A Global Perspective

By Tinker Ready
The cambodia daily

The young Khmer woman—long black hair, heavy makeup, sad eyes—leaned against the railing outside a Tuol Kok brothel.

She opened her palm to show a tiny plastic bag with about five different pills. I had asked if she insisted her customers use condoms. Only if they want to, she said through a translator.
Instead, she took this vitamin tonic from the corner pharmacist to fend off the AIDS virus.

It was summer 1995, and The Cambodia Daily had just turned 2.
The offices were where they are now, on Street 240 behind that huge smoked-glass window. The small newsroom wasn’t much different either, crowded with messy desks, glowing computer screens and overworked staffers.

I spent a year covering the medical beat for The Daily, and that meant writing about drug-resistant tuberculosis, unregulated pharmaceuticals, dengue fever and diarrhea.

I had never even heard of dengue fever when I arrived from the US. The idea of babies dying from diarrheal disease was unthinkable.
Although capable of explaining the workings of a cell, the high cost of prescription drugs or the purpose of a carotid endarterectomy, I realized I had been totally clueless about the depth of the world’s health needs.

The only constant was AIDS, but the epidemic had not yet visibly taken hold.

The World Health Organization was about to increase its estimate of HIV infections from 30,000 to as high as 90,0000, but officially, the Ministry of Health reported less than 3,000 cases and only three deaths. There was no place to get tested and AZT, the only treatment at the time, was unattainable.

Back in Tuol Kok, women in bright dresses and dull expressions lined up outside the brothels each night like strings of colored lights. Business was booming and condoms were optional. Today, about 157,000 Cambodian are infected with the virus, according to UNAIDS. Thousands die every year and about one-third of Cambodia’s sex workers are HIV-positive. But there is progress to report as well. Infection rates are down and condom use is up.

Back in the US, everyone with AIDS gets treated, and there is little interest in stories about dengue fever. The news about pharmaceuticals is that they are overpriced, not unregulated.

But I’ve watched an epidemic emerge. I’ve seen people dying of treatable diseases like TB. I’ve met children who lost their sight for lack of a simple vitamin.

I may not write from that side of the health gap much these days, but now, I know. Cambodia took my blinders away.