When the Golden Years Include HIV
November 26, 2007, —By Caroline Brennan
One of the first things that stands out when you pull into Catholic Relief Services' Svay Rieng office in southeastern Cambodia is the 20-plus mopeds, or motos as they are called here, that line the driveway like disciplined soldiers. Usually, the motos are miles from here, taking CRS staff along narrow paths that crisscross green rice fields in areas bombed during the Vietnam War. But now a new danger has crept into the lives of families in Cambodia's interior.
The growing prevalence of HIV is the latest threat to invade these communities. Thousands of Cambodian families affected by HIV are so remote, no SUV can make a path to find them. As people give directions, they say, "Take the road that is off the main road until you reach the end. Then keep going."
And that is where we meet Lay Nourn and her family: a few hours outside Svay Rieng city, down a handful of dirt paths, her home a bamboo island set on stilts in a sea of rice paddies. Nourn stands outside to greet us, her family peering from the doorway. Theirs is a scenario now commonplace: grandparents taking adult children and grandchildren back into their homes after contraction of HIV.
Upon arrival, we immediately get a tour of the place. Their home is newly constructed, part of a CRS-supported shelter, livelihood and recovery program for families affected by HIV. It's a pleasant and modest one-room home for the family of five.
Just a few years back, Nourn had no intention of being anyone's beneficiary. Her life was self-sustaining — she farmed her rice paddies, her husband was a respected primary-school teacher, and their son had secured employment as a construction worker in Phnom Penh, Cambodia's capital city. Their home was a popular meeting spot, a constant buzz of people coming and going.
It's quiet now, and few people stop by on the afternoon of our visit. Last year, Nourn's 35-year-old son learned he was HIV-positive. His first wife had died of AIDS-related causes in late 2004, but he had not been tested. He continued working in the capital city, and eventually remarried in Phnom Penh. It was only when his second wife noticed he was looking weak and insisted on testing that they learned they were both HIV-positive.
"At first, when we heard, we were very sorry for our children. We contacted our son in Phnom Penh and said please come here to get early medical care," says Nourn.
A Difficult Reality
A good clinic is less than 15 miles away and — thanks to the added help of family support — living with his parents would be more affordable than life in Phnom Penh. The son and daughter-in-law moved back in. Both are now on treatment and getting monthly antiretroviral medication. He travels back and forth between home and Phnom Penh for his work. Thanks to counseling during the daughter-in-law's recent pregnancy, the couple's new daughter has tested negative for HIV.
It is still a difficult reality for the elder parents to absorb. When Nourn's 63-year-old husband retired from teaching, this was not how they had envisioned their golden years. Now money is stretched, as are their relationships in the community.
"We have become parents again, watching over our granddaughter during the day. The community also holds something against us, the parents, even though we don't have HIV," says Nourn.
Breaking into tears, she continues, "I remember when I hired someone to transplant rice … some people said that maybe I cut myself when I was cooking and put a drop of blood in the sauce. Some are worried that the leeches in the water may transfer blood from our family to theirs."
CRS first met Nourn through a community mobilization group supported by our HIV programming. CRS focuses AIDS work here on helping people earn a living, preventing the spread of HIV through education, and involving community members in caring for children orphaned and otherwise made vulnerable by AIDS. Given the isolation of many of these families, community participation is central.
Peer groups offer counseling and monthly meetings, where people learn about taking antiretroviral medications and maintaining good nutrition. Information sessions with youth and leaders help clarify misperceptions about the disease and decrease stigma. Shelter programs build or restore homes for families who have lost their jobs or have had to relocate. For these programs, CRS provides the cement and nails while the community provides bamboo, wood and other materials, and labor. Similar programs are taking place in rural villages across the Svay Rieng and Prey Veng provinces.
Futures in Question
Having taken part in the building of their new shelter and monthly peer counseling, Nourn's family is now having to consider how to afford medical care and transportation to and from the hospital, a $5 round-trip on a moto taxi every month. Cooking or opening a shop are out of the question due to people's fear of getting HIV.
"Animals might be better for us, perhaps raising goats," speculates Nourn.
In the afternoon, Nourn served us a lunch of chicken, vegetables and rice. It must have taken her hours to prepare, and the family was proud to provide such a spread. We ate healthy portions, grateful for their generosity.
Questions remain unanswered, and it is hard to imagine where the family will be a couple of years from now. Will they be standing with a healthy slew of kid goats outside their doorstep, or still figuring out ways to keep their family afloat? But, time for conversation is ended and talk turns to the drive back to the city, long past the rice paddies and their bamboo island set on stilts.
Caroline Brennan is South Asia regional information officer for Catholic Relief Services. She is based in New Delhi, India.