Living with hiv at Borei keila: a case study
Sophal, 34, takes a picture out of an album. “This is me and my second wife,” he says. “I was 27kg when I met her at the hospital. At that time I wanted to die.” After his marriage he stopped thinking so morbidly and now accepts that “death comes someday for everybody”. For four years, Sophal has swallowed his medicine regularly four times a day. “If I am not on time, I will be sick,” he says. He doesn’t want to live through the headaches, fever and stomach pains that he felt at the beginning of his antiretroviral treatment. It was impossible for him to work. Now, Sophal has to work because his wife is often sick. “She developed a resistance to the treatment. She got thinner everywhere, only her belly has swollen,” he said. His handicrafts with a local NGO Mith Samlanh allows him to earn around $20 a week when he feels healthy. It is just enough to enable him to keep living in the “green shelter” for HIV-positive families at Borei Keila while waiting to be relocated to Toul Sambo. The NGO Hope gives him 10kg rice per month but he wonders if NGOs will still support the families at Toul Sambo. Some have already said they will not.
The Phnom Penh Post
Written by Anne-Laure Porée
Thursday, 28 August 2008
HIV-positive families face isolation, lack of access to essential medical care, after being left out of re-housing scheme once vaunted as a model for urban development
TWENTY kilometres outside Phnom Penh, past the Prey Sar prison, lies Toul Sambo village. Its proximity to the city's main jail, a grim collective of buildings housing the Kingdom's undesirables, is apt: Toul Sambo is a prison too, but one where people will be confined not by chains, padlocks or iron bars but by Aids, poverty and the municipality of Phnom Penh.
"I would prefer to live on the pavement in Phnom Penh than to live here," said Phally, an HIV-positive resident of Borei Keila who is being relocated to Toul Sambo.
This is the tail-end of the Borei Keila relocation scheme, a scheme that was supposed to be a "model project", a way for the government to demonstrate that it is possible to develop an inner-city area while still respecting the housing needs of the urban poor.
Instead, the municipality appears to be constructing a modern day "leaper colony" - the isolated village of Toul Sambo has been purposely built to house the HIV-positive families who are going to be evicted from Borei Keila.
A progressive scheme
Under the initial 2004 Borei Keila agreement signed off by the government, homeowners who were living "permanently" on the central Phnom Penh site and renters who had been living in the settlement since 2000 were considered eligible for on-site resettlement in apartments in 10 buildings constructed by the private developer.
The land-sharing project was hailed as progressive because renters and owners were, for the first time, given the same rights. The first two buildings were opened in March 2007 in a highly publicised ribbon cutting ceremony.
But the Borei Keila land share quickly ran into trouble as rights groups accused city hall of reneging on its agreement to re-house all residents. Soon, Phnom Penh's so-called "progressive" urban development scheme became mired in corruption, stymied by red tape and then forgotten.
Only the poorest of the poor remain now, most others have been given flats or have given up. But those living with HIV - who are the poorest and most marginalised members of the community - have nowhere else to go.
During a ceremony Wednesday in Borei Keila, Minister of Tourism Thong Khon said the government plans to build the new ministry offices on the Borei Keila site. Thong Khon told the Post that they expect to finish constructing the new building within a year and the ministry will return its current property to the government.
" I WOULD PREFER TO LIVE on the pavement iN PHNOM PENH THAN TO LIVE IN TOUL SAMBO. "
The majority of families not yet relocated are the HIV-positive families living in the so-called green shelters. They are expected to be moved to Toul Sambo but have no idea of when this will happen as officials refuse to disclose details of any planned relocation.
Despite the fact a considerable number of the HIV-positive families have lived at Borei Keila since 2000 or before, in theory giving them the right to an apartment, they have not been included in the on-site redevelopment.
According to Mann Chhoeun, deputy governor of Phnom Penh, these HIV-positive families have no right to stay at Borei Keila.
Instead, the families are being relocated to Toul Sambo at the expense of the municipality, he said, explaining "the municipality bought the land and is financing the construction of their new houses. We have limited means. This is our capacity to help them".
