Eleven year-old *Chivit goes to a local stream to collect water.
©UNICEF Cambodia/2017/Navy Kieng
December 2017: *Samnang Chivit is an eleven-year-old girl living with HIV.
She resides with her mother and her siblings. Her father is alive but has left the family and they do not know where he is.
Times are hard. The family do not own their own land or house and they are constantly on the move in order to find work to survive.
Chivit’s mother is the main wage earner as an agricultural worker harvesting cassava or rice, depending on the season.
She does not have a fixed income because of the seasonal nature of this employment. Since she is reliant on transitional work and the need to move frequently from place to place, the children’s ability to attend school is virtually non-existent.
Hence, they have dropped out of the classroom and lost their right to an education. They still hope to return to school to continue their learning and get the opportunity to better their lives.
Chivit’s mother described how she found out she was living with HIV. “One day when my second daughter reached one year of age, I got an abdomen pain and went to the health centre for treatment.
“The health centre midwife had doubts for my disease because they gave me treatment many times. Still, my condition did not improve, so I was asked to do a HIV test.
“Eventually, the result was found to be positive. I was then asked to bring my husband and children to do a test too. Unfortunately, my husband and second daughter were also found to be HIV positive.”
With this diagnosis, medical staff administered standard antiretroviral therapy (ART) with a combination of antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of the disease.
Despite her own health issue and young age, Chivit has taken on an important support role for her family. She said: “Every day when my mother and my older sister go to work I stay at home and carry water from a well or stream to fill a jar.
“I help cook for the family. Sometimes, I help my mother to wash clothes and look after my younger brother. Every day we drink boiled water because it is good for health. We gained this habit from local health staff who educated us about this practice.”
In many residential areas, such as the community Chivit currently lives in, there is no discrimination or prejudice against people living with HIV.
They enjoy admirable support from villagers with donations of food, especially in difficult times when people face more severe health challenges.
Once a month, Chivit and her mother travel to the provincial hospital for consultation and ARV medication.
Chivit’s mother said: “The doctor has scheduled me and my daughter to go to hospital for treatment on the same day, but in two different places. As an adult, I attend an adult clinic but my daughter gets treatment at a paediatric unit.”
Besides the delivery of ARV, both mother and daughter are recipients of vitally important support care through the ‘mmm’ (short for Mondol Mith Chuoy Mith in Khmer, meaning ‘friends help friends’) scheme whereby patients receive essential health knowledge and counselling from medical staff.
This gives them the valuable opportunity to share their feelings of living with HIV and experiences of health services with fellow patients and clinic staff. This is a significant intervention that complements their medical provision.
The hospital visits have also been made more user-friendly for young patients such as Chivit through a UNICEF-supported scheme that provides reading books and toys for children to use in the waiting room while they wait their consultation.
In addition, UNICEF helps with transportation costs so they can attend treatment sessions. The family expressed their appreciation for this support which makes it possible for them to maintain their health and the ability to earn a living.
Chivit’s mother said: “Without this support, our lives would be in jeopardy. Before we got antiretroviral treatment, my daughter and I were frequently sick. We did not have time to get a job and our lives were very difficult.
“The support we receive to cover our travel cost has helped us get regular treatment. Also, we are able to participate in the ‘mmm’ meeting so we are better informed about how to care for our health.
“With this useful information, we are able to share experiences among families of other children living with HIV.”
*Not her real name to protect her identity and that of others in the story.