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Clockwise from above:Drug litter in the

shanty town; theoutreach team; neck

injecting with theneedle exchange in

the background;gouched out; and at

the railwaycommunity.

Holiday in Cambodia

London drug worker Lee Sugden reveals how hisUnforgettable trip to the drug-littered streets of PhnomPenh took him to the front line of harm reduction.

My five-month odyssey had taken me to Singapore , Malaysia , Australia and Thailand , but the final month proved to be an action packed highlight of the whole trip as I found myself in the beautifully chaotic Kingdom of Cambodia .

Shortly after arriving in the capital city, PhnomPenh, I was put in contact with a harm reductionteam called ‘Korsang' which was founded as a Non Government Organization (NGO) in 2004 by an American drug worker called Holly Bradford. Holly began by implementing a HIV prevention program principally by distributing clean needles to drug users on the streets of Phnom Penh . Since being founded, Korsang has rapidly expanded and is now Cambodia 's leading drug project.

The modern history of Cambodia is by any standards bloody and has endured the tyrannical leadership of Pol Pot and his Khmer Rouge regime along with civil war and periods of severe famine. More than a million people were slaughtered by the Khmer Rouge and in order to escape this madness huge swathes of the population fled the country and were forced to live as refugees, many of whom arrived in America .

In the aftermath of 9/11, George Bush changed the law in America so that refugees could be deported from the country if they committed felony offences. To date, 170 young American-Cambodian men, or returnees as they are known, have been deported back to Cambodia , a country most of them knew by name only.

Many of the returnees were born in the refugee camps on the Thai/Cambodia border and were accepted into the States as young children, so many of them speak in broad American accents and have little if any knowledge of Khmer (Cambodian) language and culture. Utterly unprepared, these returnees suddenly find themselves homeless on the streets of Phnom Penh, a third world city with no social assistance or welfare.

The city is awash with high purity white Burmese heroin and yamma (methamphetamine) and some people turn to drugs and alcohol as a way of escaping the hideous reality of their plight, seemingly powerless to escape the poverty trap. There are success stories though, and a number of the former users who are now employed by Korsang are living proof of this.

When founding Korsang, Holly had the foresight to employ some of these returnees and now they are an essential part of the organization's workforce. They are contributing to their Khmer community, while being empowered by career prospects they would otherwise be unlikely to have had.

Korsang is currently based in a sturdy three-story building in a downtown part of Phnom Penh , with a team of about 60 people. They provide food twice a day, a drop-in facility five days a week, harm reduction programs, needle exchange, first aid, medical assistance and outreach work. Their full-time doctor has delivered babies, removed broken needles from limbs, stitched up serious wounds and treated clients who have been brought to the centre after overdosing, sometimes fatally. In these cases and in the absence of any family, Korsang takes care of the funeral arrangements.

I was fortunate enough to go out with the outreach team one afternoon and my eyes were truly opened to the harsh realities of frontline harm reduction work. The team of five, led by a returnee called Shy, climbed into the tuk-tuk and headed out to one of the neighboring districts which is renowned for its drug use. Slightly apprehensive, but excited all the same, I hopped on and shadowed them. After a few minutes of driving through the dusty streets of Phnom Penh we stopped at a derelict house, which has been turned into a squat where users stay and inject themselves with heroin.

As my eyes adjusted to the darkness in the building, I began to comprehend the conditions that these people are dwelling in. Slowly, bodies began to rise from the mounds of rubbish covering the floor and I realized that there were in fact several people in a room that I at first thought was empty.

Taking great care we collected used needles from the floor and placed them in the collection bucket. This building is visited almost daily by the outreach team and sometimes hundreds of needles at a time are collected from there alone. The drug workers then chatted to the users for a while and handed out packets of clean needles, giving encouragement to attend the project along the way. The people we spoke to were wearing tattered rags and had not bathed for weeks judging by the dirt-encrusted nature of their skin. Few had any teeth and almost all had open wounds and infected tracking marks clearly visible.

