Cambodia Increases Access to Care

JUNE 2004 — In Battambang, a province in northwest Cambodia severely affected by HIV/AIDS, a pioneering HIV "continuum of care" approach has demonstrated great success.

At Moung Russey Referral Hospital, HIV care and treatment activities have been integrated into existing health services. With USAID support, FHI has worked closely with the National Center for HIV/AIDS, Dermatology and STD to develop clinical trainings and to facilitate the introduction of the new services. Patients are now able to access HIV counseling and testing, diagnosis and treatment of opportunistic infections and tuberculosis, and services to prevent mother-to-child transmission of HIV. In June, the hospital began treating HIV-positive patients with antiretroviral therapy. A referral system has also been established between the hospital and care-givers in the community to enable patients to continue receiving care once they leave the hospital.

Within one year, Moung Russey has gone from a district where HIV-positive people had very little access to government health services to being the first comprehensive model of HIV care in the country. Other provinces now regard Moung Russey as a model program for establishing HIV care, support and treatment services along the continuum of care—from the hospital or health clinic to the patient's home.

Perhaps the greatest success is the increase in the capacity of the health staff to handle HIV/AIDS cases, thus reducing myths and misunderstandings about the disease. People living with HIV/AIDS (PLHA) now can attend the hospital without shame. They receive high quality care without suffering discrimination by hospital personnel.

Many HIV-positive people participate in various aspects of the program, including serving as drug adherence counselors and as peer educators at monthly gatherings of the Mondol Mith Chouy Mith (Friends Help Friends) support group. Major strides have been made in reducing the self-stigma that PLHAs feel as they cope with the disease. PLHAs clearly feel that the increased access to services has improved their health and allows them to be "just like everyone else."

As one HIV-positive woman puts it, "I don't worry about my disease. I am just trying to live my life. I don't want to dwell on my misfortune."