prevent many of these deaths.
After the admission of three new resident children at Phter Koma earlier this year, we are now at-capacity with 15 children. For this reason and also to network with other relevant institutions, this week Chaz and I attended three organisations working with children affected by HIV, to learn about their systems and establish connections. Chaz is regularly approached by medical services asking us to admit more HIV orphans, and we wanted some options for him to offer when he has to turn children away.
A few months ago the impending death of another young woman from AIDS was due to leave three siblings orphaned with noone to care for them. A colleague involved with her medical care visited Wat Opot Children’s Community in Takeo Province south of Phnom Penh to guage their capacity to take her children. They accepted the three siblings, only one of whom is HIV+. He returned extolling the virtues of this incredible community of over 45 children. His enthusiasm was contagious and I was anxious to see Wat Opot for myself.
Wayne Matthysse is from Michigan in USA. Now 70 years old, he was a medic in the US Marine Corps, deployed to Vietnam in the 1970s. He told me yesterday that his life beyond Vietnam has been his way of offering reparation for his country’s violations in the region. In 2001 he was in Cambodia during the peak of the HIV epidemic. Many people were dying without any proper care, rejected due to the stigma of their disease by families, communities and health services. A Khmer friend was teaching AIDS awareness to monks in the villages around Takeo Province and Wayne could see an urgent need for his skills. The two men formed a partnership, named themselves “Partners in Compassion” and took over a small clinic behind Wat Opot, the pagoda complex of a rural village off the main highway between Phnom Penh and Takeo. Their search for a plot of land for this purpose was difficult because noone wanted their community to be associated with this disease of the immoral while many feared it’s real and rumoured routes of transmission. Since long before AIDS came to Cambodia, locals believed the land bordering Wat Opot was haunted. As such it was vacant and the monks at the adjoining Wat offered it to Partners in Compassion.
The clinic soon became a hospice where hundreds of AIDS victims came to die from all over the country. Many arrived accompanied by their children while others brought already-orphaned children to be cared for. It became known as a place where people not only infected, but also affected, by HIV, could receive dignified treatment and care. Many of these people had very few options elsewhere. Wayne did not keep count but it was not uncommon for more than one person each day, to die here in the early to mid-2000s. A bizarre twist, for land left vacant because of fears about spirits dwelling there! Talk of spirits on the land remains, but the interpretation now has a theme of protection and of never being alone.
Today the 1km squared area is alive with healthy, happy and cared-for children. Forty seven of them. In another bizarre quirk, when we arrived the siblings from Kampong Cham, who had not previously met either of us, took an immediate interest in Chaz and I, following us diligently as we toured the grounds. They had no way of knowing that we were connected to them through our colleague. Perhaps as the newest members in the community they are just more alert to and interested in, new faces?
We spent a staggering afternoon, night and morning at Wat Opot. My words can never do justice to the experience. During my initial phone call when I rang to ask if we could visit, I was extended one of the warmest welcomes I’ve ever had. As our tuk tuk pulled in on Monday afternoon we were immediately entranced by the noisy, youthful energy bounding around us in organised chaos. Children were cycling around the 1km squared yard, swimming in muddy ponds, throwing balls, chasing dogs, interrupting the adults with frivolous requests, and booming chart music from a separate recreational room. It was apparent that this was standard for this time of the day and soon enough children began appearing from an unknown place holding bowls of rice and chicken, and a very informal outdoors dinner affair took place with some on the ground under trees, others at tables under thatched shelters and others mingling with their bowl in hand.
Soon enough the volunteers (there are currently three) and staff were called and we sat down to a similar meal at a table in “Chhang’s Cafe”, a dining room built in Chhang’s memory. After dinner Wayne sat at an open window beside the medication cabinet and slowly but surely the children receiving anti-retroviral treatment appeared on the other side of the window. Their individual cups were passed through to them and they filled them with water at a cooler before returning to receive their tablets which were swallowed under Wayne’s observation. Every child who needed treatment attended without being called. Loud music blared again from the recreation hall and children danced and played before the nightly meditation session was called. We all entered the hall and 47 children from two and three years old, up to sixteen, sat down quietly awaiting their evening routine of 15 minutes silence with the lights out and soothing music. As new faces we sat on stage with the three volunteers and two staff and after some introductions and excited applause, the room fell silent and dark.
We slept in the Volunteers’ Block at the far end of the property, a basic but comfortable building with bathrooms shared with Wayne and his one expatriate staff member. Chants of monks at a funeral somewhere in the distance woke us at sunrise and we joined the family for breakfast and more discussions about the organisation’s history, establishment, prior and current systems, what works and what doesn’t, relationships with the authorities, and a tour of the property from one end to the other.
This busy, vibrant place evolved in just over a decade, from an empty patch of haunted dirt, to a small shelter where some of the world’s most wretched pariahs converged to die in hidden silence. The natural evolution from this misery is today’s busy village of children, some living with HIV and most orphaned by it. There are gardens, accommodation and education blocks, an art room, a music room, recreational rooms, office blocks, fish and duck ponds, a rice field, sand pits shaded by frangipani trees, pet dogs and cats. Art students have painted walls of most of the buildings, the children’s paintings and sculptures adorn walls and spaces, handmade jewellery is available for sale both on-site and through an agent in Phnom Penh. Children are given domestic and gardening chores and a casually-implemented daily routine coordinates everyone’s movements. A few surviving adults from the early hospice days have their own small accommodation units on the grounds and add to the community atmosphere as they stroll around with their walking sticks or sit in the distance watching the world go by. The village school, where the children all receive a standard public education, is just across the road from one of the main gates. Villagers enter the grounds to cut grass for their animals, which they cart away on bicycles or motos, while others attend to help with maintenance and gardening. The children are very much a part of village life, and villagers beyond the fenceline are equally a part of the children’s lives.
At one edge of the property in the shadow of the nearby pagoda, stands the traditional pyre where Wayne has personally cremated an unknown number of AIDS patients because of the fear in the village of contracting HIV from the smoke. Next to it is a golden stupa, normally reserved for the ashes of one, containing the ashes of most of Wat Opot’s deceased. Their children know they are there, and inside the pyre is a room with dozens of photographs on the wall, memorialising some, not all (not everyone survived to get their photograph taken), of those Wayne nursed to their deaths.
Gail Gutradt came to Wat Opot to volunteer a number of times and she wrote a book about Wayne and her experiences there. Titled In A Rocket Made of Ice I am yet to read it but have no doubt that it can be highly recommended. PJ Coggan reviewed it glowingly on his blog last year, at http://pjcoggan.com/2014/04/07/in-a-rocket-made-of-ice/
An exciting development of our time here, is the partnership Phter Koma and Wat Opot may build with each other. With a high profile, Wat Opot receive an excess of interest from potential volunteers, which Phter Koma needs. Phter Koma regularly receives requests to accommodate children which we are not in a position to accept while Wat Opot has room for more. We also talked about our children having some sort of field trip together during the school holidays.
As our tour came to an end and our tuk tuk reappeared to collect us, I muttered to Chaz “I had no idea that such a place as this existed in the world”. Given the statistics of HIV and AIDS worldwide, I imagine that in fact, there are many such places dotted around the globe, some of them lucky enough, as Wat Opot, to emerge from the peak of an epidemic of death, into communities of frolicking, healthy children with optimistic futures. Some of the earlier children have moved away and joined the workforce, some are enrolled in higher education and some have, in Wayne’s words, “gone bad”. Few of these children would have experienced care and inclusion without the existence of Wat Opot.