Adoption Advocate Answers Your Questions
Ethicanet's Trish Maskew Offers Important Information on Domestic and International Adoption
Mar. 29, 2005 - "20/20's" Elizabeth Vargas recently reported on an international adoption scandal stemming from the adoption of children from Cambodia. In her report, Vargas spoke with Trish Maskew, president and chief executive officer of Ethica: A Voice for Ethical Adoption, who advocates better regulation of both domestic and international adoption.
ABCNEWS.com received hundreds of questions from viewers interested in adoption and in helping the Cambodian orphans featured in "20/20's" story. Below are a selection of questions and Maskew's answers. For more information about adoption issues, visit Ethicanet on the Web at www.Ethicanet.org.
Terry of Alpharetta, Ga., writes:
I saw the "20/20" special and would like to help the orphanage that was shown. Is there a way to send donation directly to them and communicate directly to them?
Trish Maskew:
Terry,
The orphanage profiled was in Siem Reap, home of the famous Angkor Wat. We are unaware of any formal programs for donations to Siem Reap at this time. After conferring with Judi Mosley, featured on the show, we agreed to accept donations here at Ethica for the Siem Reap orphanage. Ethica is a 501(c)(3) tax-exempt organization and all donations are fully tax-deductible. You can donate by check or through PayPal. Instructions are available at http://www.ethicanet.org/item.php?recordid=donations
We'd also recommend two other organizations that viewers may wish to consider.
The Tabitha Foundation (http://www.tabitha-usa.org), operated by U.S. parents of Cambodian children, builds houses and digs wells to keep birth families intact, and also provides school supplies and other needed items to the children of Cambodia.
The No Child Left Out organization (http://www.nclo.org/Feed%20the%20Children.htm) has a rice program for Cambodian orphanages.
Karen of Brighton, Mass. writes:
I am the parent of an 11-year-old Chinese girl whom I adopted in 1995 from the Hunan Province, when she was 13 months old. I have never had any reason to think that there is anything amiss with adoptions from China. Do you know any differently? Thank you very much.
Trish Maskew:
Karen,
No, to our knowledge, allegations of solicitation and trafficking have not arisen in connection with Chinese adoptions. China's adoption system is different from Cambodia's in many ways. Perhaps the greatest difference is that China has an adoption system that is centrally run through the Chinese government, under strict regulation. The Chinese have developed a system which removes the financial incentives for solicitation and trafficking in children. This centrally operated adoption system is, in many ways, a model system for other countries. It does, however, require a significant governmental infrastructure that countries such as Cambodia do not have.
One thing that the Chinese children and Cambodian children do have in common is the lack of information on their birth families and origins. Most children in China are anonymously abandoned and have no identifying information.
B. Grace of Seattle writes: Could you please point out any good sources (other than yourself, of course) where we could research more about the potential problems and issues with foreign adoption agencies? Thank you.
Trish Maskew:
Dear B. Grace,
While there are some resources available, there is not a central location from which this information can be obtained. We are aware of no other organization whose primary focus is adoption ethics and reform. A brief primer on choosing an adoption agency can be found on our site at: http://www.ethicanet.org/item.php?recordid=chooseprovider.
Undoubtedly, the very best sources available to prospective adoptive parents are other adoptive parents. Those considering adoption should join the vast Internet adoption community. There are online communities for virtually every country. Many of these are found at Yahoo Groups (www.groups.yahoo.com). The adoption Web site Comeunity (www.comeunity.com) also has a listing of online chat groups about adoption.
In the past there have been several sites that rated agencies, or provided questionnaires about agency experiences. Several have been closed due to lawsuits filed by adoption agencies, leaving a void in this type of information. There are, however, some privately run sites that provide personal stories and resources for parents such as http://www.adoptionagencychecklist.com/page651.html.
General information on adoption can be found at sites such as:
http://www.adopt.org
http://www.adoptioninstitute.org
http://naic.acf.hhs.gov
Yanny of Raytown, Mo., writes:
Has the Cambodian government made any progress in reforming the adoption process? If and when they do, is it hopeful that the moratorium on the Cambodian adoption will be lifted?
Trish Maskew:
Yanny,
Unfortunately, there has been little progress since 2001 when the moratorium was imposed. There have been attempts to write a new adoption law. The passage of the law has been stymied, however, by the fact that until recently Cambodia did not actually have a sitting legislature. Cambodia has met with various countries, including the United States and France, to discuss ways to improve the system. Various nongovernmental organizations have also lent support. One of the biggest obstacles to progress seems to be that Cambodia has little interest in investigating or prosecuting those involved in trafficking or other illegal activities.
That being said, there is indeed hope that the moratorium would be lifted if the Cambodian government moves to address problems in adoption. We believe that a reopening is definitely possible. It will require concerted effort on the part of both the Cambodian and U.S. governments. We firmly believe that the U.S. government must play a proactive role in proffering ideas and solutions to the Cambodian government, and should consider providing the necessary resources to assist the Cambodians in developing a safe, transparent adoption system. Simply waiting for Cambodia to act is not an option that puts children first. Cambodia needs to reopen, and it must do so with additional safeguards in place. In order for that to happen, both governments have to make children a priority.
ABC News
Thursday, March 31, 2005
Wednesday, March 23, 2005
Not in my bar....
I'm in Cambodia because of the people and culture, not in spite of it. Apparently this view isn't shared by all of the local bar owners. Go figure.
Phnom Penh Perspective:
Magic business plans
by Bronwyn Sloan
March 2005 (excerpted from talesofasia.com)
....Back in the expatriate world of Phnom Penh, just up the road but so far not gifted with any magic animals since that dog gave birth to a kitten last year, the traditional march towards the edge of sanity continued. Sometimes in a good way – the St Patrick's Day madness seemed equally and good humouredly shared between the Green Vespa Irish Bar, and Rory's Irish Bar, but in a tight competition for the most fun St Patrick's Day night it was Rory's on 178 Street which kept the crowds the longest despite quickly running out of free Irish stew, and Rory finally called a halt at around 3am.
[Editor's note: the following item is in no way referenced to either of the aforementioned establishments.] This is in stark contrast to the darker edge of madness that can turn new business owners thrust into the heady heights of managing a hole in the wall in Phnom Penh into megalomaniacs. Why do people who are not of the ethnic background of their menu open restaurants selling a taste of the exotic anyway, but despite the inherent risks of this business strategy then proceed to promptly bar most of their customers the poorly managed staff didn't shortchange already within the space of months of opening because, well, frankly they don't like ethnic people, or people married to ethnic people, or people who associate with ethnic people. Read "ethnic" as whatever race the owner is not. This dark edge is indeed more in keeping with the grand tradition of both Khmer and expatriate business ownership in Phnom Penh, which apparently often turns totally sane and sociable people into territorial monsters and snips out the little part of their brain that once made them likeable.
But restaurants and bars are not the only businesses where customer service is at a premium. My friend, who is Khmer, spent the entire night locked in a garage last night. Not because he wanted to, but because the panel beater had not finished fixing the dent three teens on a motorbike made in his car when they were returning blind drunk from a wedding, and he did not trust his friend the garage owner not to help himself to original parts of his car such as light fittings or siphon off his petrol if he left it overnight. The garage owner, in turn, decided he didn't trust the friend not to help himself to his hoard of spare parts either, so the customer slept in the car and the garage owner locked him inside the garage for the night while he slept in the car. Trust issues are obviously a major problem in the capital. Maybe the urge to get rid of all your customers is natural, like an immune system response?
So which is the more crazy business plan? Opening a magic cow business, or opening a bar or restaurant when you have no idea how to run one when, well, you just don't like customers all that much anyway? Or a garage for that matter, where your customers sleep over so you don't strip their car while it's in for a service? Perhaps it is time the magic cow phenomenon is taken to its natural conclusion and a licensing system for magic cows put in place. Perhaps that would placate the government, and then, for instance, people who like eating magic shit could get it from a fully taxed and licensed source, rather than dressed up as something it isn't and served with a xenophobic scowl in a nasty piece of Russian market crockery in some failing Phnom Penh restaurant.