We then drove a few blocks to another notorious road and just the feel of the place made the hair on my neck stand up. It oozed menace and shady looking characters, who I would guess were dealers, eyed us up from their motorbikes. I was assured that the dealers and Korsang agreed to leave each other alone and that we would not encounter any problems, but the sight of men openly brandishing knives did nothing to calm my nerves.

The dusty dirt track of a street was buzzing with people, and among the obvious drug-related activity ordinary people were going about their business. I was shocked to see unconscious users lining the roadside and passers-by were forced to step over them as they lay there in their heroin-induced slumber. We checked them to see that they were still alive, before moving over to two young lads that were midway through injecting each other in the neck.

As the heroin in Phnom Penh is said to be very pure, it is standard practice to simply dissolve the powder straight into a syringe full of blood drawn from a vein before re-injecting the blood back into the body, and that is exactly what these men were doing there openly in the street. Next to this spectacle, another user was gouched out in the gutter with his trousers still pulled down from where he had just injected into his groin. A hideous abscess was visible at the injection site and I couldn't help wondering what he would lose first, his leg or his life.

Cambodia has clearly got a huge problem with HIV and hepatitis C, but people in the drug using community rarely die from either of these conditions. Why?,' you may ask. Because they do not live long enough for the viruses to kill them. Usually they fall prey to the multitude of other infections that thrive in the festering conditions they are forced to endure conditions that I cannot adequately describe in words and far worse than anything I have ever seen before. Conditions that, as a drug worker, either break you or make you even more committed todelivering quality harm reduction.

We ended the day by visiting a shantytown that has grown along the tracks of a disused railway line on the banks of a large lake. Groups of friends and family gathered outside makeshift cafés and houses and people seemed genuinely pleased to see us. Grubby little children played and chased each other and old ladies gave us toothless smiles. Here we gave out condoms and kit bags containing soap, toothpaste, toothbrushes and written advice about basic healthcare.

In neighborhoods such as this one, the team tries to engage with local youngsters to educate them about the risks attached to drug taking, as these slums are fertile breeding ground for future drug users. After my earlier experience, this work felt easy and relaxed and it was wonderful to see ordinary Khmer people smiling and enjoying life!

The drive back through the humming streets of Phnom Penh was fun and as we weaved in and out of traffic, elephants and people alike I felt plugged into the high energy of this frenetic city. By the time we had returned to the project building I was exhausted and my head was spinning with graphic images that had been burnt onto my memory. I believe that these images will always remain with me.

Lee Sugden was a drug worker for Westminster Drug Project (WDP) at the Walthamstow OpenAccess, before taking a few months out to travel around Australia and SE Asia .

LIFESTYLE RISKS OF DRUG USERS IN PHNOM PENH , CAMBODIA.

Holly Bradford

BACKGROUND

Korsang began in 2004 with a staff of 5. The main goal of Korsang is to offer Harm Reduction services and HIV prevention to drug users in Phnom Penh . Today Korsang has 68 staff and is growing. Korsang offers services to over 3,500 drug users Throughout Phnom Penh .

SERVICES

Low threshold, drug user friendly drop-in center Outreach services to 20 locations HIV prevention education Needle exchange Full medical infirmary on site 24 hour emergency medical services HIV testing and case management Healthy Meals 2x daily Classes in Khmer, English, health, music, art and dance COMING SOON! Methadone Services, Woman's Center and Adventure based therapy!

Results of risk assessment

91.6 % of our participants are male and the majority of them are Cambodian (80.1%), but a significant number of Vietnamese drug users are also seen at Korsang (18.9%).Average age at 1st drug use is 19 years. 44.5% have ever injected. Of these 18.6% had shared a needle / syringe that day and a further 18.6% had shared in the last week.

