December 9, 2013

I. Background

This is Human Rights Watch’s second report on abuses in Cambodia’s drug detention centers. In January 2010, Human Rights Watch published “Skin on the Cable”: The Illegal Arrest, Arbitrary Detention and Torture of People Who Use Drugs in Cambodia. Drawing on interviews conducted in 2009 with 63 people who had been detained between 2006 and 2008, the report documented torture and cruel and inhuman treatment inflicted on drug users and other people considered by government authorities to be “undesirable.”

“Skin on the Cable” detailed how people held in the centers had been whipped with twisted electrical wire, beaten, forced to perform painful physical exercises, made to work, and sexually abused. The report concluded that the mainstays of drug treatment in Cambodia’s centers were exhausting physical exercises and military-like drills, violating the requirement under international law that health facilities and services be ethically acceptable, and scientifically and medically appropriate.

Drug Users in Cambodia

Estimates of the number of people who use drugs in Cambodia differ widely. The NACD Annual Report for 2012 claimed there were officially 4,057 drug users in Cambodia in 2012, although it recognized the actual number is likely to be higher.[2] For its part, the UN Office on Drugs and Crime, UNODC, has publicly cited reports estimating as many as 46,000 people in Cambodia use drugs.[3]

The primary response from government officials was to dismiss Human Rights Watch’s report as untrue.[4] The spokesperson for the Ministry of Social Affairs was quoted as saying: “I think these criticisms [of the centers] lack basic evidence.… All centers are working in a humanitarian fashion.”[5]

However, a number of comments that government officials provided to both local and international journalists inadvertently supported the report’s findings. For example, a Ministry of Interior spokesman was quoted as stating: “[People in detention] need to do labor and hard work and sweating—that is one of the main ways to make drug-addicted people to become normal people.”[6] Another article quoted the commander of the gendarmerie in Banteay Meanchey province as denying torture at his center, but confirming that some people in the center were forced to stand in the sun or "walk like monkeys" [i.e. on all fours] as punishment for attempting to escape.[7] An international news broadcaster entered one center and managed to film young children working there before being ordered to leave.[8]

Two months after the report was released, Prime Minister Hun Sen lashed out indirectly at Human Rights Watch in a speech to Cambodian narcotics officials, saying: “Some human rights organizations, lacking in rational consideration, take the chance to blindly attack without seeing the government’s charity.” The prime minister conceded that the centers do not offer model treatment, but justified the system as the best the country could offer.[9]

In May 2010, the grouping of UN agencies in Cambodia issued a “common viewpoint” on drug detention centers in Cambodia. It concluded that “there is no evidence that centres operated by the Royal Government of Cambodia … operate in accordance with evidence and good practice; on this basis there is no reason for the centres to remain open.”[10]

Without naming Cambodia specifically, 12 UN agencies issued a joint statement on drug detention centers in March 2012. The statement noted:

The deprivation of liberty without due process is an unacceptable violation of internationally recognised human rights standards. Furthermore, detention in these centres has been reported to involve physical and sexual violence, forced labour, sub-standard conditions, denial of health care, and other measures that violate human rights. There is no evidence that these centres represent a favorable or effective environment for the treatment of drug dependence, for the “rehabilitation” of individuals who have engaged in sex work, or for children who have been victims of sexual exploitation, abuse or the lack of adequate care and protection.[11]

The UN agencies called on states with drug detention centers “to close them without delay and to release the individuals detained. Upon release, appropriate health care services should be provided to those in need of such services, on a voluntary basis, at community level.”[12]

Drug Detention Centers

In Asia, the facilities described here as drug detention centers go by a variety of names: compulsory treatment centers, drug rehabilitation centers, detoxification centers, or (in Vietnam), “Centers for Social Education and Labor.” They are common in China and Southeast Asia, with an estimated combined population of 350,000 detainees. [13]

These facilities may differ greatly by, and even within, a country. However, regardless of their name, centers that hold people against their will for drug dependency treatment should be considered “drug detention centers” operating outside international law.