But enough. The heat is beginning to get to us all. And despite a few bad apples, there is no shortage of bars and restaurants in this cosmopolitan capital that serve great food and beverages with a smile. But after the month that was, I am beginning to see that it is no wonder so many locals are digging out magic animals to front up their dodgy businesses. There's gold in crap it seems, especially if you own a cow with great stage presence, or at least a taxi en route to a cow. Maybe the ministry should just give in and learn how to mine it?
Phnom Penh Perspective:
Magic business plans
by Bronwyn Sloan
March 2005 (excerpted from talesofasia.com)
....Back in the expatriate world of Phnom Penh, just up the road but so far not gifted with any magic animals since that dog gave birth to a kitten last year, the traditional march towards the edge of sanity continued. Sometimes in a good way – the St Patrick's Day madness seemed equally and good humouredly shared between the Green Vespa Irish Bar, and Rory's Irish Bar, but in a tight competition for the most fun St Patrick's Day night it was Rory's on 178 Street which kept the crowds the longest despite quickly running out of free Irish stew, and Rory finally called a halt at around 3am.
[Editor's note: the following item is in no way referenced to either of the aforementioned establishments.] This is in stark contrast to the darker edge of madness that can turn new business owners thrust into the heady heights of managing a hole in the wall in Phnom Penh into megalomaniacs. Why do people who are not of the ethnic background of their menu open restaurants selling a taste of the exotic anyway, but despite the inherent risks of this business strategy then proceed to promptly bar most of their customers the poorly managed staff didn't shortchange already within the space of months of opening because, well, frankly they don't like ethnic people, or people married to ethnic people, or people who associate with ethnic people. Read "ethnic" as whatever race the owner is not. This dark edge is indeed more in keeping with the grand tradition of both Khmer and expatriate business ownership in Phnom Penh, which apparently often turns totally sane and sociable people into territorial monsters and snips out the little part of their brain that once made them likeable.
But restaurants and bars are not the only businesses where customer service is at a premium. My friend, who is Khmer, spent the entire night locked in a garage last night. Not because he wanted to, but because the panel beater had not finished fixing the dent three teens on a motorbike made in his car when they were returning blind drunk from a wedding, and he did not trust his friend the garage owner not to help himself to original parts of his car such as light fittings or siphon off his petrol if he left it overnight. The garage owner, in turn, decided he didn't trust the friend not to help himself to his hoard of spare parts either, so the customer slept in the car and the garage owner locked him inside the garage for the night while he slept in the car. Trust issues are obviously a major problem in the capital. Maybe the urge to get rid of all your customers is natural, like an immune system response?
So which is the more crazy business plan? Opening a magic cow business, or opening a bar or restaurant when you have no idea how to run one when, well, you just don't like customers all that much anyway? Or a garage for that matter, where your customers sleep over so you don't strip their car while it's in for a service? Perhaps it is time the magic cow phenomenon is taken to its natural conclusion and a licensing system for magic cows put in place. Perhaps that would placate the government, and then, for instance, people who like eating magic shit could get it from a fully taxed and licensed source, rather than dressed up as something it isn't and served with a xenophobic scowl in a nasty piece of Russian market crockery in some failing Phnom Penh restaurant.
But enough. The heat is beginning to get to us all. And despite a few bad apples, there is no shortage of bars and restaurants in this cosmopolitan capital that serve great food and beverages with a smile. But after the month that was, I am beginning to see that it is no wonder so many locals are digging out magic animals to front up their dodgy businesses. There's gold in crap it seems, especially if you own a cow with great stage presence, or at least a taxi en route to a cow. Maybe the ministry should just give in and learn how to mine it?
Tuesday, March 22, 2005
There was an old woman who swallowed a fly
Given my provlivity to put dead crispy crawly things in my mouth, this is an article I can relate to. I gotta get out to the spider village one of these days...
Words by Moeun Nhean photographs by Chin Ry and Som Soren
If you are searching for something more than potato chips, peanuts and pretzels; satisfy your epicuriosity at a Cambodian market or drive to Skoun for some unique fried snacks. The array of delicious morsels this country has to offer are not preserved in strange numbers, packed with nutritional information or shelved.
Try some six-legged snacks, or a few winged-snacks. How about a kilo of jumping snacks? Cambodia is teeming with fried crickets, deep-fried a-ping (tarantulas—which some believe stop breathlessness), fried kantes-long (a black beetle), deep-fried kantea-touk (a menthol tasting beetle) fried mea phleang (winged termites), fried pupas, dried clams, lie (freshwater clams), kchorng and kchav (types of snails). How do they taste? And why on earth do Cambodian people like to eat them?
For Cambodians, who know their flavors well, they are mouth-watering. For foreigners, and judging by the grimaces, it is a whole different story.
Sok Tiek Savy is a deep-fried insect vendor at Phnom Penh’s Central Market and she says foreigners don’t buy these sorts of delicacies, but they do watch her selling them and rather than sample, take photographs. Sok says she makes up to 100,000 riel ($15-$25) a day.
Plunging a brown, shiny kantea-touk into spitting cooking oil Sok turns and says, “I have my suppliers who bring kantea-touk, kantes-long, crickets, a-ping and pupas from various provinces according to the seasons.” During the dry season vendors sell dried clams tossed in salt and most people buy them to marinate with ripe tamarind and dip in fish sauce.
Some of the insects are transported alive while others are cooked so they won’t spoil on the journey to the city. When they arrive, Sok re-cooks them with her special spices and oils. In Phnom Penh there are three wholesalers who buy insects in large quantities from the provinces for export overseas, particularly to Thailand.
A young girl selecting kantea-touk says every time she comes to the Central Market and it is cricket season, she will buy fried crickets, if it is a-ping season, she will buy deep-fried a-ping and if it is kantes-long season, she will buy fried kantes-long.
“They are not at all disgusting. In fact, they taste very nice. If you don’t believe me, close your eyes and try, and then you will know how these things taste,” she says.
Sam At is a vendor at Hun Sen Park in the capital and she says that every weekend during the evenings she sells about 7kg of snails. She sells by the plate—one plate weighs half a kilogram and costs 2,000 riel (50 cents). While down the road north of the Japanese Friendship Bridge, Bun Chantha sells 50kg of frogs a day to huge crowds of salivating students. “Ninety percent of my customers are pupils from the local schools,” Bun says. Deep-fried frogs, or kon sngoen, are also very popular amongst Cambodian men who like to chew the legs with a glass of sour palm wine.
North of Phnom Penh, stop anywhere in the town of Skoun and savor a bag of their famed arachnids. The locals have long used tarantulas not only in traditional medicine—they are thought to be good for the heart, throat and lungs—but as a source of food. According to some enthusiasts, the anatomy tastes a little like crab meat. It’s the taste of the abdomen that’s sounds worrying. Eating has never been such an adventure!
From the Cambodian, March 21
Words by Moeun Nhean photographs by Chin Ry and Som Soren
If you are searching for something more than potato chips, peanuts and pretzels; satisfy your epicuriosity at a Cambodian market or drive to Skoun for some unique fried snacks. The array of delicious morsels this country has to offer are not preserved in strange numbers, packed with nutritional information or shelved.
Try some six-legged snacks, or a few winged-snacks. How about a kilo of jumping snacks? Cambodia is teeming with fried crickets, deep-fried a-ping (tarantulas—which some believe stop breathlessness), fried kantes-long (a black beetle), deep-fried kantea-touk (a menthol tasting beetle) fried mea phleang (winged termites), fried pupas, dried clams, lie (freshwater clams), kchorng and kchav (types of snails). How do they taste? And why on earth do Cambodian people like to eat them?
For Cambodians, who know their flavors well, they are mouth-watering. For foreigners, and judging by the grimaces, it is a whole different story.
Sok Tiek Savy is a deep-fried insect vendor at Phnom Penh’s Central Market and she says foreigners don’t buy these sorts of delicacies, but they do watch her selling them and rather than sample, take photographs. Sok says she makes up to 100,000 riel ($15-$25) a day.
Plunging a brown, shiny kantea-touk into spitting cooking oil Sok turns and says, “I have my suppliers who bring kantea-touk, kantes-long, crickets, a-ping and pupas from various provinces according to the seasons.” During the dry season vendors sell dried clams tossed in salt and most people buy them to marinate with ripe tamarind and dip in fish sauce.
