Regarding the Treatment of HIV-affected Families from the Community of Borei Keila
July 28, 2009
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H.E. Samdech Hun Sen
Prime Minister
Office of the Prime Minister
No. 38, Russian Federation Boulevard
Phnom Penh, Kingdom of Cambodia

H.E. Mam Bunheng
Minister of Health
No 151-153 Kampuchea Krom Boulevard
Phnom Penh, Kingdom of Cambodia

Your Excellencies,

The Royal Government of Cambodia has won international recognition for its efforts to provide prevention, treatment, care and support for people living with HIV.  However, we the under-signed individuals and organizations write to you now to express our deep concern about the discriminatory and potentially life-threatening treatment of HIV-affected families from the community of Borei Keila in Phnom Penh, Cambodia.

On June 18, 2009, 20 HIV-affected families were evicted from Borei Keila and sent to Tuol Sambo, a remote resettlement site created by the government on the outskirts of the city.  This eviction took place despite repeated appeals to the government, including from United Nations agencies, more than 18 local and international organizations, and a national network of people affected by HIV.

We have reason to fear that relocations of HIV-affected families are continuing even as we sign this letter.

We are deeply disturbed by the Cambodian authorities' creation of a de facto AIDS colony at Tuol Sambo. Located in a desolate, flood-prone field in a semi-rural area 25 kilometers from Phnom Penh, Tuol Sambo is far away from the jobs, medical facilities, and support services that had been available to Borei Keila residents in the city.

The housing conditions at Tuol Sambo are grossly inadequate in terms of size, fire safety, and sanitation.  Residents are crowded into poorly ventilated metal sheds that are baking hot in the daytime. There are no kitchens and no running water in the sheds, which are flanked by open sewers, and only one public well to service the evicted families. According to Medecins Sans Frontieres, these conditions do not meet international minimum standards for temporary emergency housing.

While other homeless people from Phnom Penh are slated for relocation to brick houses at an adjacent site at Tuol Sambo, the HIV-affected families from Borei Keila have been placed in a separate settlement with inferior housing, distinguished by green corrugated metal roofing and walls.  Even before the evictees were resettled there, local people referred to the green sheds as "the AIDS village."

The Borei Keila evictions were carried out to make way for a commercial development, which was granted government approval in 2003 with the understanding that the developer would build new housing on site for residents displaced by the project.

With a few exceptions, the HIV-affected families thus far displaced by the development have not been screened for eligibility for the on-site housing - unlike other families who are not affected by HIV. After waiting for two years, the authorities have now acknowledged that at least 11 HIV-affected families previously slated to be sent to Tuol Sambo are in fact eligible for new on-site housing at Borei Keila. To date, however, they remain in Borei Keila and have not yet been provided new housing.

For the other families evicted to Tuol Sambo, the Ministry of Health has reportedly given assurances that antiretroviral (ARV) medication and opportunistic infection treatment will be available to them. It is not clear, however, that the ministry has a sound long-term plan to ensure this. Since the eviction, the government has not directly provided services but has relied instead on nongovernmental organizations to ensure continued access to medicines, for example by paying transportation costs for the evictees to come to hospitals in the city. 

In addition, there has been no consideration of the impact on health of the poor living conditions at Tuol Sambo and the lack of income-generating opportunities there. The living conditions at Tuol Sambo pose serious health risks, particularly to people with compromised immune systems. The risk to those people living with HIV can be life threatening. Residents report that the heat in the poorly ventilated metal sheds is so intense that they are usually unable to remain in their rooms during the afternoon and they are afraid that their ARV medication will deteriorate in the heat.

We take this opportunity to state our opposition to the segregation or isolation of people living with HIV, as such policies promote stigmatization and further discrimination and may seriously jeopardize their access to necessary prevention, care, treatment, and support services.

Furthermore, we recognize that people living with HIV need more than just medicines to survive. They need a continuum of care that addresses the psychological, legal, social, and economic consequences of living with HIV, and assures adequate shelter, nutrition, income generation, and access to education and other essential services.

In light of the above, we request the Royal Cambodian Government to:

  • Cease moving HIV-affected families to the Tuol Sambo relocation site;
  • Improve conditions at Tuol Sambo site so that they meet minimum standards for adequate shelter, sanitation, and clean water;
  • Ensure full access to quality medical services, including antiretroviral treatment, treatment of opportunistic infections, as well as 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, employment, and reintegration into society in a manner that protects their rights and livelihoods;  
  • Employ a transparent and fair screening process to determine eligibility for on-site housing at Borei Keila, and grant eligible families the housing immediately (including the 11 HIV-affected families already approved by the authorities); for those found ineligible, authorities should provide other adequate housing.

Thank you for your consideration.