"It is not discrimination to relocate them to Toul Sambo, it is an act of charity from the municipality," he said.
Another Andong
"It is offensive to say we are talking about ‘charity' when we speak about people who need access to their medication to survive," said Sharon Wilkinson, country director for CARE.
Many NGOs working on land and eviction issues in the Kingdom oppose what they say is the standard modus operandi of the Phnom Penh municipality: relocating the poorest of the poor to sites on the outskirts of Phnom Penh that lack even basic health and education services and have few, if any, employment opportunities for evictees.
In 2006, the municipality facilitated the relocation of a central Phnom Penh community to Andong. Thousands of Sambok Chab residents were dumped 22 kilometres from the city in a field lacking any basic amenities.
Two years on at the site, disease is rife, infant and maternal mortality rates have soared, and employment and education opportunities are scarce or nonexistent.
NGOs are warning that the municipality is making the same mistakes with Toul Sambo. Médecins sans Frontières wrote an assessment on the new site, decrying the fact that even "access to safe drinking water is not yet secured".
Thus the municipality's Toul Sambo proposal has alarmed many local and international NGOs and UN agencies - they worry that the assistance they provide to evictees is letting the government off the hook.
"Our medical team is happy to cooperate with the health authorities in providing continued support to evicted people at various relocation sites around Phnom Penh," said Manfred Hornung, monitoring consultant with the local rights group Licadho, which provides medical care at Andong.
"However, I believe that we all have a strong responsibility to ensure that the civic rights of the affected people are not being trampled upon, while we deliberately confine ourselves to assuming our roles as quiet service-providers," he said.
The Aids village
At Toul Sambo the plots of land allocated to the HIV-positive families are just 3.5 metres by 4.8 metres in size. Houses are made of metal sheets, and there is space for one bed, next to a small hole that serves as a toilet.
"The houses will topple over at the first storm," says HIV-positive Borei Keila resident Lakhena, who has come to see Toul Sambo for the third time.
There is no electricity, a single well is supposed to provide the new village's drinking water, the sewage system is not functioning, and the nearest adequate hospital is in Phnom Penh.
There are no employment opportunities for those evictees who are strong enough to work, nor cash compensation to tide the families over during the initial relocation period.
No provisions have been made to facilitate access to medical care, including to the lifesaving antiretroviral drugs.
Most of those to be relocated currently scrape out a living in Phnom Penh through finding work in the capital's informal economy as construction workers, trash pickers or motorcycle taxi drivers. When they move, they will be too far from the city to continue such employment.
A recent study from Catholic NGO Caritas on 13 families from Borei Keila estimated average monthly income at $97 per family and average expenditure at $94 per month.
These are the poorest of the poor, eking out a living on the fringes of the city, but now that the city has thrown them out, what can the future hold?
"People will call us the ‘Aids Village,'" said one HIV-positive Borei Keila resident who is slated for relocation to Toul Sambo.
"If we get sick, no one will bring us to Phnom Penh. We will die in Toul Sambo," the resident said.
The discrimination that HIV-positive people feel every day at Borei Keila will worsen, residents fear, when all those with the virus are forced out of their community and into an isolated village.
But they are scared to protest. "If we complain, we will get nothing," said Borei Keila resident Chea. Community representatives told all the HIV-positive families to sign documents accepting relocation in Toul Sambo, otherwise they will get nothing.
Making things worse
Kem Ley, executive director of HACC (HIV/Aids coordinating committee), a network of near 100 local and international NGOs working on Aids, said it usually takes up to five years to integrate HIV-positive people who are relocated.
"Generally it is very difficult for them to earn money and the children at school suffer high discrimination. That's why many of them return to the city," he said.
Once trumpeted as the prototype for a new wave of progressive urban development in Phnom Penh - the kind without squatters, evictions or protests - the Borei Keila social land concession project is now likely to deepen the poverty, stigmatisation and illness of the poorest and most vulnerable members of the community, observers warn.
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