Some of the insects are transported alive while others are cooked so they won’t spoil on the journey to the city. When they arrive, Sok re-cooks them with her special spices and oils. In Phnom Penh there are three wholesalers who buy insects in large quantities from the provinces for export overseas, particularly to Thailand.
A young girl selecting kantea-touk says every time she comes to the Central Market and it is cricket season, she will buy fried crickets, if it is a-ping season, she will buy deep-fried a-ping and if it is kantes-long season, she will buy fried kantes-long.
“They are not at all disgusting. In fact, they taste very nice. If you don’t believe me, close your eyes and try, and then you will know how these things taste,” she says.
Sam At is a vendor at Hun Sen Park in the capital and she says that every weekend during the evenings she sells about 7kg of snails. She sells by the plate—one plate weighs half a kilogram and costs 2,000 riel (50 cents). While down the road north of the Japanese Friendship Bridge, Bun Chantha sells 50kg of frogs a day to huge crowds of salivating students. “Ninety percent of my customers are pupils from the local schools,” Bun says. Deep-fried frogs, or kon sngoen, are also very popular amongst Cambodian men who like to chew the legs with a glass of sour palm wine.
North of Phnom Penh, stop anywhere in the town of Skoun and savor a bag of their famed arachnids. The locals have long used tarantulas not only in traditional medicine—they are thought to be good for the heart, throat and lungs—but as a source of food. According to some enthusiasts, the anatomy tastes a little like crab meat. It’s the taste of the abdomen that’s sounds worrying. Eating has never been such an adventure!
From the Cambodian, March 21
Spooks and Spice
Andy Marshall's "Trouser People" is one of the best books about...well about most anything. It happens to be about Burma (which you may know as Myanmar). Glad to see you in Cambodia Andy.
Andrew Marshall takes a memorable journey along Cambodia's haunted coastline.
March 19, 2005
I AM in Bokor National Park and my guide is called Kat Manh, also known as the Kat, a handsome Cambodian who fought with the Khmer Rouge, speaks six languages and claims to have eaten nearly every creature that has scuttled, slithered or prowled through this fauna-stuffed wilderness.
"When I was in the jungle I ate this," Kat Manh tells me. He is pointing at a drawing of a pig-tailed macaque in a park leaflet on protected species. "I also ate this crab-eating macaque and this Sunda pangolin and also this common palm civet." Very tasty, he concludes.
"Kat Manh, if I were a park ranger, I'd shoot you."
But the Kat just grins. All that happened 20 years ago, while he was a young Khmer Rouge soldier battling the Vietnamese, or so he assures me. It is hard to tell; he could have a pangolin sandwich in his knapsack and I'd never know.
Kat Manh is a spooky bloke but, then, we have come to a spooky place. In the 1920s, French colonialists built a lavish hill station on Bokor, the highest peak in the Elephant Mountain range. It remained a playground for the French and Cambodian elite until civil war and Pol Pot's genocide closed it for good. Bokor and its base camp, the sleepy riverside town of Kampot, are less than three hours' drive from the Cambodian capital, Phnom Penh, but for years most visitors avoided the coast. The area was a last stronghold of the Khmer Rouge, who in 1994 abducted and killed an Australian backpacker and two other Westerners. A bad road, plus the gravitational pull of the beaches at nearby Sihanoukville, also kept this enchanting region off most itineraries.
Not any more. Many visitors are negotiating the crumbling scab of tarmac that winds up Bokor's thickly forested flanks. The jungle is fertilised by the uncounted dead: convicts and coolies who perished building the original road, victims of Pol Pot's terror and casualties from the Vietnamese invasion that ended it.
Kat Manh and I make the journey in the standard-issue Cambodian car – a shockless Toyota Corolla with a cracked windscreen. A cantankerous old elephant used to harass visitors negotiating the road on trail bikes. He (or she) is gone now, but only last year a tiger leapt across the path of another set of motorbiking tourists, causing them to crash.
As we gain altitude, the forest thins and grows more stunted. Insects shriek in the bushes like phasers stuck on stun mode. Soon we reach a cluster of villas once used by Cambodian royals, but abandoned and then trashed during fighting between Khmer Rouge and Vietnamese troops. Crude animal drawings on the walls lend the villas an almost prehistoric creepiness. So does the rocky outcrop nearby, where wind and rain have carved Easter Island profiles into the dark boulders.
Thick mist descends. Or, more accurately, we drive up into the clouds that scour Bokor's peak. A hilltop church, its outer walls smothered with vibrant orange moss, looms from this void like an hallucination. Wind howls through a cross on the spire, the only adornment remaining on the entire church, inside or out. Inside, the walls are graffiti-strewn, the floors carpeted with rubble. It is profoundly eerie. As I turn to leave, a dark, winged figure rears before me. My heart leaps into my mouth. Kat Manh grins, his army poncho violently flapping in the wind. I am probably not the first person he has terrified.
The clouds abruptly vanish to reveal a haunting landscape of gutted buildings set around a wind-creased reservoir. This was all that survived of Bokor Hill Station. The grandest ruin was once the lavishly appointed Bokor Palace Hotel, opened on St Valentine's Day 1925 with a banquet for 120 guests. Baudouin, Cambodia's resident superieur or colonial governor, gave the after-dinner toast. Neither he, nor his detractors, who dubbed the complex Baudouin's Folly, would recognise the place today. Anything of value – light fittings, window frames, floor tiles, electrical wiring, baths – has been ripped out and carted off. The denuded walls are smothered in the same electric-orange moss, a substance like alien fur, or by a spongy green variety.
Behind the hotel a path leads through an unrecognisably overgrown garden to a decaying stone balustrade. At first, the view beyond is lost in sun-drenched clouds but then the wind switches direction and the clouds evaporate in dizzying swirls. And there, implausibly far below, is a deep green jungle canopy sweeping up to join the Gulf of Thailand, its calm waters dominated by the cloud-raked Vietnamese island of Phu Quoc. It is without doubt one of Southeast Asia's most spectacular views.
Civil war finally put Bokor out of business. Apart from some bullet holes and a rusting munitions box in the hotel's main hall, few signs of the fighting remain. But the romance of Bokor persists. I hear talk that the hotel will be refurbished by some big Japanese or French company, but don't believe it. The building is just a shell; if it were in a country with functioning safety regulations, no tourist would be allowed near it, never mind in it. Refurbish it? That would be like performing plastic surgery on a skeleton.
WHILE Bokor seems cursed, Kampot is blessed, first and foremost, with an enviable natural setting. The town is bisected by a wide, slow-moving river the colour of liquid marble. Lined with stately casuarina trees, the east bank is a French-designed grid of crumbling shophouses and government buildings. A new town has sprouted along the jungle-clad west bank, and above it looms Bokor's misty ridge.
The shophouses were built, and are often still occupied, by immigrant Chinese, who have long dominated local trade. The buildings' Santorini blues and Tuscan oranges give the streets a Mediterranean feel. A favourite riverside spot, the Little Garden Bar, once belonged to the customs officer. The former governor's house is still a well-preserved official building, although architecturally undistinguished, like a chunk of old wedding cake. On an avenue of gargantuan trees nearby is a dainty building with a cow grazing in its forecourt. This is Kampot prison, and it's still in use, although it looks as if one could break out of it with a teaspoon.
Kampot once boasted not just colonial French architecture but also fantastical, dawn-of-concrete buildings such as the police commissariat, which looked like a retro toaster, or the train station with a spire rising above the toddy palm trees, like some New Age church. The station is deserted now, its tracks rusting. The antique passenger train has not run this scenic route for more than six months.
The celebrated French naturalist and explorer Henri Mouhot stopped in Kampot – then Cambodia's main port – on his way to rediscover the ancient ruins of Angkor in 1860. He arrived from Thailand on a coast-hugging, stomach-churning voyage through high winds and heavy seas. It is hard to warm to a new destination after a cramped, turbulent journey, but that barely explains Mouhot's first impressions on stepping ashore.