Yours sincerely,

 
Organizations:

ACCES
Marseilles, France

ACT UP Philadelphia
United States

Action SIDA Comoros
Union of Comoros

AIDS Action Now!
Toronto, Canada

AIDS Action
United States

The AIDS Consortium
South Africa

AIDS Law project
South Africa

AIDS Project Los Angeles
United States

AIDS and Rights Alliance for Southern Africa
Namibia

All-Ukrainian Network of People Living with HIV/AIDS
Ukraine

Alliance for Holistic and Sustainable Development of Communities
India

American Jewish World Service
United States

Andrey Rylkov Foundation for Health and Social Justice
Russia

Asia Catalyst
United States

Asian Harm Reduction Network
Thailand

Asia Pacific Council of AIDS Service Organizations
Malaysia

Asia Pacific Network of People Living With HIV/AIDS
Thailand

Asia Pacific Network of Sex Workers
Malaysia

ASUD
France

Balance
Mexico

BAOBAB for Women's Human Rights
Nigeria

Blood Ties Four Directions Centre
Yukon, Canada

Bolivian Network of People with HIV/AIDS
Bolivia

Brazilian Drug Policy Center - Psicotropicus
Brazil

British Columbia Persons with AIDS Society
Canada

Canadian Association of Nurses in AIDS Care
Canada

Canadian Harm Reduction Network
Canada

Canadian HIV/AIDS Legal Network
Canada

Canadian Treatment Action Council
Canada

Center for Reproductive Rights
United States

Center for Health Policy and Innovation.
United States

Centre for Human Rights
Faculty of Law, University of Pretoria
South Africa

Children Education Society
Tanzania

中国北京爱之方舟感染者信息支持组织
[in English: China Beijing Ark of Love Infected Persons Information Support Organization]
China

The Secretariat of the Coalition of Asia Pacific Regional Networks on HIV and AIDS
Thailand

Comision Internacional de los Derechos Humanos para Gays y Lesbianas
[in English: International Commission of Human Rights for Gays and Lesbians]
Argentina

Consejo Latinoamericano y del Caribe de Organizaciones No Gubermentales con Servicio en VIH/SIDA
[in English: Latin American and Caribbean Council of AIDS Service Organizations]

Cultura Joven
[in English: Youth Culture]
Mexico

East Europe and Central Asia Union of PWH Organizations

Egyptian Initiative for Personal Rights
Egypt

Foundation for Integrative AIDS Research
United States

Fundación Estudio e Investigación de la Mujer
[in English: Foundation for Women's Studies]
Spain

Fundación Argentina Pro Ayuda al Niño con Sida
[in English: Argentinian Foundation for the Support of Children with AIDS]
Argentina

GESTOS - Soropositividade, Comunicação y Gênero
[in English: GESTOS - Soropositivity, Communications and Gender
Brazil

Global Action for Children
United States

Global Business Coalition on HIV/AIDS, Tuberculosis, and Malaria
United States

Global Effort for Women against AIDS
Uganda

Global Forum on MSM and HIV
United States

Global Network of People Living with HIV

Global Welfare Association
Cameroon

Gram Bharati Samiti
[in English: Society for Rural Development]
India

Grassroots Movement for Health and Development
Malawi

Grupo Esperanza y Vida
[in English: Hope and Life Group]
Uruguay

Grupo de Mujeres de Argentina
[in English: Women's Forum of Argentina]
Argentina

Health Equity and Law Clinic
Faculty of Law, University of Toronto
Canada

Health GAP (Global Access Project)
United States

Hepatitis, AIDS, Research Trust
United States

HIV&AIDS Legal Services Alliance
Los Angeles, CA, United States

Hong Guang Alliance
China

Human Rights Watch
United States

Intercambios Asociación Civil
Buenos Aires, Argentina

International AIDS Women's Caucus
Argentina

International Center for Advancement of Addiction Treatment
United States

Interagency Coalition on AIDS and Development
Canada

International Community of Women Living with HIV/AIDS
United Kingdom

International Council of AIDS Service Organizations
Canada

International Drug Policy Consortium
United Kingdom

International Harm Reduction Association
United Kingdom

International HIV/AIDS Alliance
United Kingdom

International HIV/AIDS Alliance in Ukraine
Ukraine

International Network of People Who Use Drugs

International Nursing Harm Reduction Network

International Transport Workers' Federation
United Kingdom

International Treatment Preparedness Coalition
Thailand(Secretariat)

International Women's Health Coalition
United States

INTILLA Asociación Civil
Argentina

Jamaica AIDS Support for Life
Jamaica

Japanese Network of People Living with HIV
Japan

Lawyers Collective
India

Lembaga Bantuan Hukum Masyarakat
[in English: Community Legal Aid Institute]
Indonesia

La Liga Colombiana de Lucha contra el Sida
[in English: Colombian Alliance to Fight AIDS]
Colombia

LIGA Bonaerense de Diversidad Sexual
[in English: Bonaerense Alliance for Sexual Diversity]
Argentina

Malaysian AIDS Council
Malaysia

Movimiento Latinoamericano y del Caribe de Mujeres Positivas
[in English: Latin America and Caribbean Movement of Positive Women]
Uruguay

