Despite this man’s gesture, all is not well in Tuol Sambo.
At first glance, Tuol Sambo might seem like any other Southeast Asian shantytown, with makeshift housing, overcrowding and open sewers. But the reality is far worse. Not only do the residents here lack basic facilities like clean water, sanitation and electricity, they must also do without readily accessible medical facilities. Moreover, such facilities are vital given that many of the inhabitants here are infected with the HIV virus.
Even getting to Tuol Sambo was a challenge for Artur Gutowski, the photographer who took this haunting set of pictures. “Tuol Sambo is located about 25 km from Phnom Penh – the capital city of Cambodia,” he says. “It is very difficult to find this place. It is not on the map; people on the street cannot [share] any information about it. There is only one way – full of holes, steep hills and gravel… The settlement is hidden.”
A baby lies on the floor.
After passing several other villages, Gutowski finally managed to locate the place he was looking for. The housing settlement of Tuol Sambo was created by the Cambodian government in 2009. At the time, 40 families affected by HIV were evicted from their homes in the impoverished Boreli Keila district of Phnom Penh and brought to this isolated settlement. As Gutowski pointedly describes it: “The government sent them [here] to die.”
Man with a basket of vegetables
This forced relocation of people was met with condemnation from over a hundred HIV/AIDS and human rights groups, including Amnesty International, Human Rights Watch and the International HIV/AIDS Alliance. Despite all these public objections, the Cambodian government did not back down from moving families to the site – which sits on a disused landfill. Even more worryingly, it has continued to send more families.
“The site’s long distance from the city hampers access to health services and jobs, adding to the risks,” said Brittis Edman, Amnesty International’s Cambodia researcher, at the time the first wave of evictions occurred. “The families have urgent humanitarian needs, including clean water, larger living space, access to medical services and food supplies. There is a real risk that the health of the evicted families will deteriorate there.”
Residents spend their time outside, avoiding the heat indoors.
According to a government source, Tuol Sambo has today grown to accommodate 173 families. They are housed in barrack-style accommodation under whose metal roofs it is so intensely hot during the afternoon that it is nearly impossible to stay indoors.
The small field
The heat inside the huts also poses a risk to the antiretroviral medications needed by the HIV/AIDS sufferers and other residents, who have reported the drugs deteriorating in the excessively high temperatures.
A boy swims in the pond.
As recently as March 2012, 26 residents of Tuol Sambo suffered from vomiting and diarrhea before fainting. Most of the sick were reportedly children under ten years of age. Although food poisoning was given as the most likely reason for the outbreak, the village chief said he believed the heat might also be to blame.
Two small boys play with a toy gun.
The stifling temperatures in these crowded, airless shelters are not the only difficulties the members of this disenfranchised community must face. As suggested, there is also the shortage of food, drinking water and medicines, as well as a lack of basic sanitation. According to photographer Gutowski, at the time of his visit, “There [was] only a toilet on the field, next to cows.”
Looking out the window
It’s worth emphasizing the fact that one of the most pressing needs for the HIV/AIDS-affected families – living in what is effectively an AIDS colony – is access to necessary medical attention. A local hospital operates a mobile clinic that visits the settlement each week to provide free treatment, but it is not nearly enough.
A man lies on a mattress on the floor.
Tuol Sambo’s cramped, badly ventilated and unhygienic conditions can only be detrimental to the health of the families living here. One can safely assume such an environment only encourages the spread of infections, which are especially dangerous to those with compromised immune systems.
A motorbike – unlikely to be a common sight in Tuol Sambo
Compounding the hardships already highlighted is the social stigma that comes with living in what uninfected locals have long-referred to as “the AIDS village.” People affected by HIV/AIDS already suffer discrimination, and setting them apart in a closed society only worsens this state of affairs.
Young and old alike feel the baking heat
Prum Dalish, representing the Cambodian Community of Women Living with HIV and AIDS, reports that infected Tuol Sambo residents have been the targets of gang violence, robberies, and prejudice from those in neighboring communities.
Preparing a meal
“When the children go to school, the other children don’t want to play with the [HIV] positive children,” says Dalish. “These kinds of problems can make their health worse and worse.”
One of the residents shows his tattoos.
According to Artur Gutowski, there is no school in the village itself, and naturally the education of the youngsters suffers. “The children cannot read and write,” he says. “Nobody [among the authorities] wants to change their situation. Nobody wants to take to school pupils with HIV.”
An outdoor card game
One of the biggest challenges for the adults of Tuol Sambo is earning enough money to subsist. Before they were relocated, many of the former Borei Keila residents held down jobs. “Chen was a policeman – until today he has kept his uniform – and his wife worked in the post office,” says Gutowski of one couple. “Unfortunately, nobody has money to go to the city – transport is quite expensive.”
Children with uncertain futures at play
Still, the people of this ostracized and neglected community do the best they can. “[Some] of them sew clothes, others make wallets [and] small tuk-tuks from cans,” says Gutowski. “[From time to time] they send somebody to the city center and sell things to tourists to get some money. They only have a small piece of field and cultivate wheat. There is also a pond where they keep fish.” Yet these are scant resources for people in such dire need.
The stark walls of the accommodation sheds
As of 2010, a social initiative called Cambodia Knits was working with relief and development organization Caritas to set up a knitting workshop in the settlement. At the time, knitters in Tuol Sambo were creating knitted parts that were later assembled into complete products in Phnom Penh, but plans are in place to enable residents to produce finished items by themselves.
The flagpole at the center of the village
The Phnom Penh authorities have promised, however, to improve conditions in Tuol Sambo. They have said they will build more toilets, excavate a well for water and improve the current pond while ensuring that electricity for the community is financed. There have been signs that the situation has improved since the first residents were relocated here, but much work still needs to be done.
Without access to proper medical facilities, life is especially hard for the sick and the elderly in Tuol Sambo.
And while there appears to be some good news, other reports paint a different, more unsettling picture. In January 2012, Human Rights Watch reported that people were still being forcibly resettled in Tuol Sambo. In a letter to the Prime Minister, the social justice organization reported that about 300 families living in Borei Keila had had their homes demolished, with the majority of those evicted sent to either Tuol Sambo or another isolated settlement. There were also violent clashes between the evictees and state security forces in which at least 65 people are meant to have been injured.
“Many [of the evictees] are now living in makeshift tents, without access to electricity, sanitation or clean drinking water, schools, and employment opportunities,” read the Human Rights Watch letter, which added: “At least 30 families with people living with HIV/AIDS are among those evicted.”
Chores to be done
Artur Gutowski sums up the situation in Tuol Sambo with these words: “The people are scared,” he says. “They are not sure about [the] future. Parents are worried about their children, who will be orphans. Each day is a kind of challenge.”