The lifestyle risks of drugusers in Cambodia need immediate attention. Untilhuman rights are respected and ethical services created for them, they will continue to die needlessly, and unfortunately Korsang will continue to cremate their bodies.

Korsang MOVING OVERSEAS TO Cambodia and starting a drug users' clean-needle program seems daunting enough, but Lesley alumna Holly Bradford stepped up that challenge when she decided to train deported American-Cambodians to staff the drop-in center. It was a stroke of genius. Now in its third year, the program has a staff of 60 and it's still growing. In the next few months they will begin expanding their prevention services into treatment, open the country's very first Methadone pilot program, and add a medical center for drug users on site. Now, in Holly's own words, here is the story of Korsang.

“Korsang has a staff of more than 25 American-Cambodians who have been deported from the U.S. to Cambodia for committing felony crimes, mostly gang related offenses. Together we run a non-governmental organization ( NGO ), an HIV prevention program working with Khmer injecting drug users in Phnom Penh .

“The majority of Korsang staff were born in Thai refugee camps following the Khmer Rouge/Pol Pot killing fields. As very young children they were then accepted into the U.S. as political refugees with permanent status as Americans. But due to the traumas their parents lived through, they never finished their naturalization process, leaving them vulnerable to a post 9-11 deportation policy. Deportations of American-Cambodians began in 2002. Over 170 young men have been deported so far, and up to 3,500 more are coming.

“Originally I came to Cambodia in 2003 to volunteer for a sixweek crisis intervention with the guys who had been deported. Upon arrival it was clear to me that more than counseling, they needed training and jobs. I had experience working with heroin addicts (and being one myself ) in Boston , so I introduced them to concepts involving HIV prevention and harm reduction. They loved it, so I wrote a small grant and five months later I was funded to begin a small harm reduction, HIV prevention program, and to hire and train five of the deportees as staff.

“We started out very small, opening a shack in a squatter's area as a drop-in center and walking around the city trying to locate and educate injection drug users about HIV / AIDS . Our location was pretty horrific: We had a squat toilet, two lights, no computer, some plastic chairs and a metal table. During the hot season it was 120 humid, tropical degrees under the tin roof, and every morning the staff had to sweep the rat droppings off our concrete floor. But we hung in there. Korsang has become Cambodia 's premier harm reduction, drug user HIV prevention program and now receives funding from USAID , Global Fund, UNAIDS , WHO , UNICEF and AFAO .”

“This staff has worked so hard, not only to overcome their past gang and prison socialization but to offer loving, respectful, compassionate and nonjudgmental service to the drug users of Phnom Penh . If you could see one of these former ex-con gang members, all tattooed up, cleaning an infected wound on the dirty foot of a heroin user or holding the hand of a dying AIDS patient, or carrying the deceased body of a drug user to the Temple to be cremated, it would bring tears to your eyes. They have come so far from when I first arrived, they have moved from depression and drinking too much, to delivering the utmost of quality treatment and services to people who no one cares about in this resourced strained corner of the world. I'm honored to work beside them.

” Holly credits Lesley faculty members Pam Mullins and Eleanor Roffman, saying,“These women have taught me how to give back what I've taken, and how to take care of myself in the process.”

“When you hear all that Lesley touchy-feely stuff about self as instrument and healing through relationship,” says Holly, “listen closely because it's for real. It works. I see it every day, all day long.”

The approach, the staff “Harm reduction is an approach to addiction that doesn't strive for abstinence,” says Lesley Professor of Counseling Psychology Eleanor Roffman, “but instead aims to reduce harm — clean needles and addicts not harming themselves and their families.”

Last fall, Prof. Roffman visited Holly, her former student, and spent a few days counseling Korsang staff members, who were experiencing organizational and systemic difficulties that had affected them on a personal level. “The men are ages 23 to 36, have a range of experience with formal education, and are from all over the U.S. ,” she says.