Many people are held in such centers without ever seeing a lawyer or a judge, or without having means to challenge the legality of their detention. Even when such centers are enabled by national legislation (and where that legal framework is fully respected in practice), detention in such centers is arbitrary, and violates international law because it is a medically and scientifically inappropriate response to any actual clinical need for treatment of drug dependence. [14] The various restrictions on individual rights resulting from detention in such centers are not strictly necessary, nor the least restrictive means, to achieve the purpose of drug treatment. [15]

Abuses in drug detention centers in Cambodia were specifically taken up by the Children’s Rights Committee, the UN body responsible for upholding the Convention on the Rights of the Child, in 2011. The committee called on the government to release “without delay” children in detention centers and urged “prompt investigation into allegations of ill-treatment and torture of children in those centers and the judicial prosecution of all perpetrators.”[16]

Cambodian and international law obligates Cambodian authorities to release people currently held in the centers, as their continued detention cannot be justified on legal or health grounds. It also requires Cambodian authorities to carry out thorough and impartial investigations into allegations of serious human rights violations. Those implicated in arbitrary arrest and detention, torture and ill-treatment, and forced labor in drug detention centers should be appropriately disciplined or prosecuted.

In the nearly four years since the release of “Skin on the Cable,” the Cambodian authorities have not met calls to release all detainees from the centers, investigated reports of torture and other criminal acts, or held any perpetrators accountable.

In 2010, the Cambodian government authorized small-scale voluntary, community-based drug treatment projects in Phnom Penh and in Banteay Meanchey province.[17] Project activities have since expanded to two other provinces, Battambang and Stung Treng.[18] Government officials have made it clear that such projects are not “alternatives” to drug detention centers, as at least one of Cambodia’s international donors, UNODC, has claimed.[19] The deputy governor of Banteay Meanchey province told local media, “We need both”—community-based drug treatment and drug detention centers.[20]

In early 2012, Cambodia revised its Law on the Control of Drugs. Despite the credible reports of widespread abuses related to the centers, and repeated calls for their closure, new provisions in the law replaced the existing measures on compulsory treatment in a substantially similar form. The law contains broad powers for a prosecutor to compel a person into treatment. For example, the law establishes that:

Treatment can be compulsory if it is regarded as a necessary measure to protect the general interests of, and is of benefit to, the drug addict. Treatment can also be compulsory if a drug addict is lacking the capacity to express his/her intention to accept voluntary treatment.[21]

The law remains overly broad, containing few procedural safeguards against abuse of the means by which people can be sent into treatment. Despite this, the minimal procedures required by the law before a person can be compelled into treatment are, in practice, ignored by those running the centers and the authorities rounding up people.

List of Government Drug Detention Centers in Cambodia

Name of Center

Province

Run by

Capacity

1

Orgkas Khnom center [“My Chance”]

Phnom Penh

Phnom Penh Municipality

Approx. 400

2

Gendarme center

Battambang

Gendarmerie

Approx. 100

3

Bavel Police center

Battambang

Police

Approx. 100

4

Phnom Bak center

Banteay Meanchey

Social Affairs

Approx. 120

5

Gendarme center

Banteay Meanchey

Gendarmerie

Approx. 200

6

Police center

Siem Reap

Police

Approx. 50

7

Gendarme center

Preah Sihanouk

Gendarmerie

Approx. 40

8

Military center

Koh Kong

Military

Approx. 30

According to the government’s National Authority for Combating Drugs (NACD), during 2012 at least 2,223 people passed through seven centers.[22] However this figure almost certainly underreports the actual number of people in detention.

Human Rights Watch is aware of at least one additional drug detention center not on the NACD’s 2012 list of centers: a center run by the Cambodian military located on the base of the Koh Kong provincial military headquarters near Koh Kong town.[23]

Although incomplete, the NACD’s 2012 data nevertheless provides some insights into who is locked inside Cambodia’s centers. Of the 928 people recorded in the seven centers at the beginning of 2013, 98 (11 percent) were children (between 10 and 17 years old), while the majority (532 out of 928, or 57 percent) were between 18 and 25 years old. 67 (or 7 percent of the total) were female.