"Almost every vice seemed prevalent at Komput," he wrote. "Pride, insolence, cheating, cowardice, servility [and] excessive idleness are the attributes of this miserable people." The local women were "repulsively ugly", he ungallantly noted, the customs officers were "licensed beggars", and the only hotel was scrawled with angry graffiti from its last occupants – some equally disenchanted French seamen. These days, Kampot offers better lodgings. Some riverfront shophouses have been done up as guesthouses, such as the Bokor Mountain Club.
Sitting outside is a well-groomed Italian reading an old copy of Il Messaggero. He's the manager, Angelo, who claims to have once been Steven Seagal's private chef. "My life is not a book but a whole library," he tells me. Angelo's many projects include Kampot's first beach. He has had debris cleared from a section of riverbank and covered it with sand. Nearby, chained to a tree trunk, are some lounge chairs. It was a great concept, ruined by an even better one: the monsoon season. It pours almost without let-up while I am in Kampot and Angelo is staring at his beach through metres of muddy river water. "You get the idea," he says.
Nearby is a school where orphaned and disadvantaged children are taught traditional Cambodian dance and music; visitors are welcome to watch their daily rehearsals. There is a filthy and authentic market with a raucous seafood section selling blue-speckled stingrays and, at its calm centre, a group of seamstresses hunch over pedal-driven sewing machines.
Otherwise, there isn't much to do in Kampot but it's a magical place, with a slow, tranquillising rhythm. I spend time just watching the sun go down over the river. At a long funeral nearby, a woman sings a lament in Khmer, the most bewitching of languages. With this haunting soundtrack, fresh storm clouds roil off Bokor's darkening slopes, and the sun finally set.
The show at Kampot's only cinema changes from a Khmer love story to a Taiwanese splatter flick. The three-day funeral ends and, simultaneously, two weddings begin. I almost convince myself I belong in friendly Kampot – I can't walk 100m down any road without meeting someone I know.
# Andrew Marshall is the author of The Trouser People, a travel book about Burma published by Penguin.
Andrew Marshall takes a memorable journey along Cambodia's haunted coastline.
March 19, 2005
I AM in Bokor National Park and my guide is called Kat Manh, also known as the Kat, a handsome Cambodian who fought with the Khmer Rouge, speaks six languages and claims to have eaten nearly every creature that has scuttled, slithered or prowled through this fauna-stuffed wilderness.
"When I was in the jungle I ate this," Kat Manh tells me. He is pointing at a drawing of a pig-tailed macaque in a park leaflet on protected species. "I also ate this crab-eating macaque and this Sunda pangolin and also this common palm civet." Very tasty, he concludes.
"Kat Manh, if I were a park ranger, I'd shoot you."
But the Kat just grins. All that happened 20 years ago, while he was a young Khmer Rouge soldier battling the Vietnamese, or so he assures me. It is hard to tell; he could have a pangolin sandwich in his knapsack and I'd never know.
Kat Manh is a spooky bloke but, then, we have come to a spooky place. In the 1920s, French colonialists built a lavish hill station on Bokor, the highest peak in the Elephant Mountain range. It remained a playground for the French and Cambodian elite until civil war and Pol Pot's genocide closed it for good. Bokor and its base camp, the sleepy riverside town of Kampot, are less than three hours' drive from the Cambodian capital, Phnom Penh, but for years most visitors avoided the coast. The area was a last stronghold of the Khmer Rouge, who in 1994 abducted and killed an Australian backpacker and two other Westerners. A bad road, plus the gravitational pull of the beaches at nearby Sihanoukville, also kept this enchanting region off most itineraries.
Not any more. Many visitors are negotiating the crumbling scab of tarmac that winds up Bokor's thickly forested flanks. The jungle is fertilised by the uncounted dead: convicts and coolies who perished building the original road, victims of Pol Pot's terror and casualties from the Vietnamese invasion that ended it.
Kat Manh and I make the journey in the standard-issue Cambodian car – a shockless Toyota Corolla with a cracked windscreen. A cantankerous old elephant used to harass visitors negotiating the road on trail bikes. He (or she) is gone now, but only last year a tiger leapt across the path of another set of motorbiking tourists, causing them to crash.
As we gain altitude, the forest thins and grows more stunted. Insects shriek in the bushes like phasers stuck on stun mode. Soon we reach a cluster of villas once used by Cambodian royals, but abandoned and then trashed during fighting between Khmer Rouge and Vietnamese troops. Crude animal drawings on the walls lend the villas an almost prehistoric creepiness. So does the rocky outcrop nearby, where wind and rain have carved Easter Island profiles into the dark boulders.
Thick mist descends. Or, more accurately, we drive up into the clouds that scour Bokor's peak. A hilltop church, its outer walls smothered with vibrant orange moss, looms from this void like an hallucination. Wind howls through a cross on the spire, the only adornment remaining on the entire church, inside or out. Inside, the walls are graffiti-strewn, the floors carpeted with rubble. It is profoundly eerie. As I turn to leave, a dark, winged figure rears before me. My heart leaps into my mouth. Kat Manh grins, his army poncho violently flapping in the wind. I am probably not the first person he has terrified.
The clouds abruptly vanish to reveal a haunting landscape of gutted buildings set around a wind-creased reservoir. This was all that survived of Bokor Hill Station. The grandest ruin was once the lavishly appointed Bokor Palace Hotel, opened on St Valentine's Day 1925 with a banquet for 120 guests. Baudouin, Cambodia's resident superieur or colonial governor, gave the after-dinner toast. Neither he, nor his detractors, who dubbed the complex Baudouin's Folly, would recognise the place today. Anything of value – light fittings, window frames, floor tiles, electrical wiring, baths – has been ripped out and carted off. The denuded walls are smothered in the same electric-orange moss, a substance like alien fur, or by a spongy green variety.
Behind the hotel a path leads through an unrecognisably overgrown garden to a decaying stone balustrade. At first, the view beyond is lost in sun-drenched clouds but then the wind switches direction and the clouds evaporate in dizzying swirls. And there, implausibly far below, is a deep green jungle canopy sweeping up to join the Gulf of Thailand, its calm waters dominated by the cloud-raked Vietnamese island of Phu Quoc. It is without doubt one of Southeast Asia's most spectacular views.
Civil war finally put Bokor out of business. Apart from some bullet holes and a rusting munitions box in the hotel's main hall, few signs of the fighting remain. But the romance of Bokor persists. I hear talk that the hotel will be refurbished by some big Japanese or French company, but don't believe it. The building is just a shell; if it were in a country with functioning safety regulations, no tourist would be allowed near it, never mind in it. Refurbish it? That would be like performing plastic surgery on a skeleton.
WHILE Bokor seems cursed, Kampot is blessed, first and foremost, with an enviable natural setting. The town is bisected by a wide, slow-moving river the colour of liquid marble. Lined with stately casuarina trees, the east bank is a French-designed grid of crumbling shophouses and government buildings. A new town has sprouted along the jungle-clad west bank, and above it looms Bokor's misty ridge.
The shophouses were built, and are often still occupied, by immigrant Chinese, who have long dominated local trade. The buildings' Santorini blues and Tuscan oranges give the streets a Mediterranean feel. A favourite riverside spot, the Little Garden Bar, once belonged to the customs officer. The former governor's house is still a well-preserved official building, although architecturally undistinguished, like a chunk of old wedding cake. On an avenue of gargantuan trees nearby is a dainty building with a cow grazing in its forecourt. This is Kampot prison, and it's still in use, although it looks as if one could break out of it with a teaspoon.
Kampot once boasted not just colonial French architecture but also fantastical, dawn-of-concrete buildings such as the police commissariat, which looked like a retro toaster, or the train station with a spire rising above the toddy palm trees, like some New Age church. The station is deserted now, its tracks rusting. The antique passenger train has not run this scenic route for more than six months.
The celebrated French naturalist and explorer Henri Mouhot stopped in Kampot – then Cambodia's main port – on his way to rediscover the ancient ruins of Angkor in 1860. He arrived from Thailand on a coast-hugging, stomach-churning voyage through high winds and heavy seas. It is hard to warm to a new destination after a cramped, turbulent journey, but that barely explains Mouhot's first impressions on stepping ashore.