Prof. Roffman's expertise in trauma counseling proved helpful and she decided on the first day that they should get to know one another's stories. “We sat together in one room and discussed as a group how each got there and why. Some arrived in shackles from the airport, some had been college students, some had to leave behind children, several had their own drug addictions, and all had families — who can't move to Cambodia because they left and went to the U.S. as political refugees. With their forced resettlement in Cambodia , all have had to build new lives for themselves.”

The men were receptive to the expressive arts and drama therapy Roffman used and she plans to return in January '08 to work further with the staff.

These are all trauma survivors working with trauma victims,” says Roffman. “But the guys just love Holly. Her way of communicating is realistic, and very affirming of who they are. It's a very positive frame.”

Limited treatment options for drug addicts
[Ley Van Hope recovers in Calmette Hospital, thanks to Korsang. ]

By Cat Barton

For ten days Ley Van Hope could only watch as the excruciating abscess on his hip swelled to the size of a tennis ball. As a long-term heroin addict, seeking medical attention was not an automatic response.

"I didn't want to go and get help. I didn't think about treatment. I just wanted to die," he said. "But my friends knew about an NGO and they persuaded me to go there for medical treatment and help to stop using drugs."

But Hope's delay in seeking treatment allowed his injection-related abscess to worsen. His femoral artery burst causing him to lose several pints of blood and he was rushed to Calmette for surgery. Thanks to local NGO Korsang - which in Khmer means "to rebuild" or "to fix" - and Professor Heng Taykry, the hospital's executive director, Hope is recovering well. But many of Cambodia's drug abusers are not so lucky.

According to an unpublished draft of Cambodia's National Treatment Policy (NTP), prepared by the National Authority for Combating Drugs (NACD), drug use has accelerated dramatically in Cambodia over the last ten years.

"Since the mid-1990s Cambodia has experienced a rapid increase in the population at risk for use of illicit drugs such as methamphetamine, heroin, opium, ecstasy and other synthetic drugs and cannabis," the NTP reads. "The number of those estimated at risk of illicit drug use has risen from virtually zero in the early 1990s to an estimated level at present of up to 600,000 people or 4-to-5 percent of the population, with many belonging to the 12-to-15 age group."

From local health workers to the upper echelons of the government, the upsurge of drug addiction and drug-related health problems has become a cause for concern. Officials say the government is well aware of both the risks posed by increasing drug use and of its own responsibility to help. In 2003, Hun Sen expressed the government's commitment at the first national workshop on the problems of drugs in Cambodia.

"Drug-using people are suffering from a disease that they have no idea how to heal," Hun Sen said. "In accordance with the drug control law of Cambodia, drug addicted people must have regular consultation, treatment and rehabilitation rather than being taken to court," Hun Sen said.

Despite such rhetorical commitments, actual treatment options for Cambodia's drug addicts remain scarce, and they are subject to widespread and deeply rooted social discrimination.

"Drug users are the most marginalized, oppressed, and discriminated group in society," said Holly Bradford, founder of Korsang. "They have nowhere to go. They are on the street and they are dying on the streets. They receive 100 percent pure abuse - addicts are at the bottom of the pecking order."

Bradford said that the mentality engendered by addiction discourages drug users, such as Hope, from asking for medical help.

"Addicts will wait until the last possible minute before seeking treatment," she said. "They don't believe they deserve treatment. Healthcare is not even in their realm of possibility."

The government's acknowledgment that drug users have a right to treatment is laudable said Graham Shaw, WHO technical adviser, but a lack of resources hampers their ability to provide such services.

"There is a pile of political will in Cambodia to develop good treatment," he said. "The government is aware of the problem and would like to do something. They are learning from HIV; they have seen that in other countries ignoring the spread of intravenous drug use can undo all the good achievements of HIV reduction work in the sex industry."

But while some target groups - street children, IV drug users - are able to access treatment through NGOs such as Korsang and Friends/Mith Samlanh, for drug users who do not fit the NGOs' criteria, there are few options.

