The Birds, the Bees, and the Almighty Condom (7/5/2013)

Just as I start to really settle into Cambodian life, I realize I have just two weeks left! How did that happen? I don’t understand. The days are zipping by like buzzing motos while I ride by on my bike wondering “Why the rush?” (simultaneously navigating the oncoming cement truck). Between field visits with WOMEN, work with the orphanage, and outings with the peeps, I have become very attached to my busy schedule here in this country, which feels a little more like home now that I am less frequently lost. I love my kids in the orphanage, I love my host family, and I love the feeling of familiarity that is finally settling in.

On Wednesday Chris and I accompanied our WOMEN team out into the province of Prey Veng to observe HIV classes and survey work. Across the Mekong River, these remote villages are filled with people that have never encountered a foreigner before… ever. I laughed on the boat as they stared at me smiling, attempted to speak to me in Khmer, and pointed blatantly at my white skin and non-Cambodian nose (good thing I have reasonably sturdy self-esteem). Even the cows stared at me as we motoed by. This is slightly different than in Phnom Penh, where I merely feel like a duck amongst chickens. In Prey Veng, I was a unicorn or a chupacabra or some other mythical creature that we’ve all heard about but never seen. I mention this because my Caucasianess was perhaps both beneficial and distracting to the serious conversations my team conducted throughout the day. I certainly captured the curiosity of many passerby’s who the joined the audience as my partner, Kuntheay, spoke about HIV and prevention techniques. However, I could definitely tell when the conversation switched from the illness to the mysterious fact that foreigners like to tan (“You want to be black, yes?”).

Our first stop was with a group of about 25 children at a local school. Girls vastly outnumbered boys and ages ranged from about 5 or 6 to 16. I wondered how many of the younger children knew what sex was and how many of the older kids had heard of AIDS before. The kids remained focused and involved as Kuntheay explained how transmission does and does not occur and emphasized the importance of protection. It was difficult for me to understand a majority of the conversation (my team members did not speak much English and my Khmer remains severely limited), but I am grateful for organizations like WOMEN who continue to inform a young audience about sexual health even when premarital relations remain taboo.

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Sok Lee, me, and Kuntheay after our class!

After lunch we drove to deeper into the province to even smaller villages composed of handfuls of homes and shops. I followed Kuntheay and her partner as they seemed to approach any group with a substantial amount to people to ask if they could talk. We stopped first a roadside shop and were immediately surrounded by dozens of children and several mothers. The curiosity and concern in their expressions suggested that our audience knew little of AIDS, a fact later confirmed by Kuntheay. I imagined what it would feel like to learn, after giving birth to several children, that a very dangerous and prevalent illness, which I had never heard of before, can easily spread from mother to child during pregnancy.

Reactions were similar in the next two homes we stopped in. Because houses did not have walls, it was easy to approach these families who were warm and receptive. I quietly wondered why we weren’t focused more on a teenage audience, but Kuntheay later explained to me that the team aims to teach parents so they can protect and inform their children in the future. These families were familiar with other WOMEN volunteers and Kuntheay took the time to speak with each group about their personal situation, answering any and all questions. As conversation continued, the men in each home hovered in the periphery, sometimes tending to children and sometimes talking amongst themselves. Women were very clearly our core audience. As our NGO is named WOMEN, I suppose this should not have surprised me, though I cannot help but ponder the repercussions of awareness efforts focused primarily on one gender. Women, it seems (from my limited perspective), largely carry the burden of sustaining awareness and securing protective measures.

Kuntheay speaking to our first family in Prey Veng

Kuntheay speaking to our first family in Prey Veng

A new mother cradling her 1-month-old as Kuntheay speaks

A new mother cradling her 1-month-old as Kuntheay speaks

This little guy didn't have much to say, but was pretty cute!

This little guy didn’t have much to say, but was pretty cute!

All in all, I came to admire WOMEN’s efforts to approach HIV/AIDS prevention and awareness from a variety of different angels, while also recognizing (a few of) the limits of NGO work. There are only so many children and families that WOMEN staff can talk to in one day. At the school we visited, I am still unsure how other children who did not stop by our class will come to learn about HIV/AIDS. When I visited the larger orphanage yesterday, I asked my friend Pauli (about 15 years old) if she knew about the illness. She said no and asked me if it spreads when older men have sex with younger girls. She informed me that they have talked about sex in school to some degree, but was clear that she had not previously heard of this disease. WOMEN’s capacity remains further restrained by dwindling international funding, which decreased as HIV prevalence began to decline in Cambodia over the last few years (largely due to NGO activity). This means that the few HIV-based organizations left in the country have less money and fewer staff to reach out to vulnerable and diagnosed populations who, in turn, receive less attention and support.

There is still so much work to be done. WOMEN and other NGOs must continue to work closely with instructors and other key members of social institutions to promote awareness and protection. Even as recent medical advances strengthen our hope for a cure (see the story here if you missed it!: http://www.nbcnews.com/id/48338421/ns/health-mens_health/t/two-more-men-hiv-now-virus-free-cure/#.UdaYfvn29RU), awareness and discussion- generated from the collaboration of state and nongovernmental actors- remains central to ending the HIV epidemic.

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