"Almost every vice seemed prevalent at Komput," he wrote. "Pride, insolence, cheating, cowardice, servility [and] excessive idleness are the attributes of this miserable people." The local women were "repulsively ugly", he ungallantly noted, the customs officers were "licensed beggars", and the only hotel was scrawled with angry graffiti from its last occupants – some equally disenchanted French seamen. These days, Kampot offers better lodgings. Some riverfront shophouses have been done up as guesthouses, such as the Bokor Mountain Club.
Sitting outside is a well-groomed Italian reading an old copy of Il Messaggero. He's the manager, Angelo, who claims to have once been Steven Seagal's private chef. "My life is not a book but a whole library," he tells me. Angelo's many projects include Kampot's first beach. He has had debris cleared from a section of riverbank and covered it with sand. Nearby, chained to a tree trunk, are some lounge chairs. It was a great concept, ruined by an even better one: the monsoon season. It pours almost without let-up while I am in Kampot and Angelo is staring at his beach through metres of muddy river water. "You get the idea," he says.
Nearby is a school where orphaned and disadvantaged children are taught traditional Cambodian dance and music; visitors are welcome to watch their daily rehearsals. There is a filthy and authentic market with a raucous seafood section selling blue-speckled stingrays and, at its calm centre, a group of seamstresses hunch over pedal-driven sewing machines.
Otherwise, there isn't much to do in Kampot but it's a magical place, with a slow, tranquillising rhythm. I spend time just watching the sun go down over the river. At a long funeral nearby, a woman sings a lament in Khmer, the most bewitching of languages. With this haunting soundtrack, fresh storm clouds roil off Bokor's darkening slopes, and the sun finally set.
The show at Kampot's only cinema changes from a Khmer love story to a Taiwanese splatter flick. The three-day funeral ends and, simultaneously, two weddings begin. I almost convince myself I belong in friendly Kampot – I can't walk 100m down any road without meeting someone I know.
# Andrew Marshall is the author of The Trouser People, a travel book about Burma published by Penguin.
Wednesday, March 09, 2005
Scott's Final Page
THE JUNGLE BAR AND GRILL
(Update February 25, 2005)
I probably shouldn't have put "final" up there because it sort of sounds like I kicked the bucket!!! But the sale of the bar went through on Saturday the 19th and our final blowout party was that night. Details of the final week are below so I won't belabor the introductions.
THE FINAL WEEK
The final sale and handover was to take place on Saturday the 19th of February, but there were some last minute details that needed to be done and I figured a week of transition would be good for the staff; thus I decided to fly over to Phnom Penh on the 14th with as many people as I could to supplement the festivities as well as to keep tabs on me since I knew that far too much alcohol would be consumed during the end of yet another chapter in my life. My father and his wife Jennifer, Andy (shown above with his friend Neil from a prior trip) my good friend Mike shown below as well as other assorted shady characters associated with the Jungle Bar since its inception were among the elite members to enjoy my final days as a Cambodian bar owner. The evening of the 14th was a gluttonous orgy of seafood barbecued over the traditional clay barbecues the Khmers use for just about everything. Giant prawns, garlic shrimp, swordfish steaks and other delicacies were prepared by my always capable and obliging staff. Good music, good food, good cocktails and great friends..... the trademarks of a successful and memorable bar!!!!
Trip to Sihanoukville
Since we had a some time to kill before the weekend we rented three cars and trucked on down to the beach resort of Kampong Som on Wednesday morning. Without going into gory details, the ride for me was wrought with nausea and a less than normal mental status! I was told this probably had something to do with the fact that I was working my way down the "top shelf" of bottles pouring shots for whomever was still left standing at the bar..... which obviously included me! I Since I hadn't eaten anything in 12 hours I figured that I could last the three hour trip without any major wretching. That was until Australian Peter's girlfriend just had to stop for food (nothing, I mean nothing, interrupts a Cambodian's eating schedule.) Upon opening the box filled with pungent offal, fermented fish sauce and rice, the tenuous stability of my stomach became a moot point and my head was immediately out the window ridding myself of the small amount of bile clinging to my gastric mucosa. I'm sure that was more information than many of you needed, but Peter has told pretty much everyone and I figured word would reach the USA sooner or later with Peter's big mouth! We stayed on the beach for two nights and relaxed with a few side visits to the seemier side of town. The area around the port is being expanded and many of the old "haunts" (for lack of a better word) in the area are being demolished. A few regular bars were introduced including the Endless Summer Beach Club run by Chad from the USA and the beachfront including Serendipity Beach and Ochenteal Beach. Pop and his wife are shown at right in the relaxing rooftop bar of the Fisherman's Den run by the ever vivacious and sometimes crude Kiwi Brian!! After a few days we headed back to Phnom Penh for the final contract signing and a few final days of partying.
Phnom Penh
The ride back to Phnom Penh was uneventful (compared to the ride down) save for one small detail which demonstrates that there is a God after all and he can be a just one at that. Instead of leaving the transportation details to me, Australian Peter decided he knew better than I how to arrange his car (despite not living in Cambodia and not speaking a word of the language!) To make a long story short, we ended up with one too many cars and so spread everyone out amongst four cars instead of three costing an extra thirty US dollars to boot. Everyone made it back to the capital EXCEPT PETER whose car overheated and he was forced to wait an extra two hours beside the road while the usual committee of onlookers came to a consensus on what to do. In case you have never been to Cambodia you may not realize that anything and everything that happens draws a crowd, all of whom think that they know best how to solve your problem, and will readily offer unsolicited advice!
A couple of days of swimming, a boat trip to Kep Tmai, and the final day had arrived. The contract signing went without a hitch and we were off to the final blowout on Saturday the 19th. Another orgy of food and booze and by closing time things got a bit emotional. With the handover of the keys, many of us got into a melancholy mood and reminisced about the two years of fun we all had at the Jungle. Singing to the oldies, drinking and trying to keep our spirits up, Mike, Andy, Jeff (the new owner) and I rang the bell for the last time during my reign as publican at around 3 AM.
We all wish Jeff (shown below) the best of luck and many years of prosperity in his new endeavor. All of my friends and customers can reach me at my hotmail address srlawson1@hotmail.com in the future although I will not be transferring the website to Jeff until the 15th of April. As for me, we'll see where the winds of my future blows me next!!!
NEW OWNER, JEFF, WITH STAFF
Don't leave Cambodia before visiting The Jungle.
(Update February 25, 2005)
I probably shouldn't have put "final" up there because it sort of sounds like I kicked the bucket!!! But the sale of the bar went through on Saturday the 19th and our final blowout party was that night. Details of the final week are below so I won't belabor the introductions.
THE FINAL WEEK
The final sale and handover was to take place on Saturday the 19th of February, but there were some last minute details that needed to be done and I figured a week of transition would be good for the staff; thus I decided to fly over to Phnom Penh on the 14th with as many people as I could to supplement the festivities as well as to keep tabs on me since I knew that far too much alcohol would be consumed during the end of yet another chapter in my life. My father and his wife Jennifer, Andy (shown above with his friend Neil from a prior trip) my good friend Mike shown below as well as other assorted shady characters associated with the Jungle Bar since its inception were among the elite members to enjoy my final days as a Cambodian bar owner. The evening of the 14th was a gluttonous orgy of seafood barbecued over the traditional clay barbecues the Khmers use for just about everything. Giant prawns, garlic shrimp, swordfish steaks and other delicacies were prepared by my always capable and obliging staff. Good music, good food, good cocktails and great friends..... the trademarks of a successful and memorable bar!!!!
Trip to Sihanoukville
Since we had a some time to kill before the weekend we rented three cars and trucked on down to the beach resort of Kampong Som on Wednesday morning. Without going into gory details, the ride for me was wrought with nausea and a less than normal mental status! I was told this probably had something to do with the fact that I was working my way down the "top shelf" of bottles pouring shots for whomever was still left standing at the bar..... which obviously included me! I Since I hadn't eaten anything in 12 hours I figured that I could last the three hour trip without any major wretching. That was until Australian Peter's girlfriend just had to stop for food (nothing, I mean nothing, interrupts a Cambodian's eating schedule.) Upon opening the box filled with pungent offal, fermented fish sauce and rice, the tenuous stability of my stomach became a moot point and my head was immediately out the window ridding myself of the small amount of bile clinging to my gastric mucosa. I'm sure that was more information than many of you needed, but Peter has told pretty much everyone and I figured word would reach the USA sooner or later with Peter's big mouth! We stayed on the beach for two nights and relaxed with a few side visits to the seemier side of town. The area around the port is being expanded and many of the old "haunts" (for lack of a better word) in the area are being demolished. A few regular bars were introduced including the Endless Summer Beach Club run by Chad from the USA and the beachfront including Serendipity Beach and Ochenteal Beach. Pop and his wife are shown at right in the relaxing rooftop bar of the Fisherman's Den run by the ever vivacious and sometimes crude Kiwi Brian!! After a few days we headed back to Phnom Penh for the final contract signing and a few final days of partying.