Consequently, the concerned relatives of Cambodia's drug addicts are turning to any available treatment regimes. One example is the "bootcamp" at Sisophon where patients are subjected to military-style physical training regimes that one expert referred to as "monkey-bar rehab."

Such hard line approaches, however, have been proven in Thailand and Vietnam to have relapse rates of 100 percent, and infringe on the human rights of patients, said Martin Lutterjohann, German Integrated Expert at the NACD.

"At the military 'bootcamps' the agreement is signed with the parents, not the addicts," he said. "It is all voluntary, they have not been sent there by court order," he said. "Technically, if someone then decided to leave, it would be a violation of their human rights to force them to stay. However, [staff] go out, chase the patient and get them back - then all the other residents of the center give them a beating. And they explain this practice - they don't think anything of it."

Although they lack both resources and training, police and the military are the first option for the parents of young drug users, Shaw said.

"The police are the automatic default for concerned parents and guardians," he said. "The police are inundated with parents bringing in young children with drug abuse problems as they have nowhere else to go, there are no other options. The police can't cope with the volume of addicts they are receiving."

A recently released WHO report states that "there is currently no legal definition as to what constitutes 'authorization' for persons to provide drug treatment and/or rehabilitation in Cambodia."

WHO officials said this has caused some conflict regarding what can be described as "treatment."

"The Ministry of Social Affairs believes that what the military is doing is illegal," Shaw said. "They have said they cannot refer to the bootcamps as 'rehabilitation.'"

But the popularity of such approaches in Cambodia is in line with regional perceptions about what constitutes appropriate treatment, according to Lutterjohann.

"The Cambodian people do not have a sensitivity to human rights violations - they think that it is good the military police instil discipline into these addicts," he said. "This is a manifestation of the same attitude I have seen in Thailand and Malaysia. People like the 'bootcamp' mode of treatment. In Hanoi they built a centre which isolates people from their networks and routine. They are physically kept in the treatment centre for two years. This is too long. And there is no re-entry - no gradual reintegration."

The pervasive belief in harsh institutional regimes as a cure for serious drug addiction is misplaced, said Shaw, who cited Thailand and Vietnam's recent about-face in approach to drug treatment as apt examples.

"Internationally it has been shown that [bootcamp-style treatment] does not work; the relapse rate from such centres is 100 percent," he said. "This approach has not been successful in Vietnam and is in fact now being reconsidered. There is a shift in Vietnam from an institutional approach to a community-based approach. Now the Vietnamese are interested in aftercare and reintegration. They have seen that the relapse rate improves if you can get former residents to attend follow-up classes."

Although elements of Thailand's drug policies have provoked much international concern, Lutterjohann argues that Cambodia could learn from its successes.

"Cambodia can learn lessons from the Thai war on drugs," he said. "Although there were some very bad things - such as the extrajudicial killing of over two thousand people - there were some very good things. The drugs wars mobilized local communities and called on schools and pagodas to do something, to contribute, to help."

Yet in Cambodia, local communities continue to exclude drug addicts. Pak Nyne, a Korsang employee, explains that for the IV users they work with, the NGO's drop-in center is the only place they have.

"When this place [Korsang's drop in centre] closes these people are sleeping on the streets. They just have nowhere to go, they don't know who to reach out to," Nyne said.

The lack of facilities, either community-based or institutional, is compounded by the fact that currently, internationally recognized treatments for some addictions - such as methadone, used for stabilising heroin addicts - are not available in Cambodia.

Instead, the harsh exercise regimes or total isolation - from drugs, social networks, the outside world - provided by bootcamp treatment, are considered sufficient, Shaw said.

"The bootcamps do not offer detox services, they offer cold turkey," he said. "This can be medically dangerous depending on the drugs used and the state of the addiction, but it is certainly uncomfortable. An exercise regime will help but there are more humane ways of treating people."