The most common drugs reported being used were methamphetamine in crystallized form (698, or 75 percent), methamphetamine (151, or 16 percent), and glue (49, or 5 percent). “Street children” accounted for 67 people in the centers (7 percent) and “women at entertainment places” (a common euphemism for sex workers in Cambodia) accounted for 21 (2 percent). A total of 283 individuals in the centers (30 percent) were classified as having “no real profession.”[24]

The number of government detention centers in Cambodia has decreased from 11 in 2010 to 8 in 2013— although the total number of individuals in detention each year remains roughly constant.[25]

One of the three centers closed since 2010 was the Choam Chao “Youth Rehabilitation Center,” which was situated in Phnom Penh and run by the Ministry of Social Affairs up until 2010. The center had the capacity to detain approximately 100 people. It ceased to operate in mid-2010 after the United Nations Children’s Fund, UNICEF, which had provided funding since 2006, confirmed reports of abuses against detainees and stopped funding the center.[26] In late 2012, the center’s buildings were demolished.

The frond-strewn floor of a former building inside the Choam Chao “Youth Rehabilitation Center” in Phnom Penh. Cambodia closed the center in 2010. © 2013 Human Rights Watch

The other two centers closed since 2010 include the gendarme-run center in Kampong Cham province and the center run by the Ministry of Social Affairs in Kandal province. Both were relatively small centers, holding a few dozen people.[27]

The impact of the closure of these three centers has been offset by the construction of a new unit designated for women and girls in the Orgkas Khnom center. Large numbers of women and girls were not detained in drug detention centers up until 2011. Orgkas Khnom opened a 10-room building for female drug users in May 2011.[28] According to local media, construction of the unit was funded by the Bank for Investment and Development of Vietnam.[29] According to NACD’s data, at the beginning of 2013 there were 61 females (out of 67 females held in seven drug detention centers) confined there.[30]

Additionally, while it has never been listed by the NACD as a drug center, individuals told Human Rights Watch that one other center (Prey Speu near Phnom Penh, run by the Ministry of Social Affairs) was regularly used to detain people who use drugs, as well as homeless people, beggars, street children, sex workers, and people with actual or perceived mental or developmental disabilities, during 2012.[31]

The NACD’s Annual Report for 2012 describes several recent steps that the Cambodian government has taken to prepare for a new “national” center in Preah Sihanouk province. The NACD reported that it had prepared a five-year strategic plan (2014-2018) for the center and that financial provisions have been included in the Public Investment Program 2013-2015. It also reported that it had drafted a memorandum of understanding between the governments of Vietnam and Cambodia covering the center’s construction, and sent the draft to the Vietnamese government.[32]

Local media first reported the Cambodian government’s intention to build a national center in March 2010. The then-secretary general of the NACD was reported as stating that the center would have the capacity to hold 2,000 people and would be open by 2015.[33] Land for the center was reportedly donated by Cambodian businessman and Cambodian People’s Party senator Mong Reththy, whose agricultural plantations surround the plot.[34]

In December 2010, the Council of Ministers approved the plan.[35] At that stage, the same NACD official was reported as saying that the Cambodian government had requested US$2.5 million financial support from the Vietnamese government to build the center.[36] In July 2013, Human Rights Watch visited the location of the planned center in Preah Sihanouk province and did not find any evidence of construction.

Human Rights Watch is concerned by the prospect of Vietnam providing assistance to Cambodia in the realm of drug treatment, given our findings of forced labor and other abuses in drug detention centers in Vietnam. The Human Rights Watch report The Rehab Archipelago found that forced labor is central to the purported “treatment” of people in drug detention centers in Vietnam.[37]

According to Vietnamese government regulations, labor therapy [lao dong tri lieu] is one of the official five steps of drug rehabilitation.[38] In comparison with Cambodia—where detention is usually three to six months—a person can spend up to four years in Vietnam’s drug detention centers.[39] Rates of relapse to drug use after “treatment” in Vietnam’s centers have been reported at between 80 and 95 percent.[40]

[2] National Authority for Combating Drugs, “Report about Outcome of Drug Control 2012 and Work Direction for 2013,” 2012. (Translation by Human Rights Watch). Copy on file with Human Rights Watch.

[3] Olivier Lermet, Cambodia country manager for UNODC, quoted in Zsombor Peter and Kaing Menghun, “UN says government statistics on drug users are too low,” Cambodia Daily, March 20, 2013, http://www.cambodiadaily.com/archive/un%E2%80%88says-government-statistics-on-drug-users-are-too-low-15356/ (accessed November 17, 2013).