Phnom Penh
The ride back to Phnom Penh was uneventful (compared to the ride down) save for one small detail which demonstrates that there is a God after all and he can be a just one at that. Instead of leaving the transportation details to me, Australian Peter decided he knew better than I how to arrange his car (despite not living in Cambodia and not speaking a word of the language!) To make a long story short, we ended up with one too many cars and so spread everyone out amongst four cars instead of three costing an extra thirty US dollars to boot. Everyone made it back to the capital EXCEPT PETER whose car overheated and he was forced to wait an extra two hours beside the road while the usual committee of onlookers came to a consensus on what to do. In case you have never been to Cambodia you may not realize that anything and everything that happens draws a crowd, all of whom think that they know best how to solve your problem, and will readily offer unsolicited advice!
A couple of days of swimming, a boat trip to Kep Tmai, and the final day had arrived. The contract signing went without a hitch and we were off to the final blowout on Saturday the 19th. Another orgy of food and booze and by closing time things got a bit emotional. With the handover of the keys, many of us got into a melancholy mood and reminisced about the two years of fun we all had at the Jungle. Singing to the oldies, drinking and trying to keep our spirits up, Mike, Andy, Jeff (the new owner) and I rang the bell for the last time during my reign as publican at around 3 AM.
We all wish Jeff (shown below) the best of luck and many years of prosperity in his new endeavor. All of my friends and customers can reach me at my hotmail address srlawson1@hotmail.com in the future although I will not be transferring the website to Jeff until the 15th of April. As for me, we'll see where the winds of my future blows me next!!!
NEW OWNER, JEFF, WITH STAFF
Don't leave Cambodia before visiting The Jungle.
Saturday, March 05, 2005
Bad Diagnosis
In Rural Cambodia, Avian Influenza Finds a Weak Spot
Human Cases Escape Notice Amid Ignorance, Poverty As a Pandemic Threatens
Advice: Don't Eat Sick Birds
By JAMES HOOKWAY
Staff Reporter of THE WALL STREET JOURNAL
March 4, 2005; Page A1
PHNOM PENH, Cambodia -- On a recent afternoon, Ly Sovann sat perspiring in his stuffy office and wondered if he had an epidemic on his hands. Since word spread that a Cambodian woman in a remote village succumbed to avian influenza in January, Dr. Sovann's cellphone hasn't stopped ringing as health workers call in suspected cases of the disease.
The problem: Few here know what avian flu is or how to recognize it. That makes Dr. Sovann's job as Cambodia's chief flu-hunter at the cash-strapped Ministry of Health difficult. Worse, his emergency budget for educating this country's 13 million people about bird-flu dangers is just $2,500.
"A lot of the time the reports turn out to be diarrhea or measles," Dr. Sovann said as his phone buzzed to life again.
The long-term diagnosis may not be nearly as benign. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention in Atlanta, said last week that there was a real risk of Asia's bird-flu problem transforming into a global threat, comparing the danger to the 1918 flu that killed between 20 million and 40 million people. At a conference in Vietnam last week, World Health Organization regional director Shigeru Omi went further. He said: "The world is now in the gravest possible danger of a pandemic."
A close look at Cambodia suggests a worrying complication: a critical shortage here of even the most basic tools or diagnostic skills to identify the virus in the first place, much less control or treat it.
The bird-flu strain, known to scientists as H5N1, was first spotted in Hong Kong's poultry markets in 1997. Since then, the virus has become both more lethal to birds and more widespread. When the virus appeared in Vietnam, Laos and Thailand in late 2003 and early 2004, it caused around $10 billion in damage as officials ordered the destruction of millions of chickens, ducks and other domestic poultry.
Now the virus is resurging in rural Southeast Asia. Cambodia, Thailand and Vietnam have each reported outbreaks in poultry this year. Scientists say the virus has probably become entrenched here, spread by poultry traders and wandering duck populations.
Since 2003, bird flu has killed at least 46 people, with a fatality rate of about 72%. That compares with six people who died during the 1997 outbreak in Hong Kong. The virus still doesn't easily spread from birds to humans, nor from one human to another. But each time a person catches it, the avian flu has another chance to evolve into a more readily communicable form. That's the spark believed to have set off prior pandemics -- flu epidemics that spread and kill globally.
The risks are concrete enough that the U.S. plans to begin testing a trial vaccine manufactured by Sanofi-Aventis SA of France later this month. This week, the United Kingdom unveiled a plan to stockpile 14.6 million doses of the antiviral drug Tamiflu, which has proved effective in treating avian-flu cases.
Top Priority
Tracking human cases has now become a top priority for public-health officials. Any change in the virus's behavior could provide an early warning of an emerging pandemic. Catching cases early could buy critical days or weeks in which to prepare hospitals, deliver antiviral drugs and begin producing vaccines, says Klaus Stohr, head of the WHO's influenza program. In disease surveillance, he says, "every day matters."
The biggest holes in the surveillance net are in poor countries like Cambodia, where average life expectancy is 54 years. The nation has been afflicted by years of civil war and hesitant economic development. It was turned upside down by the murderous rule of the Khmer Rouge in the 1970s. Basic malnutrition and diarrhea are common, along with illnesses such as HIV/AIDS and tuberculosis.
Cambodia has struggled to join the mainstream of Asia's economy, largely on the strength of garment exports and tourism. Secluded beaches and ancient temple complexes surrounded by thick jungle attract around a million visitors a year. But an overwhelmingly rural economy and widespread corruption have hindered development.
Because of Cambodia's skeletal infrastructure, epidemiologists worry that avian flu may already be gaining unseen footholds here. Unlike outbreaks of bird-flu strains in the Netherlands and Hong Kong, which prompted massive culling of avian populations, the response in Cambodia has been far more tentative. Cambodia reported its first infected birds last month, only after the first human casualty was found.
Currently, it's unclear how widespread the H5N1 virus may be inside the country. "There may be people dying of this disease right now and we simply wouldn't know," says Laurent Ponta, a veteran medical field worker with Health Unlimited, a British charity providing basic health care in one bird-flu-affected corner of Cambodia.
Poor countries aren't the only places where viruses can take hold. Toronto's bout with severe acute respiratory syndrome in 2002 showed that germs sometimes prefer modern cities over rural settings. But limited technical resources and desperate shortage of funds make countries like Cambodia potentially productive hosts for H5N1.
Cambodia's entire federal budget in 2003 was $644 million, about $500 million of it foreign aid. The aid helps address everything from malaria outbreaks to the establishment of a functional legal system. But it is mostly earmarked for specific purposes, making it difficult to free up for unforeseen emergencies like bird flu.
Most international interest in the country remains focused on bringing former leaders of the Khmer Rouge to justice, and the United Nations is planning a tribunal in Phnom Penh. Foreign donors are being asked to pony up the estimated $56 million needed to hold the trial. Last month, Japan contributed $18.5 million to that cause.
By contrast, several Asian countries have so far received a total of $18 million in international assistance since early 2004 for bird flu, about $1 million of it to Cambodia.
Most of that money was quickly exhausted monitoring the health of poultry flocks, culling birds or compensating farmers. Dr. Sovann, 37 years old, says he's had to scrape for funds, barely raising enough to print some pamphlets and put loudspeakers in affected villages to warn people about the dangers of handling dead birds.