The introduction of methadone into Cambodia would, Bradford argues, provide both a humane way of chemically detoxing drug users, and help reduce drug-related crime.

"When you are maintaining someone with methadone they don't have to go hustle or steal to support their habit," she said. "If we bring methadone into this country you will see a significant decrease in injection-related crime."

But treating the chemical side of drug addiction is only one part of solving the problem, Bradford said.

"None of them [Cambodian drug addicts] have had any chance to get clean; of course they want to get clean, it is all they want," she said. "But they don't realize that when they are clean all the problems which drove them to take drugs in the first place - poverty, family problems, abuse, peer pressure - will all still be there."

Unless the life circumstances of the user are radically transformed, relapse is the rule rather than the exception Shaw said.

"There is a 95 percent relapse rate globally following treatment," he said. "This is largely because people return to drug-using environments."

Hope's personal story confirms the difficulty of preventing relapses.

"I have stopped taking drugs a few times, but I have always started again," he said. "When I don't take drugs I feel I have no power, no control over my life."

While he is fortunate in having now found employment at Korsang - where he will become a peer educator and be trained to provide the NGO's risk reduction services - for the majority, the possibility of a drug-free existence seems impossible unless alternative opportunities are available following treatment.

"If you can fill the void the drug leaves then you will have some measure of success," Bradford said. "If you can't fill that void then you won't."

Phnom Penh Post, Issue 15 / 06, March 24 - April 6, 2006
© Michael Hayes, 2006. All rights revert to authors and artists on publication.
For permission to publish any part of this publication, contact Michael Hayes, Editor-in-Chief
http://www.PhnomPenhPost.com - Any comments on the website to Webmaster

Deportees fighting addiction where few dare tread

By Leonie Sherman

The roar of dirt bike engines and a cloud of dust announces the arrival of the Cambodian Harm Reduction Collaborative (CHRC) team at their drop-in center.

Covered with tattoos, they may look like a Khmer version of the "Wild Ones," but in fact they are the well-trained frontline of an innovative outreach program for drug users, sex workers and the urban poor.

Despite the high level of HIV infections in Cambodia and generous NGO attention to AIDS education and the care of HIV-positive patients, until this year nobody was hitting the streets and working directly with adult intravenous drug users to reduce their risk of infection.

In January, a determined group of six people, under the guidance of a street-hardened clinical psychologist, began a community outreach program and opened a drop-in center in the dilapidated block of flats known as "The Building." In two daily shifts, they visit key sites within Phnom Penh, talking to people about HIV prevention, vein care, overdose treatment, and providing condoms.

"A lot of NGOs are scared to get in contact with drug users, and they don't like to go to the places we go," said Chan Chrisna Buth, who goes by the name "Dreamer" and volunteers with CHRC. "They're afraid the drug users are gonna stab them with a dirty needle or something."

"But we come with our heart," said Vong Sarath, an outreach staff member who everyone calls "Bony." "We've never had any trouble."

The NGO Friends/Mith Samlanh is the only other group working with drug users in Cambodia, but their focus is on street children. CHRC works with drug users regardless of age, occupation, HIV status or social background. As a result, people are coming in from the provinces just to access CHRC services.

Project director and clinical psychologist Holly Bradford brought almost 20 years of experience working with IV drug users - much of it "sidewalk psychotherapy" with gang members - with her when she came to Cambodia in September of 2004.

"I've dedicated my whole life to working with IV drug users. A lot of people don't like 'em, but I think they're great. They're intuitive, they're creative, they're smart," said Bradford, who calls herself an "ex-dope fiend with a Master's degree."

Seeing that such a high-risk community was not being adequately assisted, she began organizing the only harm-reduction program in Cambodia.

Harm reduction, sometimes known as risk reduction, is an addiction-care philosophy currently used in the Netherlands, Britain and Canada, and rapidly catching on in other countries around the world. The philosophy is based on working with users in a compassionate, respectful and non-judgmental way, thereby building solid relationships that can become the basis of further treatment.