[4] Moek Dara, then-secretary general of the National Authority for Combatting Drugs (NACD): “There is no violence. They accuse us without proof”; Sao Sokha, deputy commander-in-chief of the Royal Cambodian Armed Forces and the national gendarmerie commander at the Ministry of Defense: “Those centres are under my control. There are no threats or violence. The information that Human Rights Watch gets is not true”; Huot Sokhom, deputy chief of the police-run center in Siem Reap: “We have never beaten them or used violence on them… Those vagrant people we collect from the streets volunteer to come with us.” Quoted in Irwin Loy and Chhay Channyda, “HRW slams rehab centers,” Phnom Penh Post, January 25, 2010, http://www.phnompenhpost.com/national/hrw-slams-rehab-centres (accessed August 31, 2013).

[5] Lem El Djurado, Ministry of Social Affairs spokesperson, quoted in James O’Toole and Vong Sokheng, “UN alarm over abuse claims,” Phnom Penh Post, June 29, 2011, http://www.phnompenhpost.com/national/un-alarm-over-abuse-claims (accessed September 2, 2013).

[6]Khieu Sopheak, Ministry of Interior spokesperson, quoted in “Human rights body says Cambodia's drug rehab centres must close,” The Nation, January 26, 2010, www.nationmultimedia.com/2010/01/26/regional/Human-rights-body-says-Cambodia&039;s-drug-rehab-c-30121185.html (accessed August 31, 2010).

[7] Brig. Gen. Rat Sreang, commander of the gendarmerie in Banteay Meanchey province, quoted in “Group: Cambodia should shut drug detention centers,” AP, January 25, 2010.

[8]Cyril Payen, “Le scandale des centres de désintoxication au Cambodge” (in French), France24, March 4, 2010, http://www.france24.com/fr/20100304-focus-exclusif-centres-desintoxication-cambodge-drogues-unicef-accusations-abus-torture (accessed September 9, 2013).

[9] Prime Minister Hun Sen, quoted in Cheang Sohka, “PM lashes out at rehab critics,” Phnom Penh Post, March 18, 2010. See also Van Roeun, “Drug centers inadequate but criticism not constructive, PM says,” Cambodia Daily, March 18, 2010.

[10] UN Country Team in Cambodia, “UN Common View Point: Support to the Royal Government of Cambodia to deliver evidence-based drug dependence detoxification, treatment and aftercare for people who use drugs,” May 2010. Copy on file with Human Rights Watch.

[11]ILO, OHCHR, UNDP, UNESCO, UNFPA, UNHCR, UNICEF, UNODC, UN Women, WFP, WHO, UNAIDS, “Joint Statement: Compulsory drug detention and rehabilitation centers,” March 2012, http://www.unaids.org/en/media/unaids/contentassets/documents/document/2012/JC2310_Joint%20Statement6March12FINAL_en.pdf (accessed August 14, 2013).

[12] Ibid.

[13] See, for example, Bradley M. Mathers et al., “HIV Prevention, Treatment and Care for People Who Inject Drugs: A Systematic Review of Global, Regional and Country Level Coverage,” Lancet, vol. 375, no. 9719 (2010), pp. 1014-1028 (see figures at pp. 72-74 in web appendix to article).

[14] "‘[A]rbitrariness' is not to be equated with ‘against the law,' but must be interpreted more broadly to include elements of inappropriateness, injustice, lack of predictability and due process of law." UN Human Rights Committee, Communication No. 458/1991, A. W. Mukong v. Cameroon, U.N. Doc. CCPR/C/51/D/458/1991 (1994), para. 9.8.

[15] See Committee on Economic, Social and Cultural Rights, General Comment 14, The Right to the Highest Attainable Standard of Health, UN Doc. E/C.12/2000/4, adopted August 11, 2000, paras. 28-29.

[16]United Nations Committee on the Rights of the Child, “Consideration of reports submitted by States parties under article 44 of the Convention, Concluding observations: Cambodia,” CRC/C/KHM/CO/2, June 20, 2011, http://www2.ohchr.org/english/bodies/crc/crcs57.htm (accessed August 31, 2013), paras. 38-39.