A fast-talking technology enthusiast, Dr. Sovann first created a do-it-yourself monitoring system two years ago, when SARS first appeared in Asia. As chief of the Ministry of Health's Disease Surveillance Bureau, he organized a group of health workers scattered across the country in preparation for that disease's arrival in Cambodia. "This is one of the strengths of Cambodians," Dr. Sovann says. "We don't have many fixed lines, so we like to use our mobile phones. We're harnessing this trend to stop these diseases."
In the end, SARS never reached Cambodia. When bird flu appeared in neighboring Vietnam in early 2004, Dr. Sovann put his phone group into action. "He's very charismatic," says Megge Miller of the WHO's Phnom Penh office, where a handful of foreign experts are based. "You can easily imagine how he talked all these people into helping."
But Dr. Sovann's improvised surveillance system is woefully thin in places. It failed to pick up Cambodia's first confirmed human victim of bird flu, a 25-year-old mother of two named Tit Sokhan.
When Ms. Sokhan first fell ill with respiratory problems in the district of Kampong Trach in January, health workers there hadn't even heard of bird flu, despite the village's heavy dependence on poultry. "We had no idea what this disease was," says Deung Sokhom, who runs a nearby health clinic.
Raising chickens is a way of life in the village, just 2.5 miles from Vietnam. Poultry provides an important source of protein in the villagers' diet and a convenient substitute for the local riel currency. Throughout the rural region, people often use bundles of live chickens tied at the feet as barter payment for major purchases.
So when valuable chickens suddenly began dying at the beginning of January, it was natural that somebody would hurry to collect them. That person was Tit Chiang, Ms. Sokhan's 14-year-old brother.
Relatives say the teenager gathered birds that had dropped dead, plucked them and prepared them for the farming family's meal. Cooking would kill any germs, but handling carcasses is risky. Oi Chanda, a cousin, said that a few days later, the youth fell ill, developing a fever and coughing violently. He died 10 days after getting sick. "We were shocked that he died so quickly," Ms. Chanda says. "He was a very healthy boy."
It's not clear whether Tit Chiang contracted bird flu. His body was cremated soon after his death according to Buddhist custom. That means no tests could be conducted to determine whether he was infected by the virus. Cooked meat isn't considered a risk, but handling sick birds is.
Dr. Sovann and WHO investigators have since concluded that Chiang's sister, Ms. Sokhan, was in close contact with his body. Several days after the teen was cremated, Ms. Sokhan also fell ill. "One theory is that she caught the virus while crying over her brother's body and preparing it for cremation," says Dr. Miller at the WHO. "But we don't really know because we couldn't test her brother."
As Ms. Sokhan's sickness worsened, her relatives took her to a nearby medical clinic. But staff there didn't know anything about bird flu and sent her home with instructions to perform a ceremony to appease the angry spirits of her ancestors.
"She performed the ceremony, but it didn't seem to make any difference. She was still sick," says Kheam Phon, Ms. Sokhan's aunt.
She decided to take her niece to a hospital in Vietnam, in the hope of getting better treatment. But it was too late. On Jan. 30, 12 days after her brother died, Ms. Sokhan also died. Tests performed by Vietnamese authorities revealed she had the H5N1 virus.
When Vietnamese doctors tipped off Dr. Sovann and his team, he drove to the village along with WHO officials to see if anybody else was ill. A cluster of several cases could be a warning sign the virus has acquired the ability to move more easily between people.
No more infections in the village were found. But the episode helped underscore for experts abroad the sizable gaps in Cambodia's surveillance network. "We only heard about it because the patient made it into Vietnam," says Dr. Stohr, the WHO influenza expert in Geneva.
Three Weeks
If a new flu strain does emerge, theoretical models prepared by the WHO suggest it could be stopped -- but only if it's caught within the first 21 days. "A massive antiviral effort, under optimal circumstances, could extinguish the fire," Dr. Stohr says.
Dr. Sovann now plans to widen his surveillance group to include contacts at all the private health clinics and pharmacies dotting the Cambodian countryside. "These are the people on the front line," he says. "We need to educate them about bird flu so they can detect it and report it back to my office."
Dr. Sovann is also doing his best to alert local populations to the virus's dangers. He has organized the distribution of cartoon pamphlets illustrating the risks of handling dead birds in a form that illiterate farmers can understand. He is also sending volunteers around villages on motorcycles, with battered loudspeakers tied to the pillion seats warning people to keep away from dead birds. "Word of mouth seems to work best," says Dr. Sovann.
An international conference on bird flu in Vietnam's Ho Chi Minh City ended on Feb. 25 with an appeal for the international community to provide vastly increased aid to countries affected by bird flu such as Vietnam, Laos and Cambodia. In their final communiqué, delegates said $100 million was needed to improve health-care services, and several hundred million more to restock culled poultry flocks.
Back in Kampong Trach, Dr. Sovann's efforts to publicize the dangers of bird flu are beginning to sink in. Ms. Chanda, one of Ms. Sokhan's cousins, say her family now knows not to collect and prepare dead birds for the cooking pot. "We will only eat chickens we kill ourselves," she says.
Some of her neighbors, however, are unwittingly taking other risks. Worried about the threat from dead chickens, some have switched to raising ducks instead, unaware that waterfowl can spread H5N1 in their droppings without showing any signs of illness.
"How can people avoid exposure to the virus when they don't know which ducks are infected and which ones are not?" says Dr. Omi, the WHO's western Pacific director.
Write to James Hookway at james.hookway@awsj.com3
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Hyperlinks in this Article:
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(3) mailto:james.hookway@awsj.com
Human Cases Escape Notice Amid Ignorance, Poverty As a Pandemic Threatens
Advice: Don't Eat Sick Birds
By JAMES HOOKWAY
Staff Reporter of THE WALL STREET JOURNAL
March 4, 2005; Page A1
PHNOM PENH, Cambodia -- On a recent afternoon, Ly Sovann sat perspiring in his stuffy office and wondered if he had an epidemic on his hands. Since word spread that a Cambodian woman in a remote village succumbed to avian influenza in January, Dr. Sovann's cellphone hasn't stopped ringing as health workers call in suspected cases of the disease.
The problem: Few here know what avian flu is or how to recognize it. That makes Dr. Sovann's job as Cambodia's chief flu-hunter at the cash-strapped Ministry of Health difficult. Worse, his emergency budget for educating this country's 13 million people about bird-flu dangers is just $2,500.
"A lot of the time the reports turn out to be diarrhea or measles," Dr. Sovann said as his phone buzzed to life again.
The long-term diagnosis may not be nearly as benign. Julie Gerberding, director of the U.S. Centers for Disease Control and Prevention in Atlanta, said last week that there was a real risk of Asia's bird-flu problem transforming into a global threat, comparing the danger to the 1918 flu that killed between 20 million and 40 million people. At a conference in Vietnam last week, World Health Organization regional director Shigeru Omi went further. He said: "The world is now in the gravest possible danger of a pandemic."
A close look at Cambodia suggests a worrying complication: a critical shortage here of even the most basic tools or diagnostic skills to identify the virus in the first place, much less control or treat it.
The bird-flu strain, known to scientists as H5N1, was first spotted in Hong Kong's poultry markets in 1997. Since then, the virus has become both more lethal to birds and more widespread. When the virus appeared in Vietnam, Laos and Thailand in late 2003 and early 2004, it caused around $10 billion in damage as officials ordered the destruction of millions of chickens, ducks and other domestic poultry.
Now the virus is resurging in rural Southeast Asia. Cambodia, Thailand and Vietnam have each reported outbreaks in poultry this year. Scientists say the virus has probably become entrenched here, spread by poultry traders and wandering duck populations.
Since 2003, bird flu has killed at least 46 people, with a fatality rate of about 72%. That compares with six people who died during the 1997 outbreak in Hong Kong. The virus still doesn't easily spread from birds to humans, nor from one human to another. But each time a person catches it, the avian flu has another chance to evolve into a more readily communicable form. That's the spark believed to have set off prior pandemics -- flu epidemics that spread and kill globally.
The risks are concrete enough that the U.S. plans to begin testing a trial vaccine manufactured by Sanofi-Aventis SA of France later this month. This week, the United Kingdom unveiled a plan to stockpile 14.6 million doses of the antiviral drug Tamiflu, which has proved effective in treating avian-flu cases.
