Thicker than Blood

Orphans of Cambodia’s AIDS epidemic form their own loving family

Boy with Guitar

image by Gail Gutradt

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The Wat Opot community is in rural Cambodia, tucked amid rice fields and villages, about an hour south of Phnom Penh. I am going there to join a group of children and adults who came together to find the safety, love, and acceptance that many of us long for in our natural families.

I’ve come as a volunteer from the United States to live with children orphaned by the AIDS epidemic that has raged in the country since the 1990s. The infection rate here is among the highest in Asia: some 130,000 out of a population of 14 million. Approximately one-third of new cases are among children born to HIV-infected mothers. Interventions that can virtually eliminate transmission to newborns exist, but only some 30 percent of mothers deliver in health care facilities.

Arriving at Wat Opot, dusty from my travels and apprehensive, I am greeted first by Mr. Tia. He is 8 years old. He runs out from the crowd of children, with an enormous toothless grin, and throws his arms around my knees. My heart is his. My uneasiness vanishes. The children help me unpack and settle in, fascinated by my First World necessities, searching my bundles and pockets for toys and candy.

After dinner, everyone walks slowly toward the pa cha, the crematorium, for the brief memorial service that is held there every evening. Back in Phnom Penh, I visited Tuol Sleng, the prison where the Khmer Rouge tortured thousands during the Cambodian genocide. The faces of the lost stared back at me from walls covered in grainy prison photographs. Here, the walls also are covered with portraits, but instead of prison numbers, there are people’s names and the dates they perished of AIDS. And here are stories, remembered and retold, because the dead are family to the living.

Wayne Dale Matthysse, cofounder of Wat Opot, can tell you the story of each portrait, such as that of Mr. Phoung Sokha, the village carpenter who built the crematorium, not yet knowing he had AIDS, and became one of the first cremated here. Wayne nursed all of these people during the last days of their illness. After they die, he salvages whatever image is available, sometimes only a tiny photo from an identity card, and creates a memorial portrait to hang in the crematorium’s family room. He says the work gives him time to meditate on the life of each patient who dies. It is his final loving service to those he has tended in life and in death.

The photos on the wall of the pa cha are only some of the faces of the AIDS epidemic. All around me are the others: children either orphaned or infected by the virus. My new friend, Mr. Tia, sits close. He arrived four years ago, a stowaway in the ambulance that carried his mother. She had been bound and beaten nearly to death. When the attendants opened the doors, out jumped a skinny little boy with no front teeth. The ambulance was gone before Wayne could find out what village they came from. The boy’s mother died the next day, so Mr. Tia came to live at Wat Opot.

Now, leaving my side, Tia takes his mother’s urn from a glass case. He holds it out so I can see and says simply, “Mama.” He smiles his vast, guileless smile, and I get the sense that he is introducing us. Through the unthinkable pathos of this moment, there is also sweetness. This little man knows just where to find his mother and wants to introduce her to his new friend.

If it seems incomprehensible that a small boy could find solace with his mother’s ashes, consider this: It is his only connection to something that, by any stretch of the imagination, could be called his own.

 

Sixty-four children like Tia currently live at Wat Opot. Twenty-three are HIV-positive; the rest have been orphaned by AIDS. They live with two dozen HIV-positive adults. Each story here begins with profound loss, for these are the poorest of the poor, the outcasts of their society, the throwaways. Whether, as is common, the virus was brought home to a poor or middle-class agrarian family by a husband who had sex with a prostitute, or was caught by a woman forced into the sex trade by poverty, the result is the same. Neighbors, even families, in terror and ignorance, may well ostracize the infected, stone them, or worse.