[17] See Irwin Loy, “Officials endorse methadone plan,” Phnom Penh Post, April 1, 2010, http://www.phnompenhpost.com/national/officials-endorse-methadone-plan (accessed August 31, 2013); Joe Freeman and Khouth Sophak Chakrya, “Drug addiction fight forges new approach,” Phnom Penh Post, August 16, 2012, http://www.phnompenhpost.com/national/drug-addiction-fight-forges-new-approach (accessed August 31, 2013).

[18] “Cambodia community-based drug treatment project expands to two more provinces,” UNODC news release, June 19, 2012, http://www.unodc.org/southeastasiaandpacific/en/cambodia/2012/06/cbtx-two-provinces/story.html (accessed November 17, 2013).

[19] For example, “Community-based drug treatment a sustainable alternative for Cambodia,” UNODC news release, June 18, 2013, http://www.unodc.org/southeastasiaandpacific/en/cambodia/2013/06/cbtx/story.html (accessed October 7, 2013).

[20]Chhum Vannarith, deputy provincial governor and member of the Provincial Drug Control Committee, quoted in Joe Freeman and Khouth Sophak Chakrya, “Drug addiction fight forges new approach,” Phnom Penh Post, August 16, 2012, http://www.phnompenhpost.com/national/drug-addiction-fight-forges-new-approach (accessed August 31, 2013). See also Neak Yuthea, director of the NACD’s Department of Legislation, Education and Rehabilitation: “We cannot say [community-based drug treatment] will replace [the centers]… The government of Cambodia always finds the appropriate way of helping people with drug addictions. Compulsory treatment might still be necessary for some people with really strong addiction.” Quoted in Brooke Lewis and Rann Reuy, “Drug-treatment plan signed,” Phnom Penh Post, October 28, 2010, http://www.phnompenhpost.com/national/drug-treatment-plan-signed (accessed August 31, 2013). See also, comments by Moek Dara, then-secretary general of the NACD, quoted in Zsombor Peter and Van Roeun, “Community or compulsory? Drug centers at a crossroads,” Cambodia Daily, March 4, 2010. Copy on file with Human Rights Watch.

[21] Law on the Control of Drugs, No. 197/1, December 1996, amended January 2010, article 107.

[22]NACD, “Report about Outcome of Drug Control 2012 and Work Direction for 2013.”

[23] Human Rights Watch confirmed the Koh Kong center detained people in the period January 2012 to May 2013. In July 2013, when a Human Rights Watch researcher visited Koh Kong, the center was still operational. NACD reports for 2007 and 2008 list the center as one of the government’s centers for “drug treatment.” See NACD, “Report on Illicit Drug data and Routine Surveillance Systems in Cambodia 2007,” June 2008, pp. 74-75; National Authority for Combating Drugs, “Report on Illicit Drug Data and Routine Surveillance Systems in Cambodia 2008,” November 2008, pp. 12-13. Copies on file with Human Rights Watch.

[24] National Authority for Combating Drugs, “Report about Outcome of Drug Control 2012 and Work Direction for 2013” (tables in annex).

[25] The NACD’s Annual Report for 2012 report claims Cambodia detained 2,223 drug users in 2012; the NACD’s data for 2008 claims 2,382 people were held in centers in 2008. See “Report from the National Residential Treatment Center Minimum Dataset: 2008,” Drug Information Center, National Authority for Combating Drugs, presented at DHA Technical Working Group Meeting, NAGA World Hotel, June 4, 2009. Copies on file with Human Rights Watch.

[26] Irwin Loy, “UNICEF finds evidence of abuses,” Phnom Penh Post, June 10, 2010, http://www.phnompenhpost.com/national/unicef-finds-evidence-abuses (accessed August 31, 2013); see also, Joseph Amon et al., “Compulsory Drug Detention in East and Southeast Asia: Evolving government, UN and Donor Responses,” International Journal of Drug Policy, July 8, 2013.

[27] NACD, “Report about Outcome of Drug Control 2012 and Work Direction for 2013.”