Top Priority
Tracking human cases has now become a top priority for public-health officials. Any change in the virus's behavior could provide an early warning of an emerging pandemic. Catching cases early could buy critical days or weeks in which to prepare hospitals, deliver antiviral drugs and begin producing vaccines, says Klaus Stohr, head of the WHO's influenza program. In disease surveillance, he says, "every day matters."
The biggest holes in the surveillance net are in poor countries like Cambodia, where average life expectancy is 54 years. The nation has been afflicted by years of civil war and hesitant economic development. It was turned upside down by the murderous rule of the Khmer Rouge in the 1970s. Basic malnutrition and diarrhea are common, along with illnesses such as HIV/AIDS and tuberculosis.
Cambodia has struggled to join the mainstream of Asia's economy, largely on the strength of garment exports and tourism. Secluded beaches and ancient temple complexes surrounded by thick jungle attract around a million visitors a year. But an overwhelmingly rural economy and widespread corruption have hindered development.
Because of Cambodia's skeletal infrastructure, epidemiologists worry that avian flu may already be gaining unseen footholds here. Unlike outbreaks of bird-flu strains in the Netherlands and Hong Kong, which prompted massive culling of avian populations, the response in Cambodia has been far more tentative. Cambodia reported its first infected birds last month, only after the first human casualty was found.
Currently, it's unclear how widespread the H5N1 virus may be inside the country. "There may be people dying of this disease right now and we simply wouldn't know," says Laurent Ponta, a veteran medical field worker with Health Unlimited, a British charity providing basic health care in one bird-flu-affected corner of Cambodia.
Poor countries aren't the only places where viruses can take hold. Toronto's bout with severe acute respiratory syndrome in 2002 showed that germs sometimes prefer modern cities over rural settings. But limited technical resources and desperate shortage of funds make countries like Cambodia potentially productive hosts for H5N1.
Cambodia's entire federal budget in 2003 was $644 million, about $500 million of it foreign aid. The aid helps address everything from malaria outbreaks to the establishment of a functional legal system. But it is mostly earmarked for specific purposes, making it difficult to free up for unforeseen emergencies like bird flu.
Most international interest in the country remains focused on bringing former leaders of the Khmer Rouge to justice, and the United Nations is planning a tribunal in Phnom Penh. Foreign donors are being asked to pony up the estimated $56 million needed to hold the trial. Last month, Japan contributed $18.5 million to that cause.
By contrast, several Asian countries have so far received a total of $18 million in international assistance since early 2004 for bird flu, about $1 million of it to Cambodia.
Most of that money was quickly exhausted monitoring the health of poultry flocks, culling birds or compensating farmers. Dr. Sovann, 37 years old, says he's had to scrape for funds, barely raising enough to print some pamphlets and put loudspeakers in affected villages to warn people about the dangers of handling dead birds.
A fast-talking technology enthusiast, Dr. Sovann first created a do-it-yourself monitoring system two years ago, when SARS first appeared in Asia. As chief of the Ministry of Health's Disease Surveillance Bureau, he organized a group of health workers scattered across the country in preparation for that disease's arrival in Cambodia. "This is one of the strengths of Cambodians," Dr. Sovann says. "We don't have many fixed lines, so we like to use our mobile phones. We're harnessing this trend to stop these diseases."
In the end, SARS never reached Cambodia. When bird flu appeared in neighboring Vietnam in early 2004, Dr. Sovann put his phone group into action. "He's very charismatic," says Megge Miller of the WHO's Phnom Penh office, where a handful of foreign experts are based. "You can easily imagine how he talked all these people into helping."
But Dr. Sovann's improvised surveillance system is woefully thin in places. It failed to pick up Cambodia's first confirmed human victim of bird flu, a 25-year-old mother of two named Tit Sokhan.
When Ms. Sokhan first fell ill with respiratory problems in the district of Kampong Trach in January, health workers there hadn't even heard of bird flu, despite the village's heavy dependence on poultry. "We had no idea what this disease was," says Deung Sokhom, who runs a nearby health clinic.
Raising chickens is a way of life in the village, just 2.5 miles from Vietnam. Poultry provides an important source of protein in the villagers' diet and a convenient substitute for the local riel currency. Throughout the rural region, people often use bundles of live chickens tied at the feet as barter payment for major purchases.
So when valuable chickens suddenly began dying at the beginning of January, it was natural that somebody would hurry to collect them. That person was Tit Chiang, Ms. Sokhan's 14-year-old brother.
Relatives say the teenager gathered birds that had dropped dead, plucked them and prepared them for the farming family's meal. Cooking would kill any germs, but handling carcasses is risky. Oi Chanda, a cousin, said that a few days later, the youth fell ill, developing a fever and coughing violently. He died 10 days after getting sick. "We were shocked that he died so quickly," Ms. Chanda says. "He was a very healthy boy."
It's not clear whether Tit Chiang contracted bird flu. His body was cremated soon after his death according to Buddhist custom. That means no tests could be conducted to determine whether he was infected by the virus. Cooked meat isn't considered a risk, but handling sick birds is.
Dr. Sovann and WHO investigators have since concluded that Chiang's sister, Ms. Sokhan, was in close contact with his body. Several days after the teen was cremated, Ms. Sokhan also fell ill. "One theory is that she caught the virus while crying over her brother's body and preparing it for cremation," says Dr. Miller at the WHO. "But we don't really know because we couldn't test her brother."
As Ms. Sokhan's sickness worsened, her relatives took her to a nearby medical clinic. But staff there didn't know anything about bird flu and sent her home with instructions to perform a ceremony to appease the angry spirits of her ancestors.
"She performed the ceremony, but it didn't seem to make any difference. She was still sick," says Kheam Phon, Ms. Sokhan's aunt.
She decided to take her niece to a hospital in Vietnam, in the hope of getting better treatment. But it was too late. On Jan. 30, 12 days after her brother died, Ms. Sokhan also died. Tests performed by Vietnamese authorities revealed she had the H5N1 virus.
When Vietnamese doctors tipped off Dr. Sovann and his team, he drove to the village along with WHO officials to see if anybody else was ill. A cluster of several cases could be a warning sign the virus has acquired the ability to move more easily between people.
No more infections in the village were found. But the episode helped underscore for experts abroad the sizable gaps in Cambodia's surveillance network. "We only heard about it because the patient made it into Vietnam," says Dr. Stohr, the WHO influenza expert in Geneva.
Three Weeks
If a new flu strain does emerge, theoretical models prepared by the WHO suggest it could be stopped -- but only if it's caught within the first 21 days. "A massive antiviral effort, under optimal circumstances, could extinguish the fire," Dr. Stohr says.
Dr. Sovann now plans to widen his surveillance group to include contacts at all the private health clinics and pharmacies dotting the Cambodian countryside. "These are the people on the front line," he says. "We need to educate them about bird flu so they can detect it and report it back to my office."
Dr. Sovann is also doing his best to alert local populations to the virus's dangers. He has organized the distribution of cartoon pamphlets illustrating the risks of handling dead birds in a form that illiterate farmers can understand. He is also sending volunteers around villages on motorcycles, with battered loudspeakers tied to the pillion seats warning people to keep away from dead birds. "Word of mouth seems to work best," says Dr. Sovann.
An international conference on bird flu in Vietnam's Ho Chi Minh City ended on Feb. 25 with an appeal for the international community to provide vastly increased aid to countries affected by bird flu such as Vietnam, Laos and Cambodia. In their final communiqué, delegates said $100 million was needed to improve health-care services, and several hundred million more to restock culled poultry flocks.
Back in Kampong Trach, Dr. Sovann's efforts to publicize the dangers of bird flu are beginning to sink in. Ms. Chanda, one of Ms. Sokhan's cousins, say her family now knows not to collect and prepare dead birds for the cooking pot. "We will only eat chickens we kill ourselves," she says.
Some of her neighbors, however, are unwittingly taking other risks. Worried about the threat from dead chickens, some have switched to raising ducks instead, unaware that waterfowl can spread H5N1 in their droppings without showing any signs of illness.
"How can people avoid exposure to the virus when they don't know which ducks are infected and which ones are not?" says Dr. Omi, the WHO's western Pacific director.
Write to James Hookway at james.hookway@awsj.com3
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