Ian Cook caught HIV while travelling in Cambodia nine years ago. Last year he returned to Phnom Penh to make a photo diary and film about HIV in the country he’s grown to love
  Patients at the Old Hospital and children at the Maryknoll home, Phnom Penh photos: ian Cook |
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Sitting here in London enjoying a café latte and a chocolate brownie, I recall my friend John’s remark: “About $1.50 a day. What you’d spend on a cup of coffee back in the west”. He was talking about the cost of saving a child’s life by supplying generic antiretrovirals and the necessary care and tests. I’ve just spent three times that. How many lives could I save?
Do people really still need to be dying of Aids?
I returned to Cambodia with a curious trepidation. It was the place where I had contracted HIV in 1994/5. A country I had loved deeply. A country with deep scars that had scarred me too.
The roads into the capital Phnom Penh are paved now. Miraculous-looking glass and steel buildings were rising through the broken old Soviet style apartment blocks and crumbling French colonial leftovers.
The people selling gasoline by the side of the road from glass Fanta bottles were still there; but so were western style gas stations and minimarts. The mines had been removed from Cambodia’s tourist pearl, Angkor Wat. The war was over.
A new enemy, though, has been busy sowing its seeds, and there is a new war to be fought.
I had returned half on holiday, half with the idea to make a film. Armed with a City and Guilds in video production and rather disgruntled girlfriend, in a hot and sticky Phnom Penh, we tried to put together the mechanisms of a documentary.
We visited the National Aids Authority. The place had a half abandoned air but we found a secretary who supplied us with a glossy Aids brochure. She seemed surprised that we would want to meet any positive people and didn’t know where we could find any. When pressed, she suggested the hospital.
Back in our sweaty hotel room I flicked through our brochure: “Out of a population of 11 million, Cambodia now has 169,000 people living with HIV. 300,000 women and children kept in slavery-like conditions...16.1 per cent of bar girls, 3.1 per cent of policemen have HIV” and so on. Obviously a lot of work had gone into this. There were sub-headings like ‘poverty’, ‘environment’, and an impressive display of acronyms. I had hoped to capture something human and emotive; these statistics just made me feel numb.
The next day we went to visit a hospital. We just walked in. There were no doctors.
Suddenly I was face to face with the virus’ unchecked work on the human form. The woman on the bed was little more than a husk now. She gave an unbearable smile, looking up and seeing a foreigner there. She had a small clutch of pills arranged on the straw mat within reach of her skeletal hand. Vitamins and paracetamol. She could have been one of those fresh faced, pretty girls that I used to party with back then. We both have the same disease, the difference being that the pills in my pocket are keeping me alive. She is dying.
“Many die here” a tired looking family member told me. “Can you give us your medicine? Just give us half”. The families sleep on the floor and cook in the rooms. Even basic supplies need to be paid for-and still there are those who can’t even afford to get here.
Across the city in the other Russian-built hospital, it was surprisingly tranquil away from the dusty bustle and prickly heat of the traffic. It is there we find Dr Didier Laureillard who takes a break from the patients coming and going to chat with us. There is an infectious energy in listening to this good-looking French man talk.
“I think like an activist but I’m a doctor.” He shrugs. He left his practice in Paris to volunteer for Médecins sans Frontières (MSF). “We give antiretrovirals to 200 patients here. We have100 per cent adherence.”
I ask him the delicate question: how do they choose who gets the pills? “Those who show a commitment to attending the walk in clinic and whose CD4 is below 200.”
It was from Dr Didier we heard about John and Kathy Tucker, a husband and wife team from Texas. We met John in his old US army jeep. He cut a heroic figure, I thought, with his well-tanned leathery skin and a big wooden cross hanging around his neck. As he negotiated the traffic, and I attempted to film him, he filled us in.
“Originally I came here to work with disabled children, then we worked on an Aids project for adults and quickly realised nothing was being done for the kids. We started working to set up a hospice with Mother Teresa’s sisters. When that became full, then we set up our own.”
John and Kathy belong to Maryknoll, the oldest lay missionary group in the US. Maryknoll is the main funder for the group homes, food and basic medicine. “For the ARVs (antiretrovirals) I get people in the states to sponsor children”.
What kind of sponsors does he get? Individual churches, concerned people who can afford $500 a year, some little old ladies”. The total cost to sponsor a child is $45 a month including all the checks ups and blood tests. The generic ARVs from Thailand cost $30 a month.
 Ian with children from Maryknoll Centre and women at the Patches of Hope Project |
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We drove to the children’s hospital and John was introduced to some of the children and mothers there. There were five children and two women. Some of the children had been abandoned. He strokes the arm of one little girl, her arm no thicker than his finger. Another little boy who is 11 but looks about seven is picked up. “The local street children’s program didn’t want him to die with the other kids, so they gave him to me. But I don’t think he has to die”. He holds the frail, skull like head in his hands. They share a joke in Cambodian, and suddenly he flashes a huge smile. I ask if I can film there. He agrees, reluctantly: it can be difficult to view images later of children that have died.
Next we visit one of the group homes. It’s such a contrast. Here the kids are bouncing around, busy helping to decorate a Christmas tree, glittering in the bright sunlight.
“We respect the children’s Buddhism, but we celebrate Christmas because the children like getting presents”, says John. He points to one little girl tucking into her lunch. “She weighed seven kilos when she came to us. Now she weighs 18. A lot of children here looked like the ones you saw in the hospital”
We accompanied Kathy to a building on a busy street in the garment district. We were greeted with smiles and the machine-gun patter of dozens of sewing machines. This was the Patches of Hope Project.
Kathy explained: “When people first come to us they can be so ashamed. They have often lost their family, their jobs. If they are well enough, we teach them how to sew and make quilts that we sell in the states. It’s a self-funding project and we can pay them $56 a month”
Kathy takes care of the adults. Although some of them manage to get medicine from MSF, there are many who need help with being able to die with some space and dignity. “If someone has family then we give them money for food and rent and a case worker who comes to visit them three times a week. For those alone we have a hospice”
We took a short ride around some back streets to visit one of the hospices. Again I was struck by such injustice and waste of life. Thankfully they had someone like Kathy to hold frail hands and give warm hugs. “We never ask how they came to be here .We just love them until the end”. At the back of the house there is a large wooden verandah where those living there could come to feel the breeze and stare out over the fields on the edge of town.
Now I am back in London with my coffee and cake. It’s a beautiful spring day. There are so many smiles on the faces of grown ups and children. In Iraq we are killing, and in Cambodia they are dying. Thank goodness for those good souls, out there on the frontline in the war on Aids.
Contacts:
John and Kathy Tucker: johnkathy@hotmail.com
