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CAMBODIA: Stalked by Hunger, HIV

Marwaan Macan-Markar

BANGKOK, Feb 6 2007 (IPS) - As the month began the fate of an already vulnerable community in Cambodia grew bleaker. An estimated 740,000 people faced with acute food shortages could see no relief in sight.

Signs of this looming crisis in one of South-east Asia’s poorest countries first emerged in October when funds from international donors began to dry up, says Thomas Keusters, country director for the World Food Programme’s (WFP) Cambodia office. ‘’We had to start reducing our assistance to schools from October, and now face suspension of key projects until the resourcing situation improves.”

But it is not only food for young children that the WFP catered to through its 1,800 food delivery points. In addition to the 650,000 children, this U.N. agency also distributed rations to 70,000 people affected with HIV and 18,000 tuberculosis (TB) patients in an initiative aimed at achieving greater reach in poverty-stricken rural communities.

‘’The largest component of the money is to feed school children, followed by the HIV/AIDS programme and support for TB,” Keusters told IPS from Phnom Penh. ‘’We have been forced to suspend these projects.”

The WFP had been hoping to receive the funds by end January for its Cambodia programme – about 10 million US dollars for its food aid package of 18,000 metric tons till the middle of this year. The traditional donors had been Australia and Japan.

Non-governmental organisations (NGOs) working with the WFP to reach Cambodians living with HIV are worried at the equally troubling consequences that this loss of food through the U.N. agencies could trigger. After all, this country is ranked among the top three in South-east Asia for having the highest incidence of HIV/AIDS, 1.6 percent adult prevalence rate a year.

The combining of food aid delivery to reach poor Cambodians living with HIV and infected with TB had served as an incentive, they say, since it ensured that people who needed medication maintained a link with the food distribution points.

‘’The sick need food first before taking medicines. You cannot take medication on an empty stomach. You must maintain a balance,” Haidy Ear-Dupuy, advocacy manager at the Phnom Penh office of World Vision, a Christian relief agency, said in an interview. ‘’The people with HIV and TB will be hit hardest with these cuts.”

World Vision, which works in five rural provinces, had ensured that each head of a family with HIV was guaranteed a regular supply of food assistance, which included a monthly ration of 15 kg rice, cooking oil, sugar and salt. ‘’We also helped them get their medication and offered counselling,” said Ear-Dupuy.

‘’Food and nutrition are an essential part of the package of care for people receiving treatment for HIV and TB,” Peter Piot, head of the Joint United Nations Programme on HIV/AIDS (UNAIDS), was quoted as having said in a recent WFP statement. ‘’Ration cuts jeopardise the effectiveness of these critical interventions.”

The predicament faced by Cambodia’s poor brings into sharp relief questions about the uneven distribution of economic growth in a country that is struggling to recover after over two decades of a brutal civil war and the destruction caused during the U.S. war in Vietnam. Peace was restored in the early 1990s, but it took many more years for the entire country to benefit from an end to violence.

Late last year, for instance, the Cambodian government of Prime Minister Hun Sen announced plans to spend 20 million dollars to better the infrastructure in Siem Reap to boost tourism earnings. The town in western Cambodia has been marked by growth, including an increase in the number of hotels, due to its proximity to the world famous temples of Angkor.

Cambodian officials expect tourism to generate 360,000 jobs and 2.3 billion dollars in revenue by 2010, the ‘Phnom Penh Post’ newspaper reported in December in a story about the country’s aim to attract four million tourists each year by 2015.

But beyond Siem Reap, Sihanoukville and Phnom Penh, the main tourism centres and ones that suggest the country is recovering at a steady pace, are vast areas in the provinces teeming with poverty. ‘’The benefits of growth have not been transferred to the rural areas,” says WFP’s Keusters. ‘’Cambodia has a very high level of poverty and very high level of food insecurity.”

The International Food Policy Research Institute (IFPRI) reminded the Hun Sen government about how dire the situation was in 2006, when the U.S.-based think tank placed Cambodia among one of the world’s 12 ‘’hunger hot spots” in its Global Hunger Index. The other countries that were ranked with it for having high nutrition deficiency were all in Sub-Saharan Africa.

IFPRI had used three indicators to make its case: child malnutrition, child mortality and ‘’estimates of people who are calorie deficient.” It also added at the time that the worst affected countries shared a common history: they had been ‘’affected by civil wars or violent conflicts.”

Nearly 35 percent of Cambodia’s 11.5 million people live below the poverty line, and the United Nations Development Programme has placed it 129th out of 177 countries in its annual ‘Human Development Report.’ The life expectancy rate in the country is 56 years, the report notes, making it one of the lowest in this region.