[28] Kim Yuthana and James O’Toole, “Fears over new women’s drugs unit in Phnom Penh,” Phnom Penh Post, May 13, 2011, http://www.phnompenhpost.com/national/fears-over-new-women%E2%80%99s-drugs-unit-phnom-penh (accessed August 21, 2013).

[29] Ibid.

[30] NACD, “Report about Outcome of Drug Control 2012 and Work Direction for 2013.”

[31] Human Rights Watch interviews with Muoy, Phnom Penh, May 2013; Thnong, Phnom Penh, May 2013; Sokrom, Phnom Penh, May 2013; Preuk, Phnom Penh, June 2013. In this report, “mental disability” refers to mental health problems such as depression, bipolar disorder, and schizophrenia. Persons with mental health problems also refer to themselves as having psychosocial disabilities, a term that reflects the interaction between psychological differences and social or cultural limits for behavior, as well as the stigma that the society attaches to persons with mental impairments. Center for the Human Rights of Users and Survivors of Psychiatry, “Manual on Implementation of the Convention on the Rights of Persons with Disabilities,” undated, p. 9, http://www.chrusp.org/home/resources (accessed November 21, 2013). “Developmental disability” is an umbrella term that includes cognitive impairments, such as Down syndrome, as well as neurological, physical and sensory impairments such as cerebral palsy, autism, epilepsy and other seizure disorders. The term “actual or perceived” is used to include those people who did not have a diagnosis, or for whom a diagnosis was not known but assumed.

[32] National Authority for Combating Drugs, “Report about Outcome of Drug Control 2012 and Work Direction for 2013.”

[33] Moek Dara, then-secretary general of the NACD, quoted in Zsombor Peter and Van Roeun, “Community or compulsory? Drug centers at a crossroads,” Cambodia Daily, March 4, 2010. Copy on file with Human Rights Watch.

[34] Ibid.

[35] May Titthara, “State approves plan for new drug centre,” Phnom Penh Post, December 13, 2010, http://www.phnompenhpost.com/national/state-approves-plan-new-drug-centre (accessed August 21, 2013).

[36] Ibid.

[37] Human Rights Watch, The Rehab Archipelago: Forced Labor and Other Abuses in Drug Detention Centers in Southern Vietnam, September 7, 2011, http://www.hrw.org/reports/2011/09/07/rehab-archipelago-0 (accessed September 3, 2013).

[38] The centers in Vietnam must “organize therapeutic labor with the aim of recovering health and labor skills for drug addicts.” The five official stages are: 1. Admission and sorting; 2. Treatment for withdrawal, the impact of detoxification and opportunistic infection; 3. Education and counseling to rehabilitate behaviors and personality; 4. Labor therapy and vocational training; 5. Preventing and fighting against relapse, preparing for community reintegration. See Interministrial Circular 41/2010/TTLT-BLDTBXH-BYT, “Guiding the Process of Rehabilitation for Drug Addicts at the Centers for Social Education and Labor for Voluntary Rehabilitation Treatment,” issued by the Ministry of Labor and the Ministry of Health, dated December 31, 2010, art. 2. (Translation by Human Rights Watch). Copy on file with Human Rights Watch.

[39] The duration of “detoxification” is stipulated as being between one and two years: Law on Preventing and Combating Narcotic Drugs, 23/2000/QH10, December 9, 2000, art. 28. An additional period of up to two years “post rehabilitation management” is also foreseen by law: Decree 94/2009/ND-CP, “Regulating in detail the implementation of the Law to Amend and Supplement a Number of Articles of the Law on Drug Prevention Regarding Post-Rehabilitation Management,” October 26, 2009, art. 33.

[40] “Relapse rate is high,” Ministry of Labour, Invalids and Social Affairs of Vietnam, February 22, 2008, http://www.molisa.gov.vn/news/detail/tabid/75/newsid/37648/seo/Ty-le-tai-nghien-con-cao/language/vi-VN/Default.aspx (in Vietnamese) (accessed September 1, 2013); “Does compulsory rehabilitation in closed settings work in Vietnam?” Gayle Martin and others, paper presented at the Informal Consultation on Compulsory Centers for Drug Users, Bangkok, Thailand, September 2010. Copy on file with Human Rights Watch.