National Council of Churches in India
India

National MSM and HIV Policy Advocacy & Human Rights Task Force
India

Naz Foundation
India

Networking Aids Community of South Africa
South Africa

Oasis de San Juan de Dios
Mexico

People's Health Movement USA
United States

Physicians for Human Rights
United States

Positive Malaysian Treatment Access & Advocacy Group
Malaysia

Positive Women Incorporated
New Zealand

Prevenir es Cuidar
[in English: To Prevent is To Cure]
Argentina

Protection Enfant SIDA
[in English: Protection of Children with AIDS]
Democratic Republic of Congo

PROYECTO SOL
Philadelphia, Pennsylvania, United States

Raks Thai Foundation
Thailand

Recovering Nepal
Nepal

Release
United Kingdom

Sampada Grameen Mahila Sanstha
India

Senderos Asociación Mutual
Colombia

Sex Workers Concern Group
Hong Kong

Sidaction
France

Society for Women Against AIDS in Africa
Senegal

Southern Africa HIV and AIDS Information Dissemination Service
South Africa

Thai AIDS Treatment Action Group
Thailand

Treatment Action Campaign
South Africa

Union Alernative Georgia
Tbilisi, Georgia

United Belize Advocacy Movement
Belize

Urban Health Research Initiative
Vancouver, British Columbia, Canada

Vikas Adhyayan Kendra's
[in English: Center for Development Studies]
Mumbai, India

WITNESS
United States

Women and Law in Southern Africa
Zambia

World Aids Campaign
South Africa

Yayasan Kesehatan Bali
[in English: The Bali Health Foundation]
Indonesia

Youth RISE International
Canada

Individuals:

Tomoko Ako
Associate Professor, Waseda University
Japan

Professor Brook K. Baker
Northeastern U. School of Law, Program on Human Rights and the Global Economy
United States

Chris Beyrer MD MPH
Director, Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health
United States

Dr. Graciela Biagini
University of Buenos Aires
Argentina

Alan Brotherton

R. Douglas Bruce MD MA MSc
Assistant Professor, Yale Center for Clinical Investigation Scholar, Yale University School of Medicine
United States

Wendy Chapkis
Professor, Sociology and Women & Gender Studies, University of Southern Maine
United States

Slyvia Chirawu
National Coordinator, WLSA Zimbabwe
Zimbabwe

Joanne Csete
Associate professor, Clinical Population and Family Health, Columbia Mailman School of Public Health
United States

Chris Curry MD PhD

Nancy M. Doctor
Attorney at Law
Berkeley, California, United States

Yu Fangqiang
China

Dhan Raj Ghimire
National Coordinator, Children at Risk Network
Nepal

Dr. Rajesh Gopal MD
Joint Director, Gujarat State AIDS Control  Society
India

Sofia Gruskin JD MIA
Director, Program on International Health and Human Rights, Harvard School of Public Health
United States

Mauro Guarinieri
Senior International Consultant, Global Network of People Living With HIV/AIDS

Christina T. Holder JD
Uriel and Caroline Bauer Human Rights Fellow, Cardozo School of Law
United States

T. Jayashree
Independent Film maker
Bangalore, India

Ralf Jürgens
Consultant HIV/AIDS, Health, Policy and Human Rights

Thomas Kerr PhD
Assistant Professor, Department of Medicine, University of British Columbia
Canada

Alana Klein
Faculty of Law, McGill University
Canada

A. Marston
United Kingdom

Laura McGrew
United States

Nicholas mbae Njeru
Kenya

Alice M. Miller JD

David B. Olson
Barrister and Solicitor
Toronto, Ontario, Canada

Dr. Nancy Ordover

Nicholas Bartlett
University of California, San Francisco
United States

Edith Pilkington
United States

Sophie Pinkham

Supattra Pisetpattanakul
Executive Officer, AIDS Society of Asia and the Pacific
Thailand

Oswaldo Rada
Colombia

Mindy Jane Roseman JD PhD
Lecturer on Law, Academic Director, Human Rights Program, Harvard Law School
United States

Mahesh Sharma
Executive Board Member, HIV/AIDS and STI Control Board
Kathmandu, Nepal

Daniel Tarantola MD
Professor of Health and Human Rights, School of Public Health and Community Medicine
Australia

Isaac Tita
Réseau Africain des Personnes Vivant avec le VIH/SIDA- Afrique Centrale
[In English: African Network of People Living with HIV/AIDS - Central Africa]
Cameroon

Carole S. Vance PhD MPH
Mailman School of Public Health, Columbia University
United States

Christine S. Waters
Staff Attorney, Legal Services of Central New York, Inc.
United States

Stan Wong
Singapore

Tian Xi 
China

 

cc:

Lok Chumteav Bun Rany Hun Sen
President, Cambodian Red Cross

Dr. Mean Chhi Vun,
Director, NCHADS, Cambodia

H.E. Teng Kunthy
Secretary General, Cambodia National Aids Authority

H.E. Kep Chuktema
Phnom Penh Municipal Governor

Douglas Broderick
UN Resident Coordinator, Cambodia

Tony Lisle
Country Coordinator, UNAIDS Cambodia

Michael O'Leary
Country Representative, World Health Organization Cambodia

Christophe Peschoux
Country Representative, Cambodia Office of the High Commissioner for Human Rights

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