Cambodia continues to deal with the long-term effects of years of conflict, wherein the country’s social support services and infrastructure were destroyed and its human resources severely depleted. Cambodia has seen unprecedented growth over the past five years, showing promise that the country is lifting itself out of its pos-conflict status to join the community of nations. Still, Cambodia remains one of the poorest countries in the world, which presents challenges to its citizens regarding national development efforts, human security, economic and human development, and national stability.

HIV/AIDS

Cambodia has the highest HIV/AIDS prevalence rate in Asia with 2.8% of the general population infected. In 2001 the estimated HIV+ population of Cambodia was more than 170,000. Over 80,000 women and men have died from AIDS since the beginning of the epidemic in 1980. The HIV+ infection rate is projected to increase to 258,000 by the year 2011 if the current rate of infection continues. The epidemic has spread beyond high-risk "core" groups, such as sex workers and intravenous drug users to the general population, with 4% of the total HIV infections occurring in newborns. Cambodia is projected to lose almost US$18 billion in unrealized earnings due to the loss in productivity arising from the epidemic.

Tuberculosis

According to the World Health Organization (WHO) Global Tuberculosis (TB) Report 2006, Cambodia has the 22nd highest TB burden worldwide. Approximately two-thirds of all Cambodia has the 22nd highest TB burden worldwide. Approximately two-thirds of all Cambodians carry the tuberculosis bacterium, and around 13,000 Cambodians die annually from the disease. There were more than 70,000 new TB cases in Cambodia in 2004, with an estimated incidence rate of 510 cases per 100,000 people. Over the last few years, data from TB services have shown a constant increase in the number of detected cases of active TB, from 19,007 in the year 2000 up to 31,105 in 2004. People Living with HIV?AIDS (PLHIV) are more susceptible to TB due to their depressed immune system. Therefore, there is an urgent need to link HIV/AIDS and TB education and awareness activities to best address a major health problem in Cambodia

Pact’s Approach

With support from “COPCL” and  in collaboration with local partners, Pact’s objectives through the TB-HIV Prevention and Treatment Program were to raise awareness of TB and HIV/AIDS prevention and treatment for at-risk groups and PLHIV in Phnom Penh and Sihanouk Ville; and map the poor and fishing communities along the Sihanouk Ville coastline for potential future Chevron program activities. 

Results

• Strengthened institutional capacity of non-governmental organization (NGO) partners, including Cambodia People Living with HIV/AIDS in Preah Sihanouk Province (SHV-CPN+) and Khmer Women’s Cooperation for Development (KWCD). Specifically, Pact Cambodia helped to increase their project management and organizational development capacity in sectors such as program planning, program management, administration, financial systems and procedures, and reporting.

• Developed TB-HIV communication and education material in Cambodia to target PLHIV and fishing communities. The first TB-HIV Prevention and Treatment Booklet was developed in collaboration with PLHIV, NGO partners, and the Ministry of Health (MoH), with special participation from the National Center for Tuberculosis and Leprosy Control (CENAT) and the National AIDS Authority (NAA). This booklet was designed for peer educators, health staff and others relevant stakeholders who work on the TB-HIV prevention and treatment in community. Five thousand copies in Khmer and 500 copies in English were printed with 5,164 booklets distributed to the target population both in Phnom Penh and Preah Sihanouk province.

• Two program launches were organized in Phnom Penh and Preah Sihanouk province to inform and disseminate information on Chevron’s project and its work in Cambodia to government agencies, NGOs, INGOs, embassies, donors, the private sector, UN agencies, media and other relevant stakeholders. Emphasis was placed on the TB-HIV Prevention and Treatment for At-Risk Groups/PLHIV Project. More than fifty participants attended each program launch.

• Mapping of impoverished fishing communities was conducted for fishing communities along the Preah Sihanouk province coastline to assess the situation on issues related to health, education, livelihoods and community’s perception of oil and gas exploration in Cambodia. This mapping also helped to identify the prioritized needs of the communities to inform future Chevron activities. This mapping activity used focus groups discussions to gather information from the communities. From the focus groups, the issues and priorities that emerged included dengue fever and malaria, sexually transmitted diseases, dermatology diseases, respiratory diseases, diabetes and heart diseases, poor sanitation and hygiene, lack of access to health services, lack of knowledge on family planning and birth spacing, and the great distance of health centers located from the communities.

• Monitoring and evaluation. With technical assistance and mentoring from Pact Cambodia, SHV-CPN+ and KWCD were able to accomplish all the activities outlined in the work-plan smoothly. Pact Cambodia, in collaboration with its NGO partners, organized a half-day end-of-project evaluation workshop for the review and evaluation of the achievements, strengths, weaknesses, obstacles/challenges, best practices and recommendations for this project. From the workshop, recommendations from the participants included: extending the project for three to five years to increase the sustainability of its achievements, providing vocational training especially on boat maintenance, as well as regular outreach education to communities on health messages including family planning, reproductive health, and hygiene and sanitation.