Harm reduction works to minimize the negative effects of risky behaviors, rather than eliminate them, and recognizes the impacts of issues like poverty, racism, social isolation and past trauma on people.

For example, rather than try to persuade users to stop injecting heroin, harm reduction workers might help a person reduce their intake gradually, teach them about safe injecting techniques and suggest services that might stabilize their lives.

To date, CHRC has opened a drop-in center, educated 3,500 people about HIV and drug risks, handed out more than 33,000 condoms, and distributed almost 7,000 educational fliers.

The outreach team has undergone a three-month training course in case management, as well as basic first aid and HIV instruction.

With a total budget of less than $4,000 per month, it's a high-impact, value-for-money initiative.

The two major umbrella organizations for HIV services in Cambodia - the International HIV/AIDS Alliance and the Khmer HIV/AIDS NGO Alliance (KHANA) - agree that there is a need for direct services to drug users.

"The Alliance and KHANA have recognized in the past year that we need to work with drug users," said Joanna Dorricott, technical support officer for the Alliance. "This is an area that has been under-prioritized."

"In general, in Cambodia, very few people are doing this work," said Oum Sopheap, executive director of KHANA.

Both the International HIV/AIDS Alliance and KHANA said they have been impressed with CHRC's outreach activities and have committed to working with the group in the future.

Currently, CHRC has 11 paid staff and five volunteers. They started with a small grant from USAID, administered through the Returnee Assistance Program, and are now seeking support from KHANA, the International HIV/Aids Alliance and AusAID, and hope to continue receiving support from USAID.

"USAID is committed to supporting risk-reduction activities in Cambodia and would like to increase its support of HIV prevention and AIDS care as it relates to substance abuse," said US embassy spokesperson David Gainer.

At the moment, CHRC resources are stretched to the limits, but with more money the program could expand to better service its client group.

"We need more supplies and an office," Bradford said. "We'd like to be able to do oral HIV testing, which I don't think is offered anywhere in Cambodia, and get set up to do a needle exchange."

Currently the only HIV testing available in the country requires people to schedule an appointment, make their way to the testing site, and then return at a later date for their results. While CHRC provides assistance and support for every step of this blood-based testing, they report low rates of testing. Often those at the highest-risk of contracting the virus also find it difficult to fit the logistics of a test into their chaotic lives.

Oral testing would allow CHRC to take swabs on-site, conduct pre- and post-test counseling, and bring the results to the homes of clients.

A crucial part of the program's early success, and a key to the future, has been the outreach staff. Most of them have been convicted of a felony in their adopted homeland of the United States and deported back to Cambodia. Many of them have a history of drug use and abuse and have served prison time.

Though former drug addicts might seem a strange choice to counsel drug users, Graham Shaw of the United Nations Office on Drugs and Crime (UNODC) insists this is a unique strength of the program.

"It's the perspective of UNODC that these people are a tremendous resource for prevention and awareness services," Shaw said. "It's internationally recognized that the best people to do drug-use prevention and awareness are those who have been addicts themselves."

The guys agree.

"We use our own experience to reach these people," said Bony.

While these former bad-boys wear clean white t-shirts with the CHRC logo for the outreach sessions, their tattoos and body piercings seem to help break down a few social barriers.

"When people see us ride up with all our tattoos and stuff, it's easy for them to interact with us, they trust us more than they would a professional in a suit and tie," said Om Roeun, a volunteer who everyone knows as "Lucky."

"They look at us like we're doin' a job," said Dreamer. "But we're rebels, too."

Phnom Penh Post, Issue 14/16, August 12 - 25, 2005
© Michael Hayes, 2005. All rights revert to authors and artists on publication.
For permission to publish any part of this publication, contact Michael Hayes, Editor-in-Chief
http://www.PhnomPenhPost.com - Any comments on the website to Webmaster