The seeds of Wat Opot were sown in 2000, when Wayne, a medic in the Vietnam War who had returned to Southeast Asia to work with street children, met Vandin San, a quietly charismatic young Cambodian man working for a Catholic relief organization. In 2001 they formed the nonsectarian organization Partners in Compassion, and building on land donated by a Buddhist pagoda named Wat Opot, they opened a small clinic and hospice. They trained home care teams to travel through villages teaching about AIDS, bringing medical care, food, and emotional support. So it went for several years, as hundreds of people were nursed and died and were given funerals. The picture changed radically in 2003, when Medecins Sans Frontieres—Doctors Without Borders—began distributing antiretroviral drugs. Wat Opot evolved from a hospice for the dying into a vibrant community where children with and without the virus eat, sleep, and play together as family.

The facility is virtually unique in Cambodia and in other places where segregation of HIV-positive children is common. For the children themselves, and as an example for the rest of us, the benefits are profound. Here, they are hugged, wrestled with, teased, taught, challenged, encouraged, and loved. Most of all, they are accepted into the human family, not merely warehoused in orphanages. Adoptions are rare and not sought after. Wayne explains, “I don’t want the ones who aren’t adopted, the older ones, those with AIDS, the ones who maybe aren’t as pretty, to feel left behind. They’ve had enough rejection. I want the kids to think of this as their family, a place to come home to.”

The handsome campus buildings, built with local labor, include the original hospice, which is now a temporary dormitory for the growing population of children, a three-room schoolhouse, an agricultural center with a ponderously pregnant sow, a weaving center where skilled silk weavers can earn a living selling their wares in the nearby market, and a circular dining room and kitchen with a soaring pointed roof that houses a small stage where the kids perform karaoke.

Everywhere there are bright flowers, mango trees, chickens, ducks, and haughty guinea hens. There are small ponds for the children to fish in, more for fun than for food, and to comfort the soul with the sight of water during the relentless dry season. Funding comes mostly from small foundations and private donors. Money is scarce, but it comes together: always enough, never more than is needed, and often at the last minute.

All of these children have watched friends and parents die of AIDS. Still, they are beginning to understand that, with care, they have an excellent chance of living near-normal lives. The future comes alive in making plans, getting an education, learning a trade that can help them make the transition into the outside world. There are plans for a vocational school, computers, and a language lab. The children of Wat Opot have experienced death with an immediacy—and have learned a kind of compassion—that few adults can comprehend. I long to see how these 64 powerful personalities will reshape their communities when they grow up.

But there is something more here, an alchemy through which children orphaned by AIDS become part of their new family. As the months went by, I observed the variations of human experience that refashion connections and build belonging. I met Baby Mai, a six-month-old whose HIV-positive mother could not care for her. An infected couple at Wat Opot who have no children agreed to look after her. The joy of a little girl transformed the new parents, and the baby’s mother visits when she can.

Chandara, whose mother has AIDS, is an older boy who came to Wat Opot to go to school. He was caught trying to fence a stolen bicycle at the bike store in the next village. Theft in this community is a serious betrayal. Before a meeting of the other boys his age, Chandara promised to do better. The boys listened gravely, eyes discretely averted, weighing Wat Opot’s reputation against the repercussions of expulsion on their friend’s future. Finally, they agreed to give him another chance, each boy stepping into the role of father and older brother, family members assuming responsibility for one another.

I met Srey Nak, a terrified little girl of 3. She sat on the end of her mother’s bed for months while the woman slowly died. Her expression never changed. She would scream uncontrollably whenever anyone tried to comfort her. Slowly, she has found friends. Slowly, she has begun to smile. The first time she let me hold her she peed on my lap, but it felt as if the sun had come out. Now she plays happily with two little girls her age. The children heal each other.

One day I was taking pictures of a young boy named Pesei and his sister Srey Lec. They were with their yei, their grandmother, who was visiting from the provinces. One of the other little girls, Srey Oun, also wanted to be in the photo. “Why?” I asked. “She’s not your yei.”

Pesei put his arm around Srey Oun and explained it all to me.

“She is our family, too.”

 

Gail Gutradt is working on a book of photographs and stories about the children of Wat Opot. Her e-mail address is hoap_bai@yahoo.com. Excerpted from Kyoto Journal(#68). Subscriptions: $50/yr. (4 issues) from 31 Bond St., New York, NY 10012; www.kyotojournal.org.