HIV doc ‘helped a lot of people’

[geovalin]

May Titthara and Joe Freeman

After being voluntarily repatriated from Thailand’s largest refugee camp in late 1992 or early 1993, a Cambodian man in his mid-30s moved to Battambang province and settled in Sangke district.

The next chapter of his life started at an auspicious time. In the summer of ’93, Cambodians were about to head to the polls to vote in historic UN-sponsored elections. The country was at a turning point in its violent history. Peace was at hand.

One day in the district, however, a resident fell gravely ill. He needed medical attention, but the man was reluctant to treat him. He had only received a basic medical education in public health in the camp and was certified by one organisation as a nurse. He also did not have a licence to practise medicine in Cambodia.

But he did it anyway, and Yem Chroeum, who is now 55 and facing murder charges for his alleged role in a mass HIV outbreak in Sangke district, became the local doctor.

“He did not want to cure people at the beginning, because he just got training as a nurse, not a doctor with professional education,” said his sister-in-law Lay Thavy, 46, in a telephone interview with the Post from her home in Thailand. “But a villager had diarrhoea and vomited a lot and may have died before being admitted to Ped Thom [the provincial hospital], so he decided to give treatment with some medicines and serum he got from the refugee camp. And the villager recovered and people liked him.”

Little is known about the sole suspect in Sangke district’s HIV outbreak, which has seen at least 119 people infected since the positive testing of an elderly man in November. On the surface, he sounds like a monster. Chroeum was charged on Monday with murder, intentionally transmitting HIV and running a clinic without permission from the Ministry of Health. Under questioning, he allegedly told police that he had reused needles at his clinic and instructed his son-in-law to burn evidence before authorities seized anything.

But this is hardly the picture that emerges after interviews with family and villagers, who described him as kind and helpful. Several documents obtained by the Post also attest to his medical training and exemplary performance on the job.

“He is a gentleman,” said Kan Sambath, deputy chief of the district’s Roka commune, ground zero of the crisis where infected residents have vowed to kill Chroeum. “He did not talk much, but he helped people in the village a lot.”

Born in May 1959, in Takeo province, Chroeum – whose name is also spelled Chrin – learned his trade in Site 2 during the late 1980s and early 1990s. Site 2 was the largest Cambodian refugee camp on the border with Thailand and the home base of movements opposed to the Vietnamese-backed government in Phnom Penh.

The UN and several aid groups worked in the camp. In 1990, the American Refugee Committee certified Chroeum as a nurse who possessed “the knowledge, skill, and priviledge [sic] to be responsible for performing nursing assessment and providing quality nursing care to the people.”

A certificate for Continuing Nursing Education shows that Chroeum completed an additional 28 hours of instruction from April 1990 to January 1991. The document notes that his attendance rate in the courses stood at 100 per cent.

In March 1992, Chroeum successfully completed a “theoretical and practical training” course in public health from the UN, according to a separate certificate. Later that year, in December, he received a commendation from the American Refugee Committee for “exceptional performance” as Fellow Nurse at the group’s hospital and office in Site 2.

“He has served in this capacity with devotion and distinction,” the commendation reads. “His leadership and creativity have contributed greatly to the effecient [sic] management of patient care in the hospital and outpatient departments.”

The praise doesn’t stop there. In 2000, he received a commendation from a government health organisation for his medical work with a local group called Buddhism for Development.

“Villagers . . . love my father-in-law very much, because he always cares for villagers in the village,” said Chhem Choeun. “He did not willingly spread HIV in that village.”

Chroeum’s first wife died, but he remarried in Battambang and lived with the woman in Sangke district. They have six children, two of them from his first marriage.

Thavy, the sister-in-law of his current wife, cannot fathom the idea of Chroeum being guilty.

“I do not believe whatsoever that he did that. If so, it is like he damaged himself and the future of his six kids. He could not do that,” she said, adding that the villagers did not seek medical help only from Chroeum.

“I am waiting to see how the court judges this case. He is a nice and good person who gave treatments for more than 20 years. Villagers got treatment from other doctors, but why is there suspicion only on him and [why was he] detained like that?”

Though Chroeum has been charged with murder and is sitting in pretrial detention, an investigation into what happened in Sangke will likely take months. Already, the facts aren’t adding up. According to the US-based Centers for Disease Control and Prevention, 99.7 per cent of needle stick or cut exposures to HIV-contaminated blood do not lead to infection.

Still, the question remains why a man with such long experience treating others would reuse needles, and whether his training meant that he may have been out of his depth when administering to serious ailments.

Sok Srun, director of the Ministry of Health’s hospital department, which oversees standards for working doctors, said that along with a specific profession, a person needs to update or renew skill sets.

“Trainings are good at the refugee camp, but the thing is that a trainee or an individual does not implement correctly as the principles are,” he said. “I am not sure and do not accuse him of any thing, but one never advises [a doctor or a nurse] to use the same needle in medical treatment like that.”

ADDITIONAL REPORTING BY PHAK SEANGLY

http://www.phnompenhpost.com/national/hiv-doc-helped-lot-people