Bun Saroeurn survived two decades as a soldier in Cambodia's ruthless civil war. But his luck in the jungles won't save him from the country's latest enemy--HIV/AIDS. Like many other veterans of the war, he frequented brothels on the Thai border during lulls in the fighting. In the late 1980s he returned to his wife and had two daughters. Now 43 and half blind, Bun clings weakly to the dirty sheets of his bed in a Phnom Penh AIDS hospice, his 73-pound body a skeleton of his former self. Bun says he doesn't know whether his daughters are in school or even have HIV, and he doesn't have the strength to think about it anyway. "I just want to die because living longer just means more suffering," he says. "I can't think about my daughters right now."
Neither can tens of thousands of other Cambodian parents who are bedridden and waiting to die from the disease. Their indecision, as well as a lack of action on the part of Prime Minister Hun Sen's government, is setting the stage for yet another humanitarian tragedy in a country that has known little but sorrow for three decades. Perhaps it's understandable. After dark years that included Pol Pot's genocide, a 10-year occupation by the Vietnamese and a bloody coup d'etat in 1997, Cambodia's leaders have been eager to brush up the country's image and make some positive news. They've busied themselves with joining ASEAN, taking their seat at the United Nations and promising investors better GDP growth rates. But Cambodia's health-care crisis is becoming too crippling to ignore. More than half a million of Cambodia's 12.5 million citizens are expected to die from HIV/AIDS in the next 10 years--a higher infection rate than any nation in the region. Already, aid workers have begun talking about a "parentless generation" that will surpass 140,000 children by 2010. "We are concerned it could get out of control," says Susan Spencer, a UNDP officer in Phnom Penh.
Few people have any idea how Cambodian authorities will stem the tide. There are no estimates on how many of Cambodia's 142,000 future orphans will test positive for the disease--though around one third of infections in Cambodia are transmitted from mother to child, says Etienne Poirot, an HIV project officer for UNICEF. Even under those bleak circumstances, that would still leave nearly 100,000 healthy orphans in need of homes--a number social workers say would require one new orphanage to be built every day, an impossible task even in developed countries. "It's not sustainable," says Geeta Sethi, Cambodia country program adviser for the United Nations AIDS program. "You can't build one orphanage a day, let alone find qualified and caring staff."
In the past, war-torn countries such as Cambodia and Vietnam have alleviated their orphan crises by allowing Western couples to adopt, but the number of orphans quickly outpaced demand. And Cambodia's adoption industry has nearly ground to a halt following recent allegations that orphanages were buying infants from destitute families and pawning them off as orphans to Westerners for as much as $20,000 per child. The U.S. Embassy in Phnom Penh froze visas for newly adopted children last year, pending further investigation by the U.S. Immigration and Naturalization Service. But foreign adoptions still wouldn't help create homes for tens of thousands of HIV-positive orphans because "most Western couples only want cute, cuddly, healthy babies," says one Western aid worker.
While Phnom Penh looks on, aid organizations are now helping Cambodians to help themselves. These groups are pushing community-based solutions that give priority to surviving relatives to adopt. If none are financially able or willing, the children would then be jointly raised by members of the community where they're from, and in some cases by local Buddhist monks. But even these local solutions face obstacles, and none is more persistent than discrimination. Like other countries with little HIV/AIDS awareness, Cambodians ostracize people known to have contracted the virus. "They are seen as a disease in the community," says Mu Sochea, the minister of Women's Affairs. "There is very little chance for them to survive." And, until Phnom Penh gives the orphan crisis the attention it deserves, the country may not do much better than that either.