CAMBODIA: Drug rehab facilities under fire

Photo: Brendan Brady/IRIN

There are conflicting views on the number of injecting drug-users in the country

via CAAI News Media

PHNOM PENH, 29 January 2010 (IRIN) - A report by Human Rights Watch (HRW) released this week describes a climate of “sadistic violence” in government-run drug rehabilitation centres in Cambodia.

“The basic approach in these centres is the same and is flawed,” Joe Amon, HRW director of health and human rights in New York, told IRIN.

“It works on the wrong assumption that what helps people with drug dependency problems is being tough, using hard work and discipline. But there’s no quick fix.”

According to Graham Shaw, a World Health Organization (WHO) technical officer based in Cambodia for issues related to drug dependence, officials running the drug centres openly admitted to visiting WHO officials 18 months ago that they did not have the skills to conduct proper drug assistance.

“The reality is that in these centres there isn’t any treatment and there isn’t rehabilitation,” he said.

The WHO reported in a publication released last year that only one in 405 people in Cambodia entered a drug treatment centre voluntarily.

Critical report

Drug users, including those in their teens and those with mental illnesses, faced beatings and arduous forced labour, while being deprived of effective treatment for their addiction, according to the HRW report released on 25 January.

HRW says the government’s approach to rehabilitation focuses on having detainees “sweat” drugs out of their system through strenuous exercise and hard labour, and prolonged exposure to the sun – methods it calls “ethically unacceptable, scientifically and medically inappropriate and of miserable quality”.

It also says officials presiding over the facilities profited by using detainees as labourers and selling blood they forced detainees to donate.

HRW says more than 2,000 people were detained in 11 of these facilities throughout the country in 2008, the vast majority involuntarily.

“The real motivations for Cambodia’s drug detention centres appear to be a combination of social control, punishment for perceived moral failure of drug use, and profit,” says the report.

Photo: Vinh Dao/IRIN

Addicted to crystal methamphetamine, 24-year-old Thom has been living on the streets of Phnom Penn for four years

Government response

But Cambodia’s government officials flatly denied allegations of violence in its facilities, noting that most of the detainees were interned at the request of their families.

Neak Yuthea, director of the department of legislation, education and rehabilitation at Cambodia’s National Authority for Combating Drugs, said the report was completely inaccurate.

“No one was forced to go there, it’s all done voluntarily,” he told IRIN. “It’s not detention. There’s no violence, rape; nothing like that.”

Government facilities used widely accepted practices of detoxification, treatment and rehabilitation for Cambodians with drug addictions, he said.

“We keep them away from drugs and treat their symptoms while they detox,” he said. “After they detox, they do things like exercise and meditation to rehabilitate.”

The HRW report coincides with a recent outcry over the government’s use of a controversial detoxification medicine, called Bong Sen, from Vietnam, on a group of drug users last month.

The government says the 17 opiate users who were given the medication for 10 days did so voluntarily.

But those who were part of the trial at the privately run “My Chance” drug treatment centre told reporters they were plucked from the street by police and forced to take the drug without being informed of its composition or effects – an allegation about which the UN has expressed concern.

If the details of a drug’s composition and efficacy are not made publicly available, administering it is a “violation of basic human rights and even qualifies as torture”, UN special rapporteur on health, Anand Grover, told IRIN from India.

HIV risk

Meanwhile, there are also warnings of a new threat to HIV prevention, as UN and rights workers predict drug users will steer clear of clean needle distribution sites for fear police will target them there for detention or drug trials.

Almost a quarter of Cambodia’s estimated 2,500 injecting drug users are HIV-positive, according to the government’s latest data.

“Any action that makes it more difficult to access these populations could be detrimental to the HIV response,” said the WHO’s Shaw.

The UN estimates that about 75,000 people in Cambodia are living with HIV/AIDS.

“There’s no reason the number [of HIV infected drug users] couldn’t double or triple over a short period if users don’t maintain access to clean needles,” Shaw warned.